Francine Behar-Cohen

• MD,PhD
• Managing Director at INSERM UMR1138 Cordeliers campus and Université Paris Descartes - Cochin Hospital Paris

High myopia (HM) and posterior staphyloma (PS) are major causes of vision loss worldwide. Genetic and environmental factors, especially light exposure, contribute to myopia. Mutations in low-density lipoprotein-related receptor type 2, LRP2 cause syndromic myopia, and the Foxg1-Cre-Lrp2lox/lox mouse is a model for myopia and PS but the involvement...

Purpose: To evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, for nonresolving central serous chorioretinopathy. Methods: This is a prospective, randomized, double-blinded, placebo-controlled cross-over study. Sixteen eyes of 16 patients with central serous chorioretinopathy and persistent subretinal fluid (SRF) for at...

Aims/Purpose: Complement inhibitors slightly reduce geographic atrophy (GA) lesion growth, yet vision loss prevention remains a challenge. Iron overload worsens retinal diseases like age‐related macular degeneration (AMD), and Transferrin (Tf) supplementation mitigates iron‐induced toxicity, offering a promising therapy for GA (Picard 2015). To avo...

Aims/Purpose: Iron (Fe) is vital for retinal health but toxic when unbound, causing oxidative stress, inflammation, and ferroptosis. Aging leads to retinal iron accumulation, exacerbating diseases like AMD. This study aimed to determine if an iron‐transferrin (Tf) imbalance contributes to GA and if apo‐Tf (not Fe‐bound) supplementation could benefi...

Aims/Purpose: Iron (Fe) is vital for retinal health but toxic when unbound, causing oxidative stress, inflammation, and ferroptosis. Aging leads to retinal iron accumulation, exacerbating diseases like AMD. This study aimed to determine if an iron‐transferrin (Tf) imbalance contributes to GA and if apo‐Tf (not Fe‐bound) supplementation could benefi...

Purpose: Overactivation of the mineralocorticoid receptor (MR) pathway is proinflammatory and contributes to the pathogenesis of diabetic retinopathy and of age-related macular degeneration. Excess of aldosterone, the specific MR ligand, is known to stimulate the production of proinflammatory cytokines and chemokines in extrarenal tissues and cells...

This Opinion details a series of errors in the methodology that was used to derive the emission limits that are supposed to protect children against the retinal phototoxicity (blue light hazard) and the intense glare with the visible light emitted by LEDs. These errors were discovered in a 2012 scientific journal paper which was transposed in the...

Purpose To compare subfoveal choroidal thickness (SFCT) between eyes with choroidal melanoma and choroidal nevi. Methods Retrospective study of 126 consecutive patients in a tertiary ocular oncology center. Eyes with tumors located less than two disc-diameters from the fovea were excluded. In eyes with naevi, factors of potential transformation in...

This study aims to correlate adaptive optics-transscleral flood illumination (AO-TFI) images of the retinal pigment epithelium (RPE) in central serous chorioretinopathy (CSCR) with standard clinical images and compare cell morphological features with those of healthy eyes. After stitching 125 AO-TFI images acquired in CSCR eyes (including 6 active...

Purpose Choroidal sympathetic innervation is impaired in central serous chorioretinopathy (CSCR) (1), throughout mineralocorticoid receptor.(2) We hypothesize that the CSCR condition modifies the entire eyeball innervation system. Corneal nerve shape is easily observed by in vivo confocal microscopy (IVCM).(3) We explored corneal nerves morphology...

The spectral distribution is a fundamental property of non-monochromatic optical radiation. It is commonly used in research and practical applications when studying how light interacts with matter and living organisms, including humans. In the field of lighting, misconceptions about the spectral distribution of light are responsible for unfounded c...

Light is known to induce retinal damage affecting photoreceptors and retinal pigment epithelium. For polychromatic light, the blue part of the spectrum is thought to be the only responsible for photochemical damage, leading to the establishment of a phototoxicity threshold for blue light (445 nm). For humans it corresponds to a retinal dose of 22 J...

