Quality of Life in a German Graves Orbitopathy Population

To evaluate the validity and responsiveness of a German-language version of the disease-specific Graves orbitopathy quality-of-life questionnaire (GO-QOL).Prospective cross-sectional study.At a multidisciplinary university orbital center, 310 consecutive unselected Graves orbitopathy outpatients answered the GO-QOL before undergoing complete ophthalmic and endocrine assessment. The main outcome measures were the GO-QOL and its 2 subscales, Visual Functioning and Appearance.The QOL scores for the subscales Visual Functioning and Appearance were (mean ± SE) 72.5 ± 1.4 and 71.3 ± 1.5, respectively. Visual Functioning and Appearance were higher in mild (82.2 ± 2.2 and 86.0 ± 17.6) than in moder…

Prevalence of Strabismus and Its Impact on Vision-Related Quality of Life

Purpose This study investigates the prevalence of manifest strabismus and its subtypes in adulthood and analyzes the risk factors and its impact on vision-related quality of life (VRQoL). Design The Gutenberg Health Study (GHS) is a population-based, observational cohort study. A cross-sectional analysis of the baseline examination was conducted. Participants Participants aged 35 to 74 years were included (n = 15  010). Methods All participants were examined with a comprehensive ophthalmologic and general examination including the Hirschberg corneal reflex test to detect manifest strabismus. The following risk factors were analyzed: age, sex, socioeconomic status, birth weight, maternal age…

The Prevalence of Amblyopia in Germany

Amblyopia is a condition in which reduced visual acuity is not directly caused by an organic defect (1). Amblyopia can develop when an infant or small child suffers from strabismus. Although both eyes are healthy, different images are formed on each fovea centralis (where vision is sharpest) and on other corresponding locations on the retina; this is in contrast to individuals without strabismus. To prevent double vision the child’s brain suppresses the image produced by one eye. Complete visual ability cannot develop in this eye during the sensitive phase of visual development (2). Approximately half of amblyopia cases (3) are caused by uncorrected higher refractive errors, which are frequ…

Association of Low Birth Weight With Altered Corneal Geometry and Axial Length in Adulthood in the German Gutenberg Health Study

IMPORTANCE: Low birth weight is associated with altered ocular organ development in childhood, including the morphology of the eye. However, no population-based data exist about this association in adulthood. OBJECTIVE: To evaluate whether low birth weight has a long-term association with anterior segment anatomy and axial length in adulthood. DESIGN, SETTING, AND PARTICIPANTS: The Gutenberg Health Study is a population-based, observational cohort study in Germany. All participants underwent ocular biometry. Among the participants with follow-up and self-reported birth weight available, associations were assessed between low birth weight and anterior segment anatomy and axial length using m…

Charles-Bonnet-Syndrom – klinische Besonderheiten eines faszinierenden Krankheitsbilds

Auch psychisch gesunde, kognitiv vollig unauffallige Personen konnen visuelle Halluzinationen wahrnehmen, die als Charles-Bonnet-Syndrom (CBS) bezeichnet werden – benannt nach einem Schweizer Wissenschaftler, der solche Wahrnehmungen erstmals im 18. Jahrhundert beschrieben hat. Den Betroffenen ist der nichtreale Charakter der Halluzinationen in der Regel bewusst. Die Definitionen des CBS sind nicht einheitlich. So ist etwa eine Sehbehinderung oder Blindheit nicht in allen Definitionen gefordert, dieses Kriterium ist dennoch haufig assoziiert mit dem CBS. Weil die Pravalenz gerade bei Sehbehinderten oder Blinden hoch ist, sollten Augenarzte dieses Syndrom kennen: betroffene Patienten bericht…

Evaluation der augenärztlichen Versorgung ehemaliger früh- und reifgeborener Kinder im Alter von 4 bis 10 Jahren in Deutschland – Ergebnisse der Wiesbaden Prematurity Study (WPS)

Zusammenfassung Hintergrund Ziele der vorliegenden Untersuchung waren die Evaluation ophthalmologischer Nachsorgeuntersuchungen ehemaliger früh- und reifgeborener Kinder im Alter von 4 bis 10 Jahren und der Vergleich mit den deutschen Leitlinien. Methodik In der prospektiven Wiesbaden Prematurity Study (WPS) wurden 503 Kinder, davon 239 Frühgeborene (FG) mit Gestationsalter (GA) ≤ 32 Wochen und 264 Reifgeborene (RG) mit GA ≥ 37 Wochen (Kontrollgruppe) im Alter von 4 bis 10 Jahren inklusive Refraktionsmessung und orthoptischem Status untersucht. Anisometropie war definiert als Refraktionsunterschied von ≥ 1 dpt sphärischem Äquivalent. Die Eltern wurden zusätzlich gefragt, ob nach der Entlass…

Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: The Gutenberg Health Study

