Neuro-Ophthalmology in France

Abstract

Interest in neuro-ophthalmology in France dates back to the 19th century with the publications by an ophthalmologist, Henri Parinaud, a collaborator of Jean-Martin Charcot in Paris. At that time, a physiologist, Claude Bernard, and a neurologist, Eugène Devic, participated in the description of various neuro-ophthalmologic syndromes. In the 1930s, academic neurologists in Paris, including Pierre Mollaret, Georges Guillain and later Jérôme Garcin, Jean Lapresle, and Mongi Ben Hamida, worked closely with specific ophthalmologists, like Hoang Xuan Man, and published original clinical cases related to neuro-ophthalmology. In the 1970s, neuro-ophthalmology emerged as a distinct subspecialty practiced by a few nonsurgical ophthalmologists, like Monique Schaison-Cusin, who saw patients in the neurology and neurosurgery departments of Pitié Salpétrière Hospital in Paris. With reform of residency training in the early 1980s, ophthalmology primarily became a surgically oriented specialty and trainees lost the opportunity to choose ophthalmology as a medical specialty, thereby precluding training in neuro-ophthalmology. This led the last generations of French ophthalmologists to have little interest in neuro-ophthalmology, yet at the same time a number of investigators became interested in eye movement disorders. These included Pierre Larmande, Charles Pierrot-Deseilligny, Alain Berthoz, and Marc Jeannerod. They developed eye movement laboratories that attracted a number of neurologists and scientists over the past few decades. French neuro-ophthalmology is usually performed part-time either by ophthalmologists or neurologists or in some locations by combined teams. Approximately, 30 clinicians currently practice neuro-ophthalmology on a regular basis in France. Two thirds of them are ophthalmologists, and most are located in academic medical centers. Three major factors have led to a dramatic increase in educational, clinical, and research activity in neuro-ophthalmology in France. First was the creation 15 years ago of a post-graduate university diploma in neuro-ophthalmology. Since then, the registration has remained full each year (60 trainees). This program spurred creation of a French textbook of neuro-ophthalmology (1). Currently, neuro-ophthalmology is included in the educational programs of ophthalmology residents and is expected to be part of the curriculum of neurology residents very soon. A number of organizations provide grant support for neuro-ophthalmology training and include Berthe Fouassier Price [Fondation de France], Société Française d’Ophtalmologie, Année recherche; Institut Servier, Fondation Planiol, Fondation Philips. These grants allow young French ophthalmologists or neurologists to train in neuro-ophthalmology centers outside of France, primarily in the United States and United Kingdom. Second, in 2003, the “Club de Neuro-Ophtalmologie Francophone” (CNOF) was established. This organization allows all clinicians interested in neuro-ophthalmology in France and French-speaking countries (Switzerland, Belgium, and for the 2014 meeting, Morocco) to share material related to clinical care, research, and education. Since its creation, the CNOF has successfully organized 3 national meetings every year, including 1 specific event and 2 events included within those, the French Society of Neurology (JNLF) and the French Society of Ophthalmology (SFO) meetings. Following the 2004 meeting of the French Society of Ophthalmology, a French textbook on neuro-ophthalmology was published (2). Three collaborative research projects have emerged from the CNOF: a survey of idiopathic intracranial hypertension in France (3); a multicenter study of recurrent optic neuritis to be published soon; and a survey of the incidence of optic neuritis in France. Recently, a website (http://www.neuro-ophtalmologie-club.org) was launched. The annual CNOF meeting takes place in different cities (Fig. 1), and the steady increase of the number of participants reflects the growing interest in neuro-ophthalmology. CNOF offers 2 travel grants a year for young investigators to allow them to attend international neuro-ophthalmology meetings.FIG. 1: Number of participants and location of annual meeting of Club Francophone de Neuro-Opthalmologie.Third, neuro-ophthalmology in France has developed an international focus. An increasing number of ophthalmologists and neurologists have been trained in the United Kingdom and the United States over the past 20 years, allowing for international collaborative projects, multiple international publications, and participations in international clinical, research, and educational meetings. In 2010, a very successful meeting of the International Neuro-Ophthalmology was held in Lyon. Neuro-ophthalmology in France has made great strides in recent years. We are excited about an even brighter future! ACKNOWLEDGMENT The authors are grateful to Valerie Biousse for her assistance.