Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Exit Strategy for Treatment of Neovascular Age-Related Macular Degeneration in a Real-World Setting: Wishful Thinking?","authors":"Michael Eastline, Sadiq Said, Martina Monika Bosch, Pascal Knecht-Bosch","doi":"10.1055/a-2511-5899","DOIUrl":"10.1055/a-2511-5899","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze our outcome for patients with neovascular age-related macular degeneration (nAMD) treated with aflibercept in a treat-and-extend regimen pursuing an exit strategy (with best possible adherence to the \"Bern\" exit criteria) over 6 years in a real-world setting. The primary objective of the study was to investigate the proportion of patients who were able to achieve and maintain treatment exit.</p><p><strong>Methods: </strong>This is a retrospective chart review study of treatment-naïve patients diagnosed with nAMD receiving intravitreal aflibercept injections performed at our department with at least 2 years of follow-up visits. The primary outcome was the percentage of patients able to achieve and maintain the treatment exit regarding intravitreal anti-VEGF injections. Further outcome measures were best-corrected visual acuity (BCVA), incidence of recurrence after treatment cessation, duration of therapy, and number and intervals of injections.</p><p><strong>Results: </strong>There were 31 eyes of 25 patients included in this retrospective study. The observation period was from September 1, 2017 to August 31, 2023. Of all included patient eyes, 22.6% (n = 7) reached exit criteria. Of all the \"exit\" patients, 28.6% (n = 2) suffered from disease relapse and therapy was restarted at a mean (± SD) of 41.5 ± 12.5 weeks (range: 29 to 54 weeks). Regarding the eyes that met treatment exit, 5 of 31 (16.1%) had no disease recurrence in the observed study period. The median BCVA (Snellen decimal; ± interquartile range: IQR) changed from 0.63 (0.27) at baseline to 0.63 (0.4) in the first year, 0.63 (0.3) in the second year, 0.63 (0.46) in the third year, 0.63 (0.3) in the fourth year, 0.63 (0.4) in the fifth year, and 0.4 (0.04) in the sixth year. The median number of injections (± IQR) per eye in the first year of treatment was 8 (2), in the second year 5 (2), in the third year 5 (2.5), in the fourth year 5 (1), in the fifth year 3 (0.8), and in the sixth year 3 (0). Extension of the treatment interval after the loading phase in weeks was achieved up to a median (± IQR) of 5.8 (4) in the first year, 8.4 (6) in the second year, 8 (5.7) in the third year, 9.4 (5.6) in the fourth year, 7 (6.9) in the fifth year, and 8.4 (3.1) in the sixth year of observation.</p><p><strong>Discussion: </strong>Our study indicates a lower rate of patients reaching exit criteria with a treat-and-extend regimen compared to clinical study settings, and a similar recurrence rate of nAMD after treatment cessation. Nonadherence to a strict treat-and-extend protocol might influence the result.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"398-404"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256139","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":"Investigation of Endothelial Cell Density after PreserFlo Implantation Compared to Contralateral Eyes without PreserFlo Implantation - A Retrospective Analysis.","authors":"Ellen Grobshäuser, Antonio Cunha Vaz Martinho, Zisis Gatzioufas, Pascal Hasler, Peter Maloca, Konstantin Gugleta","doi":"10.1055/a-2495-8580","DOIUrl":"10.1055/a-2495-8580","url":null,"abstract":"<p><strong>Background: </strong>Loss of corneal endothelial cells after glaucoma surgery can lead to corneal decompensation and reduced vision. This loss may be accelerated by drainage implants like PreserFlo, which allow controlled subconjunctival filtration. In a retrospective analysis, we examined its impact on corneal endothelial cell density (ECD).</p><p><strong>Patients and methods: </strong>Data from medical records for 94 eyes were retrospectively analyzed. This included 47 PreserFlo-operated eyes and 47 contralateral control eyes. Inclusion criteria were open-angle glaucoma, laser trabeculoplasty as the only prior glaucoma surgery, and a contralateral control eye without any previous glaucoma surgeries and without any relevant diseases. Only standalone procedures and pseudophakic eyes were considered. We included 48 eyes at 2 weeks (24 operated, 24 control eyes), 72 at 3 months (36 each), 34 at 1 year (17 each), and 36 at 3 years (18 each).