TY - JOUR A1 - Dick, Julia A1 - Krauß, Patrizia A1 - Hillenkamp, Jost A1 - Kohlmorgen, Britta A1 - Schoen, Christoph T1 - Postoperative Tropheryma whipplei endophthalmitis – a case report highlighting the additive value of molecular testing JF - JMM Case Reports N2 - 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. KW - intravitreal vancomycin and amikacin KW - intravenous ceftriaxone KW - topic ofloxacin KW - Whipple's disease KW - endophthalmitis KW - Tropheryma whipplei KW - ocular infection KW - vitrectomy KW - oral cefpodoxime KW - oral doxycycline Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158823 VL - 4 ER - TY - JOUR A1 - Ben Ami, Tal A1 - Tong, Yuehong A1 - Bhuiyan, Alauddin A1 - Huisingh, Carrie A1 - Ablonczy, Zsolt A1 - Ach, Thomas A1 - Curcio, Christine A. A1 - Smith, R. Theodore T1 - Spatial and Spectral Characterization of Human Retinal Pigment Epithelium Fluorophore Families by Ex Vivo Hyperspectral Autofluorescence Imaging JF - Translational Vision Science & Technology N2 - 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. KW - spectral characterization KW - human retinal pigment epithelium KW - fluorophores KW - hyperspectral autofluorescence imaging Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-168328 VL - 5 IS - 3 ER - TY - JOUR A1 - Bielmeier, Christina B. A1 - Schmitt, Sabrina I. A1 - Kleefeldt, Nikolai A1 - Boneva, Stefaniya K. A1 - Schlecht, Anja A1 - Vallon, Mario A1 - Tamm, Ernst R. A1 - Hillenkamp, Jost A1 - Ergün, Süleyman A1 - Neueder, Andreas A1 - Braunger, Barbara M. T1 - Deficiency in retinal TGFβ signaling aggravates neurodegeneration by modulating pro-apoptotic and MAP kinase pathways JF - International Journal of Molecular Sciences N2 - 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 Müller 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 Müller 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 Müller cells exhibits a neuroprotective effect and might pose promising therapeutic options to attenuate photoreceptor degeneration in humans. KW - TGFβ signaling KW - retina KW - retinitis pigmentosa KW - neuro-/photoreceptor degeneration KW - MAP kinase pathway KW - ferroptosis Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-283971 SN - 1422-0067 VL - 23 IS - 5 ER - TY - THES A1 - Dakroub, Mohamad T1 - Coarsened Exact Matching of Excisional to Plasma-Ablative Ab Interno Trabeculectomy T1 - Vergröbertes genaues Matching von exzisionaler zu plasmaablativer Ab-Interno-Trabekulektomie N2 - 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. N2 - Das Glaukom wird initial häufig mit topischen Medikamenten behandelt. Es ist jedoch oft der Fall, dass Patienten im Verlauf operiert werden. Ablation, Exzision und Disruption des Trabekelmaschenwerks senken bei einem primären Offenwinkelglaukom den Augeninnendruck effektiv, wenn der Ausflusswiderstand im proximalsten Anteil des konventionellen Ausflusstraktes liegt. Die plasma-vermittelte Ablation des Trabekelmaschenwerks mit dem Trabektom steht Chirurgen seit 2004 zur Verfügung, während die Exzision mit dem TrabEx+ 2014 erstmals eingeführt wurde. Diese Studie zielte darauf ab, beide Geräte zu vergleichen und verwendete Coarsened Exact Matching, um kleine, gerätespezifische Unterschiede zwischen Trabektom und TrabEx+ festzustellen. Trotz eines relativ niedrigen Augeninnendrucks reduzierten beide Geräte diesen Parameter nach 6 Monaten signifikant, aber nur das Trabektom schaffte dies nach 12 Monaten. Beide reduzierten die Anzahl der drucksenkenden Medikamente zu beiden Zeitpunkten (6 und 12 Monate) signifikant. Definiert man den chirurgischen Erfolg als Abnahme des Augeninnendrucks um mehr als 20%, so waren die Erfolgsraten in beiden Gruppen relativ niedrig. Erklärbar ist dies am ehesten durch die niedrigen Ausgangswerte des Augeninnendrucks. In Bezug auf Augeninnendruck, Sehschärfe, Erfolgsraten und Komplikationen gab es keine wesentlichen Unterschiede zwischen beiden Geräten. TrabEx+ Patienten applizierten zu allen Zeitpunkten mehr drucksenkende Augentropfen als Trabektom-Patienten. KW - Glaukom KW - glaucoma KW - glaucoma surgery KW - trabex+ KW - trabectome Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-296805 ER - TY - JOUR A1 - Schmid, Richard A1 - Tarau, Ioana-Sandra A1 - Rossi, Angela A1 - Leonhardt, Stefan A1 - Schwarz, Thomas A1 - Schuerlein, Sebastian A1 - Lotz, Christian A1 - Hansmann, Jan T1 - In Vivo-Like Culture Conditions in a Bioreactor Facilitate Improved