Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Comparison of Analytical Methods for the Validation of the Sterility of Autologous Serum Eye Drops.","authors":"Frank Blaser, Isabelle Meneau, Jana Schneider, Jürg Wiedler, Hanspeter Hinrikson, Daniel Barthelmes, Sandrine Zweifel, Anahita Bajka, Sadiq Said, Maximilian Robert Justus Wiest","doi":"10.1055/a-2468-5416","DOIUrl":"10.1055/a-2468-5416","url":null,"abstract":"<p><strong>Purpose: </strong>For specific samples, there are different methods and requirements for testing sterility. Blood and blood products are analyzed using automated blood culture methods, while pharmacopeial sterility is assessed using membrane filtration or direct inoculation according to the European Pharmacopoeia (Ph. Eur. 2.6.1.) to detect microbial growth. As autologous serum eye drops (ASEDs) may be viewed as both a blood product and a classical drug, the Swiss legislator has classified these as non-standardizable drugs, and thus, the pharmacopeial requirements apply. This study investigates ASED preparations with respect to the performance of a common automated blood culture system, BD BACTEC, in detecting aerobic and anaerobic bacteria and fungi in ASED preparations, with pharmacopeial sterility testing using agar plate cultures.</p><p><strong>Methods: </strong>Based on the European Pharmacopoeia, we inoculated sterile filtered blood serum with BioBalls of the six reference strains at a low concentration of three colony-forming units per milliliter (CFU/mL). A test battery of three different BD BACTEC culture media (hereafter referred to as Trio-BACTEC : BD BACTEC Plus Aerobic/F-Medium, BD BACTEC Lytic/10 Anaerobic/F-Medium, BD BACTEC Mycosis IC/F-Medium) and three agar plates [Tryptic Soy Agar (TSA), Chocolate Blood Agar, Sabouraud's Dextrose Agar] were inoculated per strain. We incubated the Trio- BACTEC in the BD BACTEC Blood Culture System at 35 °C for 5 days, the TSA and Chocolate plates at 35 °C for 5 days, and the Sabouraud plates at 25 °C for 7 days. We confirmed positive growth signals by microscopy or MALDI-ToF mass spectrometry and included negative controls.</p><p><strong>Results: </strong>We detected all reference strains using BACTEC and agar plates. No growth was observed in the negative controls. Overall, growth detection by BACTEC and agar plates was comparable, except for <i>Aspergillus brasiliensis</i> and <i>Candida albicans</i>, which was detected after 1 day on solid media and after 2 days on BACTEC.</p><p><strong>Conclusion: </strong>This study demonstrates the comparability of sensitivity and detection speed using the automated blood culture method and agar plates for sterility validation of ASED, even at low bacterial and fungal contamination levels.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"298-303"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523784","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":"10.1055/a-2463-0967","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"461-462"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","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":"Inflammatory Choroidal Neovascularization in Pediatric Uveitis: A Case Series.","authors":"Amandine Gauderon, Chiara Eandi, Aikaterini Koryllou, Florence Hoogewoud, Katerina Theodoropoulou, Yan Guex-Crosier","doi":"10.1055/a-2467-1804","DOIUrl":"10.1055/a-2467-1804","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study is to describe clinical features, therapy, and outcome of children with inflammatory choroidal neovascularization (CNV).</p><p><strong>Methods: </strong>Retrospective case series of children seen at the Jules-Gonin Eye Hospital between 2000 and 2024 with macular choroidal neovascularisation secondary to ocular inflammation.</p><p><strong>Results: </strong>Four children (one male, three females) developed a retro-foveolar neovascular membrane after a median time of 2.5 months (range 1 - 16 months) following uveitis onset. The median age at presentation was 12 years (range 5 - 12 years). The CNV presentation was unilateral in all four cases, with three patients having posterior uveitis and one panuveitis. Two patients had idiopathic bilateral granulomatous uveitis while the other two had suspected toxoplasmosis chorioretinitis. Idiopathic cases were treated with oral steroids, with one patient being additionally treated with adalimumab. Toxoplasmosis cases were managed with antibiotics and oral steroids. CNV treatment involved a single anti-VEGF injection in two cases, six injections in one case, and no injection in one case due to CNV inactivity. Median follow-up period was 4.25 years (range 0.75 to 11 years) and the median final best-corrected visual acuity was 0.9 (range 0.6 - 1.25). No recurrence of CNV was observed, despite uveitis reactivation in two cases.</p><p><strong>Conclusion: </strong>Anti-VEGF therapy is safe even in young children with minimal injections required to control the disease. Treating the underlying cause of uveitis with appropriate therapy is also crucial.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"466-470"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391273","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":"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":"332-338"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","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}

