Dimitrios Kalogeropoulos, Andrew John Lotery, Farid Afshar, Nigel Hall, Heytham Rezq, Abin Holla, Anthony Shinton, Stephen Lash, Bhaskar Gupta, Serafeim Antonakis
{"title":"Management of Bilateral Primary Vitreoretinal Lymphoma: A Case Report and Review of the Literature.","authors":"Dimitrios Kalogeropoulos, Andrew John Lotery, Farid Afshar, Nigel Hall, Heytham Rezq, Abin Holla, Anthony Shinton, Stephen Lash, Bhaskar Gupta, Serafeim Antonakis","doi":"10.1055/a-2338-3304","DOIUrl":"https://doi.org/10.1055/a-2338-3304","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759579","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}
Myopia, a common refractive error, has been associated with various risk factors, but time outdoors has emerged as a significant protective factor against its onset. This association is believed to be mediated by the influence of sunlight on dopamine release, a neurotransmitter crucial for regulating eye growth. Recent research has explored the specific properties of light in order to identify potential interventions for myopia control in children. Low-level red light therapy has gained attention, and has shown promise in inhibiting myopia progression, although there are concerns about safety and rebound effects. Similarly, blue light stimulation aims to upregulate retinal dopamine activity, yet conclusive evidence supporting its efficacy is lacking. Moreover, researchers explored the use of the entire visible light spectrum by digitally imposing longitudinal chromatic aberration to adjust proper eye growth. Preliminary findings suggest that digitally simulated chromatic aberration could potentially serve as a myopia control strategy and highlights the need for further investigation into long-term effects. As research progresses, understanding the efficacy and safety of light-based interventions for myopia control remains crucial for informing clinical practice and optimizing patient outcomes.
{"title":"Chromatic Light Therapy for Inhibiting Myopia Progression: Human Studies.","authors":"Barbara Swiatczak","doi":"10.1055/a-2322-9892","DOIUrl":"10.1055/a-2322-9892","url":null,"abstract":"<p><p>Myopia, a common refractive error, has been associated with various risk factors, but time outdoors has emerged as a significant protective factor against its onset. This association is believed to be mediated by the influence of sunlight on dopamine release, a neurotransmitter crucial for regulating eye growth. Recent research has explored the specific properties of light in order to identify potential interventions for myopia control in children. Low-level red light therapy has gained attention, and has shown promise in inhibiting myopia progression, although there are concerns about safety and rebound effects. Similarly, blue light stimulation aims to upregulate retinal dopamine activity, yet conclusive evidence supporting its efficacy is lacking. Moreover, researchers explored the use of the entire visible light spectrum by digitally imposing longitudinal chromatic aberration to adjust proper eye growth. Preliminary findings suggest that digitally simulated chromatic aberration could potentially serve as a myopia control strategy and highlights the need for further investigation into long-term effects. As research progresses, understanding the efficacy and safety of light-based interventions for myopia control remains crucial for informing clinical practice and optimizing patient outcomes.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897065","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}
Marie-Louise Gunnemann, Martin Ziegler, Marius Book, Frederic Gunnemann, Kai Rothaus, Georg Spital, Matthias Gutfleisch, Clemens Lange, Albrecht Peter Lommatzsch, Daniel Pauleikhoff
Background: Anti-VEGF therapy is the standard treatment for exudative neovascular age-related macular degeneration (nAMD) caused by the development of macular neovascularisation (MNV) with associated fluid exudation. The therapeutic strategies (T&E or PRN) assumed a scarring transformation of the MNV and exit strategies and were formulated accordingly. The present study investigates this hypothesis as a real-life long-term analysis.
Patients: 150 eyes of 97 patients were continuously followed up over a mean period of 5.1 years (1 - 14 years) after initiation of anti-VEGF therapy between 2009 - 2017 until 2022. Treatment was based on the PRN regimen analogous to the IVAN study with ranibizumab, aflibercept or bevacizumab. The length and intensity of therapy were evaluated.
Results: Of these 150 eyes, 119 (79.3%) required ongoing anti-VEGF therapy, while in 18 eyes (12.0%) therapy could be discontinued due to stabilisation of the situation. In 13 eyes (8.7%), therapy was discontinued due to deterioration in visual acuity to < 0.05. With ongoing therapy, therapy was often protracted, with an indication for therapy at the last documented doctor's visit, while stabilisation was often achieved within the first 2 years of treatment. The treatment intensity increased to 7.7 - 8.0 injections/year, especially after 2013, with the introduction of OCT-based treatment criteria. Most eyes (74.8%) with ongoing therapy required 6 - 9 injections/year even in the last three years of treatment.
Conclusion: The fact that in the present study there is a long-term and intensive need for therapy in the majority of patients (approx. 80%) with exudative nAMD, supports the assessment that nAMD should be regarded as a chronic disease. Therefore, a proactive treatment strategy with consistent therapy at any sign of lesion activity might be recommended. Particularly in view of the risk of irreversible loss of vision, long term adherence of patients is also crucial for the best possible long term therapeutic outcome.
