@phdthesis{Dierkes2022,
  author    = {Dierkes, Friederike},
  title     = {Management des malignen Uveamelanoms mit den Therapieregimen Ruthenium\(^{106}\)-Brachytherapie und Enukleation an der Augenklinik und Poliklinik der Universit{\"a}t W{\"u}rzburg},
  doi       = {10.25972/OPUS-26933},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-269330},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Mit der vorliegenden Arbeit wird das Management der Uveamelanome an der Augenklinik und Poliklinik der Universit{\"a}t W{\"u}rzburg n{\"a}her betrachtet. Das maligne Uveamelanom ist ein seltener, aber sehr aggressiver, intraokularer Tumor, der vorwiegend im hohen Alter auftritt. Es stehen verschiedene Therapieoptionen zur Verf{\"u}gung, darunter auch die hier verglichenen Therapien Brachytherapie und Enukleation mit ihren Auswirkungen auf Melanom, Auge und Metastasierung/{\"U}berleben.},
  subject      = {Aderhaut},
  language  = {de}
}
@phdthesis{VermaFuehring2022,
  author    = {Verma-F{\"u}hring, Raoul},
  title     = {Die Trabekulopunktion als Pr{\"a}diktiver Test f{\"u}r den Erfolg der Ab Interno Trabekulektomie im Schweineaugenmodell},
  doi       = {10.25972/OPUS-28263},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-282633},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {To investigate trabeculopuncture (TP) for predicting the outcome of ab interno trabeculectomy (AIT). Ex vivo porcine anterior segments were perfused and sequentially underwent two procedures, TP and AIT. We concluded that a 10\% reduction in IOP after TP can be used to predict the success (>20\% IOP decrease) of AIT in porcine eyes. As porcine eyes share many similarities with human eyes, our findings may have implications on the validity of this test as a predictor for surgical outcomes of AITs in humans.},
  subject      = {Glaukom},
  language  = {en}
}
@article{GlatzelPatzkoMatlachetal.2021,
  author    = {Glatzel, Caroline Maria and Patzk{\´o}, {\´A}gnes and Matlach, Juliane and Grehn, Franz},
  title     = {Ergebnisse der filtrierenden Trabekulotomie (FTO) im Vergleich zur konventionellen Trabekulektomie (TE) - eine gematchte Fall-Kontroll-Studie},
  series = {Der Ophthalmologe},
  volume    = {118},
  journal   = {Der Ophthalmologe},
  number    = {5},
  doi       = {10.1007/s00347-021-01365-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266542},
  pages     = {461-469},
  year      = {2021},
  abstract  = {Ziel Ziel dieser Studie war es, die 2‑Jahres-Ergebnisse der filtrierenden Trabekulotomie (FTO) im Vergleich zur konventionellen Trabekulektomie (TE) bei prim{\"a}rem Offenwinkelglaukom, Pseudoexfoliationsglaukom und Pigmentglaukom zu untersuchen. Patienten und Methoden Es wurden 30 konsekutive Patienten nach FTO und 87 Patienten nach TE nach intraokularem Druck (IOD) und Alter im Verh{\"a}ltnis 1:3 gematcht. Prim{\"a}rer Endpunkt war das Erreichen des Zieldrucks nach 2 Jahren. Als vollst{\"a}ndiger Erfolg wurde ein IOD ohne Medikamente von ≤ 18 mm Hg bei gleichzeitiger IOD-Reduktion um ≥ 30 \% definiert, als qualifizierter Erfolg, wenn hierf{\"u}r zus{\"a}tzlich Medikamente erforderlich waren. Sekund{\"a}re Endpunkte waren mittlere Drucksenkung, resultierende Sehsch{\"a}rfe, Komplikationen und nachfolgende Operationen. Die Operationstechnik der filtrierenden Trabekulotomie ist als Video zu diesem Beitrag abrufbar. Ergebnisse Zwei-Jahres-Daten konnten von 27 Patienten aus der FTO-Gruppe und 68 Patienten aus der TE-Gruppe erhoben werden. Die Patienten beider Gruppen wurden vor Beginn der Studie bez{\"u}glich Alter und IOD gematcht, waren aber auch bez{\"u}glich Sehsch{\"a}rfe, Geschlecht und Medikation nicht unterschiedlich. Der Median des pr{\"a}operativen IOD unter Therapie betrug in beiden Gruppen 23,0 mm Hg. Nach den oben genannten Kriterien wurde ein qualifizierter 2‑Jahres-Erfolg bei 70,4 \% der FTO-Gruppe und bei 77,6 \% der TE-Gruppe erzielt (p = 0,60), ein vollst{\"a}ndiger 2‑Jahres-Erfolg bei 33,3 \% der FTO-Gruppe und bei 56,7 \% der TE-Gruppe (p = 0,07). Beide Operationsmethoden senkten den Augeninnendruck nach 24 Monaten signifikant (p < 0,001), und zwar auf 12,8 mm Hg in der FTO-Gruppe und 11,0 mm Hg in der TE-Gruppe. Die Sehsch{\"a}rfe war postoperativ bei beiden Gruppen etwas verringert, unterschied sich jedoch nicht signifikant zwischen beiden Gruppen. Komplikations- und Reoperationsrate waren gering und unterschieden sich nicht zwischen den Gruppen. Schlussfolgerung FTO und TE sind nach 2 Jahren weitgehend gleichwertig bez{\"u}glich Zieldruck, IOD-Senkung, Sehsch{\"a}rfe und Komplikationen.},
  language  = {de}
}
@phdthesis{Reichel2022,
  author    = {Reichel, Clara Maria Christiane},
  title     = {Auswirkungen einer systemischen Chloroquin/Hydroxychloroquin-Therapie auf die quantitative Fundusautofluoreszenz},
  doi       = {10.25972/OPUS-28320},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-283202},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Ziel dieser Arbeit war es, den Einfluss von CQ- und HCQ-Einnahme auf die quantitative Fundusautofluoreszenz (QAF) zu untersuchen. Untersucht wurde, ob sich die QAF als Screening Methode in der Fr{\"u}herkennung von CQ/HCQ induzierten retinalen Ver{\"a}nderungen eignet. Dazu wurden erstmalig in einer prospektiven Querschnittsstudie 38 Patienten unter CQ/HCQ Therapie eingeschlossen und mittels multimodaler Bildgebung (FAF, QAF, SD-OCT) sowie weiteren funktionellen Test (mfERG und Perimetrie) untersucht. QAF Aufnahmen wurden mittels FIJI Plug-Ins analysiert und gegen eine alters- und geschlechtsadaptierte Kontrollgruppe verglichen. Bei 5 der 38 Patienten zeigten sich f{\"u}r die CQ/HCQ Makulopathie typische Ver{\"a}nderungen in allen Modalit{\"a}ten. Aufgrund der kontrovers diskutierten Aussagekraft der QAF im Alter {\"u}ber 60 Jahren formten wir eine Subpopulation der Patienten bis 60 Jahre, bei denen in 4 von 29 F{\"a}llen CQ/HCQ induzierte Ver{\"a}nderungen sichtbar waren. Unabh{\"a}ngig vom Alter zeigt sich bei Patienten ohne BEM, verglichen zur Kontrollgruppe, signifikant erh{\"o}hte QAF Werte. Diese fallen bereits nach kurzer Einnahmedauer auf und bleiben Jahre nach Absetzen der Therapie bestehen. Die erh{\"o}hten QAF Werte treten, mit Ausnahme der Patientin mit ausgepr{\"a}gter BEM, in Abwesenheit von Pathologien in den anderen Untersuchungsmethoden und Ver{\"a}nderungen der {\"a}ußeren Netzhaut in der SD-OCT auf. Bei Patienten mit BEM sind in den QAF Aufnahmen das typische parafoveale Autofluoreszenzmuster, sowie hohe QAF Werte außerhalb der Atrophiezone in der Perifovea zu erkennen. Erh{\"o}hte QAF Werte, bereits nach kurzer Einnahme, k{\"o}nnten auf Einlagerungen von CQ/HCQ oder deren Metaboliten zur{\"u}ckzuf{\"u}hren sein. Inwieweit sich Intensit{\"a}ten und Muster der QAF im Verlauf der Medikamenteneinnahme ver{\"a}ndern und so Hinweise auf m{\"o}gliche fr{\"u}he Netzhautsch{\"a}den durch die Medikamente geben k{\"o}nnen, ist durch diese Arbeit nicht gekl{\"a}rt. Ob die QAF ein m{\"o}gliches Screening Instrument zur fr{\"u}hen Detektion einer BEM sein kann, muss in weiteren Verlaufsstudien untersucht werden.},
  subject      = {Chloroquin},
  language  = {de}
}
@article{WaltherZimmermannTheuersbacheretal.2021,
  author    = {Walther, Grit and Zimmermann, Anna and Theuersbacher, Johanna and Kaerger, Kerstin and Lilienfeld-Toal, Marie von and Roth, Mathias and Kampik, Daniel and Geerling, Gerd and Kurzai, Oliver},
  title     = {Eye infections caused by filamentous fungi: spectrum and antifungal susceptibility of the prevailing agents in Germany},
  series = {Journal of Fungi},
  volume    = {7},
  journal   = {Journal of Fungi},
  number    = {7},
  issn      = {2309-608X},
  doi       = {10.3390/jof7070511},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241810},
  year      = {2021},
  abstract  = {Fungal eye infections can lead to loss of vision and blindness. The disease is most prevalent in the tropics, although case numbers in moderate climates are increasing as well. This study aimed to determine the dominating filamentous fungi causing eye infections in Germany and their antifungal susceptibility profiles in order to improve treatment, including cases with unidentified pathogenic fungi. As such, we studied all filamentous fungi isolated from the eye or associated materials that were sent to the NRZMyk between 2014 and 2020. All strains were molecularly identified and antifungal susceptibility testing according to the EUCAST protocol was performed for common species. In total, 242 strains of 66 species were received. Fusarium was the dominating genus, followed by Aspergillus, Purpureocillium, Alternaria, and Scedosporium. The most prevalent species in eye samples were Fusarium petroliphilum, F. keratoplasticum, and F. solani of the Fusarium solani species complex. The spectrum of species comprises less susceptible taxa for amphotericin B, natamycin, and azoles, including voriconazole. Natamycin is effective for most species but not for Aspergillus flavus or Purpureocillium spp. Some strains of F. solani show MICs higher than 16 mg/L. Our data underline the importance of species identification for correct treatment.},
  language  = {en}
}
@article{DakroubVermaFuehringAgorastouetal.2022,
  author    = {Dakroub, Mohamad and Verma-Fuehring, Raoul and Agorastou, Vaia and Sch{\"o}n, Julian and Hillenkamp, Jost and Puppe, Frank and Loewen, Nils A.},
  title     = {Inter-eye correlation analysis of 24-h IOPs and glaucoma progression},
  series = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  volume    = {260},
  journal   = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  number    = {10},
  doi       = {10.1007/s00417-022-05651-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323831},
  pages     = {3349-3356},
  year      = {2022},
