Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Is Conventional Horizontal Strabismus Surgery Still a Valid Option in High Myopia?","authors":"Lene Maurer, Anja Palmowski-Wolfe","doi":"10.1055/a-2498-0202","DOIUrl":"https://doi.org/10.1055/a-2498-0202","url":null,"abstract":"<p><strong>Background: </strong>Surgical methods to join extraocular muscles are now often used to reduce the risk of scleral perforation in strabismus surgery, but published results indicate that the outcome is highly variable. We therefore wanted to assess whether conventional horizontal strabismus surgery is still a valid option in high myopia.</p><p><strong>Patients and methods: </strong>A retrospective chart review of patients with high myopia, defined as a spherical equivalent of ≥ - 6.0 D in at least one eye, and who had undergone conventional horizontal strabismus surgery was performed. Exotropic angles were converted to positive angles to summarize the results.</p><p><strong>Results: </strong>22 patients were analyzed (15 corrected for esotropia, 7 for exotropia). Prior to surgery, the mean angle of deviation, measured with the alternate prism cover test, was 33.9 prism diopters (PD; range 13 - 75 PD) at distance and 35.3 PD (range 8 - 75 PD) at near. Three months post-surgery, the overall mean dose effect (DE in PD/mm surgery) was 2.8 (standard deviation [SD] 0.5) at distance and 2.9 (SD 0.6) at near. In esotropia, the mean DE was 3.0 at both distance and near; in exotropia, the mean DE was 2.3 at distance and 2.5 at near. There were no major complications such as scleral perforations or retinal detachment.</p><p><strong>Conclusion: </strong>Our data show that conventional horizontal strabismus surgery in high myopia is feasible, is not linked to an increased risk of scleral perforation, and offers predictable results.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Postoperative Subconjunctival Corticosteroid Injections in a Multimodal Approach for the Treatment of Severe Symblepharon.","authors":"Dmitri Artemiev","doi":"10.1055/a-2511-3586","DOIUrl":"https://doi.org/10.1055/a-2511-3586","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Die neuen ANTI-VEGF Präparate: Evolution oder Revolution?","authors":"Ramin Khoramnia, Lucy J Kessler, Gerd U Auffarth, Michael Albrecht","doi":"10.1055/a-2370-7389","DOIUrl":"https://doi.org/10.1055/a-2370-7389","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exit Strategy for Treatment of Neovascular Age-Related Macular Degeneration in a Real-World Setting: Wishful Thinking?","authors":"Michael Eastline, Sadiq Said, Martina Monika Bosch, Pascal Knecht-Bosch","doi":"10.1055/a-2511-5899","DOIUrl":"https://doi.org/10.1055/a-2511-5899","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze our outcome for patients with neovascular age-related macular degeneration (nAMD) treated with aflibercept in a treat-and-extend regimen pursuing an exit strategy (with best possible adherence to the \"Bern\" exit criteria) over 6 years in a real-world setting. The primary objective of the study was to investigate the proportion of patients who were able to achieve and maintain treatment exit.</p><p><strong>Methods: </strong>This is a retrospective chart review study of treatment-naïve patients diagnosed with nAMD receiving intravitreal aflibercept injections performed at our department with at least 2 years of follow-up visits. The primary outcome was the percentage of patients able to achieve and maintain the treatment exit regarding intravitreal anti-VEGF injections. Further outcome measures were best-corrected visual acuity (BCVA), incidence of recurrence after treatment cessation, duration of therapy, and number and intervals of injections.</p><p><strong>Results: </strong>There were 31 eyes of 25 patients included in this retrospective study. The observation period was from September 1, 2017 to August 31, 2023. Of all included patient eyes, 22.6% (n = 7) reached exit criteria. Of all the \"exit\" patients, 28.6% (n = 2) suffered from disease relapse and therapy was restarted at a mean (± SD) of 41.5 ± 12.5 weeks (range: 29 to 54 weeks). Regarding the eyes that met treatment exit, 5 of 31 (16.1%) had no disease recurrence in the observed study period. The median BCVA (Snellen decimal; ± interquartile range: IQR) changed from 0.63 (0.27) at baseline to 0.63 (0.4) in the first year, 0.63 (0.3) in the second year, 0.63 (0.46) in the third year, 0.63 (0.3) in the fourth year, 0.63 (0.4) in the fifth year, and 0.4 (0.04) in the sixth year. The median number of injections (± IQR) per eye in the first year of treatment was 8 (2), in the second year 5 (2), in the third year 5 (2.5), in the fourth year 5 (1), in the fifth year 3 (0.8), and in the sixth year 3 (0). Extension of the treatment interval after the loading phase in weeks was achieved up to a median (± IQR) of 5.8 (4) in the first year, 8.4 (6) in the second year, 8 (5.7) in the third year, 9.4 (5.6) in the fourth year, 7 (6.9) in the fifth year, and 8.4 (3.1) in the sixth year of observation.