Cemre Altas, Thomas A Fuchsluger, Tobias Brockmann, Anna Graumüller, Marcus Walckling
{"title":"Efficacy, Confounders and Safety of the Preserflo Microshunt.","authors":"Cemre Altas, Thomas A Fuchsluger, Tobias Brockmann, Anna Graumüller, Marcus Walckling","doi":"10.1055/a-2325-9286","DOIUrl":"10.1055/a-2325-9286","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma is a leading cause of blindness worldwide. We evaluated the efficacy, confounders, and safety of the Preserflo Microshunt over a one-year follow-up period.</p><p><strong>Methods: </strong>In this retrospective monocentric study, 111 eyes were evaluated. 83 eyes had primary open angle glaucoma, and 28 eyes secondary open angle glaucoma. Intraocular pressure (IOP), visual acuity, number of glaucoma medications, complications, and reoperations were evaluated postoperatively, at 1, 3, 6, 9, and 12 months. The influence of age, sex, type of glaucoma, previous surgery and lens status was also analysed. Bleb revision was indicated if corrected IOP exceeded 18 mmHg.</p><p><strong>Results: </strong>Intraocular pressure significantly decreased from 24.50 ± 8.94 to 14.62 ± 4.86 mmHg (4 - 32 mmHg; p < 0.001), the number of medications from 3.19 ± 1.14 to 0.98 ± 1.39 (0 - 4; p < 0.001). Confounders of interest did not affect efficacy. Bleb revision was performed in 22.5% of eyes and a cyclophotocoagulation was performed in 9.9% of eyes. Complete surgical success (IOP ≤ 17 mmHg, IOP reduction ≥ 20%, without medication) was achieved in 36.9% (n = 41) and qualified success (with medication) in 51.4% (n = 57) of eyes. Transient hypotension (≤ 5 mmHg) occurred in 19.8% after primary implantation and in 1.8% after bleb revision (duration ≤ 3 months).</p><p><strong>Conclusion: </strong>To date, the Preserflo Microshunt has demonstrated good efficacy and a low risk profile.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"1048-1056"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759576","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":"Acute Idiopathic Blind Spot Enlargement Syndrome (AIBSES) in the Era of OCT - a Review.","authors":"Julian Alexander Zimmermann, Julia Biermann","doi":"10.1055/a-2130-5131","DOIUrl":"10.1055/a-2130-5131","url":null,"abstract":"<p><p>There are only about 100 case reports on the Acute Idiopathic Blind Spot Enlargement Syndrome (AIBSES). This is characterised by the eponymous visual field loss in the blind spot area, acute onset photopsia, and funduscopically little or no change in the optic disc area, with conspicuous outer retinal bands on optical coherence tomography (OCT). Typical is the unilateral occurrence. Predominantly young women are affected. While previous reviews of AIBSES either predate the introduction of OCT or focus on differentiation from potentially related outer retinal conditions (e.g., multiple evanescent white dot syndrome and acute zonal occult outer retinopathy), the present review will concentrate on the current perspective and treatment strategies that have been developed and will aim to help increase awareness. Since the first description of AIBSES in the late 1980s, the introduction of OCT has simplified the diagnosis and characterisation of AIBSES as a disease of the outer retina. Nevertheless, misdiagnosis remains common in the spectrum of optic neuritis, as AIBSES may be ignored in differential diagnosis.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"1032-1038"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10552776","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":"Role of Artificial Intelligence in Retinal Diseases.","authors":"Julia Mai, Ursula Schmidt-Erfurth","doi":"10.1055/a-2378-6138","DOIUrl":"https://doi.org/10.1055/a-2378-6138","url":null,"abstract":"<p><p>Artificial intelligence (AI) has already found its way into ophthalmology, with the first approved algorithms that can be used in clinical routine. Retinal diseases in particular are proving to be an important area of application for AI, as they are the main cause of blindness and the number of patients suffering from retinal diseases is constantly increasing. At the same time, regular imaging using high-resolution modalities in a standardised and reproducible manner generates immense amounts of data that can hardly be processed by human experts. In addition, ophthalmology is constantly experiencing new developments and breakthroughs that require a re-evaluation of patient management in routine clinical practice. AI is able to analyse these volumes of data efficiently and objectively and also provide new insights into disease progression and therapeutic mechanisms by identifying relevant biomarkers. AI can make a significant contribution to screening, classification and prognosis of various retinal diseases and can ultimately be a clinical decision support system, that significantly reduces the burden on both everyday clinical practice and the healthcare system, by making more efficient use of costly and time-consuming resources.