Tissue Quality in Corneal Storage JF - Biotechnology Journal N2 - 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. KW - bioreactor KW - corneal endothelium KW - corneal epithelium KW - corneal storage KW - tissue culture Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-228620 VL - 13 IS - 1,1700344 ER - TY - JOUR A1 - Müller, Philipp L. A1 - Meigen, Thomas T1 - M-sequences in ophthalmic electrophysiology JF - Journal of Vision N2 - 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. KW - vision Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-165796 VL - 16 IS - 1,15 ER - TY - THES A1 - Glatzel, Caroline T1 - Ergebnisse einer neuen Filtrationsoperation im Vergleich zur konventionellen Trabekulektomie bei Glaukom T1 - Results of a new filtering operation compared to the conventional trabeculectomy in glaucoma N2 - 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 Universität Würzburg operiert worden. Eingeschlossen wurden Patienten mit primärem 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 Universität Würzburg oder von den weiterbehandelnden niedergelassenen Augenärz- ten mit Hilfe eines für diese Studie entworfenen Fragebogens erhoben. Endpunkt: Als primärer 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 sekundäre 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. Präoperativ 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 präoperativ 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 präoperativ deutlich über der der TE- Gruppe. Der IOD lag präoperativ 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 präoperativen 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 präoperativen 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 präoperativen IOD gesenkt werden. Bei einem Vergleich zwischen den Gruppen lag der IOD der FTO- Gruppe einmalig über dem der TE-Gruppe. In den anderen Fällen traten keine signifikan- ten Druckunterschiede zwischen den Gruppen auf. Der postoperative Visus unterschied sich zu keinem Zeitpunkt, ob mit oder ohne Kunstlinse, im prä- 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 möglich war. Die Verteilung der Glaukomformen hatte sich auch nach 1,5 und 2 Jahren nicht verändert. 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 äquivalent. Im Langzeitverlauf traten in der FTO Gruppe nicht mehr Komplikationen als nach TE auf. Nach 1 Jahr waren in der FTO-Gruppe signifikant mehr frühe Komplikationen auf- getreten als in der TE. Nach 2 Jahren war die Rate an Komplikationen in den Gruppen nicht mehr signifikant unterschiedlich. N2 - Purpose • To determine the long-term outcome of filtering trabeculotomy in comparison to conventional trabeculectomy for primary open-angle glaucoma, pseudo-exfoliative glaucoma and pigmentary glaucoma. Methods • Thirty patients who underwent filtering trabeculotomy were included in this study and followed prospectively, while 69 patients who underwent conventional trabeculectomy were followed retrospectively. Surgeries were performed by the same surgeon between 2007 and 2012. The duration of follow up was 24 month. Patients were matched by intraocular pressure and age. • The primary endpoints were defined as reduction of IOP below 18mmHg and intraocular pressure reduction of more than 30%. Complete success was defined as IOP < 18mmHg and minimal pressure reduction >= 30% without medication, qualified success was defined as IOP < 18mmHg an IOP reduction >= 30% with additional medication. • Secondary endpoints were defined as IOP, visual acuity, medication, complications and subsequent surgeries. Results • Over 2 years the data of 27 patients undergoing fitrating trabeculotomy and 68 patients with conventional trabeculectomy were collected. Patients of both groups were comparable in age, IOP, visual acuity (p=0,60), sex (p=0,30) and medication (p= 0,05). The number of patients with pigmentary glaucoma (p=0,02) and pseudophakia (p=0,02) was significant higher in the group that underwent filtrating trabeculotomy. • The preoperative IOP was 23mmHg (interquartile range 20,0-27,0) in the conventional trabeculectomy group and 23mmHg (20,0-27mmHg) in the filtrating trabeculotomy group. • Complete response was achieved in 33,3% of the filtrating trabeculectomy group and 56,7% in the conventional trabeculectomy group after 2 years. Qualified success was reached in 70,4% of of patients in the filtrating trabeculectomy group and 77,6% in the conventional trabeculectomy group, showing