{"title":"Is Exudative Neovascular AMD a Chronic Disease? Analysis of Long-term Progression under Anti-VEGF Therapy.","authors":"Marie-Louise Gunnemann, Martin Ziegler, Marius Book, Frederic Gunnemann, Kai Rothaus, Georg Spital, Matthias Gutfleisch, Clemens Lange, Albrecht Peter Lommatzsch, Daniel Pauleikhoff","doi":"10.1055/a-2239-6394","DOIUrl":"10.1055/a-2239-6394","url":null,"abstract":"<p><strong>Background: </strong>Anti-VEGF therapy is the standard treatment for exudative neovascular age-related macular degeneration (nAMD) caused by the development of macular neovascularisation (MNV) with associated fluid exudation. The therapeutic strategies (T&E or PRN) assumed a scarring transformation of the MNV and exit strategies and were formulated accordingly. The present study investigates this hypothesis as a real-life long-term analysis.</p><p><strong>Patients: </strong>150 eyes of 97 patients were continuously followed up over a mean period of 5.1 years (1 - 14 years) after initiation of anti-VEGF therapy between 2009 - 2017 until 2022. Treatment was based on the PRN regimen analogous to the IVAN study with ranibizumab, aflibercept or bevacizumab. The length and intensity of therapy were evaluated.</p><p><strong>Results: </strong>Of these 150 eyes, 119 (79.3%) required ongoing anti-VEGF therapy, while in 18 eyes (12.0%) therapy could be discontinued due to stabilisation of the situation. In 13 eyes (8.7%), therapy was discontinued due to deterioration in visual acuity to < 0.05. With ongoing therapy, therapy was often protracted, with an indication for therapy at the last documented doctor's visit, while stabilisation was often achieved within the first 2 years of treatment. The treatment intensity increased to 7.7 - 8.0 injections/year, especially after 2013, with the introduction of OCT-based treatment criteria. Most eyes (74.8%) with ongoing therapy required 6 - 9 injections/year even in the last three years of treatment.</p><p><strong>Conclusion: </strong>The fact that in the present study there is a long-term and intensive need for therapy in the majority of patients (approx. 80%) with exudative nAMD, supports the assessment that nAMD should be regarded as a chronic disease. Therefore, a proactive treatment strategy with consistent therapy at any sign of lesion activity might be recommended. Particularly in view of the risk of irreversible loss of vision, long term adherence of patients is also crucial for the best possible long term therapeutic outcome.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106270","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}
Tamara Bilic, Marie-Alice Amblard, Andre Maurice Trouvain, Anna-Maria Seuthe, Annekatrin Rickmann
{"title":"[Acute Loss of Vision after Parabulbar Injection of Triamquinolone Acetonide].","authors":"Tamara Bilic, Marie-Alice Amblard, Andre Maurice Trouvain, Anna-Maria Seuthe, Annekatrin Rickmann","doi":"10.1055/a-2338-3394","DOIUrl":"https://doi.org/10.1055/a-2338-3394","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498360","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}
Warda Darwisch, Boris Stanzel, Martin Bedersdorfer, Philipp Ken Roberts, Peter Szurman, Annekatrin Rickmann
{"title":"[Spontaneous Closure of a Full-Thickness Macular Hole].","authors":"Warda Darwisch, Boris Stanzel, Martin Bedersdorfer, Philipp Ken Roberts, Peter Szurman, Annekatrin Rickmann","doi":"10.1055/a-2331-6968","DOIUrl":"https://doi.org/10.1055/a-2331-6968","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498362","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}
Background: The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration.
Material and methods: This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017.
Results: The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 - 7) minutes in group 1 and 8.23 ± 1.26 (8 - 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001).
Conclusions: The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.
{"title":"Facilitated Tenon-Free Conjunctival Autograft Preparation and Limited Tenon Removal Technique in Pterygium Surgery.","authors":"Fikret Ucar, Lutfi Seyrek, Servet Cetinkaya, Huseyin Ture, Ekrem Kadioglu","doi":"10.1055/a-1648-4753","DOIUrl":"10.1055/a-1648-4753","url":null,"abstract":"<p><strong>Background: </strong>The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration.</p><p><strong>Material and methods: </strong>This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017.</p><p><strong>Results: </strong>The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 - 7) minutes in group 1 and 8.23 ± 1.26 (8 - 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001).</p><p><strong>Conclusions: </strong>The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39600934","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}
Pub Date : 2024-07-01Epub Date: 2024-05-24DOI: 10.1055/a-2305-5053
Dirk Bahlmann, Christian van Oterendorp
Glaucoma filtration surgery has been a standard surgical therapy for decades. An increasing knowledge about wound healing processes in the eye, the introduction of antimetabolite treatment and continuous improvements of the surgical technique helped making trabeculectomy - the prototype filtration surgery - a very effective therapeutic tool. However, best results will only be regularly achieved with a high level of experience and time dedicated to postoperative follow-up. Furthermore, the potential for severe early and late complications still remains high. Thus, novel stent-based filtration surgery approaches, such as the Preserflo and the XEN shunt have been introduced. This review presents these three bleb-forming filtration procedures, covering the basic principles of surgical technique, data on effectivity as well as complications.