The analysis of the current safety standards for electric toys showed that the normative intensity limits for visible light emitted by LEDs integrated in toys are overestimated. These limits were originally set in a scientific article published in 2012 that was adapted into the international safety standard published in 2017, and into the subsequen...

The analysis of the current safety standards for electric toys showed that the normative intensity limits for visible light emitted by LEDs integrated in toys are overestimated. These limits were originally set in a scientific article published in 2012 that was adapted into the international safety standard published in 2017, and into the subsequen...

Purpose: Corneal neovascularization (CN) is a major cause of blindness worldwide. We previously showed that endothelial mineralocorticoid receptor (MR) contributed to CN in mice. In this study, we investigated the mechanisms of action of MRA in a rat model of limbal deficiency. Methods: CN was induced in Lewis rats by total corneal de‐epithelializa...

Purpose Indocyanine green (ICG) is an albumin and lipoprotein binding dye absorbing in the far red used in angiography to visualize choroidal vessels (ICG angiography [ICGA]). To guide interpretation, ICG transport in the choroid, RPE, and retina of rats was studied. Methods Two conditions were used: RPE/choroid organoculture, incubated for 45 min...

Literature provides few if no data on the current use and exposure of individuals to virtual reality (VR) and/or augmented reality (AR) technologies in the wild. Most of the publications concern prototypes and systems tested in laboratories, whereas actual uses in private and professional situations are poorly documented. Obtaining a clear picture...

Purpose To investigate systemic and ocular toll-like receptor (TLR)-4 expression and its association with oxidative stress markers in ocular rosacea (OR) Methods This prospective study included 40 patients with rosacea with ocular involvement and 20 healthy volunteers. Tear break-up time (TBUT), Schirmer test, meibomoscore, and ocular surface dise...

Purpose To investigate oxidative stress markers in tears and serum of patients with ocular rosacea and to examine their association with both ocular surface parameters and cutaneous rosacea subtypes. Methods This prospective study includes rosacea patients with ocular involvement and healthy controls. We performed ophthalmological examination of a...

Abnormal corneal wound healing can compromise corneal transparency and lead to visual impairment. Mineralocorticoid receptor antagonists (MRA) are promising candidates to promote corneal remodeling with anti-inflammatory properties and lack gluococorticoids-associated side effects. In this preclinical study, a new polymer-free hydroxypropyl-gamma-c...

Purpose To report eplerenone use by retina specialists worldwide for central serous chorioretinopathy (CSCR). Methods A self-reporting questionnaire was distributed to retina specialists worldwide to gather clinicians’ perspectives on CSCR cases treated, eplerenone dosage and duration, reasons to use it, and side effects. Results The survey inclu...

Central serous chorioretinopathy (CSCR) belongs to the pachychoroid spectrum, a pathological phenotype of the choroidal vasculature, in which blood flow is under the choroidal nervous system (ChNS) regulation. The pathogenesis of CSCR is multifactorial, with the most recognised risk factor being intake of glucocorticoids, which activate both the gl...

The exact link between systemic and ocular endogenous corticoids (steroidome) is unclear and whether the ocular steroidome is altered in CSCR eyes is unknown. The aims of this study were to analyze the human steroidome in the aqueous humor as a function of age, sex and time of the day, to correlate systemic and ocular steroidome and to analyze the...

The treatment of posterior eye segment diseases through intravitreal injection requires repeated injections of an active molecule, which may be associated with serious side effects and poor patient compliance. One brilliant strategy to overcome these issues is the use of drug-loaded microparticles for sustained release, aiming at reducing the frequ...

The central serous chorioretinopathy (CSCR) is characterized by serous retinal detachments SRD associated with one or several retinal pigment epithelium detachments/irregularities (PEDs). The choroid is thickened with dilated choroidal veins and choroidal hyperpermeability suggesting an underlying choroidopathy. CSCR belongs to the pachychoroid spe...

Purpose: To assess the rate of late phase hyperfluorescent plaque (LPHP) in type 1 macular neovascularization (MNV) in CSCR (central serous chorioretinopathy) and AMD (age-related macular degeneration) and to evaluate its prognostic value. Methods: Retrospective study including type 1 MNV in AMD and CSCR, from 2012 to 2020. Eyes with a late ICG-...