</p><p><strong>Results: </strong>Preoperatively, the 47 eyes that were planned for surgery had a mean ECD of 2141 ± 527 cells/mm², and the 47 control eyes had an ECD of 2114 ± 561 cells/mm². Two weeks postoperatively, ECD decreased by 5.4% in the operated eyes and increased by 1.1% in the control eyes. After 3 months, endothelial cell loss (ECL) was 3.6% (operated) and 1.9% (controls). After 1 year, ECL was 11.7% (operated) and 5.6% (controls); after 3 years it was 7.6% (operated) and 2.9% (controls). No significant differences in ECL dynamics between the operated and control eyes were detected by the analysis of variance.</p><p><strong>Conclusion: </strong>Although there was a trend to accelerated ECL in operated eyes compared to controls, this difference was not significant. Overall, the Preserflo procedure appears safe as regards to its influence on endothelial cell count.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"392-397"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052769","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":"Long-term Therapy Results of Topical Dorzolamide Treatment in Enhanced S-Cone Syndrome.","authors":"Dmitri Artemiev, Margarita G Todorova","doi":"10.1055/a-2495-8656","DOIUrl":"10.1055/a-2495-8656","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"432-434"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391228","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":"Primary Meningococcal Keratoconjunctivitis in an 11-Year-Old Child.","authors":"Dilsah Körpe, Walter Ferrini","doi":"10.1055/a-2493-8811","DOIUrl":"https://doi.org/10.1055/a-2493-8811","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 4","pages":"316-317"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000337","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":"Automated Measurement of Strabismus Angle Using a Commercial Virtual Reality Headset.","authors":"Rino Vicini, Dominik Brügger, Hilary Grabe, Mathias Abegg","doi":"10.1055/a-2466-0284","DOIUrl":"10.1055/a-2466-0284","url":null,"abstract":"<p><p>Current clinical measurements of strabismus angles (SAs) are manual and require a skilled examiner and active cooperation by patients. This results in high interexaminer variability, and clinical use is limited by the availability of trained examiners. An objective and automated procedure, independent of the examiner, would be useful. This single-center, prospective, diagnostic feasibility study compared the vertical and horizontal SA of patients, as measured with a commercially available virtual reality headset (VRH) and custom software with the gold standard measurements performed manually with the Harms tangent screen (HW) and the alternate prism cover test (ACT). We implemented the ACT by showing the patient a fixation target on each eye alternatively with the VRH while recording the eye position of the patient. We then processed the data with custom written software to calculate the SA of the patients. These measurements were then compared to the SA measured with HW and the clinical ACT. Thirty-three patients took part in our study. We found good correlation between the VRH method and the HW as well as the clinical ACT. Best correlation was found for horizontal SA in the primary position, with the vertical SA in the primary position also correlating well. Peripheral gaze resulted in a slightly lower correlation due to the overestimation of horizontal SA and underestimation of vertical SA; cyclorotation was not measured with the VRH. Overall, VRH, HW, and clinical ACT correlated similarly well as the published interexaminer correlation for ACT. The automated measurement of strabismus with a VRH is feasible, easily applicable, fast, accurate, and can be run on consumer hardware that is affordable and increasingly available.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"485-488"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854655","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 Acute Serous Retinal Detachment with Pachychoroid Following Postpartum Haemorrhage: A Case Report.","authors":"Enrico Meduri, Ariane Malclès, Gabriele Thumann, Giorgio Enrico Bravetti","doi":"10.1055/a-2542-5369","DOIUrl":"https://doi.org/10.1055/a-2542-5369","url":null,"abstract":"<p><strong>Purpose: </strong>To elucidate the development and resolution of a unilateral acute serous retinal detachment (SRD) in a healthy patient following a complicated postpartum haemorrhage. This underscores the impact of systemic volume alterations and stress-induced factors on retinal fluid balance.