Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"[Choroidal Melanoma in the Advent of Generative Artificial Intelligence - a Conversation with ChatGPT].","authors":"Aleksandr Martynov, Nikolaos E Bechrakis, Mael Lever","doi":"10.1055/a-2318-9946","DOIUrl":"10.1055/a-2318-9946","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"127-132"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158499","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":"Internal Limiting Membrane Peeling in Primary Rhegmatogenous Retinal Detachment: Functional and Morphologic Results.","authors":"Franziska Eckardt, Julian Klaas, Jakob Siedlecki, Benedikt Schworm, Leonie Franziska Keidel, Denise Vogt, Thomas Kreutzer, Siegfried Priglinger","doi":"10.1055/a-2441-7791","DOIUrl":"10.1055/a-2441-7791","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the influence of internal limiting membrane (ILM) peeling on the repair of proliferative vitreoretinopathy grade B (PVR B) primary rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>Thirteen consecutive eyes that underwent pars plana vitrectomy (ppV) with ILM peeling for PVR B (group 1) were matched to a cohort of 13 eyes with primary RRD without PVR and without ILM peeling (group 2). Minimum follow-up was 6 months, and all eyes were operated by the same surgeon. Preoperative characteristics (age, lens status, macula-ON/OFF) were similar in the two groups (p ≥ 0.113).</p><p><strong>Results: </strong>At the end of follow-up, reattachment rates were comparable, with 92.3% in group 1 and 92.3% in group 2 (p = 1.0). Postoperative epiretinal membrane formation based on OCT was significantly reduced by ILM peeling (p = 0.04). Visual acuity was also comparable (group 1: 0.26 ± 0.29, group 2: 0.15 ± 0.17 logMAR; p = 0.125).</p><p><strong>Conclusion: </strong>This study suggests that intraoperative removal of the ILM in PVR B RRD can improve functional and morphological outcomes to levels obtained in uncomplicated RRD without PVR. ILM peeling does not appear to negatively affect postoperative visual acuity. Studies with longer follow-up are warranted to gauge a potential positive impact.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 2","pages":"153-159"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414492","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":"Treatment-Related Complications and Functional Results after Ruthenium-106 Brachytherapy in Small to Medium Size Uveal Melanomas (Part 2).","authors":"Fotios Lalos, Dirk Flühs, Maja Guberina, Norbert Bornfeld, Martin Stuschke, Wolfgang Sauerwein, Nikolaos E Bechrakis","doi":"10.1055/a-2275-5575","DOIUrl":"10.1055/a-2275-5575","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the treatment-related complications after ruthenium-106 brachytherapy in patients with uveal melanoma in terms of radiation-induced optic neuropathy, maculopathy and retinopathy, radiation-related vitreous hemorrhage, and retinal detachment, as well as secondary glaucoma and radiogenic cataract. In addition, the course of visual acuity was analyzed.</p><p><strong>Patients/methods and materials: </strong>This retrospective study included 608 patients treated with ruthenium-106 brachytherapy between January 2008 and December 2010 at the Department of Ophthalmology, University Hospital Essen. The follow-up time was 11 years. The occurrence of the radiation-induced complications was analyzed using the Kaplan-Meier method. Cox regression was used for univariate and multivariate risk factor analyses. Hazard ratios were calculated for each variable.</p><p><strong>Results: </strong>Regarding the complications, 34% (N = 207) of the patients had no reported side effects or complications during follow-up. Radiation optic neuropathy was observed in 18.8% (N = 114) of the patients, with a median time to onset of 16 months (range: 3 - 78 months). Radiation maculopathy occurred in 8.2% (N = 50) after a median time of 17 months (range: 3 - 67 months). Radiation retinopathy was observed in 20.1% (N = 122), with a median time to onset of 21 months (range: 6 - 67 months). Secondary glaucoma developed in 9.7% of the patients (N = 53) and radiogenic cataract in 46.8% (N = 227). Vitreous hemorrhage (11.8%, N = 72) and scleral necrosis (2.1%, N = 13) occurred relatively rarely.</p><p><strong>Conclusion: </strong>The observed radiogenic complication rate is comparable with that reported in previous studies.