Klinische Monatsblatter fur Augenheilkunde最新文献

{"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}

{"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":"https://doi.org/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":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","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":"Cat Eyes - Iris Capture as Unusual Complication after Implantation of the Phakic Posterior Chamber Intraocular Lens.","authors":"Jascha Wendelstein, Tamara Wolfinger, Theo G Seiler, Kamran M Riaz, Marina Casazza, Isaak Fischinger, Thomas Kohnen, Matthias Bolz","doi":"10.1055/a-2480-7584","DOIUrl":"10.1055/a-2480-7584","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":"142687431","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":"Evaluation of Tele-Education in Malawi for Detection of Macular Features Using Optical Coherence Tomography.","authors":"Thokozani Zungu, Shaffi Mdala, Halima Sumayya Twabi, Petros Kayange, Faik Gelisken","doi":"10.1055/a-2441-7861","DOIUrl":"https://doi.org/10.1055/a-2441-7861","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to assess the reliability of tele-education in training a Malawian ophthalmology resident to interpret optical coherence tomography (OCT) images of patients with macular conditions.</p><p><strong>Methods: </strong>This was a retrospective analysis of 1000 macula-centered OCT image series from 1000 eyes of 1000 consecutive patients from Malawi, which involved initial interpretation by a German retina specialist (observer 1) (T₀). Observer 1 then trained a Malawian resident (observer 2) via email, and observer 2 independently interpreted images at T₁, followed by face-to-face training in Malawi and reinterpretation at T₂ and T₃ (3-month intervals). The observers had to recognize, on OCT imaging, the normal macular structure, vitreofoveal traction (VFT), absent fovea depression (FD), epiretinal membrane (ERM), lamellar macular hole (LMH), full-thickness macular hole (FTMH), foveoschisis, intraretinal pseudocyst (IPC), intraretinal hyperreflective foci (IHF), subretinal fluid (SRF), pigment epithelial detachment (PED), and drusen. Cohen's Kappa statistic measured inter-observer agreement.</p><p><strong>Results: </strong>At T₁ post-tele-education, almost perfect agreement (κ = 0.86; 99.6% agreement) was observed for FTMH. Agreement remained high at T₂ post-face-to-face training (κ = 0.9; 99.7%) and decreased substantially at T₃ (κ = 0.77; 99.4%). Following tele-education (T₁), substantial agreement (κ range: 0.77 - 0.86) was found for IPC, PED, IHF, and FD, while ERM showed fair agreement (κ = 0.33; 81%). Face-to-face training notably improved agreement for SRF (T₁ κ = 0.6, T₂ κ = 0.63), LMH (T₁ κ = 0.6, T₂ κ = 0.67), and normal macular structure (T₁ κ = 0.6, T₂ κ = 0.62).</p><p><strong>Conclusion: </strong>There was good agreement in the detection of the majority of the OCT features seen in most of the macular pathologies following training through tele-education and the results did not change significantly following face-to-face teaching. Tele-education could reliably complement training in vitreoretinal diagnostic skills in resource-limited settings.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029127","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":"Comment on Artificial Intelligence in Neovascular Age-Related Macular Degeneration.","authors":"Thiago Gonçalves Dos Santos Martins","doi":"10.1055/a-2487-5978","DOIUrl":"https://doi.org/10.1055/a-2487-5978","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007955","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":"Corneal Stress Distribution Using the Procedure of Goldmann Applanation Tonometry, as Tested on a Human Cornea Model.","authors":"Javier Gonzalez-Toscano, Francisco Gonzalez","doi":"10.1055/a-2490-7056","DOIUrl":"10.1055/a-2490-7056","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effect of corneal thinning and changes in intraocular pressure (IOP) on the distribution of corneal stress induced by Goldmann applanation tonometry (GAT).</p><p><strong>Methods: </strong>A 2D model of a human cornea was created using a computer-aided design and finite element analysis software, employing previously reported corneal biomechanical properties. The GAT procedure was simulated, and the magnitude and distribution of stress in the corneal stroma were obtained for several corneal thicknesses, stiffnesses, and IOP.</p><p><strong>Results: </strong>A significant increase in stress was found in the outer and inner layers of the central cornea and in the inner layers of the surrounding central region. The maximal stress value was observed in the central outer layers when the stiffness was doubled, as in our theoretical baseline cornea (125.16 kPa). Minimal stress was observed in the central inner layers for a central corneal thickness of 300 µm (28.17 kPa). The thickness and stiffness of the cornea significantly influenced the magnitude of the stress, whereas the stress distribution in the cornea did not show significant changes. The change in IOP did not induce significant changes in either stress magnitude or stress distribution.