Klinische Monatsblatter fur Augenheilkunde最新文献

{"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":"[Glaucoma drainage devices: Indications, intraoperative management and postoperative follow-up].","authors":"Karl Mercieca, Constance Weber","doi":"10.1055/a-2423-9133","DOIUrl":"10.1055/a-2423-9133","url":null,"abstract":"<p><p>Glaucoma drainage devices (GDD) are used for patients with secondary glaucoma, such as uveitic or neovascular glaucoma, which is uncontrolled under local therapy. They are also used in patients with conjunctival scarring, for example after a previous vitrectomy or after unsuccessful previous glaucoma surgery, such as trabeculectomy. They are also a treatment option for congenital glaucoma, aphakic glaucoma or for the treatment of iridocorneoendothelial syndromes. The conventional GDD were the Baerveldt, Molteno or Ahmed glaucoma implant, whereby the first two were valveless and the latter had a valve. Newer GDD include the PAUL glaucoma implant, the Ahmed Clear Path and the EyeWatch system. Hypotony is a feared complication after GDD surgery, and there are various options for avoiding it: external ligation of the tube or intraluminal suture obstruction. However, low IOP may still occur postoperatively. If early postoperative hypotension occurs in combination with a shallow anterior chamber, the injection of a viscoelastic can be helpful. Late hypotension is usually treated with permanent occlusion or removal of the tube. Furthermore, GDD erosion and migration can occur postoperatively, in such cases a surgical revision is required. Corneal decompensation can also occur after GDD; Descemet's membrane endothelial keratoplasty (DMEK) is the treatment of choice in many centers and is performed more frequently than a penetrating keratoplasty. Finally, double vision is a possible complication after GDI. Most patients have short-term, self-limited diplopia or can be adequately treated with prism glasses; a few require strabologic surgery.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"161-173"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792073","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":"Tumor- and Radiation-Related Complications after Ruthenium-106 Brachytherapy in Small to Medium Uveal Melanomas (Part 1).","authors":"Fotios Lalos, Dirk Flühs, Maja Guberina, Norbert Bornfeld, Martin Stuschke, Wolfgang Sauerwein, Nikolaos E Bechrakis","doi":"10.1055/a-2268-0985","DOIUrl":"10.1055/a-2268-0985","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to analyze tumor-related complications after ruthenium-106 brachytherapy in patients with uveal melanoma, with respect to local tumor control, insufficient radiation response, enucleation, and metastasis rate.</p><p><strong>Patients/methods and materials: </strong>This retrospective study included 608 patients treated consecutively with ruthenium-106 brachytherapy between January 2008 and December 2010 at the Department of Ophthalmology, University Hospital Essen. The occurrence of radiation-induced results was analyzed by estimating the risk by applying the Kaplan-Meier method, i.e., the \"time to event\" analysis. The Cox model test was used for the univariate and multivariate risk factor analyses. The median follow-up was 51 months after primary treatment.</p><p><strong>Results: </strong>Tumor recurrence was found in 21 patients (3.5%) and repeated treatment due to insufficient effect after the initial ruthenium-106 brachytherapy was performed in 40 patients (6.6%). The 5-year cumulative risk of recurrence was 4.0% and that of insufficient effect was 7.3%. Thirteen patients (2.1%) underwent a secondary enucleation; 8 because of a local recurrence and 5 because of severe post-brachytherapy complications. The cumulative enucleation risk was 2.3% after 5 years and 2.9% after 10 years, corresponding to eye preservation of 97.7 and 97.1%, respectively. In forty-two patients (7.2%), metastatic disease was diagnosed during the follow-up. The metastatic rate as calculated by the Kaplan-Meier method was 9.0, and 13.1% at 5 and 10 years, respectively.</p><p><strong>Conclusion: </strong>Our study demonstrated that ruthenium-106 brachytherapy is an excellent treatment option for achieving local tumor control and eye preservation in well-selected patients. The metastatic rate is in agreement with that of previous studies analyzing small to medium size uveal melanomas.