Universitats Augenklinik Tubingen

Germany

Universitats Augenklinik Tubingen

Germany
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Cayless A.,Open University Milton Keynes | Bende T.,Universitats Augenklinik Tubingen
Zeitschrift fur Medizinische Physik | Year: 2015

Background: This paper presents preliminary observations on the use of a commercial pupillometric instrument (Albomed PupilX) for the detection and quantification of Relative Afferent Pupillary Defect (RAPD). In this pilot study, video-based pupillometry was used in conjunction with calibrated LED illumination to simulate the effects of the traditional swinging-flashlight test using neutral density filters. Methods: The results presented in this study follow a method described by Wilhelm et al. (Tübingen SWIFT-test) in which the eyes are illuminated alternately and the response in pupil diameter measured by video pupillometry. Using the PupilX instrument, the LED intensity can be programmed in logarithmic steps starting from a maximum intensity of 1000 lux (lx), with each reduction of 50% in illumination intensity corresponding to a 0.3 log-units increase in filter density. Results: The eyes were stimulated unilaterally with illumination intensities corresponding to a neutral density range of 0.0 to 0.9 log-units. In all normal subjects a symmetrical pupil reaction was seen, independent of which eye was stimulated. In contrast, in a subject with known RAPD, a clear asymmetry in the reaction to stimulation of the left and the right eyes was seen. Conclusions: These measurements were compared with typical results from the original Tübingen SWIFT study and good qualitative agreement was seen. Furthermore, the method can clearly differentiate between healthy subjects and those with a known RAPD, indicating that the PupilX, programmed with specific stimulus sequences and in conjunction with a suitable analysis software, has the potential for recognition and quantification of RAPD, and prompting the suggestion for further study involving a range of patients including both normal subjects and those with a known and quantified RAPD. © 2015.


Krohne T.U.,Universitats Augenklinik Bonn | Aisenbrey S.,Universitats Augenklinik Tubingen | Holz F.G.,Universitats Augenklinik Bonn
Ophthalmologe | Year: 2012

Retinopathy of prematurity is one of only few potentially blinding retinal diseases of infancy amenable to prevention of visual loss by appropriate and timely therapeutic measures. Retinal ablative therapies, such as laser coagulation eliminate the disease-causing secretion of vascular endothelial growth factor (VEGF) by the avascular peripheral retina. Blockage of VEGF activity by intravitreal administration of VEGF-inhibitory drugs has likewise proven effective in recent clinical studies. Advanced stages of the disease may require surgical intervention. Knowledge of indications and techniques of the different currently available treatment options is crucial to ensure an optimal visual outcome for the affected children. © 2012 Springer-Verlag Berlin Heidelberg.


PubMed | Open University Milton Keynes and Universitats Augenklinik Tubingen
Type: Journal Article | Journal: Zeitschrift fur medizinische Physik | Year: 2016

This paper presents preliminary observations on the use of a commercial pupillometric instrument (Albomed PupilX) for the detection and quantification of Relative Afferent Pupillary Defect (RAPD). In this pilot study, video-based pupillometry was used in conjunction with calibrated LED illumination to simulate the effects of the traditional swinging-flashlight test using neutral density filters.The results presented in this study follow a method described by Wilhelm et al. (Tbingen SWIFT-test) in which the eyes are illuminated alternately and the response in pupil diameter measured by video pupillometry. Using the PupilX instrument, the LED intensity can be programmed in logarithmic steps starting from a maximum intensity of 1000 lux (lx), with each reduction of 50% in illumination intensity corresponding to a 0.3 log-units increase in filter density.The eyes were stimulated unilaterally with illumination intensities corresponding to a neutral density range of 0.0 to 0.9 log-units. In all normal subjects a symmetrical pupil reaction was seen, independent of which eye was stimulated. In contrast, in a subject with known RAPD, a clear asymmetry in the reaction to stimulation of the left and the right eyes was seen.These measurements were compared with typical results from the original Tbingen SWIFT study and good qualitative agreement was seen. Furthermore, the method can clearly differentiate between healthy subjects and those with a known RAPD, indicating that the PupilX, programmed with specific stimulus sequences and in conjunction with a suitable analysis software, has the potential for recognition and quantification of RAPD, and prompting the suggestion for further study involving a range of patients including both normal subjects and those with a known and quantified RAPD.


Rohrbach J.M.,Universitats Augenklinik Tubingen | Leitritz M.A.,Universitats Augenklinik Tubingen
Ophthalmologe | Year: 2017

Not only the scientific successes but also his personality caused Albrecht von Graefe (1828–1870) to gain a worldwide reputation. His two foundations “Archive for Ophthalmology” in 1854 and the “(German) Ophthalmological Society” (DOG) in 1857 as well as his famous eye clinic in Berlin were important for his colleagues and patients from many countries and most continents. The 2017 DOG congress has the motto “German Ophthalmology internationally”; thus, it is worthwhile to be reminded of this great ophthalmologist. © 2017 The Author(s)


Ehrhardt J.,Universitats Augenklinik Tubingen | Gelisken F.,Universitats Augenklinik Tubingen
Ophthalmologe | Year: 2017

We report on a 30-year-old male patient presenting with acute bilateral loss of vision. Fundus examination showed bilateral retinal hemorrhages, cotton-wool spots, macular edema and optic disk hyperemia. The blood pressure was elevated. The patient was referred to the emergency department with the diagnosis of severe stage IV hypertensive retinopathy. Further examination revealed a previously unknown IgA glomerulonephritis with terminal renal failure and secondary blood pressure derailment. Hypertensive retinopathy can be a first sign of acute renal failure. In cases of hypertensive retinopathy the differential diagnosis including systematic screening is of utmost importance. © 2017 Springer Medizin Verlag GmbH