no statistical difference. • Surgical treatment significantly reduced IOP in both groups (p<0,001). After 24 month the IOP was 12,80 ± 3,79 mmHg in filtrating trabeculotomy group and 11mmHg (IQR 9-13) in the conventional trabeculectomy group. The IOP was comparable between the groups after 2 years (p 24 month= 0,12). • The postoperative visual acuity was reduced compared to the preoperative visual acuity (p2a= 0,00), but was not significantly different between the groups. • Patients with pseudoexfoliative glaucoma had significantly lower IOP-values after surgery. Postoperative visual acuity was not significantly different from preoperative visual acuity. Conclusion • Filtrating trabeculectomy and conventional trabeculectomy are comparable in regard of IOP, visual acuity and postoperational success. After 2 years the complication rate was equal between the groups/ Complications occurred equally in both groups. KW - Glaukom KW - konventionelle Trabekulektomie KW - filtrierende Trabekulotomie KW - Trabekulektomie KW - Glaukomoperation KW - Glaukom KW - Glaukomoperation KW - filtrierende Trabekulotomie KW - filtrierende Glaukomoperation KW - Trabekulektomie Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-167192 ER - TY - JOUR A1 - Balasubramanian, Srikkanth A1 - Othman, Eman M. A1 - Kampik, Daniel A1 - Stopper, Helga A1 - Hentschel, Ute A1 - Ziebuhr, Wilma A1 - Oelschlaeger, Tobias A. A1 - Abdelmohsen, Usama R. T1 - Marine sponge-derived Streptomyces sp SBT343 extract inhibits staphylococcal biofilm formation JF - Frontiers in Microbiology N2 - 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. KW - medicine KW - marine sponges KW - actinomycetes KW - Streptomyces KW - staphilococci KW - biofilms KW - contact lens Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-171844 VL - 8 ER - TY - JOUR A1 - Litts, Katie M. A1 - Ach, Thomas A1 - Hammack, Kristen M. A1 - Sloan, Kenneth R. A1 - Zhang, Yuhua A1 - Freund, K. Bailey A1 - Curcio, Christine A. T1 - Quantitative Analysis of Outer Retinal Tubulation in Age-Related Macular Degeneration From Spectral-Domain Optical Coherence Tomography and Histology JF - Investigative Ophthalmology & Visual Science N2 - 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. KW - spectral-domain optical coherence tomography KW - photoreceptors KW - cones KW - Müller cells KW - age-related macular degeneration KW - outer retinal tubulation KW - ellipsoid KW - histology Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-165532 VL - 57 ER - TY - JOUR A1 - Lotz, Christian A1 - Schmid, Freia F. A1 - Rossi, Angela A1 - Kurdyn, Szymon A1 - Kampik, Daniel A1 - De Wever, Bart A1 - Walles, Heike A1 - Groeber, Florian K. T1 - Alternative Methods for the Replacement of Eye Irritation Testing JF - ALTEX - Alternatives to Animal Experimentation N2 - 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. KW - eye irritation testing KW - alternatives KW - Draize eye test KW - OECD guideline KW - corneal equivalent Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-164444 VL - 33 IS - 1 ER - TY - THES A1 - Arampatzis, Konstantinos T1 - Astigmatismuskorrektur im Rahmen moderner, minimalinvasiver Kataraktchirurgie – eine retrospektive Analyse T1 - Correction of astigmatism during modern, minimal invasive cataract surgery – a retrospective Analysis N2 - Hintergrund: Die Kataraktoperation ist der am meisten durchgeführte operative Eingriff in der Medizin überhaupt. Astigmatismus ist einer der häufigsten Refraktionsfehlern wobei 15-20% der Bevölkerung einen klinisch relevanten Astigmatismus von > 1,5 Dpt zeigen. Im Rahmen der Kataraktoperation besteht die Möglichkeit neben der Linsentrübung 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 Effektivität und Sicherheit bzgl. Astigmatismuskorrektur, der PCCRI überlegen. PCCRI ist eine gute, kostengünstige Alternative. Astigmatismusbeträge bis 1,5 Dpt können sowohl durch PCCRI als auch durch TIOL korrigiert werden. Bei höheren Beträgen 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. N2 - Objective: Cataract surgery is the most common kind of surgery in medical world. Astigmatism is one of the most common refractive errors. 15-20% of the population has a clinical significant astigmatism of > 1.5 Dpt. During cataract surgery there is a unique chance to correct the astigmatic error together with the cataract. Material and methods: 176 cataract surgeries with astigmatism correction were retrospectively analyzed. 