TY  - JOUR
A1  - Lang, Stefan J.
A1  - Messmer, Elisabeth M.
A1  - Geerling, Gerd
A1  - Mackert, Marc J.
A1  - Brunner, Tobias
A1  - Dollak, Sylvia
A1  - Kutchoukov, Borislav
A1  - Böhringer, Daniel
A1  - Reinhard, Thomas
A1  - Maier, Philip
T1  - Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus
JF  - BMC Ophthalmology
N2  - 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.
KW  - ultraviolet-a
KW  - riboflavin
KW  - Scheimpflug
KW  - eyes
KW  - haze
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-151498
VL  - 15
IS  - 78
ER  - 
TY  - JOUR
A1  - Grassmann, Felix
A1  - Fritsche, Lars G.
A1  - Keilhauer, Claudia N.
A1  - Heid, Iris M.
A1  - Weber, Bernhard H. F.
T1  - Modelling the Genetic Risk in Age-Related Macular Degeneration
JF  - PLoS One
N2  - Late-stage age-related macular degeneration (AMD) is a common sight-threatening disease of the central retina affecting approximately 1 in 30 Caucasians. Besides age and smoking, genetic variants from several gene loci have reproducibly been associated with this condition and likely explain a large proportion of disease. Here, we developed a genetic risk score (GRS) for AMD based on 13 risk variants from eight gene loci. The model exhibited good discriminative accuracy, area-under-curve (AUC) of the receiver-operating characteristic of 0.820, which was confirmed in a cross-validation approach. Noteworthy, younger AMD patients aged below 75 had a significantly higher mean GRS (1.87, 95% CI: 1.69-2.05) than patients aged 75 and above (1.45, 95% CI: 1.36-1.54). Based on five equally sized GRS intervals, we present a risk classification with a relative AMD risk of 64.0 (95% CI: 14.11-1131.96) for individuals in the highest category (GRS 3.44-5.18, 0.5% of the general population) compared to subjects with the most common genetic background (GRS -0.05-1.70, 40.2% of general population). The highest GRS category identifies AMD patients with a sensitivity of 7.9% and a specificity of 99.9% when compared to the four lower categories. Modeling a general population around 85 years of age, 87.4% of individuals in the highest GRS category would be expected to develop AMD by that age. In contrast, only 2.2% of individuals in the two lowest GRS categories which represent almost 50% of the general population are expected to manifest AMD. Our findings underscore the large proportion of AMD cases explained by genetics particularly for younger AMD patients. The five-category risk classification could be useful for therapeutic stratification or for diagnostic testing purposes once preventive treatment is available.
KW  - AMD
KW  - complement factor-H
KW  - grading system
KW  - United States
KW  - vitamin C
KW  - prevalence
KW  - variants
KW  - susceptibility
KW  - association
KW  - maculopathy
KW  - variant genotypes
KW  - genetic loci
KW  - macular degeneration
KW  - genetics of disease
KW  - eyes
KW  - cased-control studies
KW  - genotyping
KW  - human genetics
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-131315
VL  - 7
IS  - 5
ER  -