Abstract:
:Choroidal neovascularisation (CNV) in the context of exsudative age-related macular degeneration (nAMD) can be divided into type 1 (occult) and type 2 (classical) membranes. Retinal angiomatous proliferation (RAP) or polypoidal choroidal vasculopathy (PCV) are "rare subtypes" of chorioretinal neovascularisation and are distinguished by their distinct morphology and the sometimes worse response to therapy. Chorioretinal anastomosis, severe exsudates with serosanguinous pigment epithelial detachment and, in PCV, orange-red lesions in the papillomacular bundle can be diagnostic. Indocyanine green angiography (ICGA) is considered the gold standard for diagnosis of PCV and delivers important information for RAP too. Typical characteristics of PCV include foci of hyperfluoresence, with pulsatile filling in the early phase. This characterises choroidal polypoidal lesions, often in connection with an abnormal choroidal vascular network. In RAP, typical retino-retinal anastomosis can be identified, in particular in areas with pigment epithelial detachment. Optical coherence tomography (OCT) can complement diagnostic testing. In cases of RAP, early therapy initiation with intravitreal anti-VEGF is crucial for the prognosis of visual acuity. PCV can exhibit spontaneous regression. In active disease, photodynamic therapy (PDT) is efficient in the closure of PCV polyps. In association with CNV, it makes sense to combine PDT and intravitreal anti-VEGF medication. In spite of the initial increase in visual acuity, this state is normally "only" stabilised in the long term. In patients with idiopathic secondary CNV membranes (high myopia, post-inflammatory, post-traumatic changes or in hereditary connective tissue diseases), small "classical" type 2 membranes are mostly involved. Hence, these are strictly speaking not directly rare subtypes. Nevertheless, these patients are mostly younger, with less protracted illness and limited available regeneration ability of the retinal pigment epithelium (RPE): they may therefore differ favourably from the courses with nAMD, with earlier inactivation and with fewer required anti-VEGF injections. CNV with angioid streaks are a special case in this group. Unfortunately, these lesions have a recurrent, protracted and, in the end, mostly frustrating course. :Choroidale Neovaskularisationsmembranen (CNV) im Rahmen einer neovaskulären altersassoziierten Makuladegeneration (nAMD) können in Typ-1- (okkulte) und Typ-2- (klassische) Membranen unterteilt werden. Hiervon abzugrenzen sind, wegen ihrer differierenden Morphologie und des teils schlechteren Ansprechens, neovaskuläre „Sonderformen“ wie retinale angiomatöse Proliferationen (RAP) oder die polypoidalen choroidalen Vaskulopathien (PCV). Klinisch hinweisend sind chorioretinale Anastomosen, kräftige Exsudationen mit – für die PCV – serosanguinösen Pigmentepithelabhebungen (PED) und typischen orangerotfarbenen Läsionen im papillomakulären Bündel. Die Indocyaningrünangiografie (ICGA) stellt den diagnostischen Goldstandard für die PCV dar und liefert wichtige Informationen auch bei den RAP. Die Polypen der PCV stellen sich hier frühzeitig als fokale Hyperfluoreszenz mit z. T. pulsierender Füllung dar, häufig in Verbindung mit einem anormalen choroidalen Netzwerk. Über Arealen mit einer PED können bei RAP retinoretinale Anastomosen gut identifiziert werden. Die Befunde der optischen Kohärenztomografie (OCT) ergänzen die Diagnostik. Ein möglichst frühzeitiger und konsequenter Therapieansatz mit intravitrealer Anti-VEGF-Gabe ist bei RAP für die Visusprognose entscheidend. PCV können eine spontane Regression zeigen. Besteht Therapiebedarf, sprechen die Polypen besser auf eine photodynamische Therapie (PDT) an. Bei assoziierter CNV ist die Kombination aus PDT und intravitrealer Anti-VEGF-Gabe sinnvoll. Trotz initialem Anstieg kann im Langzeitverlauf der Visus zumeist „nur“ stabilisiert werden. Bei idiopathischen wie sekundären CNV-Membranen (Myopia magna, postentzündlich, posttraumatisch oder im Rahmen hereditärer Bindegewebserkrankungen) handelt es sich zumeist um kleine (klassische) Typ-2-Membranen. Sie stellen streng genommen keine direkten Sonderformen dar. Durch ein meist jüngeres Patientenalter, eine kürzere Erkrankungsdauer, eine begrenzte Regenerationsfähigkeit des retinalen Pigmentepithels (RPE) können sie sich jedoch günstig von der nAMD unterscheiden, mit rascher Inaktivierung sowie einem insgesamt geringeren Anti-VEGF-Injektionsbedarf. Eine Sonderstellung innerhalb dieser Gruppe nimmt die CNV bei Angioid Streaks ein. Diese ist leider durch einen rezidivierenden, langwierigen und letztlich zumeist frustranen Verlauf gekennzeichnet.