Abstract Aims To evaluate the prevalence of diabetic retinopathy/maculopathy (DR/DMac) and its associations with cardiovascular risk factors (CRF) in participants with prediabetes (PwPD) in a large European cohort within the population-based Gutenberg Health Study (GHS). Methods The study was based on a sub-cohort of the GHS (n=5,000, age: 35–74 y). Prediabetes was diagnosed according to HbA 1c levels (5.7–6.4%). DR/DMac was graded from fundus photographs. Blood samples and comprehensive questionnaires served for evaluation of laboratory results and CRF. Results The prevalence of prediabetes was 22.4%, and of DR/DMac 8.1%/0.2%, respectively. The majority of participants had mild DR (7.2%). …

Langzeitverlauf 10 Jahre nach transpupillarer Thermotherapie (TTT) kleiner, posteriorer maligner Aderhautmelanome

Background The aim of this study was to evaluate the long-term results of transpupillary thermotherapy (TTT) for small malignant choroidal melanomas. Patients and methods In the time period 1/1998 to 10/1999 in a prospective non-randomised analysis 26 eyes with small malignant melanomas (located posterior to the equator with base ≤ 12 and thickness ≤ 4.5 mm) were primary treated with the TTT standard protocol (follow-up over a time span of at least 10 years). Results Thirteen women and thirteen men (mean age: 64 years) underwent TTT. The mean preoperative tumour thickness was 2.45 mm (0.8 - 4.5 mm). Ten years postoperatively tumour regression without recurrence after 1.4 treatment sessions …

Association of low birth weight with myopic refractive error and lower visual acuity in adulthood: results from the population-based Gutenberg Health Study (GHS).

PurposeLow birth weight (BW) is linked to impaired organ development in childhood, including altered ocular morphological and functional development. The aim of this study was to evaluate whether low BW has long-term effects on visual acuity and refraction in adulthood.MethodsThe Gutenberg Health Study is a population-based, observational cohort study in Germany, including 15 010 participants aged between 35 and 74 years. These participants were divided into three different BW groups (low: <2500 g; normal: between 2500 and 4000 g; and high: >4000 g). Best-corrected visual acuity and objective refraction were examined. We used multivariable linear regression models with adjustment for …

Teprotumumab Efficacy, Safety, and Durability in Longer-Duration Thyroid Eye Disease and Re-treatment

PURPOSE To evaluate teprotumumab safety/efficacy in patients with thyroid eye disease (TED) who were nonresponsive or who experienced a disease flare. DESIGN The Treatment of Graves' Orbitopathy to Reduce Proptosis with Teprotumumab Infusions in an Open-Label Clinical Extension Study (OPTIC-X) is a teprotumumab treatment and re-treatment trial following the placebo-controlled teprotumumab Phase 3 Treatment of Graves' Orbitopathy (Thyroid Eye Disease) to Reduce Proptosis with Teprotumumab Infusions in a Randomized, Placebo-Controlled, Clinical Study (OPTIC) trial. PARTICIPANTS Patients who previously received placebo (n = 37) or teprotumumab (n = 14) in OPTIC. METHODS OPTIC nonresponders or …

Ocular ductions after rectus muscle recession and resection in thyroid eye disease.

Background: Recession and resection of rectus muscles for correction of strabismus in Thyroid Eye Disease (TED) is relatively unpopular as it is assumed to enhance the restriction of ocular ductions. Therefore, the purpose of this study was to compare ductions of recession only and recess/resect procedures. Methods: We retrospectively reviewed the charts of 119 patients who underwent strabismus surgery for TED from 1991 to 2015, of which 102 were included in the present study. Forty-six interventions were performed on horizontal, 56 on vertical rectus muscles; comprising 41 recess/resect surgeries for horizontal deviations, and 7 in patients with vertical strabismus. Ocular ductions and ali…

Laser and other treatment options in the therapy of infantile capillary eyelid and periorbital hemangiomas: An overview

Abstract Hemangiomas in infancy generally require a multidisciplinary approach. As a result of their natural course, usually with spontaneous involution, a “watch-and-wait” strategy often seems to be sufficient. Nevertheless, in periorbital hemangiomas not only cosmetic but also functional aspects may require an early intervention. There are many treatment options such as steroids, surgery, cryotherapy, magnesium seeds and laser. The present paper focuses on the different types of laser used in the treatment of infantile capillary eyelid and periorbital hemangiomas.

Total retinal detachment caused by a KIF11 mutation.

Purpose This is a case report of bilateral retinal detachment associated with KIF11 mutation. Methods In our university hospital, an 8-week-old patient presented with a potential bilateral congenital cataract, iris atrophy, and iridocorneal contact in the left eye. An examination revealed microcephaly and edema of the dorsa of the feet. The eye examination showed a clear lens in both eyes with a dislodged anterior chamber in the left eye with vessels drawn from the iris to the lens. A retrolental white bilateral mass with vessels was also observed. The MRI and the ultrasound revealed a potential peritoneal hyperplastic glass body. Bilateral retinal detachment was diagnosed during surgery. R…

Measuring corneal clouding in patients suffering from mucopolysaccharidosis with the Pentacam densitometry programme

Aim To identify a means to objectively measure corneal clouding in patients with mucopolysaccharidosis in a prospective controlled clinical trial. Methods Corneal haze was assessed by slit lamp examination and measured using the densitometry programme of the Pentacam, a rotating Scheimpflug camera in 33 mucopolysaccharidoses (MPS) patients and 32 controls. Results Pentacam measurements were available in 31 right and 31 left eyes of 32 patients and in 32 left and right eyes of 32 subjects in the control group. Slit lamp findings correlated very well with corneal density measurements (Spearman correlation right eye (OD)/left eye (OS)=0.782/0.791). MPS patients had higher density units (median…

Interne Ophthalmoplegie: erstes Zeichen einer Kompression des N. oculomotorius?

