Die Ophthalmologie最新文献

{"title":"[When the retina sparkles-Crystalline deposits in the retina].","authors":"V B N Weiß, R Schirò, J M Weller","doi":"10.1007/s00347-025-02378-5","DOIUrl":"10.1007/s00347-025-02378-5","url":null,"abstract":"<p><strong>Background: </strong>Crystalline retinopathies are characterized by refractile deposits within different retinal layers and may be associated with genetic, systemic, toxic, or iatrogenic causes. Talc retinopathy represents a well-described toxic entity related to intravenous drug abuse.</p><p><strong>Case presentation: </strong>A 44-year-old male presented with intermittent bilateral visual impairment over four weeks. Best-corrected visual acuity was 0.8 in both eyes. Funduscopic examination revealed multiple fine, glistening crystalline deposits in the central retina without signs of intraocular inflammation. Optical coherence tomography demonstrated hyperreflective crystalline deposits involving inner and outer retinal layers. No evidence of retinal ischemia or vascular occlusion was observed. A targeted medical history revealed previous intravenous drug abuse, including amphetamines and cocaine, most recently in 2023. The patient's history did not suggest a medication-related cause; a hereditary etiology appeared unlikely based on clinical and imaging findings.</p><p><strong>Conclusion: </strong>The findings are consistent with a non-inflammatory toxic crystalline retinopathy, most compatible with talc retinopathy. This case highlights the importance of multimodal retinal imaging and targeted historytaking for accurate diagnosis.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":"396-400"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986064","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":"[Relative scotoma rethought-Comparison between rapid campimetry and standard automated perimetry].","authors":"Friedrich Hoffmann, Thilo Knacke, Fabian Müller, Christian Meltendorf","doi":"10.1007/s00347-026-02419-7","DOIUrl":"10.1007/s00347-026-02419-7","url":null,"abstract":"<p><p>The visual field test of rapid campimetry offers a new perspective on relative scotomas. When passing through a relative scotoma at a speed of 6°/s, the bright test point flickers. With a reduced test dot size from GIII to GII and a reduced running speed of 0.75°/s, a rapid change from no light perception (absolute scotoma proportion 72%) to light perception (proportion 28%) is observed in the relative scotoma. The relative scotoma appears to consist of a juxtaposition of intact nerve fibers and multiple mini-Bjerrum scotomas.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":"401-405"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349779","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":"[Spontaneous course of a lattice corneal dystrophy with initially atypical corneal findings in childhood and a 10-year follow-up].","authors":"Viola Katharina Merk, Berthold Seitz, Loay Daas, Elias Flockerzi, Tim Berger","doi":"10.1007/s00347-026-02409-9","DOIUrl":"10.1007/s00347-026-02409-9","url":null,"abstract":"<p><p>Lattice corneal dystrophy (LCD) is an epithelial-stromal TGFβI corneal dystrophy that affects both stromal cells and the corneal epithelium. Over a period of ten years, the spontaneous course of LCD has been documented and described in a patient with a positive family history from the age of 11. Initially, there was an atypical corneal finding with isolated fine superficial patchy and star-shaped opacities in the anterior corneal stroma in both eyes, but without the lattice lines typical of LCD. Over time, there was an increase in the number and density of the lattice lines, accompanied by subepithelial stromal haze, recurrent corneal erosions, and a reduction in visual acuity in young adulthood.Although in this case the diagnosis was facilitated by the positive family history, initially atypical clinical presentations can lead to diagnostic uncertainty. In particular, recurrent corneal erosions can occur even before the appearance of opacities or lattice lines detectable by slit lamp biomicroscopy, which can vary depending on the underlying mutation. In such cases, genetic testing is advisable if the findings are unclear in order to enable early diagnosis and targeted therapy. Therapeutic options include the application of artificial tears and phototherapeutic keratectomy, followed by deep anterior lamellar or penetrating keratoplasty if the findings worsen.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":"386-390"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313070","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":"[Knowledge and attitudes towards corneal donation among medical students].","authors":"Wilhelm Flat, Tobias Röck, Karl Ulrich Bartz-Schmidt, Daniel Röck","doi":"10.1007/s00347-026-02405-z","DOIUrl":"10.1007/s00347-026-02405-z","url":null,"abstract":"<p><strong>Background: </strong>Corneal transplantation can greatly improve or even fully restore vision in people with corneal diseases. In Germany, organ donation rates have been low for many years, so the demand for corneal tissue continues to exceed the available supply. A major reason for this shortage is the limited awareness and understanding of corneal donation. This study aimed to assess the knowledge of medical students at the University of Tübingen about corneal donation and to examine what influence a lecture on the topic could have.</p><p><strong>Methods: </strong>A total of 129 students completed a questionnaire with 21 items assessing their attitudes towards and knowledge of corneal donation, both before and after attending a lecture on the subject.