Abstract:
:Acute posterior and panuveitis mostly affect younger patients and affect both eyes in more than half of cases. Because of the severe consequences in the clinical course, rapid and broad differential diagnosis are critical steps. Permanent loss of vision after a delay in starting therapy and the initiation of ineffective treatment are both serious risks. The initial diagnostic classification is based on clinical presentation (anatomical localisation and type of inflammation) and clinical course and, secondarily, on the response to acute therapy. The aetiology is acute in as many as one third of cases. The most frequent acute posterior uveitis in immunocompetent persons is acute viral retinal necrosis. It is difficult to distinguish this clinically from Behçet uveitis, as long as there are no systemic manifestations. In patients with disease threatening the macula, high dose steroid therapy must be started no later than 24 hours after the start of antiviral and anti-parasitic acute therapy. Thus, misdiagnosis has therapeutic consequences. Moreover, the prognosis is favourably affected by aggressive treatment of acute posterior uveitis. Any delay in starting therapy increases infectious and inflammatory tissue damage, and increases the risk of involvement of the other eye and of other organs. On the other hand, the use of high doses of steroids, immunosuppressives and biological agents can lead to uncontrolled proliferation of the pathogen and relapses. :Die breite Differenzialdiagnose der akuten posterioren und Panuveitis, die meist jüngere Individuen und in mehr als der Hälfte beide Augen betrifft, macht die rasche diagnostische Einordnung und die therapeutische Entscheidung wegen ihrer erheblichen Konsequenzen für den weiteren Verlauf zu kritischen Schritten. Das Risiko eines bleibenden Visusverlustes infolge eines verzögerten Therapiebeginns ist dabei ebenso bedeutsam wie das Einleiten einer nicht genügend wirksamen Therapie. Klinische Präsentation (anatomische Lokalisation und Entzündungstyp), Verlauf und sekundär das Ansprechen auf die Akuttherapie lassen eine erste diagnostische Eingrenzung zu, wobei eine infektiöse Ätiologie in bis zu einem Drittel der Fälle vorliegt. Die häufigste akute posteriore Uveitis bei immunkompetenten Patienten ist eine akute virale Netzhautnekrose. Diese lässt sich oft klinisch nicht sicher von einer Behçet-Uveitis unterscheiden, solange keine systemischen Manifestationen vorliegen. Bis zur definitiven diagnostischen Einordnung muss deshalb bei makulabedrohender Erkrankung spätestens 24 Stunden nach Beginn einer antiviralen und antiparasitären Akuttherapie eine hochdosierte Steroidtherapie begonnen werden. Den therapeutischen Konsequenzen der Fehleinschätzung der Erkrankung stehen prognostische Überlegungen gegenüber, die ein aggressives Vorgehen gerade bei akuten posterioren Uveitiden rechtfertigen: Jede Verzögerung des Therapiebeginns vermehrt die infektiöse und entzündliche Gewebsschädigung, erhöht das Risiko einer Affektion des Partnerauges und anderer Organe, wohingegen der Einsatz höherer Steroiddosen, Immunsuppressiva und Biologika zu unkontrollierter Erregerproliferation und zu Rezidiven führen kann.