The Prevalence of Visual Impairment in the Adult Population

Background The distribution of visual impairment is an indicator of the health status of the population and for the frequency of diseases of the eye. Methods The Gutenberg Health Study (GHS) is a population-based cohort study in Germany concerning adults aged 35 to 74. 15 010 subjects from the Mainz-Bingen region underwent general medical and ophthalmological examination, with measurement of the distance-corrected visual acuity in each eye separately. As per the World Health Organization criteria, visual impairment was defined as an acuity below 0.3 in the better eye, and blindness as an acuity below 0.05. All patients who were found to be visually impaired or blind underwent further indivi…

Trochlear palsies caused by isolated trochlear schwannomas.

To describe clinical features and management of 4 patients suffering from unilateral superior oblique palsies due to MRI-documented trochlear nerve schwannomas.Chart reviews of 4 patients seen at the departments of ophthalmogy and neurology at the University of Mainz.All four patients were male, aged 36 to 72 years at initial presentation. None suffered from neurofibromatosis. The history of double vision prior presentation was 9 months to 13 years, follow-up time was 9 to 156 months. Two patients didn't receive any intervention: one remained stable over the follow-up time of 9 months. In patient #2, fourth nerve palsy was diagnosed 13 years prior to confirmation of a trochlear schwannoma b…

Correlations between central corneal thickness and general anthropometric characteristics and cardiovascular parameters in a large European cohort from the Gutenberg Health Study.

PURPOSE The aim of this study was to evaluate the correlations between general anthropometric features and cardiovascular parameters and central corneal thickness (CCT) in an adult European cohort. METHODS Analysis was based on a Gutenberg Health Study cohort that included 5000 subjects (2540 male, 2460 female), aged 35 to 74 years at enrollment. The participants underwent a standardized protocol with a comprehensive questionnaire; ophthalmic examination (slit-lamp biomicroscopy; autorefractometry; noncontact tonometry; fundus photography; CCT measurements (optical pachymetry); visual field testing; and a thorough general examination focused on cardiovascular parameters, psychosomatic evalu…

No Benefit of a Pediatric Screening in Discovering Reduced Visual Acuity in Children: Experiences from a Cross-Sectional Study in Germany

Background: The newly introduced German pediatric screening examination at the end of the third year of life (U7a) incorporates visual function testing in particular

Prevalence and Time Trends in Myopia Among Children and Adolescents.

Background Myopia (near-sightedness) is increasing worldwide, especially in Asia. The aim of this study was to describe trends in the prevalence of myopia in Germany. Methods We analyzed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS; baseline survey 2003-2006, N = 17 640; wave 2, 2014-2017, N = 15 023). The presence of myopia was determined from a parent questionnaire and validated by the use of a visual aid. The population prevalence of myopia was calculated. Based on the KiGGS wave 2 data, potential risk factors for myopia were identified by means of logistic regression. Results The prevalence of myopia at the age of 0-17 years in Germany…

Prävalenz und Risikofaktoren der Kurzsichtigkeit bei Kindern und Jugendlichen in Deutschland – Ergebnisse der KiGGS-Studie

Zusammenfassung Hintergrund Ziel dieser Studie ist die Bestimmung der Prävalenz von Kurzsichtigkeit (Myopie) bei Kindern und Jugendlichen in Deutschland und die Evaluation damit assoziierter Risikofaktoren. Methodik Die Prävalenz von Myopie in Deutschland wurde durch die „Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland“ (KiGGS Basiserhebung 2003–2006) erhoben (N=17,640, 49% Mädchen). Das Vorliegen einer Myopie und die Verwendung einer Sehhilfe wurden durch einen Elternfragebogen erfasst. Potentielle Risikofaktoren wurden mittels kausalem Diagramm identifiziert und mit multiplen logistischen Regressionsmodellen untersucht. Ergebnisse Die Prävalenz von Myopie in Deutschland …

Tolerability of 24-hour intraocular pressure monitoring of a pressure-sensitive contact lens.

Purpose To investigate tolerability and safety of a new diagnostic device for 24-hour intraocular pressure monitoring in healthy subjects and age-matched glaucoma patients. Patients and methods Twenty healthy subjects (group 1) and 20 age-matched glaucoma patients (group 2) were included in this prospective, single-center, open, observational parallel group study. The SENSIMED Triggerfish Sensor is a soft disposable contact lens embedding a telemetry chip and strain gauge sensor for continuous intraocular pressure monitoring. The Sensor was placed in 1 eye for 24 hours. Tolerability was evaluated using a visual analog scale (range, 0 to 100; 0=no discomfort; 100=very severe discomfort). Saf…