</p><p><strong>Discussion: </strong>Our study indicates a lower rate of patients reaching exit criteria with a treat-and-extend regimen compared to clinical study settings, and a similar recurrence rate of nAMD after treatment cessation. Nonadherence to a strict treat-and-extend protocol might influence the result.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wie eine exzentrische Fixation nützlich sein kann: Einseitige Aussparung der Fovea bei einer bilateralen Laser induzierten Makulopathie.","authors":"Özlem Ural Fatihoğlu, Ayse Bozkurt Oflaz, Anıl Akdeniz, Eda Humaz, Aylin Yaman, Ali Osman Saatci","doi":"10.1055/a-2533-5028","DOIUrl":"https://doi.org/10.1055/a-2533-5028","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Oregis Dashboard: Web-based Ophthalmic Research Benchmarking in Germany.","authors":"Julian Alexander Zimmermann, Christopher Dicke, Maren Arndt, Noel-Adrian Hollosi, Jens Julian Storp, Nicole Eter","doi":"10.1055/a-2481-2044","DOIUrl":"https://doi.org/10.1055/a-2481-2044","url":null,"abstract":"<p><strong>Introduction: </strong>The oregis registry operated by the German Ophthalmological Society (DOG) serves as a central digital platform for collecting and analysing ophthalmological healthcare data in Germany. The aim of oregis is to provide a comprehensive picture of the current healthcare situation and promote healthcare research using real-world-data from inpatient and outpatient facilities. Since its launch in 2020, oregis has continuously expanded its database to enable scientific analyses on a wide range of topics. This paper presents the new dashboard feature allowing participating centres to compare their own patient data with aggregated data in real time while also covering privacy aspects of the system.</p><p><strong>Materials and methods: </strong>The oregis steering committee opted to implement the oregis dashboard based on existing medical registries. First, forty-nine national and international registries were analysed to identify common features such as benchmarking functionality. This was followed by technical realisation and implementation.</p><p><strong>Results: </strong>Each centre connected to oregis has secure access to the oregis dashboard, which displays key indicators for patients, diagnoses, and treatments. Dynamic filtering options allow targeted data analysis, comparing each centre's results anonymously with aggregated data from other centres. The dashboard uses Apache Superset data visualisation software [! etwas informativer]. Data is synchronised using an integrated oregis Konnektor module to anonymise patient data according to defined standards. Extensive security and privacy measures ensure data security, including server-side encryption, transport encryption, and two-factor authentication. The dashboard is part of a comprehensive privacy policy developed and validated for oregis by privacy experts.</p><p><strong>Conclusion: </strong>The number of centres connected to oregis is still growing. The new web-based dashboard allows flexible analysis of data and comparison with other centres without allowing conclusions to be drawn about any individual care centre; this ensures data privacy and independence in each centre. More features can be added to provide a more thorough overview of eye care in Germany as oregis grows.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospektives internationales Register für Treatment Exit Options in Uveitis (TOFU) – die ersten fünf Jahre.","authors":"Carsten Heinz, David J Fink, Jennifer Dell, Moritz Berger, Matthias Schmid, Robert P Finger","doi":"10.1055/a-2529-0057","DOIUrl":"https://doi.org/10.1055/a-2529-0057","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Changing Physicians on Compliance with Management of Myopia Progression.","authors":"Fabian Schibli, Anja Palmowski-Wolfe","doi":"10.1055/a-2493-9295","DOIUrl":"https://doi.org/10.1055/a-2493-9295","url":null,"abstract":"<p><strong>Background: </strong>The global incidence of high myopia is increasing, with projections indicating a rise from 3 to 10% of the global population by 2050. Effective treatment options exist to reduce myopia progression, but their success is contingent on patient adherence. This study assesses the impact of changes in treating physicians on adherence to therapy to control myopia progression.</p><p><strong>Patients and methods: </strong>This retrospective observational study analyzed data from the Myopia Clinic at the University Eye Hospital of Basel from 2020 to 2023. Adherence rates were compared between consultations with and without a change in the treating physician, as well as between resident and senior physicians. Statistical analysis was performed using unpaired t-tests and chi-squared tests.