journal_name
Klin Monbl Augenheilkdjournal_title
Klinische Monatsblatter fur Augenheilkundeauthors
Garweg JG,Messerli Jdoi
10.1055/a-0828-7395subject
Has Abstractpub_date
2019-04-01 00:00:00pages
487-491issue
4eissn
0023-2165issn
1439-3999journal_volume
236pub_type
杂志文章abstract:BACKGROUND:Disturbances in the microcirculation are a source of retinal diabetic alterations. Comprehensive studies of blood flow parameters have been performed, but it is not known how ageing, duration of diabetes, blood sugar, glycolysed haemoglobin and elevated systemic blood pressure act in the early stages of diab...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-963156
更新日期:2007-05-01 00:00:00
abstract::An early diagnosis, differential diagnosis and possible decision about therapeutic interventions has considerable consequences for the personal and social life of patients affected with inherited retinal dystrophies (IRD). For the ophthalmologist, the clinical heterogeneity interferes with a simple diagnostic approach...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/a-1118-3705
更新日期:2020-03-01 00:00:00
abstract:AIM:The aim of this study was to evaluate the functional effect of bilateral implantation of apodised diffractive versus progressive multizonal refractive multifocal intraocular lenses compared to standard monofocal intraocular lenses. PATIENTS AND METHOD:229 patients underwent cataract extraction; 66 Array SA40N (AMO...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0032-1328642
更新日期:2013-08-01 00:00:00
abstract::Sometimes the statistical comparison of diagnostic measurement methods or subsequent measurement series in the same individuals is based on bivariate scattergrams; correlation coefficients and linear regression lines are provided in addition. However, this strategy for data representation must be considered inappropri...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2002-35165
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Diagnosis of syphilis is often very difficult due to the absence of typical organ manifestation. In addition syphilis has the ability to imitate any ocular inflammation. This may result in misdiagnosis and delay of appropriate antimicrobial therapy. Up to now the first choice therapy is penicillin. CASE REP...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2001-17141
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the significance of different clinical appearances of the vitreoretinal interface in the surgical management of acute postoperative endophthalmitis. PATIENTS AND METHODS:22 patients underwent vitrectomy and were divided intraoperatively in 3 groups according to the degree...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0028-1109286
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Assessment of visual acuity depends on the optotypes used for measurement. The ability to recognize different optotypes differs even if their critical details appear under the same visual angle. Since optotypes are evaluated on individuals with good visual acuity and without eye disorders, differences in the...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2005-858613
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:With the discrepancy between availability and demand for corneal donors, the purpose of our study was to identify significant factors influencing the suitability and affecting the main reasons for discarding organ-cultured corneas. We thus aimed to minimise the percentage of unsuitable corneas in...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1141-3703
更新日期:2020-11-01 00:00:00
abstract::A report is given on seventeen cases of spontaneous regression of diabetic retinopathy. The diabetes became manifest, without exception, at an early age, particularly in childhood. Regression came on slowly and inconspicuously, retinopathy disappearing completely in two thirds of the cases. Of the other forms of diabe...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::The tearing eye (epiphora) is the guiding symptome of nasolacrimal duct obstruction. Depending on the localization of stenosis, mucopurulent lacrimal discharge occurs additionally. These symptoms induce alterations of the optical system and can cause severe complications such as acute phlegmonous dacryocystitis. The g...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1283-9271
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:After consulting the here presented CT-images of the orbit, the question was raised whether the ocular bulbus was really enucleated or the anamnesis was wrong and a lymphoma existed in the orbit. We will therefore discuss a case of a special follow-up after an enucleation with implantation of a "Bangerter Pl...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035393
更新日期:1995-12-01 00:00:00
abstract::Background Eyes with severe corneal opacifications and insufficient prognosis for high-risk corneal transplantation can be considered for the implantation of a Boston-keratoprosthesis. Since 2013, this technique of "artificial" corneal replacement is provided to high-risk eyes at the Department of Ophthalmology, Unive...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0043-110572
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Data from national graft registries suggests a limited prognosis in the group of all repeat keratoplasties. This group might rather consist mostly of cases already classified as high risk in the first place, however. Thus, repeat keratoplasties in normal risk indications might have a substantially better pro...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1027127
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Vitamin A, the fat soluble vitamin, must be supplied orally before resorption in the mucosa of the small intestine and storage in the liver. Vitamin A deficiency can cause alterations in the anterior segment of the eye, from Bitot spots, which are reversible, to irreversible keratomalacia. PATIENTS AND METH...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045496
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Photorefractive keratectomy (PRK) is an accepted procedure to correct myopia in Germany. The purpose of this study was to evaluate photoastigmatic refractive keratectomy (PARK) for myopic astigmatism. MATERIAL AND METHODS:PARK using the VISX 20/20 excimer laser was performed in 50 eyes of 36 patients (25 fe...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1034713