Purpose: To investigate the association between the 2 acute phase proteins, C-reactive protein (CRP) and pentraxin 3 (PTX3) with central serous chorioretinopathy (CSCR), as PTX3 is a glucocorticoid-induced protein. Design: Cross-sectional multicenter study. Participants: Patients with CSCR compared with age- and sex-matched healthy participant...

Limbal epithelial stem/progenitor cells (LSCs) are adult stem cells located at the limbus, tightly regulated by their close microenvironment. It has been shown that Wnt signaling pathway is crucial for LSCs regulation. Previous differential gene profiling studies confirmed the preferential expression of specific Wnt ligands (WNT2, WNT6, WNT11, WNT1...

Retinal haemorrhages are present in several retinal pathologies, such as exudative AMD, diabetic retinopathy, or myopic degeneration. As a consequence of erythrocytes lysis following haemorrhage, haemoglobin (Hb) is released into the extracellular space, and heme is degraded into iron, which becomes under a free (unbound) form. While iron is essent...

Introduction: The performance of "en-face" optical coherence tomography (OCT) in screening for chloroquine (CQ) or hydroxychloroquine (HCQ) retinopathy has not been largely explored. The aim of this study was to determine the concordance of "en-face" OCT with multifocal electroretinography (mfERG) in screening for CQ/HCQ retinopathy. Methods: Th...

Iron is essential for retinal metabolism, but an excess of ferrous iron causes oxidative stress. In glaucomatous eyes, retinal ganglion cell (RGC) death has been associated with dysregulation of iron homeostasis. Transferrin (TF) is an endogenous iron transporter that controls ocular iron levels. Intraocular administration of TF is neuroprotective...

Congenital PAX6-aniridia, initially characterized by the absence of the iris, has progressively been shown to be associated with other developmental ocular abnormalities and systemic features making congenital aniridia a complex syndromic disorder rather than a simple isolated disease of the iris. Moreover, foveal hypoplasia is now recognized as a...

Objective To image healthy retinal pigment epithelial cells (RPE) in vivo using Transscleral OPtical Imaging (TOPI) and to analyze statistics of macular RPE cell features as a function of age, axial length (AL) and eccentricity. Design Single-center, exploratory, prospective, and descriptive clinical study. Participants 49 eyes (AL: 24.03±0.93 mm...

Purpose: Choroidal and retinal neovascularization plays an essential role in various ocular diseases. In this study, we examined the role of nestin in this process. Nestin is an intermediate filament protein known to play several roles, including as a marker of neural progenitor and proliferating endothelial cells. Methods: We used Brown Norway...

The eye is formed by tissues and cavities that contain liquids whose compositions are highly regulated to ensure their optical properties and their immune and metabolic functions. The integrity of the ocular barriers, composed of different elements that work in a coordinated fashion, is essential to maintain the ocular homeostasis. Specialized junc...

The pathogenesis of diabetic retinopathy in humans remains imperfectly understood; in particular, the kinetics of the various pathogenic events in the very early stages of retinal damage are difficult to recognize [...]

Purpose Validation of a recently described central serous chorioretinopathy (CSCR) classification system and assessment of levels of agreement among 10 retina physicians. Methods This was a cross-sectional (inter-reader agreement) study. Ten retina physicians (assigned a role of masked grader) were provided with a comprehensive dataset of 61 eyes...

(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical form of their disease, multimodal imaging findings and the presence of macular neovascu...

Background: Ursodeoxycholic (UDCA) and tauroursodeoxycholic (TUDCA) acids have shown neuroprotective properties in neurodegenerative diseases, but differential effects of the two bile acids have been poorly explored. The aim of this study was to evaluate the neuroprotective effects of UDCA versus TUDCA in a neuroretinal degeneration model and to co...

Central serous chorioretinopathy (CSCR) can be complicated by different types of choroidal neovascularization (CNV). The purpose of this study was to investigate the incidence and quantitative optical coherence tomography angiography (OCT-A) features of CSCR-related CNVs. Methods: This was a retrospective multicenter study including 102 eyes of 1...