  abstract  = {Purpose To determine whether 24-h IOP monitoring can be a predictor for glaucoma progression and to analyze the inter-eye relationship of IOP, perfusion, and progression parameters. Methods We extracted data from manually drawn IOP curves with HIOP-Reader, a software suite we developed. The relationship between measured IOPs and mean ocular perfusion pressures (MOPP) to retinal nerve fiber layer (RNFL) thickness was analyzed. We determined the ROC curves for peak IOP (T\(_{max}\)), average IOP(T\(_{avg}\)), IOP variation (IOP\(_{var}\)), and historical IOP cut-off levels to detect glaucoma progression (rate of RNFL loss). Bivariate analysis was also conducted to check for various inter-eye relationships. Results Two hundred seventeen eyes were included. The average IOP was 14.8 ± 3.5 mmHg, with a 24-h variation of 5.2 ± 2.9 mmHg. A total of 52\% of eyes with RNFL progression data showed disease progression. There was no significant difference in T\(_{max}\), T\(_{avg}\), and IOP\(_{var}\) between progressors and non-progressors (all p > 0.05). Except for T\(_{avg}\) and the temporal RNFL, there was no correlation between disease progression in any quadrant and T\(_{max}\), T\(_{avg}\), and IOP\(_{var}\). Twenty-four-hour and outpatient IOP variables had poor sensitivities and specificities in detecting disease progression. The correlation of inter-eye parameters was moderate; correlation with disease progression was weak. Conclusion In line with our previous study, IOP data obtained during a single visit (outpatient or inpatient monitoring) make for a poor diagnostic tool, no matter the method deployed. Glaucoma progression and perfusion pressure in left and right eyes correlated weakly to moderately with each other. Key messages What is known: ● Our prior study showed that manually obtained 24-hour inpatient IOP measurements in right eyes are poor predictors for glaucoma progression. The inter-eye relationship of 24-hour IOP parameters and disease progression on optical coherence tomography (OCT) has not been examined. What we found: ● 24-hour IOP profiles of left eyes from the same study were a poor diagnostic tool to detect worsening glaucoma. ● Significant inter-eye correlations of various strengths were found for all tested parameters},
  language  = {en}
}
@article{WaxmanStrzalkowskaWangetal.2023,
  author    = {Waxman, Susannah and Strzalkowska, Alicja and Wang, Chao and Loewen, Ralitsa and Dang, Yalong and Loewen, Nils A.},
  title     = {Tissue-engineered anterior segment eye cultures demonstrate hallmarks of conventional organ culture},
  series = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  volume    = {261},
  journal   = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  number    = {5},
  doi       = {10.1007/s00417-022-05915-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323845},
  pages     = {1359-1368},
  year      = {2023},
  abstract  = {Background Glaucoma is a blinding disease largely caused by dysregulation of outflow through the trabecular meshwork (TM), resulting in elevated intraocular pressure (IOP). We hypothesized that transplanting TM cells into a decellularized, tissue-engineered anterior segment eye culture could restore the outflow structure and function. Methods Porcine eyes were decellularized with freeze-thaw cycles and perfusion of surfactant. We seeded control scaffolds with CrFK cells transduced with lentiviral vectors to stably express eGFP and compared them to scaffolds seeded with primary TM cells as well as to normal, unaltered eyes. We tracked the repopulation behavior, performed IOP maintenance challenges, and analyzed the histology. Results Transplanted cells localized to the TM and progressively infiltrated the extracellular matrix, reaching a distribution comparable to normal, unaltered eyes. After a perfusion rate challenge to mimic a glaucomatous pressure elevation, transplanted and normal eyes reestablished a normal intraocular pressure (transplanted = 16.5 ± 0.9 mmHg, normal = 16.9 ± 0.9). However, eyes reseeded with eGFP-expressing CrFK cells could not regulate IOP, remaining high and unstable (27.0 ± 6.2 mmHg) instead. Conclusion Tissue-engineered anterior segment scaffolds can serve as readily available, scalable ocular perfusion cultures. This could reduce dependency on scarce donor globes in outflow research and may allow engineering perfusion cultures with specific geno- and phenotypes.},
  language  = {en}
}
@phdthesis{Willmann2023,
  author    = {Willmann, Lukas},
  title     = {Altersabh{\"a}ngige Makuladegeneration - Regeneration des retinalen Pigmentepithels durch Anregung zur Proliferation durch den Transkriptionsfaktor E2F2},
  doi       = {10.25972/OPUS-29183},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-291833},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Altersbedingte Makuladegeneration (AMD) ist weltweit die h{\"a}ufigste Ursache von irreversibler Erblindung des alternden Menschen. Mit der anti-VEGF-Behandlung steht f{\"u}r die deutlich seltenere feuchte AMD eine zugelassene Therapie bereit, die deutlich h{\"a}ufigere trockene AMD entzieht sich aktuell jedoch jeglicher Therapie. Ein zentraler Pathomechanismus der AMD ist der progrediente Untergang des retinalen Pigmentepithels (RPE). Die Rarifizierung und letztendlich Atrophie des RPEs f{\"u}hrt zum Untergang der funktionellen Einheit aus RPE, Photorezeptoren und Bruch'scher Membran und somit zum irreversiblen Funktionsverlust. Ein m{\"o}glicher therapeutischer Ansatz, der progredienten Atrophie des RPEs entgegenzuwirken, ist, das prinzipiell post- mitotischen RPE zur Proliferation anzuregen. Grundlage unserer in vitro Untersuchungen ist das ARPE-19 Zellmodell. Um die Proliferation anzuregen wurden die RPE-Zellen mit E2F2, einem Zellzyklus- regulierendem Transkriptionsfaktor, transfiziert. Zun{\"a}chst wurde ein nicht-proliferatives RPE-Zellmodell mit spontanem Wachstumsarrest etabliert. Innerhalb von zwei Wochen konnte die Ausbildung von Zonulae occludentes als Zeichen der Integrit{\"a}t des adh{\"a}renten Zellmonolayers beobachtet werden. Die chemische Transfektion von E2F2 unter einem CMV-Promoter f{\"u}hrte zur {\"U}berexpression von E2F2-Protein. Der proliferationssteigernde Effekt von E2F2 konnte durch die Proliferationsmarker Cyclin D1 sowie Ki67, dem Anstieg der BrdU-Aufnahme und der nach Transfektion mit E2F2 zunehmenden Gesamtzellzahl nachgewiesen werden. Der Zellzahlerh{\"o}hung standen jedoch potentiell qualitative und funktionelle Einbußen entgegen. So zeigten sich nach Behandlung mit E2F2 die Zellviabilit{\"a}t reduziert und die Apoptoserate sowie die Permeabilit{\"a}t des Epithels erh{\"o}ht. Diese Einschr{\"a}nkungen waren jedoch nur passager bis 7 Tage nach Transfektion sichtbar und reversibel. Unsere Ergebnisse weisen darauf hin, dass diese Defizite nicht durch E2F2 selbst, sondern durch das Transfektionsreagenz PEI bedingt waren. Weitere funktionelle Defizite k{\"o}nnten durch epithelial-mesenchymale Transition (EMT) verursacht werden. Hier zeigte sich durch E2F2 keine De-Differenzierung im Sinne einer typischen EMT-Marker- Expression. Die vorliegende Arbeit zeigt in einem in vitro Zellmodell die Grundlagen eines vielversprechenden Ansatzes zur Therapie der trockenen AMD: Durch {\"U}berexpression eines den Zellzyklus regulierenden Gens (hier E2F2) wurde die RPE-Regeneration angeregt. Analog zur schon zugelassenen Gentherapie des RPEs bei RPE65-assoziierten Netzhautdystrophien durch den Transfer von funktionst{\"u}chtigem RPE65-Gen mittels Adeno-assoziierten Viren k{\"o}nnte mittels E2F2, {\"u}bertragen mit einem lentiviralen Verktor, eine Stimulation des RPEs zur Proliferation m{\"o}glich sein. Entscheidend ist der m{\"o}glichst gute Struktur- und Funktionserhalt des Photorezeptor-Bruch-Membran-RPE Komplexes. Eine Therapie sollte daher in fr{\"u}hen Krankheitsstadien erfolgen, um die Progression zu fortgeschrittenen Erkrankungsstadien mit irreversiblem Funktionsverlust zu verz{\"o}gern oder zu verhindern.},
  subject      = {Netzhaut},
  language  = {de}
}
@article{GuggenbergerVogtSongetal.2023,
  author    = {Guggenberger, Konstanze V. and Vogt, Marius L. and Song, Jae W. and Weng, Andreas M. and Fr{\"o}hlich, Matthias and Schmalzing, Marc and Venhoff, Nils and Hillenkamp, Jost and Pham, Mirko and Meckel, Stephan and Bley, Thorsten A.},
  title     = {Intraorbital findings in giant cell arteritis on black blood MRI},
  series = {European Radiology},
  volume    = {33},
  journal   = {European Radiology},
  number    = {4},
  doi       = {10.1007/s00330-022-09256-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324978},
  pages     = {2529-2535},
  year      = {2023},
  abstract  = {Objective Blindness is a feared complication of giant cell arteritis (GCA). However, the spectrum of pathologic orbital imaging findings on magnetic resonance imaging (MRI) in GCA is not well understood. In this study, we assess inflammatory changes of intraorbital structures on black blood MRI (BB-MRI) in patients with GCA compared to age-matched controls. Methods In this multicenter case-control study, 106 subjects underwent BB-MRI. Fifty-six patients with clinically or histologically diagnosed GCA and 50 age-matched controls without clinical or laboratory evidence of vasculitis were included. All individuals were imaged on a 3-T MR scanner with a post-contrast compressed-sensing (CS) T1-weighted sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) BB-MRI sequence. Imaging results were correlated with available clinical symptoms. Results Eighteen of 56 GCA patients (32\%) showed inflammatory changes of at least one of the intraorbital structures. The most common finding was enhancement of at least one of the optic nerve sheaths (N = 13, 72\%). Vessel wall enhancement of the ophthalmic artery was unilateral in 8 and bilateral in 3 patients. Enhancement of the optic nerve was observed in one patient. There was no significant correlation between imaging features of inflammation and clinically reported orbital symptoms (p = 0.10). None of the age-matched control patients showed any inflammatory changes of intraorbital structures. Conclusions BB-MRI revealed inflammatory findings in the orbits in up to 32\% of patients with GCA. Optic nerve sheath enhancement was the most common intraorbital inflammatory change on BB-MRI. MRI findings were independent of clinically reported orbital symptoms. Key Points • Up to 32\% of GCA patients shows signs of inflammation of intraorbital structures on BB-MRI. • Enhancement of the optic nerve sheath is the most common intraorbital finding in GCA patients on BB-MRI. • Features of inflammation of intraorbital structures are independent of clinically reported symptoms.},