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:The laser flare meter FM-500 (Kowa, diode laser, 670 nm) is a simplified version of the laser flare-cell meter FC-1000 (Kowa, He-Ne laser, 632.8 nm). the aim of this study was to compare flare measurements of the laser flare meter FC-500 with the established laser flare-cell meter FC-1000 and to determine th...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2008-1035284
更新日期:1996-08-01 00:00:00
abstract::This work is a survey of 82 cases of keratoconus which have been followed up for 1 to 12 years. Among them only 66 were fitted with contact lenses. The contra-indications for them are: 1. a better visual acuity with spectacles than with contact lenses, 2. advanced cases (4th degree of Amsler) whose fitting is impossib...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::It has been shown by a series of 127 dacryocystorhinostomies using the Toti technique, that this operation, which is independent of age or aethiology, can be performed using a simple procedure and a short hospitalization time. The success rate of over 90% indicates that this operation should be used as a standard proc...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Most reports on transscleral suture fixation of posterior chamber lenses (PCL) do not mention the principal difficulty that the surgeon has no valid information which structures were perforated by the needle and where he happened to fix the PCL loops. To know this exactly is a "conditio sine qua non". Withou...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045599
更新日期:1993-04-01 00:00:00
abstract::In the last four years we have treated with the mobile argon-laser beam 25 cases of aphakic pupillary block glaucoma (p. b. g.). According to the time of manifestation of the p. b. g. the patients were divided into an "early" and a "late" group. In the "early" group (17 eyes) the glaucoma manifested itself 1--4 days a...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-08-01 00:00:00
abstract::Report on 530 lens implantation procedures performed in the years from 1981 to 1985. Different complications with different lens models are mentioned, in particular cystoid macular edema, subluxation or luxation of the artificial lens, vitreous complication, secondary cataract, and retinal detachment. A comparison was...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1054355
更新日期:1985-11-01 00:00:00
abstract::Between August 1982 and August 1984 3059 intraocular operations were performed with topical prophylactic antibiotics. Results of conjunctival cultures did not influence the surgical schedule. 8179 intraocular operations were performed between September 1984 and August 1988. An intraocular operation was postponed until...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045734
更新日期:1992-03-01 00:00:00
abstract::Oral doses of propranolol and metoprolol were tested on 24 patients without glaucoma. The aim of this study was to compare the decrease in intraocular pressure in normal eyes following a single oral dose of propranolol or metoprolol. A statistically significant decrease in IOP was noticed, but no difference was seen b...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Antibodies (Ab) against the acetylcholine receptor (AChR) are found in 80 - 90 % of generalized myasthenia gravis (MG), but only in 50 % of pure ocular MG. Furthermore, Ab against the muscle-specific receptor tyrosine kinase (MuSK) were detected in 38 - 54 % of patients with AChR-Ab-negative ("seronegative")...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2005-858629
更新日期:2006-01-01 00:00:00
abstract::27 children with severe brain injuries were examined by an ophthalmologist and had several paediatric examinations during an eight or ten weeks' course of rehabilitation. With highly reduced levels of consciousness they had hardly any cortical visual function but frequently had brainstem controlled reactions of eyelid...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045861
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Arteriovenous communications in which blood flows from meningeal branches of the internal and external carotid arteries into the venous circulation around and in the cavernous sinus are termed spontaneous (dural) carotid sinus cavernous fistulas. Due to their mostly low shunt volume they are rarely life thre...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2000-10356
更新日期:2000-10-01 00:00:00
abstract::Report on a rare case of an iris-ringmelanoma. Arising from the iris base the primary tumor spread in a continuous line along the anterior chamber angle and a shedding of tumor cells in other places of the iris surface could be stated as well. A unilateral dark spotted colouring of the iris with a secondary glaucoma w...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract::By means of a new optical device developed by Reiner, an "optical implantation" of 6 different bi- and multifocal intraocular lenses (MIOLs) was performed in 20 young healthy subjects, and results were compared with those of a monofocal reference IOL. The following parameters were investigated: distance and near visua...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045916
更新日期:1992-12-01 00:00:00
abstract::Real-time tracking of eye movements offers a solution to various problems in ophthalmology. Different types of image analysis and processing techniques is discussed and an advanced pattern recognition eye-tracking system has been developed; it can track a retinal target (in real time) under conditions typical for opht...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050488
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:In the treatment of center-involving diabetic macular edema, despite initial therapy with an anti-VEGF compound, an insufficient response may occur. Further therapy options include a switch of anti-VEGF products or to corticosteroid implants, such as Fluocinolone acetonide or Dexamethasone. OBJECTIVES:First...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0043-125076
更新日期:2019-02-01 00:00:00