Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Orbital Floor Fractures in Germany: Interdisciplinary Care without a Uniform Standard - Results of a Multicentre Survey.","authors":"Christoph Holtmann, Mathias Roth, Gesine Szurman, Ulrike Grenzebach, Norbert Schrage, Christian Brinkmann, Bettina Wabbels, Burkhard Dick, Markus Kohlhaas, Gernot Freißler, Marc Schargus, Lutz Hesse, Johann Roider, Agata Anna Wykrota, Arthur Müller, Gangolf Sauder, Frank Tost, Jürgen Walther, Andreas Scheider, Mathias M Maier, Kathi Hartmann, Eckart Bertelmann, Christoph Hintschich, Markus Ladewig, Anja Eckstein, Thomas Reinhard, Michael P Schittkowski, Alexander C Rokohl, Ludwig Maximilian Heindl, Ina Sterker, Salvatore Grisanti, Giulia Renieri, Heike Maria Elflein, Tobias Brockmann, Patrizia Krauss, Karsten Hufendiek, Volker Besgen, Katja Ruediger, Jens Heichel, Arne Viestenz, Maria Borrelli, Gerd Geerling","doi":"10.1055/a-2642-2470","DOIUrl":"10.1055/a-2642-2470","url":null,"abstract":"<p><strong>Objective: </strong>Surgical treatment of orbital floor fractures (OFF) in Germany is performed by several subspecialties. In an emergency setting, the question of necessity and urgency of surgery is frequently answered without ophthalmological consultation.</p><p><strong>Purpose: </strong>The aim of this survey was to investigate the current management of OFF in German centres with emergency care, among the members of the national oculoplastic society (Section Ophthalmoplastic and Reconstructive Surgery [SORC]).</p><p><strong>Methods: </strong>An 11-question questionnaire was sent to the main ophthalmology departments and members of the Section for Ophthalmic Reconstructive Surgery (SORC). Open (2), semi-open/multiple choice variant with multiple choice (6) and closed/dichotomous questions were used (3).</p><p><strong>Results: </strong>The questionnaire response rate was 36.3% (37/102). Patients with OFF are treated by oral and maxillofacial surgeons at 86.1% of the sites and by ear, nose and throat specialists (in some cases interdisciplinary) at 25% of the sites. When the indication for surgery was made, the orthoptic status was only carried out at 72% of the sites and preoperative imaging was carried out at 75%. At 58.3% of the sites, OFF correction was also performed without any preoperative clarification by an ophthalmologist, predominantly in cases of polytrauma. The time of surgery was between 0 and 25 days, with a median of 7 days after the accident (8 ± 6 days).</p><p><strong>Conclusions: </strong>In Germany, the initial surgical treatment of OFF is predominantly performed without prior ophthalmologic consultation and not by ophthalmologists. As early reconstruction can cause considerable individual ophthalmologic loss of function, it is important to promote interdisciplinary cooperation and, in particular, the corresponding oculoplastic care expertise in ophthalmology in order more reliably to avoid inadequate indications. The development of an interdisciplinary S2 guideline and the establishment of a national registry for orbital floor fractures appear to be urgently required to improve the quality of care.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"927-934"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484911","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":"[Correction: Comparative Surface Imaging Study of Multifocal Diffractive Intraocular Lenses].","authors":"Hyeck Soo Son, Jung Min Lee, Ramin Khoramnia, Chul Young Choi","doi":"10.1055/a-1696-6077","DOIUrl":"10.1055/a-1696-6077","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"e5"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39647256","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":"Causes of Treatment Discontinuation in Retinal Diseases Treated with Intravitreal Injections.","authors":"Alaa Din Abdin, Nicolas Barakat, Wissam Aljundi, Yaser Abu Dail, Cristian Munteanu, Isabel Weinstein, Berthold Seitz","doi":"10.1055/a-2679-9763","DOIUrl":"https://doi.org/10.1055/a-2679-9763","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the most common reasons for treatment discontinuation in patients with retinal diseases undergoing intravitreal injections (IVI s).</p><p><strong>Methods: </strong>A retrospective study was conducted with all patients who underwent IVI therapy in our Department of Ophthalmology between January 2016 and January 2024. We investigated the reasons for therapy discontinuation, including non-persistence (declining therapy). Patients who declined therapy (non-persistence) were compared with the remaining patients to determine the potential factors responsible for their decision.