</p><p><strong>Results: </strong>Overall, 77.5% of participants were willing to donate their corneas but only 23.3% had ever discussed the topic with family members. Before the lecture, students answered an average of 4.1 out of 9 knowledge questions correctly (45.6%), compared to 7.7 (85.6%) afterward.</p><p><strong>Discussion: </strong>Even among advanced medical students, there are considerable knowledge gaps regarding corneal donation. Integrating this topic more deeply into medical education could improve understanding and, in the long run, increase willingness to donate.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":"375-381"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273164","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":"[Recurrence of herpetic eye disease following cataract surgery: risk factors and prevention].","authors":"Lars H B Mackenbrock, An Ting L Xu, Tadas Naujokaitis, Ramin Khoramnia","doi":"10.1007/s00347-026-02411-1","DOIUrl":"10.1007/s00347-026-02411-1","url":null,"abstract":"<p><p>Herpetic eye disease poses a significant challenge in cataract surgery. On the one hand, patients with a history of herpes infections develop cataracts more rapidly and the surgery itself is associated with a higher rate of intraoperative complications. On the other hand, the risk of herpetic recurrence after cataract surgery is markedly increased (46% for herpes simplex virus and up to 40% for herpes zoster virus). The prognosis is significantly worse in the event of a recurrence, which is why reducing the recurrence rate is of great clinical interest. Preoperatively, attention should be paid to signs of prior herpes infections, such as corneal scars, neovascularization, synechiae and neurotrophic keratopathy. Risk factors for recurrence include the duration of quiescence, the number of previous episodes, a temporal tunnel incision, immunosuppressive therapy, diabetes mellitus and atopy. Prophylactic perioperative antiviral therapy is frequently used; however, randomized data specifically addressing cataract surgery are lacking, so that current recommendations are largely based on indirect evidence and expert consensus.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":"353-358"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437919","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":"[Persistent hyaloid artery].","authors":"Sarah Hessemer, Julian Bucur, Thomas Kohnen","doi":"10.1007/s00347-026-02442-8","DOIUrl":"https://doi.org/10.1007/s00347-026-02442-8","url":null,"abstract":"","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790169","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":"[The Frequency of rhegmatogenous retinal detachment at the Kiel University Eye Clinic in 1914, 1939/40, 1956/57, and 1967].","authors":"Udo Hennighausen, Johann Roider","doi":"10.1007/s00347-026-02443-7","DOIUrl":"https://doi.org/10.1007/s00347-026-02443-7","url":null,"abstract":"<p><strong>Background: </strong>As causes for the increasing incidence of rhegmatogenous retinal detachment (RD) during the past 20 years, primarily demographic changes and the increasing incidence of myopia and cataract surgery, especially in younger patients, are considered.</p><p><strong>Objective: </strong>The aim of this study was to create an inventory of cases of RD treated at the Kiel University Eye Clinic before the era of pseudophakia and vitrectomy.</p><p><strong>Materials and methods: </strong>Archival patient records of the Kiel University Eye Clinic for 1914, 1939/40, 1956/57, and 1967 were reviewed, and the identified cases of nontraumatic RD were analyzed.</p><p><strong>Results: </strong>In 1914, three documented cases of RD were found, but there was no documented surgery. Between 1939 and 1967, the number of documented RD cases increased (from 2% to 6.3%), as did the percentage of successfully operated patients (from 44.4% to 70.6%). For the year 1967, the mean age of the patients was 60.12 years, which aligns with published data for the period from 2005 to 2019. Concerning the main catchment area of Kiel University Eye Clinic, an incidence of 5.78 cases of RD per 100,000 persons years was found. Upon discharge from the hospital after RD surgery, visual acuity (VA) was measured as follows: 27.3% of patients had a VA of 1/50 or less, 55.3% had a VA between > 1/50 and 0.33, 8.7% had a VA between > 0.33 and 0.7, and 8.7% had a VA greater than 0.7.</p><p><strong>Conclusion: </strong>This medicohistorical study shows an incidence of inpatient RD prior to 1970 which corresponds to that found in the literature for the 1970s. As the medical, demographic, and sociological circumstances existing in 1970 are not comparable to those of the present, the number of undocumented cases of RD in 1970 is considered to be higher than is it today; therefore, only limited conclusions can be drawn regarding the overall incidence of RD at that time and regarding the question of whether RD has increased over time. Nevertheless, this study depicts the development of diagnosis and treatment of RD at the Kiel University Eye Clinic until the end of the 1960s, supplemented by aspects of medical sociology.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790188","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":"[Amniotic membrane transplantation in various systemic diseases : Success and recurrence rates in relation to concomitant systemic medication, corneal status, and surgical technique].","authors":"Eva Süßmaier, Derya Kahraman, Kassandra Xanthopoulou, Tim Berger, Cristian Munteanu, Berthold Seitz","doi":"10.1007/s00347-026-02444-6","DOIUrl":"https://doi.org/10.1007/s00347-026-02444-6","url":null,"abstract":"<p><strong>Background: </strong>Amniotic membrane transplantation (AMT) has been an important procedure for treatment of persistent corneal epithelial defects for many years. The aim of this study was to evaluate the influence of underlying systemic diseases, concomitant systemic medication, corneal status, depth of the epithelial defect, and surgical technique on AMT success and recurrence rates.