Inhoffen W.,Universitats Augenklinik Tubingen | Ziemssen F.,Universitats Augenklinik Tubingen | Bartz-Schmidt K.U.,Universitats Augenklinik Tubingen
Klinische Monatsblatter fur Augenheilkunde | Year: 2012

Central neurosensory detachments (NSD) with time-dependent height constitute a disease called central serous chorioretinopathy (CSC), if not arising from uveitis, choroidal neovascularisations (CNV) or leaking retinal vessels. In 10 % of these patients, CSC develops into a chronic disease with recurrent NSD, atrophy of photoreceptors and severe drop in visual acuity. This review article summarises recent progress in understanding this disease and its appearance in funduscopy, FLA, ICG, OCT, autofluorescence as well as its progress, therapy and possible development into secondary CNV. The provided examples illustrate the progression of acute CSC into chronic CSC and with CNV over years. The different appearance of polypoidal choroidal vasculopathy (PCV) in ICG and some of the signs of atypical chronic CSC are discussed. To distinguish between cCSC and wet AMD - both exhibiting leakage in FLA - typical signs are helpful, e.g., "gravitational trackso", retinal precipitates and missing drusen. However, in small lesions, it may be difficult or almost impossible to ensure the correct diagnosis of the underlying disease. The same holds for occult and classic secondary CNV in cCSC vs. CNV in AMD, where photodynamic therapy (PDT) can be successful only in cCSC-CNV and in cCSC without CNV. Corticosteroids often lead to further impairment, even in cases of atypical cCSC, when frequently misdiagnosed as uveitis. As a duration of NSD of more than 4 months is suspected to induce an impairment of photoreceptors, regular examinations are necessary not only in chronic CSC but also after acute CSC (as this form can develop into chronic CSC), while effective therapies are available to resolve the NSD (PDT, anti-VEGF). © Georg Thieme Verlag KG Stuttgart · New York.


Voykov B.,Universitats Augenklinik Tubingen | Rohrbach J.M.,Universitats Augenklinik Tubingen
Ophthalmologe | Year: 2016

Canaloplasty is a recently introduced non-penetrating surgical technique for glaucoma, which seeks to improve the natural outflow of aqueous humor through Schlemm’s canal and the collector channels. Just as in all forms of glaucoma surgery there are a certain number of failures of the procedure and further surgery is often needed to reduce the intraocular pressure in these cases. This article describes some of the revision procedures after canaloplasty. © 2016 Springer-Verlag Berlin Heidelberg


Petermeier K.,Universitats Augenklinik Tubingen | Szurman P.,Universitats Augenklinik Tubingen | Bartz-Schmidt U.K.,Universitats Augenklinik Tubingen | Gekeler F.,Universitats Augenklinik Tubingen
Klinische Monatsblatter fur Augenheilkunde | Year: 2010

Cataract formation is one of the most common complications after vitrectomy and cataract extraction in such cases will have to be performed under more difficult conditions. A knowledge of the different types of cataract, their frequency and causes may help to develop strategies to prevent this complication. In addition to a progressive nuclear opacification, which may occur after any type of vitrectomy, transient feathering of the lens often occurs after intraocular gas tamponade, while permanent subcapsular opacification may occur in silicone oil-filled eyes. Nuclear opacification after vitrectomy morphologically and histologically resembles age-related cataracts, but shows a faster progression: two years after vitrectomy half of the eyes require cataract extraction and there seems to be an age limit: the opacification progresses faster in patients over 50 years old. The main cause for nuclear cataracts most probably is oxidative stress. Oxygen in the avascular lens is provided by diffusion, meaning that the surrounding oxygen content is crucial for the oxygen content within the lens and thus for the formation of reactive oxygen species. In rabbits and also in humans the partial oxygen pressure is highly elevated in the vitreous cavity after vitrectomy and posterior to the lens since the vitreous is lacking as a diffusion barrier for the oxygen. The partial oxygen pressure might be additionally elevated by ventilation with oxygen and a high oxygen pressure in the infusion fluid during surgery. This elevated partial oxygen pressure may lead to increased oxygen stress and thus to lens opacification by oxidation of structural proteins. The key for the prevention of cataract formation therefore seems to be avoidance of oxidative stress, factors that might increase the protective or repair systems are so far not available. Ventilation with oxygen should be minimised as should be the partial oxygen tension in the infusion fluid. New hydrogels as vitreous substitutes might have a beneficial influence on intraocular partial oxygen tension. © Georg Thieme Verlag KG Stuttgart New York.


Nessmann A.,Universitats Augenklinik Tubingen | Schramm C.,Universitats Augenklinik Tubingen | Gelisken F.,Universitats Augenklinik Tubingen
Ophthalmologe | Year: 2016

A 64-year-old female patient complained of a bilateral reduction in vision. The foveal reflex was remarkable bilaterally and optical coherence tomography (OCT) demonstrated the absence of a foveal depression. After exclusion of possible diseases foveal hypoplasia was diagnosed. This rare alteration of the fovea should not be mistaken for foveal edema. A volume scan with a narrow grid is advisable to avoid a misinterpretation. © 2015, Springer-Verlag Berlin Heidelberg.


PubMed | Universitats Augenklinik Tubingen
Type: Journal Article | Journal: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft | Year: 2016

A 64-year-old female patient complained of a bilateral reduction in vision. The foveal reflex was remarkable bilaterally and optical coherence tomography (OCT) demonstrated the absence of a foveal depression. After exclusion of possible diseases foveal hypoplasia was diagnosed. This rare alteration of the fovea should not be mistaken for foveal edema. A volume scan with a narrow grid is advisable to avoid a misinterpretation.

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