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"241 9","pages":"1023-1031"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alper Halil Bayat, Gozde Aksoy Aydemir, Emre Aydemir, Haci Hasan Özkan, Gürkan Yardimci, Bilge Aydin Türk, Emine Özkul Kilinç
{"title":"Conjunctival Histopathological Changes and Clinical Tear Film in Children with Atopic Dermatitis.","authors":"Alper Halil Bayat, Gozde Aksoy Aydemir, Emre Aydemir, Haci Hasan Özkan, Gürkan Yardimci, Bilge Aydin Türk, Emine Özkul Kilinç","doi":"10.1055/a-2376-3114","DOIUrl":"10.1055/a-2376-3114","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluation of changes in the ocular surfaces in children with a diagnosis of atopic dermatitis (AD).</p><p><strong>Methods: </strong>Thirty-six children with a diagnosis of AD (Eye-AD group) and 40 healthy subjects (Eye-HS group) were enrolled in this prospective case-control study. Tear film break-up time (T-BUT), Schirmer tear test (STT), conjunctival impression cytology (CIC), tear meniscus height (TMH), tear meniscus area (TMA), and ocular surface disease index (OSDI) were measured.</p><p><strong>Results: </strong>The participants were similar in terms of demographic characteristics, such as mean age and gender (p > 0.05). The mean T-BUT was 9.3 ± 2.22 s (5 - 16) in the Eye-AD group and 11.83 ± 2.03 s (7 - 16) in the Eye-HS group. The mean STT was 11.12 ± 3.28 mm (5 - 21) in the Eye-AD group and 15.44 ± 3.8 mm (8 - 20) in the Eye-HS group (p < 0.001, p < 0.001, respectively). The mean OSDI scores were 13.12 ± 1.41 (10 - 15) in the Eye-AD group and 13.97 ± 2.93 (8 - 20) in the Eye-HS group (p = 0.052). Mean TMH and TMA were 306.48 ± 7.29 µm and 0.22 ± 0.004 mm<sup>2</sup>, respectively, in the Eye-AD group, and 312.94 ± 5.31 µm and 0.027 ± 0.005 mm<sup>2</sup>, respectively, in the Eye-HS group. In the CIC analyses, 22 of the samples in the Eye-AD group and 35 in the Eye-HS group had a classification of grade 0, 10 in the Eye-AD group and 5 in the Eye-HS group had a classification of grade 1, and 4 in the Eye-AD group and none in the Eye-HS group had a classification of grade 2 (p = 0.015).</p><p><strong>Conclusion: </strong>Pediatric patients with AD may have significant changes in conjunctival histopathology. These changes can be manifested in the tests used to measure the tear film. Dry eye was shown to be present in the majority of children with AD.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855941","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}
Kathrin Marie Grimm, Isabella Diana Baur, Arthur Mueller, Josef Märtz
{"title":"[The Orbital Apex - Dangerous Terrain!]","authors":"Kathrin Marie Grimm, Isabella Diana Baur, Arthur Mueller, Josef Märtz","doi":"10.1055/a-2378-5330","DOIUrl":"https://doi.org/10.1055/a-2378-5330","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080786","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}
Carl Erb, Clivia Erb, Avaz Kazakov, Gulnara Kapanova, Burkhard Weisser
{"title":"Lifestyle Changes in Aging and their Potential Impact on POAG.","authors":"Carl Erb, Clivia Erb, Avaz Kazakov, Gulnara Kapanova, Burkhard Weisser","doi":"10.1055/a-2372-3505","DOIUrl":"https://doi.org/10.1055/a-2372-3505","url":null,"abstract":"<p><p>Primary open angle glaucoma is a primary mitochondrial disease with oxidative stress triggering neuroinflammation, eventually resulting in neurodegeneration. This affects many other areas of the brain in addition to the visual system. Aging also leads to inflammaging - a low-grade chronic inflammatory reaction in mitochondrial dysfunction, so these inflammatory processes overlap in the aging process and intensify pathophysiological processes associated with glaucoma. Actively counteracting these inflammatory events involves optimising treatment for any manifest systemic diseases while maintaining chronobiology and improving the microbiome. Physical and mental activity also provides support. This requires a holistic approach towards optimising neurodegeneration treatment in primary open angle glaucoma in addition to reducing intraocular pressure according personalised patient targets.