{"title":"[Glaucoma Filtration Surgery - Bleb-forming Procedures].","authors":"Dirk Bahlmann, Christian van Oterendorp","doi":"10.1055/a-2305-5053","DOIUrl":"10.1055/a-2305-5053","url":null,"abstract":"<p><p>Glaucoma filtration surgery has been a standard surgical therapy for decades. An increasing knowledge about wound healing processes in the eye, the introduction of antimetabolite treatment and continuous improvements of the surgical technique helped making trabeculectomy - the prototype filtration surgery - a very effective therapeutic tool. However, best results will only be regularly achieved with a high level of experience and time dedicated to postoperative follow-up. Furthermore, the potential for severe early and late complications still remains high. Thus, novel stent-based filtration surgery approaches, such as the Preserflo and the XEN shunt have been introduced. This review presents these three bleb-forming filtration procedures, covering the basic principles of surgical technique, data on effectivity as well as complications.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092812","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}
Pub Date : 2024-07-01Epub Date: 2022-04-14DOI: 10.1055/a-1775-8405
Vera Elisabeth Pawlik, Armin Mohi, Felix Rommel, Vinodh Kakkassery, Mahdy Ranjbar, Salvatore Grisanti
{"title":"[Transparent Depiction of Case Reports Linked to COVID-19 and its Vaccination - a Temporal Coincidence].","authors":"Vera Elisabeth Pawlik, Armin Mohi, Felix Rommel, Vinodh Kakkassery, Mahdy Ranjbar, Salvatore Grisanti","doi":"10.1055/a-1775-8405","DOIUrl":"10.1055/a-1775-8405","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75337699","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}
Pub Date : 2024-07-01Epub Date: 2023-06-19DOI: 10.1055/a-2062-3751
Dimitrios Kalogeropoulos, Lincoln Shaw, Dimitra Skondra, Soon Wai Ch'ng, Aikaterini Christodoulou, Chris Kalogeropoulos
Central serous chorioretinopathy (CSCR) is a relatively common retinal disorder that leads to central vision impairment, often with a high recurrence rate. The exact etiology and pathogenetic mechanisms have not been fully elucidated but are likely to be associated with hyperpermeability of the choroidal capillaries and failure of the retinal pigment epithelium (RPE), leading to serous detachment of the neurosensory retina. Multimodal imaging plays a critical role in the diagnostic approach and monitoring of CSCR. Fortunately, the natural course of the disease is usually self-limiting, with spontaneous resolution and total fluid reabsorption. However, some patients may exhibit recurrences or persistent subretinal fluid (chronic CSCR), leading to progressive and irreversible RPE atrophy or photoreceptor damage. Thus, to prevent permanent visual loss, individualized treatment should be considered. Recent developments in the diagnostic and therapeutic approach have contributed to better outcomes in patients with CSCR. More studies are required to improve our understanding of epidemiology, pathogenesis, diagnosis, and treatment, with a significant impact on the management of this challenging clinical entity. The purpose of this review is to summarize the current knowledge about the clinical features, diagnostic workup, and therapeutic approach of CSCR.
{"title":"Central Serous Chorioretinopathy: An Update on the Current State of Management.","authors":"Dimitrios Kalogeropoulos, Lincoln Shaw, Dimitra Skondra, Soon Wai Ch'ng, Aikaterini Christodoulou, Chris Kalogeropoulos","doi":"10.1055/a-2062-3751","DOIUrl":"10.1055/a-2062-3751","url":null,"abstract":"<p><p>Central serous chorioretinopathy (CSCR) is a relatively common retinal disorder that leads to central vision impairment, often with a high recurrence rate. The exact etiology and pathogenetic mechanisms have not been fully elucidated but are likely to be associated with hyperpermeability of the choroidal capillaries and failure of the retinal pigment epithelium (RPE), leading to serous detachment of the neurosensory retina. Multimodal imaging plays a critical role in the diagnostic approach and monitoring of CSCR. Fortunately, the natural course of the disease is usually self-limiting, with spontaneous resolution and total fluid reabsorption. However, some patients may exhibit recurrences or persistent subretinal fluid (chronic CSCR), leading to progressive and irreversible RPE atrophy or photoreceptor damage. Thus, to prevent permanent visual loss, individualized treatment should be considered. Recent developments in the diagnostic and therapeutic approach have contributed to better outcomes in patients with CSCR. More studies are required to improve our understanding of epidemiology, pathogenesis, diagnosis, and treatment, with a significant impact on the management of this challenging clinical entity. The purpose of this review is to summarize the current knowledge about the clinical features, diagnostic workup, and therapeutic approach of CSCR.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219427","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}