journal_name
Klin Monbl Augenheilkdjournal_title
Klinische Monatsblatter fur Augenheilkundeauthors
Sandner Ddoi
10.1055/s-0042-123833subject
Has Abstractpub_date
2018-08-01 00:00:00pages
905-926issue
8eissn
0023-2165issn
1439-3999journal_volume
235pub_type
杂志文章abstract::Although difficult, recurrent forms of pterygium are seldom seen in central Europe, they cause considerable therapeutic problems because they cannot be cured by simple dissection and conjunctivoplasty. A useful method of treatment in these cases is the marginal, lamellar keratoplasty, which, according to the type of i...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract:BACKGROUND:About 3-10% of patients suffering from metastatic disease develop metastatic choroidal tumors. In this case report ocular symptoms were the first sign of a systemic malignancy. CASE REPORT:A 65-year old man complained of an increasing painful redness of his left eye. He showed a white mass with 10 mm in thi...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2000-10578
更新日期:2000-05-01 00:00:00
abstract::Three hundred twenty-three eyes enucleated because of intraocular tumor were studied. The microscopic features were compared with survival data from 6 to 21 years after surgery, thus permitting the prognostic value of certain findings to be determined. Of the tumors, 299 were malignant melanomas of the choroid (262 ey...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1055271
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:The incidence of neurosyphilis, one of the late manifestations of syphilis, is reemerging. Affection of the eye is often associated with the disease. It may present with various clinical symptoms, leading to diagnostic difficulties. In cases of early diagnosis and adequate treatment the prognosis of the dise...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1027867
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The application of anti fibroses agents during glaucoma surgery leads to more satisfactory results with lower i.o. pressure, yet eliciting complications in wound healing, avascular filtering blebs and frequent chronic hypotonias. In patients with lower risk for failure a reduction of concentration and applic...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035446
更新日期:1995-05-01 00:00:00
abstract::The authors describe some modifications of the surgical technique of external dacryocystorhinostomy. The preliminary exploration methods and their evaluation are considered. An arched skin incision is used for a more anatomical dissection to approach the lacrimal sac. The following bone trepanation is then made with b...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract:BACKGROUND:Sleepiness behind the wheel is the second most frequent cause of fatal highway accidents when trucks are involved. Spontaneous pupillary oscillations provide objective and quantitative measures of the tonic central nervous activation which is a precondition for higher level mental performance. First experien...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1027453
更新日期:2008-09-01 00:00:00
abstract::From previous experience with all current surgery methods and kinds of anterior capsulotomy as well as of 6-year follow-up observation we developed our own diagonally-shaped (linear) capsulotomy technique. This technique was used in more than 500 successive extracapsular cataract extractions, followed by implantation ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1046104
更新日期:1991-12-01 00:00:00
abstract::The fusion amplitude of image pairs with aniseikonia was measured using the synoptophore. Aniseikonia was produced in five subjects by alteration of slide drawings. The subject's right eye was in cycloplegia after paralysis with cycloplegic eye drops. To compare these measurements with aniseikonic pictures to those us...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050555
更新日期:1987-12-01 00:00:00
abstract::These techniques are used in far-advanced cases of glaucoma when the campimetric method is not practicable due to a considerable loss of visual field. The patient takes a mixture of glycerol and ascorbic acid as a hypotensive agent, his visual field or visual acuity and intraocular pressure are checked every 30 minute...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1055143
更新日期:1982-06-01 00:00:00
abstract:BACKGROUND:To examine the differences in intraocular pressure (IOP) measurements obtained with Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT) in subjects with thin corneas and to correlate these with structural and functional parameters of glaucoma damage. PATIENTS AND METHODS:One hund...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0041-104772
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The Color Vision Meter 712 (CVM) is a new automatic computerized anomaloscope relying on both the Rayleigh and the Moreland equation. In the present study the diagnostic value of Color Vision Meter was examined in glaucoma for the first time and was compared with the Farnsworth 100 hue test. PATIENTS AND ME...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035512
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:A broad differential diagnosis has to be considered in a patient with swollen discs. Myeloproliferative disorders such as leukemia and lymphoma can in rare cases cause infiltrative optic neuropathy. HISTORY AND SIGNS:Two patients initially presented with slowly progressive severe visual loss. History was un...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2004-812857
更新日期:2004-05-01 00:00:00
abstract::Catalase may provide protection against photochemical action of superoxide radicals and hydrogen peroxide. The authors tried to measure its activity in freshly enucleated calf eyes before and after argon laser irradiation. It was established by iodometric titration that catalase activity was reduced after irradiation ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050720