{"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":"10.1055/a-2511-3586","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"293-297"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","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":"Unexpected Intracameral Foreign Bodies During Regular Cataract Surgeries.","authors":"David Goldblum, Tamer Tandogan","doi":"10.1055/a-2419-1850","DOIUrl":"10.1055/a-2419-1850","url":null,"abstract":"<p><strong>Background: </strong>Unexpected intracameral foreign bodies during regular cataract surgery appear relatively often but seem to be underreported, since they are almost often immediately removed. They rarely remain in the anterior chamber and can be the source of inflammation, infections, or lead to corneal endothelial decompensation. We report two series of cases with different materials of different origins and review the literature.</p><p><strong>Patients and methods: </strong>During several cases of uncomplicated phacoemulsifications under topical anesthesia, unknown foreign bodies visibly flushed in through the sleeve of the phaco handpiece. The material was always removed and submitted to the (Eidgenössische Materialprüfungs- und Forschungsanstalt; Federal Institute for Materials Testing and Research) for further investigations.</p><p><strong>Results: </strong>Spectral analysis revealed that, in our cases, the foreign bodies were remnants of otherwise intact phaco sleeves that had not been cleaned properly during production. In another case series, the resin granules from the water filtration system for the instrument washing machine had found their way into the phaco handpieces.</p><p><strong>Conclusion: </strong>Many shapes and materials of different origins might unexpectedly appear during cataract surgery in the eye. Their immediate extraction is necessary, as they might cause corneal endothelial damage, chronic inflammation, or could be the source of infections. Vigilance reporting is also important for the controlling medicinal organizations and companies to assure early recognition of systematic problems.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"353-356"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400677","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":"Presumed Ectopic Trilateral Retinoblastoma: Case Report.","authors":"Cecilia Clara Maria Mattavelli, Meriam Koob, Maja Beck-Popovic, Vincent Dunet, Francis Munier, Christina Stathopoulos","doi":"10.1055/a-2497-6568","DOIUrl":"10.1055/a-2497-6568","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"426-428"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567573","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 Foveal Herniation on Surgical Outcomes of Idiopathic Epiretinal Membrane Peeling: A Challenging Presentation.","authors":"Giacomo Edoardo Bravetti, Matteo Mandrioli, Luca Cappuccini, Giorgio Enrico Bravetti","doi":"10.1055/a-2511-6405","DOIUrl":"10.1055/a-2511-6405","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this report is to describe the visual symptoms and spectral-domain optical coherence tomography (SD-OCT) findings associated with foveal herniation with epiretinal membrane and to evaluate the postoperative visual, anatomical, and surgical outcomes.</p><p><strong>Background: </strong>Foveal herniation occurs when neuroretinal tissue protrudes through and above the level of an epiretinal membrane. The pathogenesis of foveal herniation is still unknown, though it is likely attributable to the centripetal contraction of the epiretinal membrane (ERM). Moreover, thinning of the prefoveolar internal limiting membrane (ILM) may further exacerbate this process by reducing the structural support for the retina in that area. In the literature, foveal herniation with ERM is rare and usually described as unilateral. Most cases present a good visual outcome after surgical intervention.</p><p><strong>Case description: </strong>We describe the case of a 37-year-old Caucasian male patient, without any previous ocular history, who presented with metamorphopsia and a sustained reduction visual acuity to his left eye that had persisted for several months. The baseline best-corrected visual acuity (BCVA) was recorded as 0.05 decimals. Anterior segment examination was unremarkable, while dilated fundoscopy revealed an ERM with a concentric ring of foveal tissue prolapse. SD-OCT showed the foveal tissue protruding through and above the ERM, demonstrating the severe foveal herniation. A diagnosis of idiopathic ERM with foveal herniation was established based on these findings. Subsequently, the patient was scheduled for surgical intervention to undergo pars-plana vitrectomy with ERM peeling. After the surgery, the patient experienced progressive restoration of the foveal anatomy and an improvement of vision to 0.6 decimals from baseline at 3 months.