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  • 1
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    Online Resource
    Microsporidial Stromal Keratitis: A Rare Entity in Central Europe
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 04 ( 2023-04), p. 387-390
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 04 ( 2023-04), p. 387-390
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-2013-2600
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
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  • 2
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    No Pain, No Gain – Topical Anesthesia-Induced Keratopathy
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 04 ( 2023-04), p. 456-458
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 04 ( 2023-04), p. 456-458
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-2013-2661
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
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  • 3
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    Smartphone Slit Lamp Imaging—Usability and Quality Assessment
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 3 ( 2023-01-24), p. 423-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 3 ( 2023-01-24), p. 423-
    Abstract: Purpose: To assess the usability and image quality of a smartphone adapter for direct slit lamp imaging. Methods: A single-center, prospective, clinical study conducted in the Department of Ophthalmology at the University Hospital Zurich, Switzerland. The smartphone group consisted of 26 medical staff (consultants, residents, and students). The control group consisted of one ophthalmic photographer. Both groups took images of the anterior and the posterior eye segment of the same proband. The control group used professional photography equipment. The participant group used an Apple iPhone 11 mounted on a slit lamp via a removable SlitREC smartphone adapter (Custom Surgical GmbH, Munich, Germany). The image quality was graded independently by two blinded ophthalmologists on a scale from 0 (low) to 10 (high quality). Images with a score ≥ 7.0/10 were considered as good as the reference images. The acquisition time was measured. A questionnaire on usability and experience in smartphone and slit lamp use was taken by all of the participants. Results: Each participant had three attempts at the same task. The overall smartphone quality was 7.2/10 for the anterior and 6.4/10 for the posterior segment. The subjectively perceived difficulty decreased significantly over the course of three attempts (Kendall’s W). Image quality increased as well but did not improve significantly from take 1 to take 3. However, the image quality of the posterior segment was significantly, positively correlated (Spearman’s Rho) with work experience. The mean acquisition time for anterior segment imaging was faster in the smartphone group compared to the control group (156 vs. 206 s). It was vice versa for the posterior segment (180 vs. 151 s). Conclusion: Slit lamp imaging with the presented smartphone adapter provides high-quality imaging of the anterior segment. Posterior segment imaging remains challenging in terms of image quality. The adapter constitutes a cost-effective, portable, easy-to-use solution for recording ophthalmic photos and videos. It can facilitate clinical documentation and communication among colleagues and with the patient especially outside normal consultation hours. Direct slit lamp imaging allows for time to be saved and increases the independence of ophthalmologists in terms of patient mobility and the availability of photographic staff.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13030423
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 4
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    Analysis of Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) Parameters in Young Adults after SARS-CoV-2 Infection (COVID-19) Compared with Healthy Young Controls
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 7 ( 2023-03-28), p. 1283-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 7 ( 2023-03-28), p. 1283-