  language  = {en}
}
@article{YousefStrzalkowskaHillenkampetal.2020,
  author    = {Yousef, Yousef Al and Strzalkowska, Alicja and Hillenkamp, Jost and Rosentreter, Andr{\´e} and Loewen, Nils A.},
  title     = {Comparison of a second-generation trabecular bypass (iStent inject) to ab interno trabeculectomy (Trabectome) by exact matching},
  series = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  volume    = {258},
  journal   = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  issn      = {0721-832X},
  doi       = {10.1007/s00417-020-04933-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232613},
  pages     = {2775-2780},
  year      = {2020},
  abstract  = {Purpose To achieve a highly balanced comparison of trabecular bypass stenting (IS2, iStent inject) with ab interno trabeculectomy (T, Trabectome) by exact matching. Methods Fifty-three IS2 eyes were matched to 3446 T eyes. Patients were matched using exact matching by baseline intraocular pressure (IOP), the number of glaucoma medications, and glaucoma type, and using nearest neighbor matching by age. Individuals without a close match were excluded. All surgeries were combined with phacoemulsification. Results A total of 78 eyes (39 in each group) could be matched as exact pairs with a baseline IOP of 18.3 ± 5.1 mmHg and glaucoma medications of 2.7 ± 1.2 in each. IOP in IS2 was reduced to 14.6 ± 4.2 mmHg at 3 months and in T to a minimum of 13.1 ± 3.2 mmHg at 1 month. In IS2, IOP began to rise again at 6 months, eventually exceeding baseline. At 24 months, IOP in IS2 was 18.8 ± 9.0 mmHg and in T 14.2 ± 3.5 mmHg. IS2 had a higher average IOP than T at all postoperative visits (p < 0.05 at 1, 12, 18 months). Glaucoma medications decreased to 2.0 ± 1.5 in IS2 and to 1.5 ± 1.4 in T. Conclusion T resulted in a larger and sustained IOP reduction compared with IS2 where a rebound occurred after 6 months to slightly above preoperative values.},
  language  = {en}
}
@article{ChenWaxmanWangetal.2020,
  author    = {Chen, Si and Waxman, Susannah and Wang, Chao and Atta, Sarah and Loewen, Ralitsa and Loewen, Nils A.},
  title     = {Dose-dependent effects of netarsudil, a Rho-kinase inhibitor, on the distal outflow tract},
  series = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  volume    = {258},
  journal   = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  issn      = {0721-832X},
  doi       = {10.1007/s00417-020-04691-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-231893},
  pages     = {1211-1216},
  year      = {2020},
  abstract  = {Purpose To characterize the effects of netarsudil on the aqueous humor outflow tract distal to the trabecular meshwork (TM). Wehypothesized that netarsudil increases outflow facility in eyes with and without circumferential ab interno trabeculectomy (AIT)that removes the TM. Methods Sixty-four porcine anterior segment cultures were randomly assigned to groups with (n= 32) and without circumferential AIT (n= 32). Cultures were exposed to 0.1, 1, and 10μM netarsudil (N= 8 eyes per concentration). For each concentration,IOP and vessel diameters were compared with their respective pretreatment baselines. Outflow tract vessel diameters wereassessed by spectral-domain optical coherence tomography (SDOCT) and rendered in 4D (XYZ time series). Results Netarsudil at 1μM reduced IOP both in eyes with TM (-0.60 ± 0.24 mmHg,p= 0.01) and in eyes without TM (-1.79 ±0.42 mmHg,p< 0.01). At this concentration, vessels of the distal outflow tract dilated by 72\%. However, at 0.1μMnetarsudilelevated IOP in eyes with TM (1.59 ± 0.36 mmHg,p< 0.001) as well as in eyes without TM (0.23 ± 0.32 mmHg,p<0.001). Vessels of the distal outflow tract constricted by 31\%. Similarly, netarsudil at a concentration of 10μM elevated IOP both in eyeswith TM (1.91 ± 0.193,p< 0.001) and in eyes without TM (3.65 ± 0.86 mmHg,p< 0.001). At this concentration, outflow tractvessels constricted by 27\%. Conclusion In the porcine anterior segment culture, the dose-dependent IOP changes caused by netarsudil matched the diameterchanges of distal outflow tract vessels. Hyper- and hypotensive properties of netarsudil persisted after TM removal},
  language  = {en}
}
@article{VermaFuehringDakroubHanetal.2022,
  author    = {Verma-Fuehring, R. and Dakroub, M. and Han, H. and Hillenkamp, J. and Loewen, N. A.},
  title     = {Trabeculopuncture as a predictive test of distal outflow resistance in canal-based surgery},
  series = {Scientific Reports},
  volume    = {12},
  journal   = {Scientific Reports},
  doi       = {10.1038/s41598-022-13990-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299740},
  year      = {2022},
  abstract  = {We investigated whether trabeculopuncture (TP) could detect distal outflow resistance to predict the outcome of canal-based glaucoma surgery such as ab interno trabeculectomy (AIT). These procedures have a high utilization in open angle glaucoma, but fail in eyes with an unidentified distal outflow resistance. We assigned 81 porcine eyes to two groups: trial (n = 42) and control (n = 39). At 24 h, four YAG-laser trabeculopunctures were placed nasally, followed by a 180° AIT at the same site at 48 h. The proportion of TP responders between both AIT groups was compared. Histology and outflow canalograms were determined. Both post-TP and post-AIT IOPs were lower than baseline IOP (p = 0.015 and p < 0.01, respectively). The success rates of TP and AIT were 69\% and 85.7\%, respectively. Sensitivity and specificity values of TP as predictive test for AIT success were 77.7\% and 83.3\%, respectively. The positive and negative predictive values were 96.6\% and 38.5\%, respectively. We conclude that a 10\% reduction in IOP after TP can be used as a predictor for the success (> 20\% IOP decrease) of 180° AIT in porcine eyes.},
  language  = {en}
}
@article{LangMessmerGeerlingetal.2015,
  author    = {Lang, Stefan J. and Messmer, Elisabeth M. and Geerling, Gerd and Mackert, Marc J. and Brunner, Tobias and Dollak, Sylvia and Kutchoukov, Borislav and B{\"o}hringer, Daniel and Reinhard, Thomas and Maier, Philip},
  title     = {Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus},
  series = {BMC Ophthalmology},
  volume    = {15},
  journal   = {BMC Ophthalmology},
  number    = {78},
  doi       = {10.1186/s12886-015-0070-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151498},
  year      = {2015},
  abstract  = {Background: Corneal cross-linking is widely used to treat keratoconus. However, to date, only limited data from randomized trials support its efficacy. Methods: The efficacy and safety of corneal cross-linking for halting progression of keratoconus were investigated in a prospective, randomized, blinded, placebo controlled, multicentre trial. Twenty-nine keratoconus patients were randomized in three trial centres. The mean age at inclusion was 28 years. Longitudinal changes in corneal refraction were assessed by linear regression. The best corrected visual acuity, surface defects and corneal inflammation were also assessed. These data were analysed with a multifactorial linear regression model. Results: A total of 15 eyes were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 days. Corneal refractive power decreased on average (+/-standard deviation) by 0.35 +/- 0.58 dioptres/year in the treatment group. The controls showed an increase of 0.11 +/- 0.61 dioptres/year. This difference was statistically significant (p = 0.02). Conclusions: Our data suggest that corneal cross-linking is an effective treatment for some patients to halt the progression of keratoconus. However, some of the treated patients still progressed, whereas some untreated controls improved. Therefore, further investigations are necessary to decide which patients require treatment and which do not.},
  language  = {en}
}
@article{BreunFlockFeldheimetal.2023,
  author    = {Breun, Maria and Flock, Katharina and Feldheim, Jonas and Nattmann, Anja and Monoranu, Camelia M. and Herrmann, Pia and Ernestus, Ralf-Ingo and L{\"o}hr, Mario and Hagemann, Carsten and Stein, Ulrike},
  title     = {Metastasis associated in colorectal cancer 1 (MACC1) mRNA expression is enhanced in sporadic vestibular schwannoma and correlates to deafness},
  series = {Cancers},
  volume    = {15},
  journal   = {Cancers},
  number    = {16},
  issn      = {2072-6694},
  doi       = {10.3390/cancers15164089},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-362543},
  year      = {2023},
  abstract  = {Vestibular schwannoma (VS) are benign cranial nerve sheath tumors of the vestibulocochlear nerve. Their incidence is mostly sporadic, but they can also be associated with NF2-related schwannomatosis (NF2), a hereditary tumor syndrome. Metastasis associated in colon cancer 1 (MACC1) is known to contribute to angiogenesis, cell growth, invasiveness, cell motility and metastasis of solid malignant cancers. In addition, MACC1 may be associated with nonsyndromic hearing impairment. Therefore, we evaluated whether MACC1 may be involved in the pathogenesis of VS. Sporadic VS, recurrent sporadic VS, NF2-associated VS, recurrent NF2-associated VS and healthy vestibular nerves were analyzed for MACC1 mRNA and protein expression by quantitative polymerase chain reaction and immunohistochemistry. MACC1 expression levels were correlated with the patients' clinical course and symptoms. MACC1 mRNA expression was significantly higher in sporadic VS compared to NF2-associated VS (p \&lt; 0.001). The latter expressed similar MACC1 concentrations as healthy vestibular nerves. Recurrent tumors resembled the MACC1 expression of the primary tumors. MACC1 mRNA expression was significantly correlated with deafness in sporadic VS patients (p = 0.034). Therefore, MACC1 might be a new molecular marker involved in VS pathogenesis.},