</p><p><strong>Background: </strong>Postpartum SRD is observed in individuals with pre-eclampsia and patients with previously diagnosed central serous chorioretinopathy, both attributed to hormonal and volumetric fluctuations during pregnancy.</p><p><strong>Case description: </strong>A 33-year-old woman presented with metamorphopsia and blurry vision in her left eye 24 hours following childbirth complicated by haemorrhagic shock. Notably, the patient had pre-delivery physiological vital signs with no alterations of consciousness, arterial blood pressure, or renal function. At presentation, the visual acuity in the left eye was 1.0 decimals and the anterior segment was within normal limits, while fundoscopy revealed a slight alteration in the foveal reflex. Spectral-domain optical coherence tomography (SD-OCT) revealed the presence of a dome-shaped SRD in the foveal region with a central foveal thickness of 279 µm and pachychoroid at 410 µm retro-foveally. The examination of the right eye and SD-OCT were unremarkable, except for the presence of pachychoroid at 367 µm retro-foveally. No treatment was initiated. At 48 hours, SD-OCT scans revealed complete resorption of the SRD in the left eye with a persistent focal alteration in the foveal region of the ellipsoid zone. Retro-foveal choroid thickness (RCT) was unchanged. At one month, visual acuity remained stable, and the patient was no longer symptomatic. The left eye SD-OCT revealed a reduction in CFT (279 µm vs. 224 µm, a 20.2% reduction) and RCT (410 µm vs. 360 µm, a 14.6% reduction) compared to baseline. Remarkably, the right eye also exhibited a 14.9% reduction in RCT (367 µm vs. 309 µm).</p><p><strong>Conclusion: </strong>This case highlights the role that postpartum systemic changes and complications can play in the occurrence of retinal and choroidal changes. We believe that in this specific case, the development of acute SRD was probably due to oncotic fluctuations related to the hypovolaemic status following postpartum haemorrhage. This also emphasises the utility of SD-OCT for assessment and follow-up monitoring, providing valuable insights into retinal and choroidal changes over time.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 4","pages":"413-417"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979069","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":"Bilateral Candida Endophthalmitis - Successful Treatment by Single Amphotericin B Injection in Combination with Systemic Antimycotic Treatment.","authors":"Saskia Lindau, Pascal W Hasler, Hanna Zuche","doi":"10.1055/a-2542-3747","DOIUrl":"https://doi.org/10.1055/a-2542-3747","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 4","pages":"463-465"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033810","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":"Sterility Assessment of Reclosable Ophtioles with Unpreserved Autologous Serum during Single-Day Use.","authors":"Frank Blaser, Isabelle Meneau, Jürg Wiedler, Olga Lamprecht, Daniel Barthelmes, Sandrine Zweifel, Philip Perschak, Maximilian Robert Justus Wiest, Fabienne Fierz, Sadiq Said, Anahita Bajka","doi":"10.1055/a-2496-7289","DOIUrl":"https://doi.org/10.1055/a-2496-7289","url":null,"abstract":"<p><strong>Background: </strong>According to the European Pharmacopoeia, multidose containers for eye drops must either contain antimicrobial agents, preservatives, or be fitted with filters or non-return valves to prevent microbial contamination after opening. Vials for single-day use do not have filters or non-return valves. The aim of this study is to demonstrate the safety of reclosable vials (ophtioles) containing unpreserved autologous serum eye drops (ASEDs) by evaluating their sterility during single-day use.</p><p><strong>Material and methods: </strong>Two types of reclosable ophtioles were evaluated, one with a screw cap (Meise System, Heinz Meise GmbH, Schalksmühle, Germany) and the other one with a plug cap (COL System, BIOMED DEVICE S. R. L., Modena, Italy). Drop application over 12 hours was simulated in the laboratory following the manufacturer's instructions. For the Meise System, drops were applied at 2-hour intervals, while for the COL System, drops were applied at 1-hour intervals. Each application involved inoculating a chocolate-agar PolyViteX plate (PolyViteX, bioMérieux SA, Marcy-l'Étoile, France) with two drops spaced apart on the same plate and then incubating the plate. After 24 hours, a final inoculation was performed to check for sterility, and the plates were scored after 24 and 48 hours of incubation.