</p><p><strong>Results: </strong>The mean age of the 2218 patients (1155 women, 1063 men) who took part in the study was 77.6 ± 12.0 years. A total of 1029 patients (46.4%) achieved a dry macula in both eyes at the time of the study. Treatment was discontinued in 865 patients (39%) due to poor prognosis (visual acuity < 1.3 logMAR) (188, 8.4%), change to another medical centre (175, 7.9%), comorbid systemic diseases (128, 5.7%), loss of contact (128, 5.7%), financial problems with health insurance (13, 0.5%) or death (59, 2.6%), while 174 patients (7.8%) declined IVI therapy (non-persistence). Compared to the other patients, non-persistence patients were significantly older (76.2 ± 12 vs. 81.2 ± 11, p < 0.001), had significantly worse visual acuity (logMAR) at the last visit (0.50 ± 0.5 vs. 0.29 ± 0.2, p = 0.001), received a significantly higher number of IVI s (10 ± 11 vs. 14 ± 15, p < 0.001) and had a significantly higher proportion following the pro re nata treatment protocol (59% vs. 72%, p = 0.001).</p><p><strong>Conclusion: </strong>The most common reason for treatment discontinuation was the poor prognosis, which related to the nature of macular diseases. Advanced age, higher number of injections, pro re nata protocol and reduced visual acuity during therapy were identified as factors that affected patient non-persistence to treatment.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959472","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":"Histological Characteristics of Patients with Chronic Dacryocystitis, Depending on the Presence of Advanced Dacryolithiasis.","authors":"Jens Heichel, Marie Elisabeth Burghardt, Hans-Gert Struck, Friedrich Paulsen, Mohammad Javed Ali, Arne Viestenz, Claudia Wickenhauser, Linda Dießel","doi":"10.1055/a-2635-2419","DOIUrl":"https://doi.org/10.1055/a-2635-2419","url":null,"abstract":"<p><strong>Background: </strong>Dacryoliths (DL) are found in up to 18% of patients with chronic dacryocystitis (CDC). In particular, the role of neutrophil granulocytes in stone development needs to be clarified.</p><p><strong>Material and methods: </strong>40 histological specimens from patients with CDC and existing lacrimal sac ectasia were examined. For this purpose, sections of the medial saccus wall were obtained during a transcutaneous dacryocystorhinostomy. Twenty samples showed CDC without DL (group 1), 20 patients showed advanced dacryolithiasis (group 2). The histological criteria (inflammation, fibrosis, lymphocytes, plasma cells, macrophages, neutrophil granulocytes) were scored (0 = not present; 1 = few; 2 = moderate; 3 = numerous/strongly pronounced).</p><p><strong>Results: </strong>The gender ratio was balanced (1 : 1; 10 female and 10 male patients per group) and the age difference between groups 1 and 2 was not significant (median 53 vs. 56 y; p = 0.482). The histological parameters showed no significant differences between groups 1 and 2 (inflammation: 39/36, p = 0.292; fibrosis: 21/20, p = 0.385; lymphocytes: 37/32, p = 0.149; plasma cells: 25/24, p = 0.407; macrophages: 19/17, p = 0.152; neutrophil granulocytes: 10/13, p = 0.197).</p><p><strong>Conclusions: </strong>The histological changes in the medial lacrimal sac wall are not dependent on the presence of dacryoliths. In particular, the presence of neutrophilic granulocytes is not increased in patients with long-standing dacryolithiasis.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959415","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":"[Artificial Intelligence in Retinology].","authors":"Sandra Liakopoulos, Martin Zinkernagel, Horst Helbig","doi":"10.1055/a-2579-7957","DOIUrl":"https://doi.org/10.1055/a-2579-7957","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 9","pages":"883-884"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085914","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":"Deep Learning-Based Retinal Layer Segmentation in Optical Coherence Tomography Scans of Patients with Inherited Retinal Diseases.","authors":"Franziska Eckardt, Robin Mittas, Nastassya Horlava, Johannes Schiefelbein, Ben Asani, Stylianos Michalakis, Maximilian Gerhardt, Claudia Priglinger, Daniel Keeser, Nikolaos Koutsouleris, Siegfried Priglinger, Fabian Theis, Tingying Peng, Benedikt Schworm","doi":"10.1055/a-2227-3742","DOIUrl":"10.1055/a-2227-3742","url":null,"abstract":"<p><strong>Background: </strong>In optical coherence tomography (OCT) scans of patients with inherited retinal diseases (IRDs), the measurement of the thickness of the outer nuclear layer (ONL) has been well established as a surrogate marker for photoreceptor preservation. Current automatic segmentation tools fail in OCT segmentation in IRDs, and manual segmentation is time-consuming.