  language  = {en}
}
@phdthesis{Wobbe2023,
  author    = {Wobbe, Christina},
  title     = {Hochaufgel{\"o}ste Mikroskopie mittels strukturierter Beleuchtung zur altersabh{\"a}ngigen Akkumulation autofluoreszierender Granula im retinalen Pigmentepithel des Menschen},
  doi       = {10.25972/OPUS-32149},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-321490},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Die Technik der strukturierten Beleuchtungsmikroskopie (structured illumination microscopy, SIM) ist eine etablierte ultrastrukturelle Aufnahmemethode, die der hochaufl{\"o}senden Visualisierung intrazellul{\"a}rer Strukturen dient. In der Ophthalmologie findet diese Art der Bildgebung bisher wenig Anwendung. SIM erm{\"o}glicht die histologische Darstellung retinaler Strukturen, wie der Zellen des humanen retinalen Pigmentepithels (RPE). In den Zellen des RPE reichern sich Granula an, die f{\"u}r die Autofluoreszenz-Bildgebung von Bedeutung sind. Anhand der Morphologie und autofluoreszierenden Merkmale lassen sich grunds{\"a}tzlich drei Granulatypen im RPE unterscheiden: Melanosomen (M), Melanolipofuszin (ML)- und Lipofuszin (L)-Granula. Die Anwendung der SIM erm{\"o}glicht die pr{\"a}zise Darstellung und Differenzierung dieser autofluoreszierenden Strukturen, sowie die Bestimmung ihrer Anzahl und Lokalisation. Ziel der Arbeit ist die Darstellung der im humanen RPE lokalisierten Granula mithilfe der SIM. Anhand der unterschiedlichen Autofluoreszenz (AF) der Granula k{\"o}nnen diese innerhalb des RPE-Zellk{\"o}rpers klassifiziert, sowie deren Anzahl und Dichte analysiert werden. Diese Analyse wird in Altersgruppen und Retinalokalisationen differenziert. Zudem sind direkte Vergleiche zwischen der Histologie (SIM, ex vivo) und klinischen Aufnahmen (Fundusautofluoreszenz, in vivo) kaum existent. Durch Ermittlung der Gesamt-AF pro Zelle in Korrelation zu der intrazellul{\"a}ren Granuladichte und -verteilung soll eine neue Interpretationsebene erm{\"o}glicht werden. Diese Arbeit soll helfen anhand der gewonnenen Daten die Stoffwechselmechanismen der Retina und deren Einfluss auf die Fundusautofluoreszenz (FAF) besser verstehen zu k{\"o}nnen. Sie soll insbesondere dazu beitragen bestehende und neue klinische FAF-Bildgebungsverfahren zu validieren, die Diagnostik pathologischer Prozesse der Retina zu optimieren und sowohl eine m{\"o}glichst fr{\"u}he Erkennung als auch pr{\"a}zise Prognostik zu erm{\"o}glichen. Zudem sollen die Daten eine belastbare Basis darstellen, um die mit einem hohen Zeitaufwand verbundene manuelle Zellanalyse einer geschulten k{\"u}nstlichen Intelligenz zu {\"u}berlassen. Damit k{\"o}nnte der Analyseprozess von Gewebeproben immens beschleunigt werden und in seiner Effizienz maximiert werden.},
  subject      = {Netzhaut},
  language  = {de}
}
@phdthesis{Radun2024,
  author    = {Radun, Victoria},
  title     = {Quantitative Fundusautofluoreszenz bei systemischer (Hydroxy-)Chloroquin Therapie: ein Jahr follow-up.},
  doi       = {10.25972/OPUS-34868},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-348688},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {CQ und HCQ werden h{\"a}ufig zur Behandlung von Erkrankungen aus dem rheumatischen Formenkreis wie z.B. SLE oder RA eingesetzt. Die lange Anwendung birgt das Risiko der Entwicklung einer CQ/HCQ-assoziierten Makulopathie. Diese ist charakterisiert durch den irreversiblen Verlust von Photorezeptoren und RPE und im Verlauf progredienten Visusverlust. Die QAF-Bildgebung ist eine nicht-invasive, innovative Methode zur Diagnostik krankhafter Netzhautver{\"a}nderungen. Durch entsprechende technische Modifikationen eines cSLO sind inzwischen quantitative Aussagen bei Verlaufskontrollen der FAF derselben Patienten und Patientinnen sowie interpersonelle Vergleiche m{\"o}glich. In der vorliegenden Studie wurden 32 CQ/HCQ Patienten und Patientinnen {\"u}ber den Zeitraum von einem Jahr mittels multimodaler Bildgebung (IR-, FAF bei 488 nm und 787 nm, QAF bei 488 nm, rotfreie Aufnahmen sowie SD-OCT Bilder) auf BEM-typische Ver{\"a}nderungen am Augenhintergrund gescreent bzw. Verlaufskontrollen bei bekannter BEM durchgef{\"u}hrt. Die QAF Entwicklung innerhalb eines Jahres wurde quantitativ und r{\"a}umlich analysiert. Hierbei zeigte sich eine den erwarteten Alterseffekt {\"u}bersteigende Erh{\"o}hung der QAF. Dies k{\"o}nnte durch eine erh{\"o}hte Lipofuzingenese oder metabolische Aktivit{\"a}t der Netzhaut erkl{\"a}rt werden. Die vorgestellten Methoden k{\"o}nnten zuk{\"u}nftig eine n{\"u}tzliche Erweiterung zu den bereits bestehenden Diagnostik-Tools f{\"u}r Screening auf BEM sein. Bei CQ/HCQ Patienten und Patientinnen zeigt sich eine grunds{\"a}tzlich erh{\"o}hte QAF gegen{\"u}ber der Kontrollgruppe ohne das Medikament. Im Ein-Jahres-Verlauf gab es einige Patienten und Patientinnen, die einen {\"u}berdurchschnittlich starken Anstieg der QAF zeigen. Es bleibt zu kl{\"a}ren, ob diese Ausreißer Hinweise auf die sp{\"a}tere Entwicklung einer BEM liefern. So k{\"o}nnte die QAF im klinischen Alltag Anwendung finden und vor allem bei Verlaufskontrollen zus{\"a}tzliche Informationen bieten.},
  subject      = {Chloroquin},
  language  = {de}
}
@article{RosentreterLappasWidderetal.2018,
  author    = {Rosentreter, Andr{\´e} and Lappas, Alexandra and Widder, Randolf Alexander and Alnawaiseh, Maged and Dietlein, Thomas Stefan},
  title     = {Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices},
  series = {BMC Ophthalmology},
  volume    = {18},
  journal   = {BMC Ophthalmology},
  number    = {60},
  doi       = {10.1186/s12886-018-0721-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175534},
  year      = {2018},
  abstract  = {Background: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). Methods: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. Result: Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. Conclusions: Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.},
  language  = {en}
}
@article{SchroederMeyerterVehnFassnachtRiederleetal.2016,
  author    = {Schroeder, Katharina and Meyer-ter-Vehn, Tobias and Fassnacht-Riederle, Heidi and Guthoff, Rainer},
  title     = {Course of disease in multifocal choroiditis lacking sufficient immunosuppression: a case report},
  series = {Journal of Medical Case Reports},
  volume    = {10},
  journal   = {Journal of Medical Case Reports},
  number    = {298},
  doi       = {10.1186/s13256-016-1069-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171317},
  year      = {2016},
  abstract  = {Background: Multifocal choroiditis with panuveitis is a rare disease. The educational merit of this case presentation results from the good documentation and the impressive ocular fundus pictures. Case presentation: We illustrate the 3-year course of disease in a 22-year-old myopic white woman with multifocal choroiditis with panuveitis and secondary choroidal neovascularization. The activity of the disease was evaluated clinically by optical coherence tomography and fluorescein angiography. Choroidal neovascularization was treated by intravitreal bevacizumab (2.5 mg/0.1 ml). Our patient lacked systemic therapy for the first 11 months because of noncompliance. Conclusions: The case is remarkable as the delayed onset of peripheral lesions and the additional existence of high myopia made diagnosis difficult. In addition, it demonstrates that full outbreak of disease with multiple central and peripheral fundus lesions and secondary choroidal neovascularization can develop without systemic treatment.},
  language  = {en}
}
@article{TarauBerlinCurcioetal.2019,
  author    = {Tarau, Ioana-Sandra and Berlin, Andreas and Curcio, Christine A. and Ach, Thomas},
  title     = {The cytoskeleton of the retinal pigment epithelium: from normal aging to age-related macular degeneration},
  series = {International Journal of Molecular Science},
  volume    = {20},
  journal   = {International Journal of Molecular Science},
  number    = {14},
  issn      = {1422-0067},
  doi       = {10.3390/ijms20143578},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201781},
  year      = {2019},
  abstract  = {The retinal pigment epithelium (RPE) is a unique epithelium, with major roles which are essential in the visual cycle and homeostasis of the outer retina. The RPE is a monolayer of polygonal and pigmented cells strategically placed between the neuroretina and Bruch membrane, adjacent to the fenestrated capillaries of the choriocapillaris. It shows strong apical (towards photoreceptors) to basal/basolateral (towards Bruch membrane) polarization. Multiple functions are bound to a complex structure of highly organized and polarized intracellular components: the cytoskeleton. A strong connection between the intracellular cytoskeleton and extracellular matrix is indispensable to maintaining the function of the RPE and thus, the photoreceptors. Impairments of these intracellular structures and the regular architecture they maintain often result in a disrupted cytoskeleton, which can be found in many retinal diseases, including age-related macular degeneration (AMD). This review article will give an overview of current knowledge on the molecules and proteins involved in cytoskeleton formation in cells, including RPE and how the cytoskeleton is affected under stress conditions — especially in AMD.},
  language  = {en}
}
@article{WabbelsFrickeSchittkowskietal.2021,