110 eyes were treated with peripheral clear-cornea relaxing incisions (PCCRI) and 66 eyes with implantation of toric posterior chamber intraocular lenses (TIOL). Astigmatic effect was analyzed with vector analysis and double-angle diagrams. Results: In the PCCRI group the topographical astigmatism reduction was 0.86 ± 0.63 Dpt and the refractive reduction was 1.33 ± 1.08 Dpt. In the TIOL group the refractive reduction was 2.26 ± 1.57 Dpt and the mean postoperative axis rotation was 4.77° ± 4.18°. Conclusion: Astigmatism correction with TIOL shows high efficacy and safety, higher than PCCRI. PCCRI is a low cost alternative. Astigmatism up to 1.5 Dpt can be well corrected with both methods. TIOL is the method of choice for higher amounts of astigmatism. An axis correction in the second postoperative week may be necessary in case of clinic relevant postoperative rotation of > 8° of a TIOL. KW - Augenheilkunde KW - Astigmatismus KW - Astigmatism KW - Astigmatismuskorrektur KW - PCCRI KW - TIOL KW - LRI KW - periphere korneale Relaxationsinzisionen KW - torische Intraokularlinsen KW - limbale Relaxationsinzisionen KW - minimalinvasive Kataraktchirurgie KW - Astigmatismusanalyse KW - correction of Astigmatism KW - peripheral corneal relaxing incisions KW - toric intraocular lens KW - limbal relaxing incisions KW - minimal invasive cataract surgery KW - astigmatism analysis Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-208458 ER - TY - JOUR A1 - Matlach, Juliane A1 - Dhillon, Christine A1 - Hain, Johannes A1 - Schlunck, Günther A1 - Grehn, Franz A1 - Klink, Thomas T1 - Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial JF - Acta Ophthalmologica N2 - 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. KW - months follow-up KW - surgical outcomes KW - mitomycin C KW - canaloplasty KW - open-angle glaucoma KW - trabeculectomy KW - glaucoma surgery KW - series KW - phacocanaloplasty KW - phacotrabeculectomy KW - canal surgery KW - cataract surgery KW - flexible microcatheter KW - circumferential viscodilation Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-149263 VL - 93 ER - TY - THES A1 - Gräfin von Moltke, Pia Maria T1 - Aufbau und Implementierung eines Arbeitsablaufs zur Korrelation multimodaler in vivo und ex vivo retinaler Bildgebung mit histologischen Untersuchungen T1 - Design and implementation of a workflow for correlating multimodal in vivo and ex vivo retinal imaging with histological examinations N2 - Die retinale in vivo Bildgebung gewann in den letzten 2 Jahrzehnten zunehmend an Bedeutung. Es fehlt aber häufig die Korrelation der in vivo erstellten quasi „histologischen“ Aufnahmen mit der tatsächlichen Histologie. An der Klinik und Poliklinik für Augenheilkunde des Universitätsklinikums Würzburg 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 Abläufe geschaffen, die die ex vivo multimodale retinale Bildgebung analog zur in vivo Bildgebung an denselben Geräten ermöglichen. Die histologische Aufarbeitung des Gewebes erfolgt im Anschluss und ermöglicht die Korrelation von technisch gefundenen Veränderungen mit lichtmikroskopisch beschriebenen Auffälligkeiten. Diese histologischen Korrelate tragen zum besseren Verständnis von in vivo gefundenen Veränderungen bei. Gleichzeitig verbessern neu gefundene Auffälligkeiten in der in vivo Bildgebung das Verständnis und Früherkennung 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 neovaskulärer AMD in den Fotorezeptoraußensegmenten exprimiert wird. N2 - Retinal in vivo imaging has become increasingly important over the past two decades. However, there is often no correlation between the almost histological image quality made in vivo and the actual histology. A standardized system for comparing in vivo/ex vivo and histological retinal imaging of the human eye was established at the “Klinik und Poliklinik für Augenheilkunde des Universitätsklinikums Würzburg”. In this "proof of concept study" the workflow could be successfully demonstrated. Procedures were created that enable ex vivo multimodal retinal imaging analogous to in vivo imaging on the same devices. The histological processing of the tissue is then carried out and enables the correlation of technically found changes with abnormalities described by light microscopy. These histological correlations contribute to a better understanding of changes found in vivo. At the same time, newly found abnormalities in in vivo imaging improve the understanding and early