Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Straylight-Based Evaluation of Glare in Two Presbyopia-Correcting Intraocular Lenses.","authors":"Frederick Kremser, Grzegorz Łabuz, Agnieszka Zielińska, Ramin Khoramnia, Gerd U Auffarth","doi":"10.1055/a-2913-2611","DOIUrl":"https://doi.org/10.1055/a-2913-2611","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Presbyopia-correcting intraocular lenses (IOLs) provide a complete spectrum of vision but frequently induce dysphotopsia due to multiple focal points and diffractive designs. Standard straylight assessments using a C-Quant meter at a 7° visual angle often show no significant differences between evaluated IOLs. Therefore, evaluating glare effects effectively requires device modifications to demonstrate differences across lower visual angles. This study evaluates glare from the diffractive designs of two presbyopia-correcting IOLs.</p><p><strong>Abstract: </strong>MATERIAL AND METHODS: This in vitro laboratory study assessed two IOL models: the Clareon PanOptix (Alcon) and the Tecnis Odyssey (J&J Vision). Straylight was measured using a modified C-Quant straylight meter, allowing evaluation at the standard 7° angle as well as lower angles of 2.5° and 3.5°.</p><p><strong>Abstract: </strong>RESULTS: At 7°, the Clareon PanOptix exhibited straylight of 0.29 ± 0.19 deg²/sr, while the Tecnis Odyssey showed an 8-fold higher value of 2.29 ± 0.60 deg²/sr. At 3.5°, the Clareon PanOptix measured 3.01 ± 0.88 deg²/sr, whereas the Tecnis Odyssey demonstrated more than twice the magnitude at 6.85 ± 0.68 deg²/sr. At the smallest angle of 2.5°, the Clareon PanOptix recorded 4.57 ± 0.12 deg²/sr. In contrast, the Tecnis Odyssey reached 9.34 ± 0.41 deg²/sr, approaching the reference value of a 65-year-old natural crystalline lens.</p><p><strong>Abstract: </strong>CONCLUSION: The Clareon PanOptix demonstrated substantially lower straylight values across all measured angles compared with the Tecnis Odyssey. This suggests a reduced potential for glare phenomena. Further research using validated patient-reported questionnaires is needed to correlate these objective findings with subjective visual disturbances.</p><p><strong>Abstract: </strong>QUINTESSENCE: in vitro straylight testing shows that the Clareon PanOptix IOL exhibits lower straylight levels than the Tecnis Odyssey across all measured angles. While clinical confirmation is needed, these findings suggest that the Clareon PanOptix may be associated with a lower risk of dysphotopsia related to its diffractive design.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759928","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":"Surgical Management of Malignant Eyelid Tumors: A Retrospective Analysis over 10 Years of Surgical Treatment in 1443 Consecutive Cases.","authors":"Patrick Thelen, Daniel Böhringer, Simone Nuessle, Thomas Reinhard, Rebecca Diehl, Hans Mittelviefhaus, Cornelius Wiedenmann","doi":"10.1055/a-2883-8986","DOIUrl":"10.1055/a-2883-8986","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Malignant eyelid tumors are the most frequent malignant tumors in ophthalmology. They threaten the patients' vision and, if not treated adequately, even the patients' life. Complete resection of the tumor is the standard of care, but poses unique surgical challenges, due to the anatomical and functional importance of the eyelid region.</p><p><strong>Abstract: </strong>MATERIAL AND METHODS: We retrospectively analyzed data of 1,443 consecutive patients with malignant eyelid tumors who were treated at the Eye Center, Medical Center - University of Freiburg between 2009 and 2019. Data were collected on tumor type, post-excisional size of the lid defect, frequency of re-excisions and reconstructive effort regarding surgical duration and complexity. Reconstructive duration was categorized by the time required for eyelid reconstruction and the complexity of the reconstructive procedures, as based on the operation and procedure codes (OPS).</p><p><strong>Abstract: </strong>RESULTS: The largest mean defect size (MDS) was seen in cases of malignant melanoma (MDS: 560 mm² (95% CI: 290 - 992 mm²). Re-excisions were most common in SGC (71%), then SCC and LM (both 53%). Regarding reconstruction duration, most patients (74%) required 30 - 90 minutes, with a minority needing less than 30 minutes (21%) or more than 90 minutes (5%). Reconstructive complexity was predominantly intermediate (54%), with 22% requiring low and 24% high reconstructive complexity.