</p><p><strong>Conclusion: </strong>This case report shows a rare finding of foveal herniation with ERM. This atypical presentation is of important clinical relevance in drawing clinicians' attention to the possibility of these findings, with the goal to prevent erroneous diagnosis and unnecessary treatments. We demonstrate the visual improvement and gradual resolution of foveal herniation with SD-OCT images after ERM removal, and the images show that it may take a few months for the foveal bulge to decrease in height. When the outer retinal layers are normal, visual recovery, though delayed, is appreciable.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"451-454"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391259","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":"Prevalence of Ishihara Test Failures in a Large Cohort of Military Conscripts.","authors":"Veit Sturm, Gregor Jaggi, Margarita G Todorova, Jürg Messerli, Claudia Zawinka, Leila Sara Eppenberger","doi":"10.1055/a-2479-9147","DOIUrl":"10.1055/a-2479-9147","url":null,"abstract":"<p><strong>Purpose: </strong>Color vision deficiency (CVD) is a common vision disorder. It is predominantly caused by inherited photopigment abnormalities in the retina. The absolute number of cases with CVD is expected to increase worldwide with the growing population.</p><p><strong>Methods: </strong>Data from male military conscripts for the recruitment period of 2008 to 2017 were retrospectively analyzed. Year of recruitment, conscripts' birth year, visual acuity, refractive status (spherical equivalent), and color vision status (normal Ishihara pseudoisochromatic plates test yes/no) were available.</p><p><strong>Results: </strong>The dataset comprised data on a total of 355 657 male conscripts who had undergone recruitment between the years 2008 to 2017. The mean number of conscripts per year was 35 566 (MD = 35 440, SD = 1 249), reaching a minimum count of 33 998 conscripts in 2017 and a maximum of 37 594 in 2011. The mean age at recruitment was 19.7 years (MD = 19.0 y, SD = 1.1 y). Among the conscripts, 337 422 (94.9%) successfully passed the Ishihara test, while 18 235 (5.1%) were found to have CVD.</p><p><strong>Conclusion: </strong>The overall prevalence of CVD in our male cohort was 5.1%. This figure is slightly lower than that reported for a European Caucasian population.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"481-484"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052856","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":"Does Axial Length Influence the Dose Effect of Horizontal Strabismus Surgery?","authors":"Hatice Uecelehan, Anja Palmowski-Wolfe","doi":"10.1055/a-2511-3537","DOIUrl":"10.1055/a-2511-3537","url":null,"abstract":"<p><strong>Background: </strong>Dose effect (DE) of strabismus surgery is thought to decrease with increasing axial length (AL), and it has been suggested that this effect may be more important in hyperopes over + 2 D. Here, we analyse the influence of AL on the DE of horizontal strabismus surgery in regard to its clinical relevance.</p><p><strong>Methods: </strong>Retrospective chart analysis of patients who had undergone horizontal strabismus surgery between 2020 and 2023.</p><p><strong>Statistical analysis: </strong>descriptive analysis and ANOVA (R 4.1.2).</p><p><strong>Results: </strong>There were 65 patients (34 male and 31 female) included; mean age: 18.0 years (range 5 - 74). Mean AL was 23.50 mm (range: 20.80 - 28.50 mm). At the 3-month follow-up, 83.1% of patients demonstrated binocularity. Mean DE was 2.36 PD/mm at distance and 2.60 in near vision. There was no significant influence of AL on the DE of surgery (p = 0.30). However, DE was significantly higher in esotropia (n = 32) than exotropia (n = 33) in distant and near vision (p = 0.0 000 403) and in both groups, patients with positive binocularity had a significantly greater DE than patients without binocularity (p = 0.0032).</p><p><strong>Conclusion: </strong>Our data showed no significant correlation between AL and the DE of surgery, while the type of strabismus and binocularity had a significant influence on the DE of surgery. However, AL is still important for surgical planning, in particular, to assess the risk of a deviating muscle path or thin sclera in high myopia.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"475-477"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391186","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}