    Abstract: Purpose: To compare retinal changes in young adults with previous SARS-CoV-2 infection with healthy young controls using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: This prospective single-center study was conducted at the University Hospital of Zurich, Zurich, Switzerland. Participants were imaged from May to November 2021 using the SOLIX device (Visionix International SAS, Pont-de-l’Arche, France). We performed 12 mm × 12 mm, 6.4 mm × 6.4 mm, 6 mm × 6 mm and 3 mm × 3 mm OCT and OCTA scans, as well as fundus photography of each participant’s eyes. Results: In total, 466 participants were imaged. Of these, 233 were healthy controls with negative RT-PCR tests for SARS-CoV-2, 168 were young adults who had a SARS-CoV-2 infection at least 180 days previously, 19 were participants who had a SARS-CoV-2 infection 〈 180 days previously, and 46 were participants with asymptomatic SARS-CoV-2 infection (i.e., serologically positive but with no symptoms). Compared with healthy controls, statistically significant differences were found for OCTA recordings of the optic disc for the whole image (WI) and WI capillary vessel density, with both being higher in the SARS-CoV-2 group. Conclusion: Statistically significant results were only observed for selected variables, and in parts, only unilaterally, with relatively large p values (p = 0.02–0.03). Thus, we did not interpret these as clinically significant, leading to the conclusion that young and otherwise healthy individuals (mainly men) seem to recover from mild COVID-19 infections with no ophthalmological residues.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13071283
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 5
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    Online Resource
    Natural Course of Solar and Laser-Associated Retinal and Macular Injuries at a Primary Care Hospital in Switzerland
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 04 ( 2023-04), p. 516-521
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 04 ( 2023-04), p. 516-521
    Abstract: Background Solar and laser-associated retinopathies are rare occurrences. The two retinopathies are both photo-induced but differ in the involved intensity and duration of exposure. The purpose of this study was to evaluate the clinical features and natural course of these two entities, with a focus on the changes in the outer retina over time. Patients and Methods This retrospective analysis assessed patients with solar or laser maculopathy seen at the Department of Ophthalmology of the University Hospital Zurich in Switzerland over the last 10 years. Visual acuity (VA; Snellen) and optical coherence tomography (OCT) findings were reviewed and analyzed at baseline and last follow-up visit. Areas of damaged outer retina, identified on en face OCT images as hyporeflective areas, were tagged and compared between visits. Descriptive analysis was performed by calculating mean values ± standard deviation (SD). Statistical evaluation was done using the Wilcoxon signed rank test. A p value 〈  0.05 was considered statistically significant. Results Five patients with solar retinopathy and six patients with laser-associated retinopathy were identified. In the solar retinopathy group, mean VA at baseline was 0.80 (SD ± 0.37) and improved to 0.90 (SD ± 0.36). This was not statistically significant (p = 0.066). In the laser-associated retinopathy group, mean VA at baseline was 0.89 (SD ± 0.18) and improved to 1.03 (SD ± 0.09), which was not statistically significant either (p = 0.063). At baseline, in OCT cross-sections, initial changes were observed in the interdigitation, myoid, and ellipsoid zone, as well as the outer nuclear layer and the Henle fiber layer. At follow-up, most cases presented an alteration in the residual ellipsoid zone, with the degree of the aforementioned alterations depending on the size of the initial defect. A decrease of the hyporeflective alterations measured in en face OCT scans was observed in both groups but was only statistically significant in the laser-associated retinopathy group (p = 0.018 versus p = 0.172). Conclusions OCT can help to detect and monitor solar and laser-associated retinal injuries. Most injuries are minor, with good functional restitution. Minor changes in the ellipsoid zone often persist, even in cases with full visual recovery.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-2021-7724
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
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  • 6
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    Severe Complications after Corneal Collagen Cross-Linking (CXL)
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 04 ( 2023-04), p. 369-378
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 04 ( 2023-04), p. 369-378