</p><p><strong>Methods and material: </strong>Patients with IRD and an available OCT scan were screened for the present study. Additionally, OCT scans of patients without retinal disease were included to provide training data for artificial intelligence (AI). We trained a U-net-based model on healthy patients and applied a domain adaption technique to the IRD patients' scans.</p><p><strong>Results: </strong>We established an AI-based image segmentation algorithm that reliably segments the ONL in OCT scans of IRD patients. In a test dataset, the dice score of the algorithm was 98.7%. Furthermore, we generated thickness maps of the full retinal thickness and the ONL layer for each patient.</p><p><strong>Conclusion: </strong>Accurate segmentation of anatomical layers on OCT scans plays a crucial role for predictive models linking retinal structure to visual function. Our algorithm for segmentation of OCT images could provide the basis for further studies on IRDs.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"903-911"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806585","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":"Artificial Intelligence in Neovascular Age-Related Macular Degeneration.","authors":"Lorenzo Ferro Desideri, Martin Zinkernagel, Rodrigo Anguita","doi":"10.1055/a-2413-6782","DOIUrl":"10.1055/a-2413-6782","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into the management of neovascular age-related macular degeneration (nAMD) presents a transformative opportunity in ophthalmology. In particular, deep learning (DL) models have shown remarkable accuracy in detecting nAMD, predicting disease progression and forecasting treatment outcomes. This review provides a comprehensive analysis of current AI applications in nAMD, focusing on the performance of these models in diagnostic tasks, including classification, object detection, and segmentation, as well as their potential to outperform human experts in specific domains. The review further explores how AI-driven predictive models can personalize treatment strategies by forecasting individual responses to therapies, such as anti-VEGF, and predicting the conversion from intermediate AMD to nAMD. Despite these promising developments, significant challenges remain, including the need for extensive datasets, seamless integration into clinical workflows, and ensuring the generalizability of AI predictions across diverse populations. Continued validation and the development of user-friendly AI tools are crucial for broader adoption and improved patient outcomes. In conclusion, identifying effective pathways to overcome these challenges will be essential as the field continues to evolve.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"894-900"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290303","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":"Correction: Endothelial Cell Density and Central Corneal Thickness following Penetrating Keratoplasty of Acanthamoeba Keratitis Patients - A Retrospective Cross-Sectional Observational Study.","authors":"Lei Shi, Fabian Norbert Fries, Kassandra Xanthopoulou, Tanja Stachon, Loay Daas, Elena Zemova, Achim Langenbucher, Berthold Seitz, Nóra Szentmáry","doi":"10.1055/a-1476-2036","DOIUrl":"10.1055/a-1476-2036","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"e6"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25608783","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":"Correction: Islet Co-Expression of CD133 and ABCB5 in Human Retinoblastoma Specimens.","authors":"Marco Zschoche, Sergej Skosyrski, Neele Babst, Mahdy Ranjbar, Felix Rommel, Maximilian Kurz, Aysegül Tura, Stephanie C Joachim, Norbert Kociok, Vinodh Kakkassery","doi":"10.1055/a-1697-7467","DOIUrl":"10.1055/a-1697-7467","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"e8"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39749899","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":"Development of Focal Choroidal Excavation in the Presence of Pachychoroid.","authors":"S Makino, Y Sato, M Takezawa, Y Shimizu","doi":"10.1055/a-2303-4324","DOIUrl":"10.1055/a-2303-4324","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"935-938"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874724","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}