</p><p><strong>Patients and methods: </strong>A total of 780 AMT procedures (496 patients, 519 eyes) performed from 2013 to 2019 were retrospectively analyzed. The presence of systemic disease (divided into different categories) and concomitant medication, the depth of the corneal defect (erosion/ulcer), the corneal status (own cornea/graft), and the surgical technique (patch/sandwich/graft) were recorded. Main outcome measures included epithelial closure at 4 weeks (\"success\") and the recurrence rate. The follow-up period was 1 year. Significance was set at p ≤ 0.05.</p><p><strong>Results: </strong>There was an epithelial closure rate of 58.8% and a recurrence rate of 18.7%. Cases with thyroid gland disease had a significantly lower success rate than the rest of the study population (p = 0.003). Cases with a viral infection showed a significantly higher success rate (65.7%, n = 204) compared to cases without a viral etiology (56.5%, n = 326; p = 0.039). Regarding concomitant medication, the success rate was significantly higher when systemic steroids were used (p < 0.001). Comparing the success of AMT on the own cornea and on a graft, the success rate on the own cornea was significantly higher (p = 0.019) than on a donor cornea. There was no significant difference in surgical technique regarding success and recurrence rate.</p><p><strong>Conclusion: </strong>Amniotic membrane transplantation is a reasonable option for persistent epithelial defects even under everyday clinical conditions. Especially in case of primary success (epithelial closure after 4 weeks) can a better long-term outcome be assumed. Thyroid gland disease is related to significantly worse success rates. Significantly worse results of AMT can be expected on a transplant than on the patient's own cornea.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790827","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":"[Symptom: ptosis-Diagnosis: xanthogranulomatous disease].","authors":"Daniel Niederstraßer, Christina Schneemann, Ulrich Schaudig","doi":"10.1007/s00347-026-02439-3","DOIUrl":"https://doi.org/10.1007/s00347-026-02439-3","url":null,"abstract":"<p><strong>Clinical course: </strong>A 65-year-old female patient presented with a slowly progressive right-sided ptosis. A myasthenia was excluded and the medical history included Hashimoto's thyroiditis and a previous pneumonia. After a successful transcutaneous levator resection a recurrence of ptosis developed 2 years later accompanied by a firm, yellowish swelling of the upper eyelid and involvement of the contralateral upper eyelid.</p><p><strong>Diagnostics: </strong>The biopsy revealed lymphocytic infiltrates with lymph follicle formation, invasion into striated muscle, foam cells and Touton giant cells as well as mildly fibrotic and necrotic areas, consistent with an adult orbital xanthogranulomatous disease (AOXGD), subtype adult-onset asthma and periocular xanthogranuloma (AAPOX). A differentiation from necrobiotic xanthogranulomatosis and Erdheim-Chester disease was based on the absence of skin necrosis, minimal fibrosis and a lack of systemic involvement. Evidence of an immunoglobulin G4 (IgG4) association was noted clinically (Hashimoto's thyroiditis, chronic sinusitis) and histologically (increased IgG4-positive plasma cells).</p><p><strong>Treatment: </strong>Following renewed upper eyelid blepharoplasty and multiple triamcinolone injections, a short-term systemic corticosteroid therapy was administered due to insufficient improvement. In the absence of a BRAF mutation, steroid-sparing immunosuppressive treatment with methotrexate was initiated, leading to marked regression of the swelling.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic complexity and the importance of a combined histopathological, immunohistochemical and clinical evaluation in rare xanthogranulomatous eyelid lesions.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790244","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":"[Legal framework conditions for a digital outpatient clinic exemplified by the keratoconus outpatient clinic].","authors":"A Honeder, R Resch, L Pomberger, K Waser, M Bolz, N Hirnschall","doi":"10.1007/s00347-026-02420-0","DOIUrl":"https://doi.org/10.1007/s00347-026-02420-0","url":null,"abstract":"<p><strong>Background: </strong>As the first digital keratoconus outpatient clinic in Austria, we offer tomographic corneal measurements and their assessment at different time points in order to provide maximum flexibility to our patients. With the digital keratoconus outpatient clinic, a wide range of legal questions arise involving various legal aspects.</p><p><strong>Objective: </strong>This study analyzes the legal framework of the digital keratoconus outpatient clinic.</p><p><strong>Material and methods: </strong>First, the structure of the digital keratoconus outpatient clinic is outlined. Subsequently, the legal issues associated with the digital keratoconus outpatient clinic are analyzed.</p><p><strong>Results and conclusion: </strong>The digital keratoconus outpatient clinic is fully compliant with Austrian law.</p>","PeriodicalId":72808,"journal":{"name":"Die Ophthalmologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790012","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}