</p><p><strong>Conclusions: </strong>The changes and distribution of corneal stress when a GAT procedure is performed support the idea that variations in corneal thickness and stiffness induce changes in corneal biomechanics that may be relevant for IOP readings. These findings are relevant for assessing IOP in corneas that have undergone surgical procedures or have diseases that alter their layers.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739512","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":"National Consensus on the Assessment of Visual Function for Driving in Switzerland.","authors":"Frank Blaser, Martina Schneebeli, Kristina H Keller, Matthias Pfäffli, Margarita G Todorova, Pierre-François Kaeser, Stefano Anastasi, Hannes Wildberger, Frank Bochmann, Sandrine Zweifel, Sadiq Said","doi":"10.1055/a-2479-9305","DOIUrl":"https://doi.org/10.1055/a-2479-9305","url":null,"abstract":"<p><strong>Purpose: </strong>To establish a national consensus on assessing visual function for fitness to drive in Switzerland.</p><p><strong>Methods: </strong>The minimum medical requirements for visual function for fitness to drive are regulated by Swiss Federal Law, namely, by the Traffic Licensing Ordinance (TLO). The medical examination techniques relevant in this context and their assessment are not further specified therein, which leads to legal inequality among drivers and uncertainty among examiners. We established a study group of representatives of the Traffic Medicine Section of the Swiss Society of Forensic Medicine and the Traffic Commission of the Swiss Society of Ophthalmology to develop a national consensus on assessing visual function for fitness to drive in Switzerland. In structured meetings, the authors discussed medical examination techniques and available international and local recommendations on this topic, with respect to Swiss legislation. In the event of a contrary opinion, the topic was discussed again in a follow-up session until we reached an agreement. We defined consensus as complete agreement on the subject under discussion.</p><p><strong>Results: </strong>The study group held five in-person meetings between March 2019 and January 2023. The authors developed recommendations intended for all professional groups assessing driving fitness. We prepared an aid for daily practice on how to examine the minimum medical requirements for visual function listed in the TLO Annex 1, using standardized test procedures and considered how to interpret the findings obtained, accounting for aspects of traffic medicine and ophthalmology.</p><p><strong>Conclusions: </strong>A consensus on the assessment of visual function for fitness to drive in Switzerland is crucial to ensure legal equality for drivers and legal certainty for examiners. Regular review of the consensus is imperative if we are to consider future legal developments and new scientific evidence in assessing fitness to drive.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007957","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":"[Eye injuries and defective vision in school and club sports - Arguments for DIN-approved glasses suitable for school sports].","authors":"Gernot Jendrusch","doi":"10.1055/a-2288-3021","DOIUrl":"https://doi.org/10.1055/a-2288-3021","url":null,"abstract":"<p><p>Visual deficits/ametropia are particularly significant obstacles in sports because the visual system controls/corrects all of an athlete's movements. However, athletes are at increased risk for eye injuries caused by high-velocity objects e.g. balls or physical contact with opponents. This article presents the current (German) figures on eye injuries in club and school sports and evaluates the risk of eye injuries in various sports.2392 eye injuries, selected from the 221273 club sports injuries recorded in the Ruhr University Bochum and ARAG Sports Insurance database for the period 1987-2017 were evaluated. The school sports eye injuries recorded by the German Social Accident Insurance for 2019 were also analyzed.Of all the club sports injuries recorded, 1.08% were eye injuries; of these, 19.7% had to be treated in hospital, 13.9% required surgery, and 56.9% prevented the injured athletes from working. Blunt trauma was the most common cause of injury, comprising more than 50% of cases. Eye injuries were strongly overrepresented in club sports injuries sustained during water polo, squash, badminton, and tennis (injury proportion ratio [IPR] = 5.1-8.8). In school sports, eye injuries comprised 1.83% of the reported cases.Eye injuries in sports are relatively rare, but often serious. Based on the increased IPR found for some sports, further studies must analyze the risk of eye injury in more detail. Eye protection in the form of sport-appropriate glasses should be used.In addition, the article addresses the problem of \"defective vision in sport\" and its adequate correction and shows the requirements for spectacles suitable for (school) sport using the example of DIN 58184 \"Spectacles suitable for school sports - Requirements and test methods\".</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983916","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}