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080787","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":"[Neuroradiology for the Ophthalmologist - Part 2 Efference].","authors":"Aikaterini Fitsiori, Heimo Steffen","doi":"10.1055/a-2312-6740","DOIUrl":"10.1055/a-2312-6740","url":null,"abstract":"<p><p>Eye movements are a complex task requiring a large number of structures coordinated by three cranial nerves and their centres in the brainstem. Various pathologies may affect any part of the pathway controlling the eye movements and their diagnosis is often based on history and clinical examination. Modern advances in computed tomography and magnetic resonance imaging have recently added a valuable tool in the diagnosis of oculo-motor-related diseases.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"991-1010"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092839","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":"[ChatGPT in Ophthalmology - A Report].","authors":"Martina C Herwig-Carl","doi":"10.1055/a-2142-2910","DOIUrl":"10.1055/a-2142-2910","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"952-954"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61563247","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":"Culturing Limbal Epithelial Cells of Long-term Stored Corneal Donors (Organ Culture) In Vitro - A Stepwise Linear Regression Algorithm.","authors":"Zhen Li, Daniel Böhringer, Tanja Stachon, Mahsa Nastaranpour, Fabian Norbert Fries, Berthold Seitz, Myriam Ulrich, Cristian Munteanu, Achim Langenbucher, Nóra Szentmáry","doi":"10.1055/a-2084-7168","DOIUrl":"10.1055/a-2084-7168","url":null,"abstract":"<p><strong>Purpose: </strong>To assess various potential factors on human limbal epithelial cell (LEC) outgrowth <i>in vitro</i> using corneal donor tissue following long-term storage (organ culture) and a stepwise linear regression algorithm.</p><p><strong>Methods: </strong>Of 215 donors, 304 corneoscleral rings were used for our experiments. For digestion of the limbal tissue and isolation of the limbal epithelial cells, the tissue pieces were incubated with 4.0 mg/mL collagenase A at 37 °C with 95% relative humidity and a 5% CO<sub>2</sub> atmosphere overnight. Thereafter, limbal epithelial cells were separated from limbal keratocytes using a 20-µm CellTricks filter. The separated human LECs were cultured in keratinocyte serum-free medium medium, 1% penicillin/streptomycin (P/S), 0.02% epidermal growth factor (EGF), and 0.3% bovine pituitary extract (BPE). The potential effect of donor age (covariate), postmortem time (covariate), medium time (covariate), size of the used corneoscleral ring (360°, 270°180°, 120°, 90°, less than 90°) (covariate), endothelial cell density (ECD) (covariate), gender (factor), number of culture medium changes during organ culture (factor), and origin of the donor (donating institution and storing institution, factor) on the limbal epithelial cell outgrowth was analyzed with a stepwise linear regression algorithm.</p><p><strong>Results: </strong>The rate of successful human LEC outgrowth was 37.5%. From the stepwise linear regression algorithm, we found out that the relevant influencing parameters on the LEC growth were intercept (p < 0.001), donor age (p = 0.002), number of culture medium changes during organ culture (p < 0.001), total medium time (p = 0.181), and size of the used corneoscleral ring (p = 0.007), as well as medium time × size of the corneoscleral ring (p = 0.007).</p><p><strong>Conclusions: </strong>The success of LEC outgrowth increases with lower donor age, lower number of organ culture medium changes during storage, shorter medium time in organ culture, and smaller corneoscleral ring size. Our stepwise linear regression algorithm may help us in optimizing LEC cultures <i>in vitro</i>.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"964-971"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9400658","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}