</p><p><strong>Results: </strong>In the Meise System test series, 12 vials were tested, providing 192 measurements over 12 hours with a 2-hour application interval. With the COL System, 16 vials were tested, resulting in 448 measurements with a 1-hour application interval over 12 hours. Neither the Meise nor the COL System showed contamination of any application after 24 hours of incubation. After 48 hours of incubation, two vials of the Meise System showed a contamination in one measurement, but subsequent applications were sterile again. In the COL System, nine measurements in seven vials were positive. In three of these vials, the last application at 24 hours showed contamination after 48 hours of incubation, where no further drops were applied.</p><p><strong>Conclusion: </strong>The study confirms the sterility of ASEDs in two reclosable types of ophtiole systems during single-day use in laboratory-simulated conditions within 12 hours of application and 24 hours of incubation time. This is consistent with our several years of clinical experience of the absence of ocular infections caused by the use of ASEDs in the described ophtioles.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 4","pages":"304-309"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031319","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":"Buckle Dislocation Mimicking Eyelid Tumor.","authors":"Eleftherios Chatzimichail, Peter Meyer, Zisis Gatzioufas, Alexandra Steinemann-Inauen","doi":"10.1055/a-2506-9381","DOIUrl":"10.1055/a-2506-9381","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"459-460"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523782","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":"The Impact of Changing Physicians on Compliance with Management of Myopia Progression.","authors":"Fabian Schibli, Anja Palmowski-Wolfe","doi":"10.1055/a-2493-9295","DOIUrl":"10.1055/a-2493-9295","url":null,"abstract":"<p><strong>Background: </strong>The global incidence of high myopia is increasing, with projections indicating a rise from 3 to 10% of the global population by 2050. Effective treatment options exist to reduce myopia progression, but their success is contingent on patient adherence. This study assesses the impact of changes in treating physicians on adherence to therapy to control myopia progression.</p><p><strong>Patients and methods: </strong>This retrospective observational study analyzed data from the Myopia Clinic at the University Eye Hospital of Basel from 2020 to 2023. Adherence rates were compared between consultations with and without a change in the treating physician, as well as between resident and senior physicians. Statistical analysis was performed using unpaired t-tests and chi-squared tests.</p><p><strong>Results: </strong>A total of 73 patients, with a mean age of 10.76 years, who had at least three axial length measurements were included. Overall, 84.79% of consultations adhered to the recommended treatment. A significantly higher nonadherence rate of 21.43% was observed in consultations following a change in physician, compared to 6.42% with physician stability (p = 0.0037). Nonadherence was also higher with resident physicians (18.31%) compared to senior physicians (8.70%; p = 0.0310). No significant difference in adherence was found between optical and medical treatment options (p = 0.6293). Age and gender did not significantly influence adherence.</p><p><strong>Discussion: </strong>The study reveals a significant negative impact of physician changes on patient adherence in therapy to control myopia progression control. The findings emphasize the importance of consistent physician care, particularly in avoiding frequent rotations among resident physicians, in order to enhance treatment adherence. While the study's limitations include a small sample size and single-center data, the results suggest that strategies to minimize changes in treating physicians could improve adherence outcomes.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"435-437"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059733","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}