Klinische Monatsblatter fur Augenheilkunde最新文献

Purpose: To evaluate the utility of intraoperative optical coherence tomography (iOCT) in guiding the optimal positioning of the Preserflo MicroShunt (PMS) during glaucoma surgery, with the aim of preserving endothelial cell density (ECD) and improving postoperative outcomes.

Patients and methods: This case series includes three patients who underwent PMS repositioning due to tube-endothelium (T-E) contact identified on the anterior segment OCT (AS-OCT). Reoperations were performed using microscope-integrated iOCT to guide and verify the intraoperative position of the implant. Final T-E distance was confirmed postoperatively with AS-OCT.

Results: In all cases, AS-OCT revealed T-E contact with associated epithelial ingrowth, prompting surgical repositioning of the PMS. iOCT provided real-time visualisation during surgery, enabling accurate adjustment of tube positioning and increased T-E separation. Postoperative assessments demonstrated stable or minimally reduced ECD; intraocular pressure was effectively controlled without topical therapy, and corneal transparency was preserved in all patients.

Conclusions: iOCT is a valuable tool in PMS implantation, allowing real-time assessment and optimisation of tube positioning. Ensuring adequate T-E distance minimises endothelial trauma and reduces the risk of long-term ECD loss. Routine use of iOCT during primary implantation may enhance surgical precision and reduce the need for reinterventions.

Purpose: Evaluation of changes in the ocular surfaces in children with a diagnosis of atopic dermatitis (AD).

Methods: Thirty-six children with a diagnosis of AD (Eye-AD group) and 40 healthy subjects (Eye-HS group) were enrolled in this prospective case-control study. Tear film break-up time (T-BUT), Schirmer tear test (STT), conjunctival impression cytology (CIC), tear meniscus height (TMH), tear meniscus area (TMA), and ocular surface disease index (OSDI) were measured.

Results: The participants were similar in terms of demographic characteristics, such as mean age and gender (p > 0.05). The mean T-BUT was 9.3 ± 2.22 s (5 - 16) in the Eye-AD group and 11.83 ± 2.03 s (7 - 16) in the Eye-HS group. The mean STT was 11.12 ± 3.28 mm (5 - 21) in the Eye-AD group and 15.44 ± 3.8 mm (8 - 20) in the Eye-HS group (p < 0.001, p < 0.001, respectively). The mean OSDI scores were 13.12 ± 1.41 (10 - 15) in the Eye-AD group and 13.97 ± 2.93 (8 - 20) in the Eye-HS group (p = 0.052). Mean TMH and TMA were 306.48 ± 7.29 µm and 0.22 ± 0.004 mm², respectively, in the Eye-AD group, and 312.94 ± 5.31 µm and 0.027 ± 0.005 mm², respectively, in the Eye-HS group. In the CIC analyses, 22 of the samples in the Eye-AD group and 35 in the Eye-HS group had a classification of grade 0, 10 in the Eye-AD group and 5 in the Eye-HS group had a classification of grade 1, and 4 in the Eye-AD group and none in the Eye-HS group had a classification of grade 2 (p = 0.015).

Conclusion: Pediatric patients with AD may have significant changes in conjunctival histopathology. These changes can be manifested in the tests used to measure the tear film. Dry eye was shown to be present in the majority of children with AD.

Chemotherapeutic agents can lead to serious visual side effects in the eye, which can affect both the anterior and posterior segment. This article presents a selection of the most important chemotherapeutics causing ocular side effects. We will discuss side effects of chemotherapeutic agents that are applied directly to the eye for the treatment of an ocular neoplasia as well as side effects of systemically applied chemotherapeutic agents. Furthermore, the corresponding therapy and possible necessary adaptions of the chemotherapy are explained. Most importantly the ophthalmologist should stay in close contact with the other treating specialists.

Background: Oregis is the multi-centre registry of the German Ophthalmological Society, that systematically collects a comprehensive data set on ophthalmological care in Germany. Here we present the first analysis of Descemet Membrane Endothelial Keratoplastic (DMEK). Only two of the following centres provided the data presented here, but, in the future, participation in Oregis will increase so that data from different eye hospitals and clinics and outpatient and inpatient treatments will be covered.

Objectives: Overview of real-life care after DMEK in Germany.

Methods: The data was analysed using SweetVIZ 2.1.4. SweetViz is an open-source Python library for automated exploratory data analysis (EDA). Statistical tests were performed using R.

Results: Cystoid macular oedema (CME) and immune response are significant complications of DMEK, and both are treated by corticosteroids.

Discussion: The future expansion of the register will provide data on the current situation and indicate possible improvements in postoperative care in Germany.

Background: Symptomatic vitreous opacities (SVO) are a condition that can significantly affect patients' quality of life. This online survey aims to contribute to the scientific understanding of symptomatic vitreous opacities, by investigating the subjective burden and individual perception of floaters, using a novel tool for field of view reconstruction. In addition, correlations with demographic data and refractive status will be analysed to identify patterns and potential influencing factors.

Methods: We introduce a VO-related online survey covering patient education, experience with floaters and treatment, refraction error and eye diseases, quality of life, and a new sketching tool to simulate the individual field of view with VO. The data were collected between August 2022 and November 2023 and are analysed for correlations; participants' answers are compared to the sketching tool results. We used linear regression with gradient descent to test whether a subjective suffering index from the questionnaire can be matched with an objective suffering index from the new sketching tool.

Results: A total of 1502 people participated in the survey, of whom, 1384 reconstructed their field of view by positioning a total of 10,571 VO. There was no robust correlation between the sketched floaters and the subjective degree of suffering. Translucent VO types are more frequent in younger attendees. The dataset shows a higher prevalence of myopic participants and a lower prevalence of hyperopes with VO compared to global data.

Conclusion: We were able to collect the largest dataset to date quantifying individual experience with floaters. As evidenced by the large number of participants with SVO and individual remarks on their psychological burden, greater effort is needed to improve the care for floater patients.