Rose M. Olson, A. Harrison, Amanda C. Maltry, Ali Mokhtarzadeh
{"title":"Erfolgreiche Behandlung eines periorbitalen nekrobiotischen Xanthogranuloms mit intravenösem Immunglobulin","authors":"Rose M. Olson, A. Harrison, Amanda C. Maltry, Ali Mokhtarzadeh","doi":"10.1159/000494042","DOIUrl":"https://doi.org/10.1159/000494042","url":null,"abstract":"Hintergrund: Das nekrobiotische Xanthogranulom (NXG) ist eine seltene Nicht-Langerhanszell-Histiozytose mit kutanen Manifestationen, die vor allem die periorbitale Haut betrifft und oft mit hämatologischen Erkrankungen wie beispielsweise einer monoklonalen Gammopathie assoziiert ist. Die Therapie des nekrobiotischen Xanthogranuloms gestaltet sich schwierig und wird häufig durch einen rezidivierenden und progredienten Verlauf erschwert. Vorstellung des Falls: Die Autoren beschreiben einen Fall von NXG mit periorbitaler Beteiligung bei einer Patientin mit einer omplexen Vorgeschichte an Autoimmun- und hämatologischen Erkrankungen. Aufgrund der Biopsieergebnisse dieser seltenen Läsion erfolgte eine Suche nach der Grunderkrankung, die zur Diagnose «Multiples Myelom» führte. Unter der Behandlung mit intravenösem Immunglobulin (IVIG) besserten sich die NXG-Läsionen der Patientin deutlich. Schlussfolgerungen: Dieser Fall unterstreicht, welche wichtige Rolle der Augenarzt bei der Diagnose und Behandlung des NXG spielt, da eine frühzeitige Erkennung nicht nur die Auswirkungen auf die Augen wie Augenperforation und Erblindung verhindern kann, sondern darüber hinaus auch Anlass für weitere Untersuchungen sein kann, die - wie im vorliegenden Fall - eine mögliche Grunderkrankung oder Systembeteiligung, einschließlich maligner hämatologischer Erkrankungen, aufdecken. In einer Handvoll berichteter Fälle wurde das NXG erfolgreich mit IVIG behandelt. Soweit den Autoren bekannt, ist dies der dritte Fall eines erfolgreich mittels IVIG behandelten periorbitalen NXG, und der erste Fall in der ophthalmologischen Literatur. Übersetzung aus Case Rep Ophthalmol 2018;9:70-75 (10.1159/000485913).","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124076535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rekonstruktion der Orbita nach Enukleation: Vor- und Nachteile von Hydroxyapatit- und Dermis-Fett-Implantaten","authors":"E. Bertelmann","doi":"10.1159/000494107","DOIUrl":"https://doi.org/10.1159/000494107","url":null,"abstract":"Purpose: We report 6 patients who received a hydroxyapatite (HA) orbital implant in the socket and developed chronic orbital inflammation unresponsive to conventional medical therapy. Case Reports: We assisted 6 cases (4 males, 2 females) who received an HA orbital implant in the socket between 2015 and 2016 at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, and developed chronic orbital inflammation with chronic discharge, redness, and pain (onset from weeks to over 2 decades after surgery). Computed tomography evaluation indicated inflammation in the orbital tissues, and histological examination showed a foreign body granulomatous reaction mainly localized around and blanching the HA implant. The condition was unresponsive to usual medical treatment and was resolved immediately after implant removal. Conclusions: Chronic inflammation can occur decades after placement of an HA implant in the orbit and can be successfully treated with implant removal.","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127592956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neue, klinisch relevante Klassifizierung des diabetischen Makulaödems","authors":"Emiliano Di Carlo, Camilla Simini","doi":"10.1159/000493453","DOIUrl":"https://doi.org/10.1159/000493453","url":null,"abstract":"Purpose: The aim of this study was to define a new pathogenetic classification of diabetic macular edema (DME) and to present the results of its application in common clinical practice. Methods: One hundred and seventy-seven consecutive patients with center-involving DME, central retinal thickness (CRT) ≥250 μm, were prospectively enrolled. A complete ophthalmological examination included best-corrected visual acuity (BCVA) assessment, fundus photography, and spectral-domain optical coherence tomography (OCT). The DME classification was broken down into 4 categories, combining the presence of retinal thickening with the presence/absence of visible vascular dilations and OCT-detectable macular traction. The OCT parameters included were as follows: CRT, subretinal fluid, intraretinal cysts, and hyperreflective foci (HF). Results: Four subtypes of DME were identified: vasogenic (131 eyes, DME with vascular dilation), nonvasogenic (46 eyes, DME without vascular dilation), tractional (11 eyes), and mixed DME (13 eyes). Vasogenic DME was the pattern mainly represented in each subclass of CRT (< 300, 300-400, and > 400 μm), with tractional DME observed especially with CRT > 400 μm. Internal and external cysts and a greater presence of hard exudates were predominantly found in vasogenic DME, whereas HF was equally distributed in the 4 DME subgroups. Conclusion: The study offers a new pathogenetic classification able to detect significant differences among DME subtypes. A tailored therapeutic approach could take into consideration specific changes