Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Five-Year Data from the Interdisciplinary Giant-Cell Arteritis Registry at the University Hospital of Würzburg: Value of Temporal Artery Biopsy.","authors":"Carla Winter, Johanna Theuersbacher, Konstanze Guggenberger, Matthias Fröhlich, Marc Schmalzing, Thorsten Bley, Jost Hillenkamp","doi":"10.1055/a-2381-1884","DOIUrl":"10.1055/a-2381-1884","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Giant-cell arteritis (GCA) requires immediate diagnosis and therapy. The University Hospital of Würzburg established the Centre for Giant-cell Arteritis (ZeRi) to improve interdisciplinary collaboration.</p><p><strong>Abstract: </strong>AIM OF THE STUDY: Retrospective evaluation of five-year data to assess the clinical relevance of several diagnostic methods, including temporal artery biopsy.</p><p><strong>Abstract: </strong>PATIENTS AND METHODS: Retrospective evaluation of 101 patients with suspected GCA who had undergone interdisciplinary examination and biopsy between 2017 and 2022. We analysed specificity and sensitivity in clinical symptoms, ESR, CRP, scalp MRI, temporal artery sonography, and temporal artery biopsy.</p><p><strong>Abstract: </strong>RESULTS: GCA was diagnosed after completing diagnostic testing in 75 of 101 patients with suspected GCA. By definition, biopsy showed a positive predictive value of 100% and a specificity of 84.6%; however, negative predictive value was 51.2%. Sonography of the temporal artery and MRI showed a positive predictive value of more than 93% and sensitivity of 62.5% and 76.1%, respectively. Clinical symptoms showed the highest sensitivity at 92% with a specificity of 57.7%. ESR and CRP were significantly higher in patients with GCA than in patients without GCA, whereby CRP values showed higher predictive power than did ESR.</p><p><strong>Abstract: </strong>CONCLUSIONS: Most GCA cases can be detected with a precise medical history as well as ESR and CRP assessment. Sonography and MRI on the scalp can usually confirm suspected GCA, only requiring temporal artery biopsy in exceptional cases.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"608-615"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400675","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":"Biopsy-proven Orbital Sarcoidosis after SARS-CoV-2 mRNA Vaccination.","authors":"Mehmet Serhat Mangan, Zeynep Toker Dincer, Seda Mazmanoglu Atilman, Emire Seyahi","doi":"10.1055/a-2600-2132","DOIUrl":"10.1055/a-2600-2132","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"616-618"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804357","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":"Intravitreal Management of Ocular Lymphoma Should Use Adjusted Drug Concentrations Not Fixed Dosages.","authors":"Marc D de Smet","doi":"10.1055/a-2788-0429","DOIUrl":"10.1055/a-2788-0429","url":null,"abstract":"<p><strong>Abstract: </strong>Most vitreo-retinal lymphoma are rare high-grade B cell lymphoma of immune privileged sites. As there is considerable heterogeneity, the clinical management hampers the optimisation of treatment protocols. While most patients respond to a fixed intravitreal dose of 400 µg, corneal toxicity is seen in 20 to 50% of patients when administered at short intervals under 1 month. Local recurrence of disease is also seen in about 20% of patients. While systemic chemotherapy is weight or surface dependent, most intraocular treatment protocols follow a fixed dose regimen. By analysing existing published data, we show that both experimentally and clinically, the elimination of intraocular methotrexate follows a first order kinetic model. Starting with an initial concentration of 100 µg/ml of vitreous volume, in most instances, a therapeutic level is present for 3 to 5 days. Systemic therapy alone does not achieve these sustained ocular levels. Furthermore, with vitreous volumes which can vary between 3 and 10 ml, using a fixed Mtx dose can either lead to increased risk of toxicity or under treatment. Future treatment protocols should make use of fixed initial concentrations rather than a fixed dose, thus allowing a better comparison of outcomes. Formulas to adjust the concentration of Mtx to be delivered in a fixed volume are provided.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"590-594"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984976","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":"[Diagnostic Approaches to the Cornea (Part 1) - Anatomical Fundamentals and Standard Methods].","authors":"Klemens P Kaiser, Mehdi Shajari, Loay Daas, Thomas Kohnen","doi":"10.1055/a-2572-4631","DOIUrl":"10.1055/a-2572-4631","url":null,"abstract":"<p><strong>Abstract: </strong>The cornea plays a pivotal role in visual quality, accounting for most of the eye's refractive power. It is also frequently affected by a wide range of pathological conditions. Accurate diagnostics are therefore fundamental for making therapeutic decisions. This review provides an overview of established and emerging methods for examining the cornea, ranging from slit-lamp biomicroscopy and vital dyes to corneal topography, tomography, pachymetry, assessments of the endothelium and nerves, anterior segment optical coherence tomography, and biomechanical measurements.