0000000000025937
AUTHOR
Urs Vossmerbaeumer
Suprachoroidal Bleeding After XEN Gel Implantation
Purpose To report for the first time a clinical case of suprachoroidal bleeding after XEN45 gel implantation. Observations A 84-year old female patient with pseudoexfoliation glaucoma with intraocular pressure (IOP) (20 mm Hg) above target despite maximal IOP-lowering therapy was scheduled for XEN45 gel implantation. The XEN45 gel implantation went without complications and was properly placed in the anterior chamber and beneath the conjunctiva. On the first postoperative day, the patient presented with an IOP of 4 mm Hg, a functioning bleb and a deep anterior chamber. On the second day she developed suprachoroidal bleeding. A wait and see strategy was followed and the patient monitored ste…
A retinal snap shot may indicate individual risk for cardiovascular disease — The MIPH Eye&Health Study
Examination of retinal vasculature can be used to non-invasively quantify changes within the microvasculature of the human body and might be a predictor of cardiovascular disease. This study evaluates associations of the structure of the retinal vasculature with established risk factors for cardiovascular disease.A cross-sectional study was performed in a working age population. Several systemic cardiovascular parameters were analyzed and PROCAM- and SCORE-risk estimates were calculated. A quantitative ophthalmological examination including digital fundus imaging has taken place. Central retinal arterial/venous equivalents (CRAE/CRVE) and arterio-venous ratio (AVR) were analyzed using valid…
Optical coherence tomography-based retinal vessel analysis for the evaluation of hypertensive vasculopathy
Purpose Evaluation of retinal vessels in cardiovascular disease traditionally relies upon funduscopy, but more recently digital photo analysis has expanded the spectrum. As spectral domain optical coherence tomography (OCT) allows an in-vivo assessment of retinal tissue and its vessels on a histological scale, our study aimed at using this tool for the analysis of the retinal vasculature. Methods Circumferential peripapillary OCT scans (3DOCT-2000; Topcon Inc., Tokyo, Japan), with centration on the optic nerve head, were taken from 20 eyes (20 participants) with normal blood pressure and 20 eyes (20 participants) with arterial hypertension above 120 mmHg (mean blood pressure). The diameter …
Comparison of DMEK and DSAEK in Eyes With Endothelial Decompensation After Previous Penetrating Keratoplasty.
PURPOSE Posterior lamellar keratoplasty is increasingly applied in patients with endothelial decompensation after penetrating keratoplasty (PK). The aim of this study was to compare the results of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) after PK. METHODS In this retrospective study, clinical data of 30 patients who received DMEK (n = 19) or DSAEK (n = 11) for endothelial decompensation after PK were evaluated. All lamellar keratoplasties were performed at the Department of Ophthalmology at University Hospital Mainz, Germany. Primary end point included best-corrected visual acuity, and secondary end points included e…
Semi-automated retinal vessel analysis in nonmydriatic fundus photography.