    Abstract: Purpose To present a case series of rare and severe complications after corneal collagen cross-linking (CXL) of keratoconus patients. Methods Single-center descriptive case series covering the period of 2012 to 2022 at the Department of Ophthalmology at the University Hospital, Zurich, Switzerland. Results We present four eyes of four patients that showed severe unusual complications within the first month after CXL. Three patients had been treated with the classical epithelium-off “Dresden” protocol. One patient had been treated with the accelerated epithelium-off protocol. One patient presented with extensive corneal edema due to rubbing the eye after treatment. Two patients showed a bacterial infectious keratitis: one due to Streptococcus pneumoniae and the other due to Staphylococcus hominis, Micrococcus luteus, and Streptococcus epidermidis. The latter of the two patients exhibited extensive infectious crystalline keratopathy. The fourth patient showed a severe ulcerative lesion where no infectious cause could be found. Therefore, an autoimmune keratolytic process had to be suspected. Apart from the corneal edema, which resolved ad integrum, the other complications resulted in permanent corneal scarring and thinning. One patient needed an emergency amniotic transplant. Conclusion Severe complications after CXL remain rare. Most common causes are complications that are not directly associated with the treatment as such. Those indirect complications occur after the treatment during the healing course of the epithelium. Associations with bandage contact lenses, topical steroids, atopic disease, and inappropriate patient behavior are often suspected. Correctly performed corneal scrapings with repeated microbiological analysis and a detailed patient history are essential for establishing the correct diagnosis, especially in complicated cases that do not respond to a standard therapeutic regimen. This case series supports the efforts that are currently taken to improve the CXL technique in a way that postoperative complications are further reduced. A more efficient epithelium-on technique might be a step in that direction.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-2040-4290
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
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  • 7
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    Correlation between Macular Neovascularization (MNV) Type and Druse Type in Neovascular Age-Related Macular Degeneration (AMD) Based on the CONAN Classification
    MDPI AG ; 2022
    In:  Biomedicines Vol. 10, No. 10 ( 2022-09-22), p. 2370-
    Details
    In: Biomedicines, MDPI AG, Vol. 10, No. 10 ( 2022-09-22), p. 2370-
    Abstract: To investigate associations and predictive factors between macular neovascularization (MNV) lesion variants and drusen types in patients with treatment-naïve neovascular age-related macular degeneration (AMD). Methods: Multimodal imaging was retrospectively reviewed for druse type (soft drusen, subretinal drusenoid deposits (SDDs) or mixed) and MNV type (MNV 1, MNV 2, MNV 1/2 or MNV 3). The Consensus on Neovascular AMD Nomenclature (CONAN) classification was used for characterizing MNV at baseline. Results: One eye of each eligible patient was included (n = 191). Patients with predominant SDDs had an increased adjusted odds ratio (aOR) for MNV 2 (23.4453, p = 0.0025) and any type of MNV 3 (8.7374, p 〈 0.0001). Patients with MNV 1/2 had an aOR for predominant SDDs (0.3284, p = 0.0084). Patients with MNV1 showed an aOR for SDDs (0.0357, p 〈 0.0001). Eyes with SDDs only without other drusen types showed an aOR for MNV 2 (9.2945, p 〈 0.0001). Conclusions: SDDs represent a common phenotypic characteristic in AMD eyes with treatment-naïve MNV. The aOR for eyes with predominant SDDs to develop MNV 2 and MNV 3 was much higher, possibly due to their location in the subretinal space. The predominant druse type may help to predict which type of MNV will develop during the course of AMD.
    Type of Medium: Online Resource
    ISSN: 2227-9059
    URL: Article
    DOI: 10.3390/biomedicines10102370
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2720867-9
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  • 8
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    Safety and Efficacy of Current Sclera Fixation Methods for Intraocular Lenses and Literature Overview
    Georg Thieme Verlag KG ; 2021
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 238, No. 08 ( 2021-08), p. 868-874
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 238, No. 08 ( 2021-08), p. 868-874
    Abstract: Hintergrund Evaluation der 3 aktuell meistverwendeten Sklerafixationstechniken für Intraokularlinsen (IOL) (1) Prolene-Naht mit Hoffman-Skleratasche, (2) GoreTex-Naht mit 4-Punkt-Aufhängung, (3) nahtlose intrasklerale Fixation mit gekauterten IOL-Haptikenden und Doppelnadeltechnik („Yamane-Technik“). Material und Methoden IRB-genehmigte retrospektive klinische Studie an der Augenklinik der Ludwig-Maximilians-Universität (LMU) München. 