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"619-634"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213474","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":"Immunology of Uveitis - From Bench to Bedside.","authors":"Gerhild Wildner, Stephan Thurau","doi":"10.1055/a-2730-1076","DOIUrl":"10.1055/a-2730-1076","url":null,"abstract":"<p><strong>Abstract: </strong>Autoimmune uveitis is an orphan disease with a prevalence of 0.4% and normally very effectively prevented by the immune privilege of the eye. The immune privilege can be overcome, because an immune response that is activated outside the eye against foreign antigens enables T cells to enter the eye and also recognises intraocular antigens via cross-reactivity (antigenic mimicry) and thus triggers uveitis. This leads to the migration of lymphocytes into the eye, followed by the invasion of inflammatory cells that cause the destruction of intraocular structures. Antigenic mimicry can also be used therapeutically to induce oral tolerance. The discovery of the tolerance-inducing but non-pathogenic mimicry epitope B27PD made it possible to treat therapy-refractory uveitis patients by inducing oral tolerance. All 8 treated patients were able to reduce their steroid therapy, with stable or improved visual acuity, and two have been free of recurrence and therapy since oral tolerance induction 30 years ago. Later, the establishment of two new animal models for spontaneously recurrent and chronic uveitis has provided new insights into the role of different T cell types in the eye and allowed us to develop and test new therapies in ongoing autoimmune reactions, as corresponding to the situation in uveitis patients. These new animal models also enabled the development of a small molecule dihydroorotate dehydrogenase (DHODH) inhibitor PP-001/KIO-100 for the treatment of uveitis, which inhibits lymphocytes but has no toxic effects on intraocular cells (in vivo: rat) and human retinal pigment epithelial cells (RPE, in vitro). This was followed by a successful phase I trial for patients with non-infectious posterior uveitis, by intraocular application of PP-001/KIO-100 - without side effects, but with improvement of visual acuity and reduction in inflammation and CME.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"571-583"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220185","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":"Predictive Factors for Disease Progression Following Corneal Crosslinking in Keratoconus: a Novel Approach Using Dynamic Progression Metrics.","authors":"Othmane Touirssa, Daniel Böhringer, Paola Kammrath Betancor, Stefan J Lang, Thomas Reinhard, Philip Christian Maier","doi":"10.1055/a-2815-9227","DOIUrl":"10.1055/a-2815-9227","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: To identify predictive factors for disease progression following corneal crosslinking (CXL) in keratoconus patients, focusing on tomographic, pachymetric, and patient-specific characteristics.</p><p><strong>Abstract: </strong>PATIENTS AND METHODS: This retrospective study analyzed 147 eyes from 123 keratoconus patients who underwent conventional epithelium-off CXL (3 mW/cm² for 30 min) between 2011 and 2021, with a minimum follow-up of 12 months. Baseline parameters included preoperative maximum keratometry (pre-Kmax), dynamic preoperative annualised Kmax progression (pre-ΔKmax), corneal thickness at the thinnest point (pre-CTT), age, sex, and atopic dermatitis. A Linear Mixed Model (LMM) identified predictors of postoperative annualised ΔKmax progression (diopters/year), while a Cox regression assessed risk factors for a single postoperative Kmax increase of > 1 diopter (D), and both approaches accounted for inter-eye correlation.</p><p><strong>Abstract: </strong>RESULTS: In the LMM, atopic dermatitis showed a trend toward a higher rate of postoperative Kmax progression (β = 0.00379, p = 0.093), corresponding to an estimated increase of + 1.38 D per year. In contrast, a higher rate of preoperative progression (pre-ΔKmax; β = - 0.0684, p = 0.074) and higher baseline Kmax (pre-Kmax; β = - 0.000173, p = 0.070) demonstrated trend-level associations with reduced annual postoperative progression, reflecting greater corneal flattening over time. However, in Cox regression, higher pre-Kmax demonstrated a trend-level association with an increased risk of a single postoperative progression event (HR = 1.05; 95% CI: 0.99 - 1.10; p = 0.095). Age, sex, and pre-CTT showed no significant associations in either model.</p><p><strong>Abstract: </strong>CONCLUSION: Atopic dermatitis was identified as a potential risk factor for keratoconus progression following CXL, and showed a trend-level association with a higher annual Kmax increase. Paradoxically, while higher pre-Kmax increased the risk of isolated progression events, it was simultaneously associated with a greater long-term flattening trend. Additionally, a rapid rate of preoperative progression was associated with a greater stabilising effect, suggesting that these corneas may be particularly responsive to treatment. These findings underscore the importance of integrating event-based and trend-based analytical approaches when interpreting post-CXL outcomes and their associated predictive factors.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"243 5","pages":"595-602"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973405","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":"[Unilateral Fixed Pupil in an Intensive Care Unit].","authors":"Jonathan Mäder, Susan Gellendin, Marc Schargus, Daniel Salchow","doi":"10.1055/a-2845-2765","DOIUrl":"https://doi.org/10.1055/a-2845-2765","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"243 5","pages":"563-565"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973363","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 Retinal Disorders: Always Pay Attention to the Correct Affected Layer].","authors":"Vesna Bosic, Isabel Weinstein, Berthold Seitz, Alaadin Abdin","doi":"10.1055/a-2794-3079","DOIUrl":"10.1055/a-2794-3079","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030329","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":"Satisfactory Visual Outcome after IC-8 Intraocular Lens Implantation in a Patient with Keratoconus.","authors":"Algirdas Zabulis, Christoph Tappeiner, David Goldblum, Tamer Tandogan","doi":"10.1055/a-2819-6737","DOIUrl":"https://doi.org/10.1055/a-2819-6737","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"243 4","pages":"306-308"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729524","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":"Natural History of Keratoacanthoma: A Case of Spontaneous Regression in the Lower Eyelid.","authors":"Corina-Emilia Hornischer, Diana Sheridan, Barbara Wijker, David Goldblum","doi":"10.1055/a-2788-5304","DOIUrl":"10.1055/a-2788-5304","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"280-281"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213464","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}