Purpose Funduscopic assessment of the retinal vessels may be used to assess the health status of microcirculation and as a component in the evaluation of cardiovascular risk factors. Typically, the evaluation is restricted to morphological appreciation without strict quantification. Our purpose was to develop and validate a software tool for semi-automated quantitative analysis of retinal vasculature in nonmydriatic fundus photography. Methods matlab software was used to develop a semi-automated image recognition and analysis tool for the determination of the arterial–venous (A/V) ratio in the central vessel equivalent on 45° digital fundus photographs. Validity and reproducibility of the r…
KLEIP Deficiency in Mice Causes Progressive Corneal Neovascular Dystrophy
PURPOSE. The BTB-kelch protein KLEIP/KLHL20 is an actin binding protein that regulates cell-cell contact formation and cell migration. The aim of our study was to characterize KLEIP’s function in ocular health and disease in mice. METHODS. KLEIP -/- mice were generated, and corneas were examined histologically and stained for keratin-1, loricrin, keratin-12, keratin-14, CD31, LYVE-1, F4/80, E-cadherin, and Ki67. Corneal abrasions were performed after eyelid opening. RESULTS. Corneas of KLEIP þ/þ and KLEIP -/- mice were indistinguishable at birth. After eyelid opening corneal epithelial hyperplasia started to manifest in KLEIP -/- mice, showing a progressive epithelial metaplasia leading to …
Curvature of iris profile in spectral domain optical coherence tomography and dependency to refraction, age and pupil size - the MIPH Eye&Health Study
Purpose Optical coherence tomography (OCT) of the anterior segment allows quantitative analysis of the geometry of the iris. We performed spectral domain OCT examinations in healthy emmetropic, hyperopic and myopic subjects to investigate iris curvature and its associations. Methods In a cross-sectional study, out of 4617 eyes (2309 subjects) those with refractive errors of +3 dioptres were identified by objective refraction. The iris was examined using the anterior segment mode of a spectral domain 3D OCT-2000 (Topcon Inc., Japan) in the temporal meridian, and OCT scans were investigated with respect to presence and amount of convex and concave iris configuration. Ninety-three eyes of 50 s…
Distribution of Anterior Chamber Angle Width and Correlation With Age, Refraction, and Anterior Chamber Depth—The Gutenberg Health Study
PURPOSE Scheimpflug imaging allows quantitative analysis of the width of the anterior chamber angle. We report the population-based distribution of the anterior chamber angle width using this noncontact imaging technique and investigate associated factors. METHODS A population-based cross-sectional study was carried out in Germany. A comprehensive ophthalmologic examination including refraction, biometry, and Scheimpflug imaging was performed. Automated measurement of the anterior chamber angle was performed in each anterior chamber quadrant. Exclusion criteria were previous ocular surgery or inadequate image quality. Association analyses were carried out to determine independently associat…
Retinal Imaging through Phakic Iris-Claw IOL.
AbstractBackground: Phakic anterior chamber iris-fixated IOL (PIOL) are established for the correction of high myopia. These patients require attention to macular pathologies. This study was to evaluate the quality of imaging through the PIOLs. Methods: 54 eyes of 31 myopic and hyperopic patients with Verisyse®, Verisyse toric®, and Veriflex® phakic iris-fixated IOL were included. Mean preoperative refraction was −11.0 D and +5.7 D, respectively; mean follow-up time was 7.4 years (5–11 years). A matched control group was formed without PIOL implantation. OCT scans were performed and evaluated qualitatively and quantitatively. Results: In 52 eyes of 31 patients (96%), a 3D-OCT image and fund…
Irregularity of the posterior corneal surface during applanation using a curved femtosecond laser interface and microkeratome cutting head.
PURPOSE: To evaluate the irregularity of the posterior corneal surface and intrastromal dissection during the preparation of donor tissue for Descemet stripping automated endothelial keratoplasty (DSAEK) using a curved interface femtosecond laser and microkeratome. METHODS: Sixteen human donor corneas unsuitable for transplantation were divided into two groups: a femtosecond (FS) laser group (n=7) using the VisuMax femtosecond laser (Carl Zeiss Meditec) and a microkeratome group (n=9) using the Amadeus II microkeratome (Ziemer Ophthalmic Group). The corneas were fixed on artificial anterior chambers. Horizontal cross-sections were obtained using spectral-domain optical coherence tomography…
Visualization of corneal vascularization in peripheral hypertrophic subepithelial corneal opacification with OCT angiography.