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"105-115"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735489","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":"Editorial.","authors":"Nikolaos E Bechrakis, Antonia Joussen, Heinrich Heimann","doi":"10.1055/a-2510-9950","DOIUrl":"https://doi.org/10.1055/a-2510-9950","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 2","pages":"97"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414483","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":"[Choroidal Melanoma in the Advent of Generative Artificial Intelligence - a Conversation with ChatGPT].","authors":"Aleksandr Martynov, Nikolaos E Bechrakis, Mael Lever","doi":"10.1055/a-2318-9946","DOIUrl":"10.1055/a-2318-9946","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"127-132"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158499","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":"Ophthalmological and Interdisciplinary Surgical Approaches to the Orbit.","authors":"Eckart Bertelmann","doi":"10.1055/a-2149-0911","DOIUrl":"10.1055/a-2149-0911","url":null,"abstract":"<p><p>The treatment of orbital masses often requires an interdisciplinary approach. Ophthalmological surgical approaches include the anterior transcutaneous approach for removal of dermoids or taking biopsies. Anterior transconjunctival orbitotomy is suitable for masses of the inferior orbit or the intraconal compartment, but is inappropriate for masses of the orbital apex. The lateral transosseous orbitotomy often fits for masses of the lateral or intraconal compartment, especially for neoplasms of the lacrimal gland e.g. pleomorphic adenoma. Cryoextraction is often the technique of first choice for cavernous haemangiomas of all localisations. Transfrontal approaches are suitable for the resection of tumours of the optic nerve and of the orbital apex.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"98-104"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649342","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":"Internal Limiting Membrane Peeling in Primary Rhegmatogenous Retinal Detachment: Functional and Morphologic Results.","authors":"Franziska Eckardt, Julian Klaas, Jakob Siedlecki, Benedikt Schworm, Leonie Franziska Keidel, Denise Vogt, Thomas Kreutzer, Siegfried Priglinger","doi":"10.1055/a-2441-7791","DOIUrl":"10.1055/a-2441-7791","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the influence of internal limiting membrane (ILM) peeling on the repair of proliferative vitreoretinopathy grade B (PVR B) primary rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>Thirteen consecutive eyes that underwent pars plana vitrectomy (ppV) with ILM peeling for PVR B (group 1) were matched to a cohort of 13 eyes with primary RRD without PVR and without ILM peeling (group 2). Minimum follow-up was 6 months, and all eyes were operated by the same surgeon. Preoperative characteristics (age, lens status, macula-ON/OFF) were similar in the two groups (p ≥ 0.113).</p><p><strong>Results: </strong>At the end of follow-up, reattachment rates were comparable, with 92.3% in group 1 and 92.3% in group 2 (p = 1.0). Postoperative epiretinal membrane formation based on OCT was significantly reduced by ILM peeling (p = 0.04). Visual acuity was also comparable (group 1: 0.26 ± 0.29, group 2: 0.15 ± 0.17 logMAR; p = 0.125).</p><p><strong>Conclusion: </strong>This study suggests that intraoperative removal of the ILM in PVR B RRD can improve functional and morphological outcomes to levels obtained in uncomplicated RRD without PVR. ILM peeling does not appear to negatively affect postoperative visual acuity. Studies with longer follow-up are warranted to gauge a potential positive impact.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 2","pages":"153-159"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414492","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}

{"title":"Treatment-Related Complications and Functional Results after Ruthenium-106 Brachytherapy in Small to Medium Size Uveal Melanomas (Part 2).","authors":"Fotios Lalos, Dirk Flühs, Maja Guberina, Norbert Bornfeld, Martin Stuschke, Wolfgang Sauerwein, Nikolaos E Bechrakis","doi":"10.1055/a-2275-5575","DOIUrl":"10.1055/a-2275-5575","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the treatment-related complications after ruthenium-106 brachytherapy in patients with uveal melanoma in terms of radiation-induced optic neuropathy, maculopathy and retinopathy, radiation-related vitreous hemorrhage, and retinal detachment, as well as secondary glaucoma and radiogenic cataract. In addition, the course of visual acuity was analyzed.</p><p><strong>Patients/methods and materials: </strong>This retrospective study included 608 patients treated with ruthenium-106 brachytherapy between January 2008 and December 2010 at the Department of Ophthalmology, University Hospital Essen. The follow-up time was 11 years. The occurrence of the radiation-induced complications was analyzed using the Kaplan-Meier method. Cox regression was used for univariate and multivariate risk factor analyses. Hazard ratios were calculated for each variable.