55 Augen (n = 55) von 51 Patienten wurden eingeschlossen. Bestkorrigierter Fernvisus (BCVA), objektive Refraktion (OR), Hornhauttopografie (CCT), Biometrie, zentrale Makuladicke (CMT) mittels optischer Kohärenztomografie (OCT), Augeninnendruck (IOD), IOL-Typ und IOL-Stärke wurden vor und 3 – 12 Monate nach IOL-Sklerafixation untersucht. Eine statistische Auswertung über Unterschiede präoperativ zu postoperativ wurde mittels eines Wilcoxon-Rangsummentests (z) durchgeführt. Ergebnisse Eine Sklerafixation mittels GoreTex-Naht wurde in 14 (25,5%) Augen, mittels Prolene-Naht in 19 (34,5%,) und mittels Yamane-Technik in 22 (40,0%) Augen durchgeführt. Innerhalb der 3 – 12 Monate Beobachtungszeitraum nach Sklerafixation mussten insgesamt 2 × (14,3%) GoreTex-, 3 × (15,8%) Prolene-, 1 × (4,5%) Yamane-Augen refixiert werden. Die Analyse zeigte einen statistisch signifikanten Unterschied bei der BCVA in der gesamten Kohorte (exakter Wilcoxon-Test: z = − 3,202; p = 0,001; n = 55) und in der Yamane-Subgruppe (exakter Wilcoxon-Test: z = − 2,068; p = 0,001; n = 22) im Vergleich zu prä-OP. Die GoreTex- (n = 14) und die Prolene-Subgruppe (n = 19) zeigten keine statistisch signifikanten Unterschiede zu prä-OP. Gruppenübergreifend war kein statistisch signifikanter Unterschied bei IOD, CMT und CCT festzustellen. Es traten keine retinalen Komplikationen auf, weder während der OP noch im Beobachtungszeitraum. Schlussfolgerung Die Anzahl der IOL-Revisionen nimmt zu. Oft bleibt als einzige Option nur eine IOL-Sklerafixation zur visuellen Rehabilitation. Alle 3 untersuchten Sklerafixationsmethoden zeigten ein gutes Sicherheitsprofil ohne statistisch signifikanten Einfluss auf IOD, CMT, CCT, aber eine nennenswerte Revisionsrate. Eine visuelle Rehabilitation des BCVA auf den präoperativen Status (GoreTex [n = 14] und Prolene [n = 19] ) bzw. ein statistisch signifikanter Visusanstieg (Gesamtkohorte [n = 55] und Yamane [n = 22] ) scheint möglich. Verglichen mit der Irisfixation ist die Sklerafixation chirurgisch komplexer und hat eine steilere Lernkurve für den Chirurgen.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-1333-3199
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
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  • 9
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    Analysis of opacification patterns in intraocular lenses (IOL)
    BMJ ; 2021
    In:  BMJ Open Ophthalmology Vol. 6, No. 1 ( 2021-02), p. e000589-
    Details
    In: BMJ Open Ophthalmology, BMJ, Vol. 6, No. 1 ( 2021-02), p. e000589-
    Abstract: Intraocular lens (IOL) opacification may cause severe visual impairment. The pathogenesis remains unclear. The aim of this study was to analyse opacification patterns in different IOLs. Therefore, this multicentre, retrospective, observational study was conducted at Ludwig-Maximilians-University, Munich, Germany and University-Hospital Basel, Switzerland. Methods and analysis In this study, 75 opacified IOLs were identified and classified after extraction. Macroscopical photo documentation, light and electron microscopic analysis were done. Results 68 acrylic-hydrophilic single-piece-IOLs, 1 acrylic-hydrophilic 3-piece-IOL, 6 acrylic-hydrophobic 3-piece-IOLs were extracted. The dataset comprised IOLs known for opacification and IOLs not having been reported yet. 67 IOLs showed a fine-granular and 8 IOLs a crust-like opacification pattern. According to literature, 62 of the fine-granular opacified IOLs were graded into type 1 (processing/packaging-induced primary opacification) and 13 into type 2 (secondary opacification of unknown aetiology). The anterior surface of the IOLs was affected in all 75 IOLs, the posterior surface only in 23 cases. Of all 67 fine-granular IOLs, 43 had a central defect and 21 had a zone without opacification (clear islet). Conclusion In our series, the morphology of IOL opacification did not follow the existing pathogenetic classification that strictly discriminates between primary and secondary causes. Fine-granular IOL opacification occurs with similar patterns in both type 1 and type 2 IOL opacification, while a crust-like pattern was only detected in type 2 IOL opacifications. Consequently, susceptibility of an IOL to opacification is caused by a multifactorial combination of material and processing properties as well as individual (pathological) conditions of the patient.
    Type of Medium: Online Resource
    ISSN: 2397-3269
    URL: Article
    DOI: 10.1136/bmjophth-2020-000589
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2870303-0
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  • 10
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    Novel surgical technique of sutureless artificial iris and intraocular lens scleral fixation using Yamane technique
    Elsevier BV ; 2022
    In:  American Journal of Ophthalmology Case Reports Vol. 26 ( 2022-06), p. 101502-
    Details
    In: American Journal of Ophthalmology Case Reports, Elsevier BV, Vol. 26 ( 2022-06), p. 101502-
    Type of Medium: Online Resource
    ISSN: 2451-9936
    URL: Article
    DOI: 10.1016/j.ajoc.2022.101502
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2901220-X
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