  author    = {Wabbels, Bettina and Fricke, Julia and Schittkowski, Michael and Gr{\"a}f, Michael and Lorenz, Birgit and Bau, Viktoria and Nentwich, Martin M. and Atili, Abed and Eckstein, Anja and Sturm, Veit and Beisse, Christina and Sterker, Ina and Neppert, Birte and Mauschitz, Matthias M.},
  title     = {Yokoyama procedure for esotropia associated with high myopia: real-world data from a large-scale multicentre analysis},
  series = {Acta Ophthalmologica},
  volume    = {99},
  journal   = {Acta Ophthalmologica},
  number    = {8},
  doi       = {10.1111/aos.14808},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239939},
  pages     = {e1340 -- e1347},
  year      = {2021},
  abstract  = {Purpose High myopic patients may develop strabismus due to globe dislocation out of the normal extraocular muscle cone. Surgical correction of this strabismus type is possible by joining the superior and lateral rectus muscles without the need for a scleral suture called the Yokoyama procedure. Data from large patient samples and the evaluation of a potential effect of an additional medial rectus recession (MRR) have been lacking so far. Methods We pooled retrospective patient data of 14 departments of ophthalmology in Germany and Switzerland and analysed determinants of postoperative results using multivariable regression models. Results We included 133 patients (mean age: 59.7 ± 13.4 years, surgery between 2008 and 2017) with a mean preoperative esotropia (both Yokoyama with and without MRR) of 23.8°±4.6°. The angle of preoperative esotropia increased with age. The postoperative esotropia was 8.7° ± 9.9°, and six patients were overcorrected. While preoperative esotropia was highly associated with postoperative results, we found no association of additional MRR with any of our postoperative outcome measures. The Yokoyama procedure had a higher absolute effect in patients with higher preoperative esotropia. Conclusion Our study confirms the positive effect of the Yokoyama procedure on strabismus due to high myopia in large-scale real-world data. In some cases, MRR may be needed because of muscle contracture, although additional MRR statistically did not affect the postoperative outcome. In patients with bilateral high myopic strabismus, correction of both eyes seems beneficial. The effect size of the Yokoyama procedure appears to be mainly driven by preoperative esotropia.},
  language  = {en}
}
@article{DickKraussHillenkampetal.2017,
  author    = {Dick, Julia and Krauß, Patrizia and Hillenkamp, Jost and Kohlmorgen, Britta and Schoen, Christoph},
  title     = {Postoperative Tropheryma whipplei endophthalmitis - a case report highlighting the additive value of molecular testing},
  series = {JMM Case Reports},
  volume    = {4},
  journal   = {JMM Case Reports},
  doi       = {10.1099/jmmcr.0.005124},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158823},
  pages     = {e005124},
  year      = {2017},
  abstract  = {Introduction. Tropheryma whipplei is the causative agent of Whipple's disease. Gastrointestinal and lymphatic tissues are affected in the majority of cases, resulting in diarrhoea, malabsorption and fever. Here, we report a rare case of ocular manifestation in a patient lacking the typical Whipple symptoms. Case presentation. A 74-year-old Caucasian female presented with blurred vision in the right eye over a period of 1-2 months, accompanied by stinging pain and conjunctival hyperaemia for the last 2 days. Upon admission, visual acuity was hand motion in the affected eye. Ophthalmological examination showed typical signs of intraocular inflammation. Diagnostic and therapeutic pars plana vitrectomy including vitreous biopsy and intravitreal instillation of vancomycin and amikacin was performed within hours of initial presentation. Both microscopic analysis and microbial cultures of the vitreous biopsy remained negative for bacteria and fungi. The postoperative antibiotic regime included intravenous administration of ceftriaxone in combination with topical tobramycin and ofloxacin. Due to the empirical therapy the inflammation ceased and the patient was discharged after 5 days with cefpodoxime orally and local antibiotic and steroidal therapy. Meanwhile, the vitreous body had undergone testing by PCR for the eubacterial 16S rRNA gene, which was found to be positive. Analysis of the PCR product revealed a specific sequence of T. whipplei. Conclusion. In our patient, endophthalmitis was the first and only symptom of Morbus Whipple, while most patients with Whipple's disease suffer from severe gastrointestinal symptoms. 16S rDNA PCR should be considered for any intraocular infection when microscopy and standard culture methods remain negative.},
  language  = {en}
}
@article{BenAmiTongBhuiyanetal.2016,
  author    = {Ben Ami, Tal and Tong, Yuehong and Bhuiyan, Alauddin and Huisingh, Carrie and Ablonczy, Zsolt and Ach, Thomas and Curcio, Christine A. and Smith, R. Theodore},
  title     = {Spatial and Spectral Characterization of Human Retinal Pigment Epithelium Fluorophore Families by Ex Vivo Hyperspectral Autofluorescence Imaging},
  series = {Translational Vision Science \& Technology},
  volume    = {5},
  journal   = {Translational Vision Science \& Technology},
  number    = {3},
  doi       = {10.1167/tvst.5.3.5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-168328},
  pages     = {5},
  year      = {2016},
  abstract  = {Purpose: Discovery of candidate spectra for abundant fluorophore families in human retinal pigment epithelium (RPE) by ex vivo hyperspectral imaging. Methods: Hyperspectral autofluorescence emission images were captured between 420 and 720 nm (10-nm intervals), at two excitation bands (436-460, 480-510 nm), from three locations (fovea, perifovea, near-periphery) in 20 normal RPE/Bruch's membrane (BrM) flatmounts. Mathematical factorization extracted a BrM spectrum (S0) and abundant lipofuscin/melanolipofuscin (LF/ML) spectra of RPE origin (S1, S2, S3) from each tissue. Results: Smooth spectra S1 to S3, with perinuclear localization consistent with LF/ML at all three retinal locations and both excitations in 14 eyes (84 datasets), were included in the analysis. The mean peak emissions of S0, S1, and S2 at λ\(_{ex}\) 436 nm were, respectively, 495 ± 14, 535 ± 17, and 576 ± 20 nm. S3 was generally trimodal, with peaks at either 580, 620, or 650 nm (peak mode, 650 nm). At λ\(_{ex}\) 480 nm, S0, S1, and S2 were red-shifted to 526 ± 9, 553 ± 10, and 588 ± 23 nm, and S3 was again trimodal (peak mode, 620 nm). S1 often split into two spectra, S1A and S1B. S3 strongly colocalized with melanin. There were no significant differences across age, sex, or retinal location. Conclusions: There appear to be at least three families of abundant RPE fluorophores that are ubiquitous across age, retinal location, and sex in this sample of healthy eyes. Further molecular characterization by imaging mass spectrometry and localization via super-resolution microscopy should elucidate normal and abnormal RPE physiology involving fluorophores. Translational Relevance: Our results help establish hyperspectral autofluorescence imaging of the human retinal pigment epithelium as a useful tool for investigating retinal health and disease.},
  language  = {en}
}
@article{BielmeierSchmittKleefeldtetal.2022,
  author    = {Bielmeier, Christina B. and Schmitt, Sabrina I. and Kleefeldt, Nikolai and Boneva, Stefaniya K. and Schlecht, Anja and Vallon, Mario and Tamm, Ernst R. and Hillenkamp, Jost and Erg{\"u}n, S{\"u}leyman and Neueder, Andreas and Braunger, Barbara M.},
  title     = {Deficiency in retinal TGFβ signaling aggravates neurodegeneration by modulating pro-apoptotic and MAP kinase pathways},
  series = {International Journal of Molecular Sciences},
  volume    = {23},
  journal   = {International Journal of Molecular Sciences},
  number    = {5},
  issn      = {1422-0067},
  doi       = {10.3390/ijms23052626},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-283971},
  year      = {2022},
  abstract  = {Transforming growth factor β (TGFβ) signaling has manifold functions such as regulation of cell growth, differentiation, migration, and apoptosis. Moreover, there is increasing evidence that it also acts in a neuroprotective manner. We recently showed that TGFβ receptor type 2 (Tgfbr2) is upregulated in retinal neurons and M{\"u}ller cells during retinal degeneration. In this study we investigated if this upregulation of TGFβ signaling would have functional consequences in protecting retinal neurons. To this end, we analyzed the impact of TGFβ signaling on photoreceptor viability using mice with cell type-specific deletion of Tgfbr2 in retinal neurons and M{\"u}ller cells (Tgfbr2\(_{ΔOC}\)) in combination with a genetic model of photoreceptor degeneration (VPP). We examined retinal morphology and the degree of photoreceptor degeneration, as well as alterations of the retinal transcriptome. In summary, retinal morphology was not altered due to TGFβ signaling deficiency. In contrast, VPP-induced photoreceptor degeneration was drastically exacerbated in double mutant mice (Tgfbr2\(_{ΔOC}\); VPP) by induction of pro-apoptotic genes and dysregulation of the MAP kinase pathway. Therefore, TGFβ signaling in retinal neurons and M{\"u}ller cells exhibits a neuroprotective effect and might pose promising therapeutic options to attenuate photoreceptor degeneration in humans.},
  language  = {en}
}
@phdthesis{Dakroub2022,
  author    = {Dakroub, Mohamad},
  title     = {Coarsened Exact Matching of Excisional to Plasma-Ablative Ab Interno Trabeculectomy},