Center-involving diabetic macular edema (DME) is a leading cause of vision impairment in working-age adults. While its management is particularly challenging in a poorly compliant population, continuous innovation and the advent of new molecules have improved its outcome. The control of glycemia and of systemic aggravating factors remain essential...

In the retina, the mineralocorticoid receptor is expressed in retinal and choroidal vessels and in cells from neural and glial origins. Like in the brain, the major ligand of the mineralocorticoid receptor is cortisol, and the mineralocorticoid/glucocorticoid receptor balance regulates the activation of the MR pathway. Experimental mineralocorticoi...

Citation: Zola, M.; Mejlachowicz, D.; Gregorio, R.; Naud, M.-C.; Jaisser, F.; Zhao, M.; Behar-Cohen, F. Chronic Systemic Dexamethasone Regulates the Mineralocorticoid/Glucocorticoid

Purpose The neuroprotective properties of hydrophilic bile acids are recognized but whether their oral administration can benefit to patients with retinal diseases is unknown. Rhegmatogenous retinal detachment (RD) is a threatening visual condition and a human disease model for retinal degenerations. Despite surgical reattachment, vision does not f...

We have read with interest the paper of Brinks et al. (1). In this paper, the authors failed to identify the mineralocorticoid receptor (MR) in endothelial cells from the choroid of human eyes collected around 24 hours after death. The authors missed the important information, published 10 years ago by the team who developed the antibody they have...

Purpose: The purpose of this study was to describe the effect of topical prednisolone on intraretinal fluid in patients with peripapillary pachychoroid syndrome. Methods: We selected 11 consecutive patients (17 eyes) with a diagnosis of peripapillary pachychoroid syndrome, who were treated with topical prednisolone (Pred Forte [PF] 10 mg/mL) thr...

Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated with several diseases. The aim of this study was to report the incidence of AMN cases diagnosed during the 2020 coronavirus disease 2019 (COVID-19) pandemic year in a French hospital, and to describe their different forms. Methods: All patients diag...

The corneal epithelium is consistently regenerated by limbal stem/progenitor cells (LSCs), a very small population of adult stem cells residing in the limbus. Several Wnt ligands, including Wnt6, are preferentially expressed in the limbus. To investigate the role of Wnt6 in regulating proliferation and maintenance of human LSCs in an in vitro LSC e...

The aim of the study is to report on the indocyanine green angiography (ICGA) and OCT findings in patients hospitalized for severe COVID infection. In this observational prospective monocentric cohort study, we included patients hospitalized for severe COVID infection. The main outcomes were ICGA and OCT findings. A total of 14 patients with a mean...

Purpose: To investigate cone density in the asymptomatic fellow eye of patients with unilateral central serous chorioretinopathy (CSCR). Methods: Seventeen asymptomatic fellow eyes of patients with unilateral CSCR and 17 eyes of aged- and gender-matched healthy controls underwent adaptive optics ophthalmoscopy. Cone density and spacing were asse...

La choroïde est explorée en pratique courante par des méthodes d'imagerie qui visualisent les composants vasculaires de sa structure. Les composants cellulaires et neuronaux qui ne sont pas accessibles à l'observation régulent le système vasculaire choroïdien. Ils produisent et libèrent des substances vasoactives, neuromodulatrices et immunomodulat...

(1) Indocyanine green angiography (ICG-A) shows the presence of mid-phase hyperfluorescent area in central serous chorioretinopathy (CSCR). However, their exact meaning remains uncertain. (2) The clinical and multimodal imaging findings of 100 patients (133 eyes) with CSCR, including the enhanced-depth-imaging OCT (EDI-OCT), blue-light fundus autof...

In the retina, mineralocorticoid receptor (MR), expressed in vessels, glial and neuronal cells, is mainly activated by glucocorticoids. Under pathological conditions, ocular MR expression and corticoids change, leading in most cases to MR overactivation. Experimental models using MR agonists or antagonists, administered systemically or intraocularl...

Glucocorticoids are amongst the most used drugs to treat retinal diseases of various origins. Yet, the transcriptional regulations induced by glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) activation in retinal pigment epithelium cells (RPE) that form the outer blood–retina barrier are unknown. Levels of endogenous corticoids, lig...