</p><p><strong>Abstract: </strong>CONCLUSIONS: The majority of malignant eyelid tumor reconstructions can be managed with surgical procedures that typically last between 30 and 90 minutes and have intermediate complexity, but surgeons must maintain expertise in complex reconstruction techniques for challenging cases.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"823-830"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397052","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 Tumors].","authors":"Miltiadis Fiorentzis, Nikolaos E Bechrakis, Tobias Kiefer","doi":"10.1055/a-2680-5849","DOIUrl":"10.1055/a-2680-5849","url":null,"abstract":"<p><strong>Abstract: </strong>Choroidal tumors comprise a heterogeneous group of intraocular lesions ranging from benign entities such as choroidal nevus and circumscribed choroidal hemangioma to malignant tumors including uveal melanoma and choroidal metastasis. Accurate differentiation is crucial, as management and prognosis exhibit significant variations.Choroidal nevi are the most prevalent benign intraocular tumors and are generally asymptomatic. However, a small subset of these nevi carries a risk of malignant transformation into melanoma. Risk stratification utilizing multimodal imaging criteria, such as the TFSOM-DIM and MOLES systems, is pivotal in clinical decision-making.Uveal melanoma represents the most common primary intraocular malignancy in adults and is associated with high metastasis rates, particularly to the liver. Prognosis depends on tumor size, location, histopathologic features, and molecular alterations such as monosomy 3 or BAP1 loss. Treatment options range from globe-preserving radiotherapy to adjuvant or neoadjuvant surgical resection and enucleation in advanced cases.Choroidal hemangioma is a benign vascular tumor that can lead to visual impairment due to exudative retinal detachment. Photodynamic therapy is currently considered the preferred treatment in symptomatic cases.Choroidal metastases represent the most prevalent intraocular malignancies, with a primary origin in breast or lung carcinoma. Multimodal imaging is essential for diagnosis and monitoring, and management requires interdisciplinary coordination.A structured multimodal diagnostic approach is crucial for accurate classification, risk assessment, and individualized therapeutic planning in patients with choroidal tumors.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"851-875"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474412","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":"[Quality Assurance in Optical Coherence Tomography for Fundus Diagnostics - Statement of the German Society of Ophthalmology (DOG), the German Retina Society (RG), and the German Professional Association of Ophthalmologists (BVA). Status: 7. March 2026].","authors":"","doi":"10.1055/a-2897-9995","DOIUrl":"https://doi.org/10.1055/a-2897-9995","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"243 8","pages":"809-822"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794940","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":"Supervised Automated Kinetic Perimetry (SAKP) Using Simulated Visual Field Data - Presentation of a New Examination Technique.","authors":"Ulrich Schiefer, Michael Wörner, Ditta Zobor","doi":"10.1055/a-2427-3556","DOIUrl":"10.1055/a-2427-3556","url":null,"abstract":"<p><strong>Abstract: </strong>PURPOSE: The aim of this study was to develop, optimise, train, and evaluate an algorithm for performing Supervised Automated Kinetic Perimetry (SAKP) using digitalised perimetric simulation data.</p><p><strong>Abstract: </strong>METHODS: The original SAKP algorithm was based on findings from a multicentre study to establish reference values by semi-automated kinetic perimetry (SKP) combined with an automated examination method with moving stimuli (\"Program K\", developed in Japan). The algorithm evaluated the outer angles of isopter segments and responded to deviations from expected values by placing examination vectors to measure the outer boundaries of the visual field (VF). Specialised interpolation methods were also used to create individual 3D hills of vision and local \"probing vectors\" to optimise the eccentricity of the vector origins. This algorithm was trained iteratively on seven representative digitalised 3D VF results from five typical classes and optimised in each step: (1) Normal VF, (2) Central scotoma, (3) Concentric VF constriction, (4) Retinal nerve fibre layer defects in the visual field (VFDs), (5) VFDs with respect to the vertical meridian. The optimised SAKP algorithm was then applied to a new set of twenty 3D VF results of varying origin and severity. The primary targets were measured in agreement between actual calculated VF expressed as accuracy (A), that is, the ratio between the area containing correct predictions and total area of predictions measured between 0 = worst and 1 = best, and examination duration (T). The results are given as median (and interquartile range). We also verified the test's robustness by varying individual error rates (ERs) and error magnitudes (EMs).