  doi       = {10.25972/OPUS-29680},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-296805},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Abstract Purpose: To compare ab interno trabeculectomy by trabecular meshwork excision to plasma-mediated ablation in primary open-angle glaucoma. Methods: Retrospectively collected data of TrabEx+ (n=56) and Trabectome (n=99) were compared by coarsened exact matching to reduce confounding and matched based on baseline intraocular pressure and age. Primary outcomes were intraocular pressure and the number of glaucoma medications. Complications and the need for additional glaucoma surgery were assessed. Patients were followed for up to one year. Results: 53 TrabEx+ could be matched to Trabectome. Baseline intraocular pressure was 16.5 ± 4.6 mmHg in both; age was 73.7 ± 8.8 years and 71.5 ± 9.9 years in TrabEx+ and Trabectome, respectively. TrabEx+ were taking more medications than Trabectome (p<0.001). Intraocular pressure was reduced to 14.8±4.3 in TrabEx+ and 13.4±3.4 in Trabectome at 6 months, and to 14.9±6.0 (p=0.13) in TrabEx+ and to 14.1±3.8 mmHg (all p<0.05) in Trabectome at 12 months. Medications were reduced at both 6 and 12 months (p< 0.05). No differences were seen between both groups at 6 and 12 months. In TrabEx+, only one serious complication occurred, and two patients required further glaucoma surgery. Conclusion: Although both groups had a baseline intraocular pressure considered low for ab interno trabeculectomy, intraocular pressure and medications were reduced further at 6 and 12 months. Intraocular pressure reduction did not reach significance in TrabEx+ at 12 months. The inter-group comparison did not reveal any significant differences. Both had a low complication rate.},
  subject      = {Glaukom},
  language  = {en}
}
@article{SchmidTarauRossietal.2018,
  author    = {Schmid, Richard and Tarau, Ioana-Sandra and Rossi, Angela and Leonhardt, Stefan and Schwarz, Thomas and Schuerlein, Sebastian and Lotz, Christian and Hansmann, Jan},
  title     = {In Vivo-Like Culture Conditions in a Bioreactor Facilitate Improved Tissue Quality in Corneal Storage},
  series = {Biotechnology Journal},
  volume    = {13},
  journal   = {Biotechnology Journal},
  number    = {1,1700344},
  doi       = {10.1002/biot.201700344},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228620},
  pages     = {1-7},
  year      = {2018},
  abstract  = {The cornea is the most-transplanted tissue worldwide. However, the availability and quality of grafts are limited due to the current methods of corneal storage. In this study, a dynamic bioreactor system is employed to enable the control of intraocular pressure and the culture at the air-liquid interface. Thereby, in vivo-like storage conditions are achieved. Different media combinations for endothelium and epithelium are tested in standard and dynamic conditions to enhance the viability of the tissue. In contrast to culture conditions used in eye banks, the combination of the bioreactor and biochrom medium 1 allows to preserve the corneal endothelium and the epithelium. Assessment of transparency, swelling, and the trans-epithelial-electrical-resistance (TEER) strengthens the impact of the in vivo-like tissue culture. For example, compared to corneas stored under static conditions, significantly lower optical densities and significantly higher TEER values were measured (p-value <0.05). Furthermore, healing of epithelial defects is enabled in the bioreactor, characterized by re-epithelialization and initiated stromal regeneration. Based on the obtained results, an easy-to-use 3D-printed bioreactor composed of only two parts was derived to translate the technology from the laboratory to the eye banks. This optimized bioreactor facilitates noninvasive microscopic monitoring. The improved storage conditions ameliorate the quality of corneal grafts and the storage time in the eye banks to increase availability and reduce re-grafting.},
  language  = {en}
}
@article{MuellerMeigen2016,
  author    = {M{\"u}ller, Philipp L. and Meigen, Thomas},
  title     = {M-sequences in ophthalmic electrophysiology},
  series = {Journal of Vision},
  volume    = {16},
  journal   = {Journal of Vision},
  number    = {1,15},
  doi       = {10.1167/16.1.15},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165796},
  pages     = {1-19},
  year      = {2016},
  abstract  = {The aim of this review is to use the multimedia aspects of a purely digital online publication to explain and illustrate the highly capable technique of m-sequences in multifocal ophthalmic electrophysiology. M-sequences have been successfully applied in clinical routines during the past 20 years. However, the underlying mathematical rationale is often daunting. These mathematical properties of m-sequences allow one not only to separate the responses from different fields but also to analyze adaptational effects and impacts of former events. By explaining the history, the formation, and the different aspects of application, a better comprehension of the technique is intended. With this review we aim to clarify the opportunities of m-sequences in order to motivate scientists to use m-sequences in their future research.},
  language  = {en}
}
@phdthesis{Glatzel2021,
  author    = {Glatzel, Caroline},
  title     = {Ergebnisse einer neuen Filtrationsoperation im Vergleich zur konventionellen Trabekulektomie bei Glaukom},
  doi       = {10.25972/OPUS-16719},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-167192},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Ziel: Die vorliegende Studie untersucht das Langzeitoutcome der filtrierenden Trabe- kulotomie (FTO) und vergleicht diese mit der konventionellen Trabekulektomie. Nach- dem in der Arbeit von Matlach et al. bereits gezeigt werden konnte, dass die filtrierende Trabekulotomie nach einem Jahr im Bezug auf die Augeninnendrucksenkung und das Auftreten von postoperativen Komplikationen mit der konventionellen Trabekulektomie vergleichbar ist (32), sollte in der vorliegenden Arbeit der Langzeiterfolg der beiden Ope- rationsmethoden miteinander verglichen werden. Untersucht wurde deshalb der intraoku- lare Druck, Langzeitkomplikationen, Folgeoperationen und der Visus nach eineinhalb und zwei Jahren. Methode: In einer Fall-Kontroll-Studie wurden 30 Patienten nach einer filtrierenden Tra- bekulotomie (prospektiv) mit 87 Patienten nach einer konventionellen Trabekulektomie (retrospektiv) verglichen. Alle Patienten waren zwischen 2007 und 2012 von demselben Operateur an der Augenklinik der Universit{\"a}t W{\"u}rzburg operiert worden. Eingeschlossen wurden Patienten mit prim{\"a}rem Offenwinkelglaukom, Pseudoexfoliationsglaukom und Pigmentdispersionsglaukom. Die Patienten waren nach Alter und intraokularem Druck (IOD) gematcht worden. Die Daten der vorliegenden Studie wurden an der Augenklink der Universit{\"a}t W{\"u}rzburg oder von den weiterbehandelnden niedergelassenen Augen{\"a}rz- ten mit Hilfe eines f{\"u}r diese Studie entworfenen Fragebogens erhoben. Endpunkt: Als prim{\"a}rer Endpunkt wurde ein Augeninnendruck von < 18 mmHg und eine Augeninnendrucksenkung um ≥ 30 \% des Ausgangswertes festgelegt. Wurden diese Kriterien ohne Medikamente erreicht, sprach man von einem „absoluten Erfolg" (com- plete-success), andernfalls von einem „relativen Erfolg" (qualified-success). Als sekund{\"a}re Endpunkte galten der intraokulare Druckverlauf, die Erfassung der Kom- plikationen, Folgeeingriffe, der Visusverlauf und die Medikation. Ergebnisse: Von den anfangs 117 eingeschlossenen Patienten konnten nach 2 Jahren die Daten von 95 Patienten (27 aus der FTO-Gruppe und 68 aus der TE-Gruppe) erhoben werden. Pr{\"a}operativ unterschieden sich die beiden Studiengruppen nicht signifikant im Bezug auf das Alter und den IOD, nach denen die Gruppen gematcht worden waren, den Visus (p= 0,60), das Geschlecht (p = 0,30) und die pr{\"a}operativ verwendeten Medikamente (p≥ 0,05). In der FTO-Gruppe lag die Zahl der Patienten mit Pigmentdispersionsglaukom (p= 0,02) und Pseudophakie (p = 0,02) schon pr{\"a}operativ deutlich {\"u}ber der der TE- Gruppe. Der IOD lag pr{\"a}operativ in beiden Operationsgruppen bei 23 mmHg (IQR 20- 27), wobei im Median 3,0 verschiedene augendrucksenkende Medikamente angewendet wurden. Der absolute Erfolg (complete-success) unterschied sich im Zeitraum der vorliegenden Studie zu keinem Zeitpunkt signifikant zwischen den Studiengruppen (p 18Mon. = 0,50 ; p 24Mon. = 0,067). Auch der relative Erfolg (qualified-success) unterschied sich zwischen den Gruppen nicht signifikant (p 18Mon. = 0,23 ; p 24Mon. = 0,60). Nach 2 Jahren erreichten 33,3 \% der FTO- und 56,7 \% der TE-Patienten einen absoluten Erfolg und 70,4 \% bzw. 77,6 \% einen relativen Erfolg. Der mediane postoperative IOD konnte auch 1,5 und 2 Jahre nach den Operationen sig- nifikant unter den pr{\"a}operativen IOD gesenkt werden (p < 0,001) und betrug nach 2 Jah- ren in der FTO-Gruppe 12,80 ± 3,79 mmHg und in der TE-Gruppe 11 mmHg (IQR 9- 13). Er unterschied sich auch zwischen beiden Gruppen zu keinem Zeitpunkt signifikant (p 18Mon. = 0,18 ; p 24Mon. = 0,12). Der mediane postoperative Visus unterschied sich 1,5 und 2 Jahre nach der OP zwischen den Gruppen nicht signifikant (p 1,5a = 0,11; p 2a = 0,77). In der FTO-Gruppe verschlech- terte sich der Visus der Patienten von 0,10 logMAR (0,79) nach 18 Monaten auf 0,20 logMAR (0,63) nach 24 Monaten. Der Visus in der TE-Gruppe blieb konstant (0,15 log- MAR). Insgesamt hatte sich der Visus der Patienten nach 1,5 und 2 Jahren im Vergleich zum pr{\"a}operativen Visus signifikant verschlechtert (p 1,5a = 0,02; p 2a = 0,00). Bei der separaten Auswertung der Patienten mit PEX-Glaukom konnte der IOD postope- rativ zu allen statistisch beurteilbaren Zeitpunkten signifikant unter den pr{\"a}operativen IOD gesenkt werden. Bei einem Vergleich zwischen den Gruppen lag der IOD der FTO- Gruppe einmalig {\"u}ber dem der TE-Gruppe. In den anderen F{\"a}llen traten keine signifikan- ten Druckunterschiede zwischen den Gruppen auf. Der postoperative Visus unterschied sich zu keinem Zeitpunkt, ob mit oder ohne Kunstlinse, im pr{\"a}- postoperativen Vergleich und zwischen den Gruppen. Die Anzahl der Wirkstoffklassen unterschied sich zwischen den Gruppen nicht signifi- kant. Reoperationen traten nach beiden Operationsmethoden so selten auf, sodass eine statistische Bewertung nicht m{\"o}glich war. Die Verteilung der Glaukomformen hatte sich auch nach 1,5 und 2 Jahren nicht ver{\"a}ndert. Die Zahl pseudophaker Patienten war im Beobachtungszeitraum auch in der TE-Gruppe stetig angestiegen, so dass sie sich nach 2 Jahren nicht mehr signifikant zwischen den Gruppen unterschied. Schlussfolgerung: Die FTO ist im Bezug auf den IOD, den Visus und die Erfolgsrate der TE {\"a}quivalent. Im Langzeitverlauf traten in der FTO Gruppe nicht mehr Komplikationen als nach TE auf. Nach 1 Jahr waren in der FTO-Gruppe signifikant mehr fr{\"u}he Komplikationen auf- getreten als in der TE. Nach 2 Jahren war die Rate an Komplikationen in den Gruppen nicht mehr signifikant unterschiedlich.},