The aim of this study was to assess the short-term effect of anti-vascular endothelial growth factor (VEGF) treatment on type 1 macular neovascularization (MNV) secondary to central serous chorioretinopathy (CSCR) and to identify potential predictive factors for treatment response using multimodal imaging. Retrospective, multicentre study in CSCR p...

Diabetic retinopathy remains a major cause of vision loss worldwide. Mineralocorticoid receptor (MR) pathway activation contributes to diabetic nephropathy but its role in retinopathy is unknown. In this study, we show that MR is overexpressed in the retina of type 2 diabetic Goto-Kakizaki (GK) rats and humans and, that cortisol is the MR ligand in...

Rho-associated kinase (ROCK) activation was shown to contribute to microvascular closure, retinal hypoxia, and to retinal pigment epithelium (RPE) barrier disruption in a rat model of diabetic retinopathy. Fasudil, a clinically approved ROCK inhibitor, improved retinal perfusion and reduced edema in this model, indicating that ROCK inhibition could...

Diabetic retinopathy (DR) remains a major cause of vision loss, due to macular edema, retinal ischemia and death of retinal neurons. We previously demonstrated that acute administration of glibenclamide into the vitreous, or given orally at a non-hypoglycemic dose, protected the structure and the function of the retina in three animal models that e...

The aim of this study was to evaluate the potential anti-angiogenic effect of MTRN (meteorin) in the laser-induced CNV rat model and explore its mechanisms of action. MTRN, thrompospondin-1, glial cell markers (GFAP, vimentin), and phalloidin were immuno-stained in non-human primate flat-mounted retinas and human retina cross sections. The effect o...

The cornea is consistently regenerated by limbal stem/progenitor cells (LSCs), a very small population of adult stem cells residing in the limbus. Several Wnt ligands, including Wnt6, are preferentially expressed in the limbus. To investigate the role of Wnt6 in regulating proliferation and maintenance of human LSCs in an in vitro LSC expansion set...

Purpose The term “pachychoroid” refers to a newly described phenotype in which functional and structural choroidal changes are thought to play a key pathogenic role in a spectrum of related retinal disorders. A more detailed understanding of how the choroid is involved within this spectrum and a better knowledge of the most relevant clinical signs...

Impaired wound healing in patients receiving glucocorticoid therapy is a serious clinical concern: mineralocorticoid receptor (MR) antagonists can counter glucocorticoid-induced off-target activation of MR receptors. The aim of this study was to investigate the cutaneous delivery of the potent MR antagonist, spironolactone (SPL), from polymeric mic...

Rosacea is a chronic inflammatory disease that affects the face skin. It is clinically classified into the following four subgroups depending on its location and severity: erythematotelangiectatic, papulopustular, phymatous, and ocular. Rosacea is a multifactorial disease triggered by favoring factors, the pathogenesis of which remains imperfectly...

In central serous chorioretinopathy (CSC), the macula is detached because of fluid leakage at the level of the retinal pigment epithelium. The fluid appears to originate from choroidal vascular hyperpermeability, but the etiology for the fluid is controversial. The choroidal vascular findings as elucidated by recent optical coherence tomography (OC...

Purpose: To investigate choroidal blood flow changes after isometric exercise in patients with chronic central serous chorioretinopathy nontreated or treated with mineralocorticoid receptor antagonists (MRA). Methods: Foveolar choroidal laser Doppler flowmetry parameters - velocity (ChVel), volume (ChVol) and blood flow (ChBF) - of 22 eyes of 22...

Rhegmatogenous retinal detachment (RD) is a threatening visual condition and a human disease model for retinal degenerations. Despite successful reattachment surgery, vision does not fully recover, due to subretinal fluid accumulation and subsequent photoreceptor cell death, through mechanisms that recapitulate those of retinal degenerative disease...

Purpose To identify the factors predicting the visual and anatomical outcomes in eyes with central serous chorioretinopathy (CSCR) through 12 months. Methods Patients with diagnosis of CSCR, either acute or chronic, were included in this multicentric, retrospective study. Demographic factors; systemic risk factors; central macular thickness (CMT),...