detection of many retinal diseases. The advantages of excellently preserved, processed and histologically examined samples were presented here using CNTF expression as an example. It could be shown that this cytokine is expressed in the photoreceptor outer segments, particularly in neovascular AMD. KW - Ciliary neurotrophic factor KW - Optische Kohärenztomografie KW - in vivo/ ex vivo Korrelation KW - retinale Bildgebung Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-273500 ER - TY - JOUR A1 - Kunzmann, S. A1 - Ngyuen, T. A1 - Stahl, A. A1 - Walz, J. M. A1 - Nentwich, M. M. A1 - Speer, C. P. A1 - Ruf, K. T1 - Necrotizing enterocolitis after intravitreal bevacizumab in an infant with Incontinentia Pigmenti – a case report JF - BMC Pediatrics N2 - 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. KW - Necrotizing enterocolitis KW - Incontinentia pigmenti KW - Bevacizumab KW - Retinopathy KW - VEGF Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201024 VL - 19 ER - TY - THES A1 - Molina Galindo, Lara Sophia T1 - Glaukomtherapie: Intraindividueller Vergleich zwischen der konventionellen Trabekulektomie und der filtrierenden Trabekulotomie T1 - Glaucoma therapy: Intraindividual comparison of the conventional trabeculectomy and the filtering trabeculotomy N2 - Hintergrund: Die konventionelle Trabekulektomie (TET) stellt trotz einem eher ungünstigen 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 durchgeführter intraindividueller Vergleich über 36 Monate an 20 Patienten mit Offenwinkelglaukom nach TET an einem Auge und FTO am anderen Auge an der Augenklinik der Universität Würzburg. Primärer Endpunkt war das Erreichen des absoluten/Teilerfolgs (IOD ≤18 mmHg und ≥ 20 % Druckreduktion ohne/mit Medikation). Als sekundäre Endpunkte wurden das Auftreten von Komplikationen sowie der Verlauf von Augeninnendruck, Visus und lokaler Pharmakotherapie analysiert. Ergebnisse: Beide Operationsverfahren führten 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 % gegenüber 33,3 %. Zu Komplikationen kam es mit Ausnahme des häufigeren Auftretens eines Hyphämas 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 überlegen. Die möglichen Vorteile der Operation durch die genannten Modifikationen konnten nicht bestätigt werden. N2 - Background: Despite its numerous short- and long-term complications Trabeculectomy (TET) remains the gold standard of surgical management of glaucoma. It offers more effective IOP control than minimal invasive glaucoma surgery. Objectives: Comparison of the outcome of the TET and a modified trabeculectomy with a second outflow-resistance level of the aqueous humor and without iridectomy (“Filtering Trabeculotomy” (FTO)). Methods: Intraindividual comparison of 20 patients with open-angle glaucoma after TET on the first eye and FTO of the other eye in a retrospective design over a follow-up period of 36 month. Primary outcome measure was the rate of complete and qualified success (IOP ≤18 mmHg and ≥ 20 % reduction without/with medication). Secondary outcome measures were the development of IOP, visual acuity, anti-glaucoma medication and complications. Results: Both surgical procedures reduced the IOP significantly. After 36 month of follow-up 50 % of the patients in the TET-group and 20 % in the FTO-group had a complete success. For qualified success there were lower rates with 71,4 % and 33,3 %, respectively. Complications were comparable in both groups with the exception of hyphema, which was seen more frequently in the FTO-group. Visual acuity and anti-glaucoma medication did not differ significantly. Conclusions: TET was superior to the FTO regarding success rates and complications. Potential benefits of the modifications of the surgical procedure could not be proved. KW - Offenwinkelglaukom KW - Trabekulotomie KW - Iridektomie Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-246412 ER - TY - JOUR A1 - Doppler, Christopher E. J. A1 - Meyer, Linda A1 - Dovern, Anna A1 - Stühmer-Beckh, Jaro A1 - Weiss, Peter H. A1 - Fink, Gereon R. T1 - Differential impact of social and monetary reward on procedural learning and consolidation in aging and its structural correlates JF - Frontiers in Aging Neuroscience N2 - 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. KW - serial reaction time task KW - procedural learning KW - reinforcement learning KW - voxel-based morphometry KW - motor aging Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222394 VL - 11 ER -