  subject      = {Glaukom},
  language  = {de}
}
@article{BalasubramanianOthmanKampiketal.2017,
  author    = {Balasubramanian, Srikkanth and Othman, Eman M. and Kampik, Daniel and Stopper, Helga and Hentschel, Ute and Ziebuhr, Wilma and Oelschlaeger, Tobias A. and Abdelmohsen, Usama R.},
  title     = {Marine sponge-derived Streptomyces sp SBT343 extract inhibits staphylococcal biofilm formation},
  series = {Frontiers in Microbiology},
  volume    = {8},
  journal   = {Frontiers in Microbiology},
  doi       = {10.3389/fmicb.2017.00236},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171844},
  year      = {2017},
  abstract  = {Staphylococcus epidermidis and Staphylococcus aureus are opportunistic pathogens that cause nosocomial and chronic biofilm-associated infections. Indwelling medical devices and contact lenses are ideal ecological niches for formation of staphylococcal biofilms. Bacteria within biofilms are known to display reduced susceptibilities to antimicrobials and are protected from the host immune system. High rates of acquired antibiotic resistances in staphylococci and other biofilm-forming bacteria further hamper treatment options and highlight the need for new anti-biofilm strategies. Here, we aimed to evaluate the potential of marine sponge-derived actinomycetes in inhibiting biofilm formation of several strains of S. epidermidis, S. aureus, and Pseudomonas aeruginosa. Results from in vitro biofilm-formation assays, as well as scanning electron and confocal microscopy, revealed that an organic extract derived from the marine sponge-associated bacterium Streptomyces sp. SBT343 significantly inhibited staphylococcal biofilm formation on polystyrene, glass and contact lens surfaces, without affecting bacterial growth. The extract also displayed similar antagonistic effects towards the biofilm formation of other S. epidermidis and S. aureus strains tested but had no inhibitory effects towards Pseudomonas biofilms. Interestingly the extract, at lower effective concentrations, did not exhibit cytotoxic effects on mouse fibroblast, macrophage and human corneal epithelial cell lines. Chemical analysis by High Resolution Fourier Transform Mass Spectrometry (HRMS) of the Streptomyces sp. SBT343 extract proportion revealed its chemical richness and complexity. Preliminary physico-chemical characterization of the extract highlighted the heat-stable and non-proteinaceous nature of the active component(s). The combined data suggest that the Streptomyces sp. SBT343 extract selectively inhibits staphylococcal biofilm formation without interfering with bacterial cell viability. Due to absence of cell toxicity, the extract might represent a good starting material to develop a future remedy to block staphylococcal biofilm formation on contact lenses and thereby to prevent intractable contact lens-mediated ocular infections.},
  language  = {en}
}
@article{LittsAchHammacketal.2016,
  author    = {Litts, Katie M. and Ach, Thomas and Hammack, Kristen M. and Sloan, Kenneth R. and Zhang, Yuhua and Freund, K. Bailey and Curcio, Christine A.},
  title     = {Quantitative Analysis of Outer Retinal Tubulation in Age-Related Macular Degeneration From Spectral-Domain Optical Coherence Tomography and Histology},
  series = {Investigative Ophthalmology \& Visual Science},
  volume    = {57},
  journal   = {Investigative Ophthalmology \& Visual Science},
  doi       = {10.1167/iovs.16-19262},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165532},
  pages     = {2647-2656},
  year      = {2016},
  abstract  = {Purpose: To assess outer retinal tubulation (ORT) morphology from spectral-domain optical coherence tomography (SD-OCT) volumes and donor eye histology, analyze ORT reflectivity, and estimate the number of cones surviving in ORT. Methods: In SD-OCT volumes from nine patients with advanced AMD, ORT was analyzed en face and in B-scans. The hyperreflective ORT border in cross-section was delineated and surface area calculated. Reflectivity was compared between ORT types (Closed, Open, Forming, and Branching). A flatmount retina from a donor with neovascular AMD was labeled to visualize the external limiting membrane that delimits ORT and allow measurements of cross-sectional cone area, center-to-center cone spacing, and cone density. The number of cones surviving in ORT was estimated. Results: By en face SD-OCT, ORT varies in complexity and shape. Outer retinal tubulation networks almost always contain Closed cross-sections. Spectral-domain OCT volumes containing almost exclusively Closed ORTs showed no significant direction-dependent differences in hyperreflective ORT border intensity. The surface areas of partial ORT assessed by SD-OCT volumes ranged from 0.16 to 1.76 mm2. From the flatmount retina, the average cross-sectional area of cone inner segments was 49.1 ± 7.9 μm2. The average cone spacing was 7.5 ± 0.6 μm. Outer retinal tubulation cone density was 20,351 cones/mm2. The estimated number of cones in ORT in a macula ranged from 26,399 to 186,833 cones, which is 6\% to 44\% of the cones present in a healthy macula. Conclusions: These first estimates for cone density and number of cones surviving in ORT suggest that ORT formation considerably distorts the photoreceptor mosaic. Results provide additional insight into the reflectivity characteristics and number of ORT cones observable in living patients by SD-OCT, as cones persist and disease progresses.},
  language  = {en}
}
@article{LotzSchmidRossietal.2016,
  author    = {Lotz, Christian and Schmid, Freia F. and Rossi, Angela and Kurdyn, Szymon and Kampik, Daniel and De Wever, Bart and Walles, Heike and Groeber, Florian K.},
  title     = {Alternative Methods for the Replacement of Eye Irritation Testing},
  series = {ALTEX - Alternatives to Animal Experimentation},
  volume    = {33},
  journal   = {ALTEX - Alternatives to Animal Experimentation},
  number    = {1},
  doi       = {10.14573/altex.1508241},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-164444},
  pages     = {55-67},
  year      = {2016},
  abstract  = {In the last decades significant regulatory attempts were made to replace, refine and reduce animal testing to assess the risk of consumer products for the human eye. As the original in vivo Draize eye test is criticized for limited predictivity, costs and ethical issues, several animal-free test methods have been developed to categorize substances according to the global harmonized system (GHS) for eye irritation. This review summarizes the progress of alternative test methods for the assessment of eye irritation. Based on the corneal anatomy and current knowledge of the mechanisms causing eye irritation, different ex vivo and in vitro methods will be presented and discussed with regard to possible limitations and status of regulatory acceptance. In addition to established in vitro models, this review will also highlight emerging, full thickness cornea models that might be suited to predict all GHS categories.},
  language  = {en}
}
@phdthesis{Arampatzis2020,
  author    = {Arampatzis, Konstantinos},
  title     = {Astigmatismuskorrektur im Rahmen moderner, minimalinvasiver Kataraktchirurgie - eine retrospektive Analyse},
  doi       = {10.25972/OPUS-20845},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-208458},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Hintergrund: Die Kataraktoperation ist der am meisten durchgef{\"u}hrte operative Eingriff in der Medizin {\"u}berhaupt. Astigmatismus ist einer der h{\"a}ufigsten Refraktionsfehlern wobei 15-20\% der Bev{\"o}lkerung einen klinisch relevanten Astigmatismus von > 1,5 Dpt zeigen. Im Rahmen der Kataraktoperation besteht die M{\"o}glichkeit neben der Linsentr{\"u}bung auch den Astigmatismus zu korrigieren. Material und Methoden: 176 Kataraktoperationen mit simultaner Astigmatismuskorrektur wurden retrospektiv untersucht, davon bei 110 Augen durch periphere clear-cornea Relaxationsinzisionen (PCCRI) und bei 66 Augen durch die Implantation von torischen Hinterkammerlinsen (TIOL). Es erfolgte eine topographische und refraktive Astigmatismusanalyse mittels Vektorenanalyse und Doppelwinkeldiagramme. Ergebnisse: Mittels PCCRI wurde eine topographische Reduktion des Astigmatismus von 0,86 ± 0,63 Dpt sowie eine refraktive Reduktion von 1,33 ± 1,08 Dpt erreicht. Mittels TIOL lag die refraktive Reduktion auf 2,26 ± 1,57 Dpt. Die mittlere Achsenabweichung der TIOL postoperativ lag bei 4,77° ± 4,18°. Diskussion: Die Implantation von TIOL zeigt eine hohe Effektivit{\"a}t und Sicherheit bzgl. Astigmatismuskorrektur, der PCCRI {\"u}berlegen. PCCRI ist eine gute, kosteng{\"u}nstige Alternative. Astigmatismusbetr{\"a}ge bis 1,5 Dpt k{\"o}nnen sowohl durch PCCRI als auch durch TIOL korrigiert werden. Bei h{\"o}heren Betr{\"a}gen ist die Implantation von TIOL die Korrektur der ersten Wahl. Eine Revision einer postoperativen Achsenabweichung einer TIOL von > 8° sollte bei klinischer Relevanz in der zweiten postoperativen Woche erwogen werden.},
  subject      = {Augenheilkunde},
  language  = {de}
}
@article{MatlachDhillonHainetal.2015,
  author    = {Matlach, Juliane and Dhillon, Christine and Hain, Johannes and Schlunck, G{\"u}nther and Grehn, Franz and Klink, Thomas},