Purpose was to create an in vitro model of human retinal detachment (RD) to study the mechanisms of photoreceptor death. Methods Human retinas were obtained through eye globe donations for research purposes and cultivated as explants. Cell death was investigated in retinas with (control) and without retinal pigment epithelium (RPE) cells to mimic...

No systemic biomarker of Central Serous Chorioretinopathy (CSCR) has been identified. Lipocalin 2 (LCN2 or NGAL), alone or complexed with MMP-9 (NGAL/MMP-9), is increased in several retinal disorders. Serum levels of LCN2 and NGAL/MMP-9 were measured in CSCR patients (n = 147) with chronic (n = 76) or acute/recurrent disease (n = 71) and in age- an...

The present review draws together wide-ranging studies performed over the last decades that catalogue the effects of artificial-light-at-night (ALAN) upon living species and their environment. We provide an overview of the tremendous variety of light-detection strategies which have evolved in living organisms - unicellular, plants and animals, cove...

Sulfonylureas, widely used as hypoglycemic agents in adults with type 2 diabetes, have neuroprotective effects in preclinical models of central nervous system injury, and in children with neuropsychomotor impairments linked to neonatal diabetes secondary to ATP-sensitive potassium channel mutations. In the human and rodent retina, we show that the...

Les yeux et le regard participent de façon majeure à notre langage non verbal, avant même l’apparition du verbe. Depuis la Bible jusqu’au langage contemporain, en passant par la mythologie grecque, le théâtre, la littérature ou le langage parlé, une multitude d’expressions et de proverbes mettent en scène l’œil, ce qu’il voit et ce qu’il symbolise....

Aims Glucocorticoid intake is a well‐established risk factor for central serous chorioretinopathy that belongs to the pachychoroid spectrum disease (PSD). The study aimed to assess the prevalence of PSD and analyse the choroidal phenotype in patients with Cushing syndrome. Methods A cross‐sectional study was performed in Ophtalmopôle hôpital Cochi...

Purpose: Central serous chorioretinopathy (CSCR) has been associated with oxidative stress–related risk factors. The objective of this study was to optimize an analytical method for evaluating the oxidative stress biomarker malondialdehyde (MDA) in human tears and determine its level in the tears of patients with CSCR. Methods: In this pilot study,...

Les molécules anti-TNF-α administrés par voie générale ont été approuvés récemment pour le traitement des uvéites non inflammatoires, élargissant l’arsenal thérapeutique dans le traitement de ces pathologies responsables de cécité évitable si l’inflammation est contrôlée. Quand seul l’œil est atteint, des stratégies d’administration locale permettr...

La rétinopathie du prématuré (ROP) est la principale cause évitable de cécité infantile. Son incidence augmente avec la survie de nouveau-nés extrêmement prématurés. La ROP est une pathologie multi-factorielle du développement de la rétine et du réseau vasculaire rétinien, impliquant des facteurs oxygéno-dépendants et nutritionnels. La multiplicité...

Dysregulation of iron metabolism is observed in animal models of retinitis pigmentosa (RP) and in patients with age-related macular degeneration (AMD), possibly contributing to oxidative damage of the retina. Transferrin (TF), an endogenous iron chelator, was proposed as a therapeutic candidate. Here, the efficacy of TF non-viral gene therapy based...

Dans la rétine, couche neurosensorielle de l’œil, les photorécepteurs transforment le signal lumineux en influx nerveux interprétable par le cerveau. Malgré sa spécialisation dans le traitement des signaux lumineux, la rétine peut subir des dommages, à la suite d’une exposition excessive à la lumière ; on parle alors de phototoxicité rétinienne. Ce...

L’œdème maculaire est une augmentation de volume de la macula, zone centrale de la rétine, responsable de l’acuité visuelle. Des symptômes visuels handicapent la vie de millions de patients atteints d’œdème maculaire secondaire à une maladie chronique et parfois aiguë de la rétine. Les protéines qui neutralisent la voie du facteur de croissance de...