</p><p><strong>Abstract: </strong>RESULTS: The median and interquartile range (IQR, in brackets) for the total of representative VFs were 0.93 (0.02) for A and 7.0 min (5.2 min) for T, respectively. A gave the best result for altitudinal VFDs and VFDs with hemianopic character and macular sparing (0.98 each) and worst in superior wedge-shaped VFDs (0.78); T was shortest in blind spot displacement (3.9 min) and longest in hemianopic VFDs with hemianopic character and macular sparing with preserved temporal crescent (12.1 min). Error rate and magnitude (up to 30% each) only showed a comparatively low influence on A and T.</p><p><strong>Abstract: </strong>CONCLUSION: The SAKP algorithm presented here achieves a comparatively high degree of accuracy and robustness for actual, simulated visual field data within acceptable examination times. This algorithm is currently being prepared for application in real patient examinations under clinical conditions.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"831-842"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792007","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":"Change in Corneal Endothelial Cells after Gonioscopy-Assisted Transluminal Trabeculotomy.","authors":"İhsan Çakır, Gizem Taşkın, Neşe Alagöz, Gülay Yalçınkaya Çakır, Çiğdem Altan, Tekin Yaşar","doi":"10.1055/a-2679-3120","DOIUrl":"10.1055/a-2679-3120","url":null,"abstract":"<p><strong>Abstract: </strong>PURPOSE: To examine the change in corneal endothelial cell density (ECD) after gonioscopy-assisted transluminal trabeculotomy (GATT) surgery alone or in combination with phacoemulsification (phaco).</p><p><strong>Abstract: </strong>METHODS: In this prospective monocentric comparative study, consecutive patients were enrolled with open angle glaucoma (OAG) and who had been treated with GATT or phaco + GATT, with complete endothelial cell data and at least 6 months of follow-up. Patients who underwent phaco surgery alone during the same period were recorded as the control group. The main outcomes were ECD changes.</p><p><strong>Abstract: </strong>RESULTS: The study included 64 OAG (40 eyes in the GATT and 24 eyes in the GATT + phaco groups) and 30 control eyes (phaco group). There was a significant decrease in mean ECD compared to baseline in the GATT, phaco + GATT, and phaco groups (p < 0.001 for all). At the end of follow-up, percent cumulative ECD reduction values were 6.89%, 14.47% and 10.32% in the GATT, phaco + GATT, and phaco groups, respectively (p = 0.01 for all groups). The ECD reduction in the phaco + GATT group (p = 0.02) and in the phaco group (p = 0.04) was significantly higher than in the GATT group. ECD reduction was similar in the phaco + GATT and phaco groups (p = 0.69).</p><p><strong>Abstract: </strong>CONCLUSIONS: A significant ECD loss was observed in 6 months period after GATT surgery compared to the baseline. The ECD reduction observed after GATT combined with phacoemulsification was greater than with GATT alone. There was no significant difference between phaco-GATT combined surgery and phaco alone.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"843-850"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799519","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: Corneal Neurotisation in Neurotrophic Keratopathy: A Retrospective Analysis of Functional Outcomes and Clinical Courses.","authors":"Patrick Thelen, Jakob B W Weiss, Thomas Reinhard, Wolf Alexander Lagrèze, Steffen U Eisenhardt, Philip Christian Maier","doi":"10.1055/a-2942-5992","DOIUrl":"https://doi.org/10.1055/a-2942-5992","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"243 8","pages":"e4"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850901","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":"An Eight-Year Review of Paediatric Ophthalmic Surgical Services at a Tertiary Eye Centre in Malawi.","authors":"Priscilla P Mhango, Lonjezo M Jemi, Vivien Mayer, Shaffi Mdala, Petros Kayange, Thokozani L Zungu, Gerald R Msukwa, Esther Misanjo, Faik Gelisken","doi":"10.1055/a-2915-2961","DOIUrl":"https://doi.org/10.1055/a-2915-2961","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Childhood visual impairment is a significant public health challenge, with prevalence rates in sub-Saharan Africa exceeding those in high-income countries. While surgical intervention is the mainstay of treatment for many blinding paediatric conditions, access to these services is constrained in low-resource settings. We report a comprehensive analysis of demographic and geographic patterns of paediatric ophthalmic surgical services at a tertiary eye centre in Malawi.