  title     = {Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial},
  series = {Acta Ophthalmologica},
  volume    = {93},
  journal   = {Acta Ophthalmologica},
  doi       = {10.1111/aos.12722},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149263},
  pages     = {753-761},
  year      = {2015},
  abstract  = {Purpose: To compare the outcomes of canaloplasty and trabeculectomy in open-angle glaucoma. Methods: This prospective, randomized clinical trial included 62 patients who randomly received trabeculectomy (n = 32) or canaloplasty (n = 30) and were followed up prospectively for 2 years. Primary endpoint was complete (without medication) and qualified success (with or without medication) defined as an intraocular pressure (IOP) of ≤18 mmHg (definition 1) or IOP ≤21 mmHg and ≥20\% IOP reduction (definition 2), IOP ≥5 mmHg, no vision loss and no further glaucoma surgery. Secondary endpoints were the absolute IOP reduction, visual acuity, medication, complications and second surgeries. Results: Surgical treatment significantly reduced IOP in both groups (p < 0.001). Complete success was achieved in 74.2\% and 39.1\% (definition 1, p = 0.01), and 67.7\% and 39.1\% (definition 2, p = 0.04) after 2 years in the trabeculectomy and canaloplasty group, respectively. Mean absolute IOP reduction was 10.8 ± 6.9 mmHg in the trabeculectomy and 9.3 ± 5.7 mmHg in the canaloplasty group after 2 years (p = 0.47). Mean IOP was 11.5 ± 3.4 mmHg in the trabeculectomy and 14.4 ± 4.2 mmHg in the canaloplasty group after 2 years. Following trabeculectomy, complications were more frequent including hypotony (37.5\%), choroidal detachment (12.5\%) and elevated IOP (25.0\%). Conclusions: Trabeculectomy is associated with a stronger IOP reduction and less need for medication at the cost of a higher rate of complications. If target pressure is attainable by moderate IOP reduction, canaloplasty may be considered for its relative ease of postoperative care and lack of complications.},
  language  = {en}
}
@phdthesis{GraefinvonMoltke2022,
  author    = {Gr{\"a}fin von Moltke, Pia Maria},
  title     = {Aufbau und Implementierung eines Arbeitsablaufs zur Korrelation multimodaler in vivo und ex vivo retinaler Bildgebung mit histologischen Untersuchungen},
  doi       = {10.25972/OPUS-27350},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-273500},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Die retinale in vivo Bildgebung gewann in den letzten 2 Jahrzehnten zunehmend an Bedeutung. Es fehlt aber h{\"a}ufig die Korrelation der in vivo erstellten quasi „histologischen" Aufnahmen mit der tats{\"a}chlichen Histologie. An der Klinik und Poliklinik f{\"u}r Augenheilkunde des Universit{\"a}tsklinikums W{\"u}rzburg wurde ein standardisiertes System zur vergleichenden in vivo/ex vivo und histologischen retinalen Bildgebung des menschlichen Auges etabliert. In der vorliegenden „proof of concept study" konnte der Arbeitsablauf erfolgreich gezeigt werden. Es wurden Abl{\"a}ufe geschaffen, die die ex vivo multimodale retinale Bildgebung analog zur in vivo Bildgebung an denselben Ger{\"a}ten erm{\"o}glichen. Die histologische Aufarbeitung des Gewebes erfolgt im Anschluss und erm{\"o}glicht die Korrelation von technisch gefundenen Ver{\"a}nderungen mit lichtmikroskopisch beschriebenen Auff{\"a}lligkeiten. Diese histologischen Korrelate tragen zum besseren Verst{\"a}ndnis von in vivo gefundenen Ver{\"a}nderungen bei. Gleichzeitig verbessern neu gefundene Auff{\"a}lligkeiten in der in vivo Bildgebung das Verst{\"a}ndnis und Fr{\"u}herkennung vieler retinaler Erkrankungen. Die Vorteile exzellent konservierter, aufbereiteter und histologisch untersuchter Proben wurde hier am Beispiel der CNTF-Expression dargestellt. Es konnte gezeigt werden, dass dieses Zytokin insbesondere bei neovaskul{\"a}rer AMD in den Fotorezeptoraußensegmenten exprimiert wird.},
  subject      = {Ciliary neurotrophic factor},
  language  = {de}
}
@article{KunzmannNgyuenStahletal.2019,
  author    = {Kunzmann, S. and Ngyuen, T. and Stahl, A. and Walz, J. M. and Nentwich, M. M. and Speer, C. P. and Ruf, K.},
  title     = {Necrotizing enterocolitis after intravitreal bevacizumab in an infant with Incontinentia Pigmenti - a case report},
  series = {BMC Pediatrics},
  volume    = {19},
  journal   = {BMC Pediatrics},
  doi       = {10.1186/s12887-019-1732-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201024},
  pages     = {353},
  year      = {2019},
  abstract  = {Background Incontinentia Pigmenti is a rare disease affecting multiple organs. Fifty of patients show affection of the eye with retinopathy and possible amaurosis being the worst outcome. Treatment has commonly been panretinal laser coagulation but intravitreal application of bevacizumab as VEGF-inhibitor has shown to effectively suppress retinal neovascularization. Case presentation A six-week-old female infant with Incontinentia Pigmenti developed a foudroyant necrotizing enterocolitis shortly after intravitreal injection of bevazicumab due to a retinopathy with impending tractional detachment of the left eye. Since the onset of abdominal symptoms occurred immediately after the intravitreal application, a link between the two events seemed likely. Sequential analyses of the VEGF serum concentrations showed a massive suppression of endogenous VEGF with only a very slow recovery over weeks. Such a severe systemic adverse event has not been reported after intravitreal treatment with bevacizumab in an infant. Conclusion This case report shows a relevant systemic uptake of bevacizumab after intravitreal application as suppressed VEGF levels show. There seems to be a connection between suppressed VEGF levels and the onset of necrotizing enterocolitis. Therefore, treatment with bevacizumab should be carefully considered and further research is needed to assess this drug's safety profile.},
  language  = {en}
}
@phdthesis{MolinaGalindo2021,
  author    = {Molina Galindo, Lara Sophia},
  title     = {Glaukomtherapie: Intraindividueller Vergleich zwischen der konventionellen Trabekulektomie und der filtrierenden Trabekulotomie},
  doi       = {10.25972/OPUS-24641},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246412},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Hintergrund: Die konventionelle Trabekulektomie (TET) stellt trotz einem eher ung{\"u}nstigen Komplikationsprofil weiterhin den Goldstandard der operativen Glaukomtherapie dar, da sie eine effektivere langfristige Drucksenkung als neuere Operationsverfahren aufweist. Fragestellung: Vergleich der Erfolgsquote und des Risikoprofils der TET mit einer durch Schaffen einer zweiten Filtrationsebene sowie Vermeiden einer peripheren Iridektomie modifizierten Trabekulektomie („Filtrierende Trabekulotomie" (FTO)). Material und Methode: Retrospektiv durchgef{\"u}hrter intraindividueller Vergleich {\"u}ber 36 Monate an 20 Patienten mit Offenwinkelglaukom nach TET an einem Auge und FTO am anderen Auge an der Augenklinik der Universit{\"a}t W{\"u}rzburg. Prim{\"a}rer Endpunkt war das Erreichen des absoluten/Teilerfolgs (IOD ≤18 mmHg und ≥ 20 \% Druckreduktion ohne/mit Medikation). Als sekund{\"a}re Endpunkte wurden das Auftreten von Komplikationen sowie der Verlauf von Augeninnendruck, Visus und lokaler Pharmakotherapie analysiert. Ergebnisse: Beide Operationsverfahren f{\"u}hrten zu einer signifikanten Reduktion des Augeninnendrucks zu jedem postoperativen Zeitpunkt. Nach 36 Monaten zeigte sich ein absoluter Erfolg bei 50 \% der Augen in der TET-Gruppe und 20 \% der FTO-Gruppe sowie ein Teilerfolg bei 71,4 \% gegen{\"u}ber 33,3 \%. Zu Komplikationen kam es mit Ausnahme des h{\"a}ufigeren Auftretens eines Hyph{\"a}mas in der FTO-Gruppe in vergleichbarem Ausmaß in beiden Gruppen. Der Visus und postoperative Medikamentenscore unterschieden sich nicht signifikant voneinander. Schlussfolgerung: Die TET war der FTO in Hinblick auf Erfolg und Komplikationsrisiko {\"u}berlegen. Die m{\"o}glichen Vorteile der Operation durch die genannten Modifikationen konnten nicht best{\"a}tigt werden.},
  subject      = {Offenwinkelglaukom},
  language  = {de}
}
@article{DopplerMeyerDovernetal.2019,
  author    = {Doppler, Christopher E. J. and Meyer, Linda and Dovern, Anna and St{\"u}hmer-Beckh, Jaro and Weiss, Peter H. and Fink, Gereon R.},
  title     = {Differential impact of social and monetary reward on procedural learning and consolidation in aging and its structural correlates},
  series = {Frontiers in Aging Neuroscience},
  volume    = {11},
  journal   = {Frontiers in Aging Neuroscience},
  doi       = {10.3389/fnagi.2019.00188},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222394},
  year      = {2019},
  abstract  = {In young (n = 36, mean +/- SD: 24.8 +/- 4.5 years) and older (n = 34, mean +/- SD: 65.1 +/- 6.5 years) healthy participants, we employed a modified version of the Serial Reaction Time task to measure procedural learning (PL) and consolidation while providing monetary and social reward. Using voxel-based morphometry (VBM), we additionally determined the structural correlates of reward-related motor performance (RMP) and PL. Monetary reward had a beneficial effect on PL in the older subjects only. In contrast, social reward significantly enhanced PL in the older and consolidation in the young participants. VBM analyses revealed that motor performance related to monetary reward was associated with larger grey matter volume (GMV) of the left striatum in the young, and motor performance related to social reward with larger GMV of the medial orbitofrontal cortex in the older group. The differential effects of social reward in young (improved consolidation) and both social and monetary rewards in older (enhanced PL) healthy subjects point to the potential of rewards for interventions targeting aging-associated motor decline or stroke-induced motor deficits.},
  language  = {en}
}