Purpose The major goal of this study was to test the hypothesis that in patients with peripheral hypertrophic subepithelial corneal opacification (PHSCO), visualization of corneal vessels is better with optical coherence tomography angiography (OCTA) than with conventional slit lamp microphotography. Methods Patients with PHSCO were included in this prospective study. The corneal findings were photographed using a slit lamp camera (Haag Streit BM 900® ) and visualized with anterior-segment OCT (Optovue XR Avanti, Fremont, California, USA). Additionally, OCTA with the Angiovue Imaging™ System was performed in the area of PHSCO. Results Thirty-four eyes of 19 patients (26% male and 74% female…
Corneal opacity and copper levels of the Lewis syndrome after systemic chemotherapy
Abstract Purpose To report a female patient of biclonal Lewis syndrome which consists of a trias: biclonal gammopathy of undetermined significance, paraproteinemic keratopathy in form of a brownish discoid opacification at the level of Descemet's membrane and hypercupremia. After several years there was a conversion to multiple myeloma. Systemic chemotherapy led to a complete remission of multiple myeloma and to a normalization of the copper level in the blood that lasted five years. The corneal opacification remained unchanged. Observations A currently 66-year-old woman suffered from biclonal Lewis syndrome. On both eyes there is a central discoid yellow-brownish discoloration in the Pre-D…
Application principles of excimer lasers in ophthalmology
Abstract Excimer lasers (193 nm) can be used for photoablation of the human cornea due to their specific physical characteristics. This laser is applied in corneal refractive surgery for the targeted removal of corneal tissue for the purpose of correcting refractive errors. This article provides a short overview of the scientific development of excimer lasers for use in ophthalmic surgery and of the range of applications of these tools.
Ionising radiation and lens opacities in interventional physicians: results of a German pilot study
We assessed the feasibility of an epidemiological study on the risk of radiation-related lens opacities among interventional physicians in Germany. In a regional multi-centre pilot study associated with a European project, we tested the recruitment strategy, a European questionnaire on work history for the latter dosimetry calculation and the endpoint assessment. 263 interventional physicians and 129 non-exposed colleagues were invited. Questionnaires assessed eligibility criteria, risk factors for cataract, and work history relating to occupational exposure to ionising radiation, including details on type and amount of procedures performed, radiation sources, and use of protective equipmen…
Expanding the clinical spectrum of COL1A1 mutations in different forms of glaucoma
Background Primary congenital glaucoma (PCG) and early onset glaucomas are one of the major causes of children and young adult blindness worldwide. Both autosomal recessive and dominant inheritance have been described with involvement of several genes including CYP1B1, FOXC1, PITX2, MYOC and PAX6. However, mutations in these genes explain only a small fraction of cases suggesting the presence of further candidate genes. Methods To elucidate further genetic causes of these conditions whole exome sequencing (WES) was performed in an Italian patient, diagnosed with PCG and retinal detachment, and his unaffected parents. Sanger sequencing of the complete coding region of COL1A1 was performed in…
The Impact on Vision of Aspheric to Spherical Monofocal Intraocular Lenses in Cataract Surgery
Purpose To provide a summary of the impact on vision of an aspheric intraocular lens (IOL) compared with a spherical IOL in cataract surgery. Design Systematic review with meta-analysis. Participants Patients from published randomized controlled trials (RCTs) of cataract surgery with aspheric compared with spherical monofocal IOL implantation. Methods We systematically searched the peer-reviewed literature in MEDLINE, EMBASE, Web of Science, BIOSIS, and the Cochrane Library according to the Cochrane Collaboration method to identify relevant RCTs. The inclusion criteria were RCTs on cataract surgery comparing the use of aspheric versus spherical IOL implantation that assessed visual acuity, …
Retinal vessel analysis and heart rate variability
Heart rate variability (HRV) is used to index the vegetative nervous system and is linked with cardiovascular and nervous diseases [1]. Funduscopic assessment of the retinal vasculature can be utilized to evaluate the health status of microcirculation and to assess the predisposition of major vascular diseases [2]. The purpose of this study was, for the first time, to examine the influence of HRV on microcirculation as an early marker of cardiovascular alteration. The study population was comprised of apparently healthy employees of a high-tech company in Germany. The participants spanned the entire age of the work force (18–65 years) and all levels of socioeconomic status. A total of 292 s…