更新日期:1986-06-01 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::Corneal topographs that measure the anterior and posterior corneal surface with optical methods need a clear cornea for precise measurements. Opacities cause artifacts in the corneal thickness (with measurements usually being too thin) and corneal curvatures. This is important to know as certain pathologies may repeat...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0032-1327956
更新日期:2012-12-01 00:00:00
abstract::A red or painful eye may be the clue to a systemic condition, many of which are of a rheumatological or immunological nature. Conjunctivitis may occur in Sjögren's Syndrome, Reiter's Syndrome (and other sero negative spondyloarthropathies) and with infections such as chlamydia and viruses. 70% of cases of episcleritis...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1045602
更新日期:1993-05-01 00:00:00
abstract::Arteriovenous malformation is a rare vascular disease of the orbit that has to be differentiated from arteriovenous fistulas (e.g., of the carotid sinus), arterial aneurysms, the varices and the angiomas. It develops in the presence of an underlying constitutional maldifferentiation of the vascular bed but usually onl...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1046343
更新日期:1989-02-01 00:00:00
abstract::A number of cases of necrotic sclerokeratitis following eye surgery have been reported in recently published literature. The condition was presumably triggered by surgical inflammation and caused by localized occlusive vasculitis: in one case deposits of immune complexes in vessel walls were demonstrated. The authors ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050312
更新日期:1988-12-01 00:00:00
abstract::Die Tränendrüse kann von einer Vielzahl neoplastischer, infektiöser und autoimmunologischer Erkrankungen betroffen sein. Eine radiologische Charakterisierung der Veränderungen kann Hinweise für die differenzialdiagnostische Einordnung liefern. Erkrankungen der ableitenden Tränenwege, insbesondere Tränenwegsverschlüsse...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0033-1358102
更新日期:2015-03-01 00:00:00
abstract::Screening by immune disease is useful for one part in the various ocular inflammatory processes, uveitis, vasculitis, (epi)scleritis and myositis, for the other in collagen diseases with possible eye complications. The various forms of uveitis can be related either to rheumatic disease, to some HLA antigen, to a micro...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1045632
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Cysticercosis is one of the two infections caused by Taenia solium. It is endemic in areas with poor hygienic standards. In western countries the patients history of previous living or travelling in endemic areas is important. Neurocysticercosis is a manifestation with single or multiple ocular, orbital or c...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1034723
更新日期:1999-11-01 00:00:00
abstract:INTRODUCTION:Chronic hepatitis C-therapy is limited to the combined use of PEG-ylated interferons and ribavirin. Side effects of this therapy include retinal changes that manifest with bleeding, cotton wool spots and/or thrombosis. PATIENT:A 51-year-old man presented with a sudden decrease of visual acuity. Chronic he...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2004-813607
更新日期:2004-09-01 00:00:00
abstract::Optic neuritis is a frequent neuro-ophthalmological disease in which the diagnosis can be based on just a few symptoms and findings. It is not only important to differentiate from other optic nerve disorders but also to recognise special types of optic neuritis, which is mostly only possible during the course of the d...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1382930
更新日期:2014-11-01 00:00:00
abstract::The position of the ophthalmologist as an unbiased and impartial expert in the field of tension between the client and the patient is a responsible task that should not be underestimated. Since the ophthalmological expert assessment often has far-reaching legal and financial consequences, it is very important that it ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/a-0889-9523
更新日期:2019-04-18 00:00:00
abstract:BACKGROUND:All three types of lattice stromal dystrophy of the cornea use to appear bilaterally. We report on two patients with an unilateral manifestation of type III. PATIENTS:A 54 and a 87-years-old man presented a strictly unilateral atypical lattice dystrophy of the cornea and suffered from corneal erosion. Strik...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045681
更新日期:1993-10-01 00:00:00
abstract::Millions of people work or spend their free time sitting in front of VDUs that induce contingent visual effects. However, only a few notice irritations in the course of everyday work: motion after-images such as the waterfall illusion or tilt after-effects are possible. A new effect may be caused by those new VDU moni...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2006-926691
更新日期:2006-08-01 00:00:00
abstract::Two pairs of albinotic brothers, a severely myopic albino and an aged albinotic woman patient were examined; visual acuity was 0.2. In the nystagmogram there were varied rhythmic wave-forms with 1) oscillations of high frequency; 2) slow arrhythmic movements; 3) deviation tendencies with a fast nystagmus component. In...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1057553
更新日期:1980-05-01 00:00:00
abstract::To mark the congress of the Berlin Ophthalmological Society in December 1989, the authors review the development of ophthalmology in Berlin and in particular the history of this ophthalmological society. The review was prompted by the political changes which began in October 1989, enabling ophthalmologists from the ea...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 历史文章,杂志文章
doi:10.1055/s-2008-1045970
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:Epiphora is the result of hypersecretion or reduced tear outflow because of relative or absolute obstruction of the lacrimal system. For the treatment a specific surgical procedure is usually required. Herein we present the subjective and objective findings of 243 consecutive patients with non-irritative ind...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0029-1245455
更新日期:2010-11-01 00:00:00