</p><p><strong>Results: </strong>Regarding the complications, 34% (N = 207) of the patients had no reported side effects or complications during follow-up. Radiation optic neuropathy was observed in 18.8% (N = 114) of the patients, with a median time to onset of 16 months (range: 3 - 78 months). Radiation maculopathy occurred in 8.2% (N = 50) after a median time of 17 months (range: 3 - 67 months). Radiation retinopathy was observed in 20.1% (N = 122), with a median time to onset of 21 months (range: 6 - 67 months). Secondary glaucoma developed in 9.7% of the patients (N = 53) and radiogenic cataract in 46.8% (N = 227). Vitreous hemorrhage (11.8%, N = 72) and scleral necrosis (2.1%, N = 13) occurred relatively rarely.</p><p><strong>Conclusion: </strong>The observed radiogenic complication rate is comparable with that reported in previous studies.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"116-126"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940173","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":"Management of Bilateral Primary Vitreoretinal Lymphoma: A Case Report and Review of the Literature.","authors":"Dimitrios Kalogeropoulos, Andrew John Lotery, Farid Afshar, Nigel Hall, Heytham Rezq, Abin Holla, Anthony Shinton, Stephen Lash, Bhaskar Gupta, Serafeim Antonakis","doi":"10.1055/a-2338-3304","DOIUrl":"10.1055/a-2338-3304","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"133-136"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759579","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":"Comparing Different Self-Tonometry Devices against Goldmann Applanation Tonometry - Special Focus on Biomechanical Properties of the Cornea.","authors":"Allam Tayar, Rico Großjohann, Andreas Stahl, Frank Tost","doi":"10.1055/a-2480-1772","DOIUrl":"10.1055/a-2480-1772","url":null,"abstract":"<p><strong>Background: </strong>Interest in self-tonometry as an additional component to glaucoma monitoring has been increasing for several years. Two self-tonometry devices, Ocuton S and iCare HOME, have seen clinical use, but reports are lacking as to how individual biomechanical corneal properties might influence readings. We compared the two devices against Goldmann applanation tonometry (GAT) as a reference method.</p><p><strong>Patients and methods: </strong>Intraocular pressure (IOP) was measured by GAT and the two self-tonometers, Ocuton S*TT-MV and iCare HOME, on 108 patients with glaucoma, suspected glaucoma, or ocular hypertension at different times in alternating order during diurnal profiling for intraocular pressure. Corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF) were recorded using an Ocular Response Analyzer^® (ORA) to determine biomechanical corneal properties.</p><p><strong>Results: </strong>We first determined measurement deviations using GAT as the established reference method. The mean difference was - 1.73 ± 2.84 (- 3.95 - 7.41 mmHg) between iCare HOME and GAT, and + 1.49 ± 2.9 mmHg (- 7.29 - 4.31 mmHg) between Ocuton S*TT-MV and GAT. Differences between iCare HOME readings within measurement sequences were statistically significant (p < 0.001). Ocuton S*TT-MV did not show any significant difference from GAT using the measurement sequence (p = 0.262; p = 0.063). In contrast, previous tonometry measurements exerted a significant influence on iCare HOME readings. We found a significant correlation in both self-tonometers with corneal thickness on investigating the possible impact of biomechanical corneal properties on self-tonometry results. The impact of corneal thickness on readings was moderate to strong in iCare HOME. IOP values measured using both self-tonometers correlated significantly with CRF values (p < 0.001). Ocuton S*TT-MV values also correlated significantly with CH values (p = 0.024), unlike iCare HOME (p = 0.853).</p><p><strong>Conclusion: </strong>We consider differences in readings using the two self-tonometers compared against GAT as the established reference method to be within acceptable tolerances. Monitoring changes in readings using either device over an extended period - such as gradual increases in intraocular pressure values - is far more important in clinical practice. The measurement sequence requires special consideration due to interplay between measurement methods when comparing readings from different tonometers. We recommend taking iCare HOME readings before applanation tonometry. Biomechanical corneal properties especially need to be considered in iCare HOME and Ocuton S*TT-MV self-tonometers. CRF values affect readings from both self-tonometers. CH values should also be considered when interpreting readings from Ocuton S*TT-MV.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"137-145"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682109","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}