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"116-126"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940173","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":"Management of Bilateral Primary Vitreoretinal Lymphoma: A Case Report and Review of the Literature.","authors":"Dimitrios Kalogeropoulos, Andrew John Lotery, Farid Afshar, Nigel Hall, Heytham Rezq, Abin Holla, Anthony Shinton, Stephen Lash, Bhaskar Gupta, Serafeim Antonakis","doi":"10.1055/a-2338-3304","DOIUrl":"10.1055/a-2338-3304","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"133-136"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759579","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":"Comparing Different Self-Tonometry Devices against Goldmann Applanation Tonometry - Special Focus on Biomechanical Properties of the Cornea.","authors":"Allam Tayar, Rico Großjohann, Andreas Stahl, Frank Tost","doi":"10.1055/a-2480-1772","DOIUrl":"10.1055/a-2480-1772","url":null,"abstract":"<p><strong>Background: </strong>Interest in self-tonometry as an additional component to glaucoma monitoring has been increasing for several years. Two self-tonometry devices, Ocuton S and iCare HOME, have seen clinical use, but reports are lacking as to how individual biomechanical corneal properties might influence readings. We compared the two devices against Goldmann applanation tonometry (GAT) as a reference method.</p><p><strong>Patients and methods: </strong>Intraocular pressure (IOP) was measured by GAT and the two self-tonometers, Ocuton S*TT-MV and iCare HOME, on 108 patients with glaucoma, suspected glaucoma, or ocular hypertension at different times in alternating order during diurnal profiling for intraocular pressure. Corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF) were recorded using an Ocular Response Analyzer^® (ORA) to determine biomechanical corneal properties.</p><p><strong>Results: </strong>We first determined measurement deviations using GAT as the established reference method. The mean difference was - 1.73 ± 2.84 (- 3.95 - 7.41 mmHg) between iCare HOME and GAT, and + 1.49 ± 2.9 mmHg (- 7.29 - 4.31 mmHg) between Ocuton S*TT-MV and GAT. Differences between iCare HOME readings within measurement sequences were statistically significant (p < 0.001). Ocuton S*TT-MV did not show any significant difference from GAT using the measurement sequence (p = 0.262; p = 0.063). In contrast, previous tonometry measurements exerted a significant influence on iCare HOME readings. We found a significant correlation in both self-tonometers with corneal thickness on investigating the possible impact of biomechanical corneal properties on self-tonometry results. The impact of corneal thickness on readings was moderate to strong in iCare HOME. IOP values measured using both self-tonometers correlated significantly with CRF values (p < 0.001). Ocuton S*TT-MV values also correlated significantly with CH values (p = 0.024), unlike iCare HOME (p = 0.853).</p><p><strong>Conclusion: </strong>We consider differences in readings using the two self-tonometers compared against GAT as the established reference method to be within acceptable tolerances. Monitoring changes in readings using either device over an extended period - such as gradual increases in intraocular pressure values - is far more important in clinical practice. The measurement sequence requires special consideration due to interplay between measurement methods when comparing readings from different tonometers. We recommend taking iCare HOME readings before applanation tonometry. Biomechanical corneal properties especially need to be considered in iCare HOME and Ocuton S*TT-MV self-tonometers. CRF values affect readings from both self-tonometers. CH values should also be considered when interpreting readings from Ocuton S*TT-MV.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"137-145"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682109","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":"Prospektives internationales Register für Treatment Exit Options in Uveitis (TOFU) – die ersten fünf Jahre.","authors":"Carsten Heinz, David J Fink, Jennifer Dell, Moritz Berger, Matthias Schmid, Robert P Finger","doi":"10.1055/a-2529-0057","DOIUrl":"https://doi.org/10.1055/a-2529-0057","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066454","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":"https://doi.org/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":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-28","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}

{"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":"https://doi.org/10.1055/a-2463-0967","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","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}