</p><p><strong>Abstract: </strong>METHODS: A retrospective analysis of paediatric patients who underwent ophthalmic surgeries at Lions Sight First Eye Unit, Queen Elizabeth Central Hospital (QECH) in Southern Malawi, between January 2015 and December 2022 was undertaken. Demographic variables included age group, sex and distance travelled to reach the facility. Descriptive statistics summarised trends, and a chi-square test assessed the association between sex and distance travelled.</p><p><strong>Abstract: </strong>RESULTS: Of 3,807 identified patient files, 3,263 (85.7%) were eligible for analysis. A male predominance was observed (61.0% male vs 39.0% female), with a mean age of 5.7 (±4.4) years. The majority of children (<i>n</i> = 2783, 85.3%) were from the Southern region. More than half of the patients (52.6%, <i>n</i> = 1717) travelled over 50 km to reach QECH. A statistically significant association was found between sex and distance travelled (χ² = 14.46, <i>p</i> = 0.013). Annual surgical volumes plateaued during the study period.</p><p><strong>Abstract: </strong>CONCLUSION: Paediatric ophthalmic surgical services in Malawi are concentrated at a single tertiary facility, creating geographic disparities in access. The male predominance in the number of children accessing the surgical services across different paediatric eye diseases highlights the need for gender-sensitive community awareness initiatives to ensure equitable access to surgical eye care for all children. Furthermore, the surgical numbers failing to increase in line with the national population growth can be an indicator of an overwhelmed system. These findings emphasise the urgent need to establish additional specialised centres to overcome these barriers.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648588","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":"Seltene vaskuläre Erkrankungen der Netzhaut – Teil 2.","authors":"Kristina Pfau, Albrecht Lommatzsch, Clemens Lange, Andreas Schüler, Ulrich Kellner","doi":"10.1055/a-2878-5961","DOIUrl":"https://doi.org/10.1055/a-2878-5961","url":null,"abstract":"<p><strong>Abstract: </strong>Less frequent retinal disorders associated with vascular alterations frequently present a diagnostic and therapeutic challenge. Vascular alterations may develop either at the posterior pole or peripheral of the vascular arcades, while subjective signs and visual function loss usually develop when the macula is involved. The differential diagnosis includes myopic macular neovascularisation, macular telangiectasia type 1, MacTel 2, pseudoxanthoma elasticum with angioid streaks, retinal arterial macroaneurysms, Coats disease and the combination of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN syndrome). Due to the low prevalence, early signs are often overlooked or misdiagnosed, and the diagnosis is established when secondary complications develop. Early detection is of high relevance for the affected patients: treatment in early stages may avert severe and permanent visual function loss. The development of multimodal retinal imaging techniques including optical coherence tomography, optical coherence tomography angiography, and widefield fluorescein angiography has markedly improved the early detection and differential diagnosis of these disorders. Differential diagnosis and definition of the disease stage is mandatory for a treatment according to current guidelines, recommendations or clinical experience. Larger studies to define optimal treatment regimens require multicenter cooperation and are not available for all disorders mentioned. The present review provides a concise overview of the early diagnosis, differential diagnosis and stage-related treatment regimens of these less frequent retinal vascular disorders.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579198","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":"Near-Complete Structural and Functional Recovery in a Paediatric Case of Laser-Induced Maculopathy.","authors":"Batuhan Aksoy, Faik Gelisken, Daniel A Wenzel, Caroline J Wenzel","doi":"10.1055/a-2737-3674","DOIUrl":"10.1055/a-2737-3674","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438390","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}