The risk of leukaemia increases with increasing exposure to external radiation; this is consistent with published results on other nuclear workers cohorts.

Excesses observed will have to be related to occupational exposures in the on-going cohort study on French nuclear workers which includes a retrospective exposures assessment.

Melanoma-associated retinopathy (MAR) is a rare autoimmune syndrome in patients with melanoma characterized by visual disorders. MAR is induced by the degeneration of bipolar cells of the retina and the presence of serum autoantibodies against retina proteins. Ipilimumab, an anti-cytotoxic T lymphocyte-associated antigen 4 antibody, improves survival in previously treated patients with metastatic melanoma, but is responsible for a spectrum of immune-related adverse events. Administration of ipilimumab to patients with autoimmune diseases (such as MAR or vitiligo) is actually not recommended. We report a patient presenting with MAR occurring during a melanoma relapse. Surgery and chemotherapy had no effect on visual acuity and melanoma increased. In the absence of alternative antitumoral treatment, we focused on the vital prognosis and treated the patient with ipilimumab. Two years after the treatment the patient is free from new metastasis but has presented with exacerbation of vitiligo and MAR. In the very rare case of melanoma with autoimmune disease without a therapy option, ipilimumab could be discussed, taking into account the fact that it can be effective on tumor burden but can also increase autoimmunity.

Purpose To evaluate ocular phototoxicity in mountaineer guide in Chamonix, France, exposed to altitude characterized by increased ultraviolet (UV) radiation. Methods 96 guides working and 90 subjects living in plains, older than 50 years, replied to a questionnaire assessing altitude exposure and wearing protective eyewear. We performed slit lamp examination after pupil dilatation, retinal photography (Topcon) and crystalline lens density analysis (Oculyzer®, Alcon). Student t‐test was used to compare the groups and logistic regression to evaluate risks factors in guides group. Results Guides mean age was 59.8years and 59.1 for control (p=0.39). Guides developed more chronic blepharitis (52.1% vs. 10.6%, p<0.01), pterygium (8.9% vs. 0%, p<0.01), pinguecula (58.3% vs. 21.7%, p<0.001). Their corneal break up time was shorter (4.5secs vs. 7secs, p<0.01). Guides presented more cortical cataract (p<0.01) and cataract surgery (p=0.01). Only 61.5% guides had normal ocular fundus vs. 81.1% in control group (p<0.01). They developed more drusenoid deposit (27.2% vs. 15.6%, p<0.01). Guides group analysis showed that exposure superior to 3000m is risk factor to develop anterior cortical cataract (OR=1.16, p<0.01). Exposition to snow increases risk of maculopathy (OR=1.9, p<0.01). Questionnaire reveals discontinuous eye protection in medium altitude. Wearing ski mask reduces cataract, age related maculopathy and chronic blepharitis risk. Conclusion Ocular findings highlight the higher incidence of ocular surface pathology, anterior cortical lens opacities and drunenoid deposits. This data emphasize the potential deleterious role of UVs and importance to wear sunglasses even in low to medium altitude but also when climbing.