associated with the different DME subtypes.","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130308584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lernen in der Weiterbildung - digital und praxisnah","authors":"","doi":"10.1159/000494046","DOIUrl":"https://doi.org/10.1159/000494046","url":null,"abstract":"in der vierten Ausgabe es diesjährigen «OphthalmoCampus» in KARGER KOMPASS OPHTHALMOLOGIE haben wir zwei sehr interessante Beiträge. Johanna Dörner und ihre Schwester Dr. Friederike Dörner lassen uns nicht nur an ihren persönlichen Erfahrungen zur Weiterbildung in einer Praxis teilhaben. Beide sind aktuell in der Praxis ihres Vaters tätig, Johanna Dörner noch recht am Anfang ihrer Weiterbildung zur Augenärztin, während ihre Schwester diese im letzten Jahr abgeschlossen hat. Gemeinsam mit ihrem Vater geben sie im Interview interessante Einblicke in die Weiterbildung sowie die Tätigkeit als Augenarzt bzw. Augenärztin in der Niederlassung. In dem Beitrag zum Simulatortraining wird der Eyesi-Chirurgiesimulator zum Erlernen und Training von Eingriffen am vorderen und hinteren Augenabschnitt vorgestellt. Die Klinik für Augenheilkunde in Frankfurt nutzt diesen Simulator bereits regelmäßig, um Studierende zu unterrichten. Aber auch auf Fortbildungen und Tagungen kommen diese Geräte zum Einsatz. Bei der Lektüre des neuen «OphthalmoCampus» wünsche ich Ihnen nun viel Vergnügen!","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116838463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Einseitige Sehverschlechterung nach Lokalanästhesie für eine Zahnbehandlung","authors":"K. Göbel","doi":"10.1159/000494039","DOIUrl":"https://doi.org/10.1159/000494039","url":null,"abstract":"Intraoral local anesthetics are widely used for performing painless dental treatments; however, in some cases, they may cause ocular complications such as meiosis, diplopia, nystagmus, ophthalmoplegia, ptosis, and amaurosis. Mostly, the symptoms disappear after several hours; rarely, they have a prolonged character. We describe the case of a 38-year-old young man who had reduced vision in the left eye 5 days after having received intraoral local anesthesia. A diagnosis of cilioretinal artery occlusion with optic disc swelling was made. Ten weeks later, the patient's visual acuity had increased to 20/20, and the swelling of the optic disc had subsided. Although various possible mechanisms for ocular complications after intraoral local anesthetic administration were suggested in the literature, the exact etiology remains unclear. In this case, inadvertent intravascular injection is believed to be the cause.","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114214193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kaleidoskop","authors":"","doi":"10.1159/000493771","DOIUrl":"https://doi.org/10.1159/000493771","url":null,"abstract":"In der Augenheilkunde kommen Laser häufig zum Einsatz. Vor diesem Hintergrund erforschen Wissenschaftlerinnen und Wissenschaftler der Universitätsmedizin Rostock und der Leibniz Universität Hannover die Wechselwirkungen zwischen Laser und Augengewebe. Sie entwickeln in standortübergreifenden Projekten neue Diagnostikund Therapiekonzepte für Hornhauterkrankungen und Kurzsichtigkeit mit speziellen laseroptischen Methoden. «Wir hoffen, bioKarger Kompass Ophthalmol 2018;4:226–229 DOI: 10.1159/000493771","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114724483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Veränderungen in der Produktion entzündlicher Zytokine bei Patienten mit zentralem retinalem Venenverschluss nach Behandlung mit Aflibercept oder Ranibizumab","authors":"O. Strauss","doi":"10.1159/000494040","DOIUrl":"https://doi.org/10.1159/000494040","url":null,"abstract":"Purpose: To investigate dynamic changes in aqueous humor levels of vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and inflammatory factors in patients receiving intravitreal ranibizumab injection (IRI) or intravitreal aflibercept injection (IAI) to treat central retinal vein occlusion (CRVO) with macular edema. Methods: In 22 CRVO patients scheduled to receive 3 doses of ranibizumab (11 eyes) or aflibercept (11 eyes) at monthly intervals, aqueous samples were collected at the time of intravitreal injection. The concentrations of VEGF, PlGF, soluble intercellular adhesion molecule-1, monocyte chemotactic protein (MCP)-1 (CCL2), platelet-derived growth factor-AA, interleukin (IL)-6, IL-8 (CXCL8), IL-12(p70) (IL12B), and IL-13 in aqueous samples were measured by the suspension array method. Results: Visual acuity and foveal thickness improved significantly in both the IRI group and the IAI group. In addition, aqueous levels of VEGF and PlGF as well as MCP-1 and IL-6 decreased significantly over time in both groups. These parameters did not significantly differ between both groups. Conclusions: In CRVO patients, both ranibizumab and aflibercept achieved similar improvement in clinical parameters and similar reductions in aqueous VEGF, PlGF, MCP-1, and IL-6 levels.","PeriodicalId":253335,"journal":{"name":"Karger Kompass Ophthalmologie","volume":"148 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125482412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}