</p><p><strong>Results: </strong>A total of 73 patients, with a mean age of 10.76 years, who had at least three axial length measurements were included. Overall, 84.79% of consultations adhered to the recommended treatment. A significantly higher nonadherence rate of 21.43% was observed in consultations following a change in physician, compared to 6.42% with physician stability (p = 0.0037). Nonadherence was also higher with resident physicians (18.31%) compared to senior physicians (8.70%; p = 0.0310). No significant difference in adherence was found between optical and medical treatment options (p = 0.6293). Age and gender did not significantly influence adherence.</p><p><strong>Discussion: </strong>The study reveals a significant negative impact of physician changes on patient adherence in therapy to control myopia progression control. The findings emphasize the importance of consistent physician care, particularly in avoiding frequent rotations among resident physicians, in order to enhance treatment adherence. While the study's limitations include a small sample size and single-center data, the results suggest that strategies to minimize changes in treating physicians could improve adherence outcomes.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Focal Corneal Edema and Recurrent Uveitis Anterior due to Retained Lens Fragment after Uneventful Cataract Surgery.","authors":"Eleftherios Chatzimichail, Alexandra Steinemann-Inauen, Oussama Habra, Peter Meyer, Nicolas Feltgen, Zisis Gatzioufas","doi":"10.1055/a-2463-0967","DOIUrl":"https://doi.org/10.1055/a-2463-0967","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"19-Year Follow-up on Patients with Axenfeld-Rieger Anomaly or Syndrome and Fuchs' Endothelial Dystrophy Including the 6th Generation in a Pedigree.","authors":"Angelika Schuknecht, Josephine Wachtl, Alessandra Baumer, Christoph Kniestedt","doi":"10.1055/a-2498-0245","DOIUrl":"https://doi.org/10.1055/a-2498-0245","url":null,"abstract":"<p><strong>Background: </strong>Nineteen-year follow-up after initial examination on patients with Axenfeld-Rieger anomaly or syndrome (ARAS) and coexisting Fuchs' endothelial dystrophy (FED). All individuals had previously been tested positive for the PITX2 (g.20 913 G>T) mutation. Additionally, we addressed their descendants for phenotype and genotype examination to determine their penetrance into the next generations.</p><p><strong>Patients and methods: </strong>Twenty-nine patients (9 patients and 20 of their descendants) participated in this prospective observational study. Nine patients were examined and tested positive for the PITX variant (g.20 913 G>T) in our previous study in 2001. Fourteen descendants were genetically and clinically examined. Six descendants were not available for clinical examination but donated saliva samples for genetic analysis. Ophthalmic examination was performed, consisting of visual acuity (VA) testing, applanation tonometry, gonioscopy, and anterior segment and central fundus biomicroscopy. Peripapillary optical coherence tomography (pOCT) was performed, and endothelial cell density (ECD) and central corneal thickness (CCT) were measured. Clinical disease progression in patients with a positive PITX2 mutation, genetic defect transmission, and clinical penetrance in subsequent third to sixth generations were the main outcome measures.</p><p><strong>Results: </strong>Ten out of twenty descendants tested positive for the PITX2 variant (g.20 913 G>T). Eight were identified as being affected by ARAS. FED was found in six patients. All of them showed ARAS. Third generation patients (mean age 82) progressed significantly in both coexisting diseases. Four of six eyes ended up in corneal edema, with VA below 0.2. Glaucoma assessment was compromised due to corneal edema. Fourth generation patients (mean age 43) showed a mean CCT of 611 µm, ECD of 1230, and intraocular pressure (IOP) of 17.5 mmHg and thinning of the peripapillary nerve fiber layer. One eye was newly diagnosed with glaucoma, elevated IOP, and mild corneal edema. Fifth generation patients (mean age 27) presented with a mean CCT of 564 µm, ECD of 2802, and IOP of 14.4 mmHg.</p><p><strong>Conclusion: </strong>Genetic analysis confirmed the PITX2 (g.20 913 G>T) mutation was associated with Axenfeld-Rieger and FED in 10 of 20 descendants in this family. This matches the autosomal dominant inheritance pattern with a probability of 50%. Glaucoma and corneal decompensation were progressive over 19 years, with variable expression and early onset in subsequent pedigree members.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}