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Andreas Wedrich

Publications and source records attributed to Andreas Wedrich.

At least 19 recordsLinked to original sources
PubMed2006

Magnification-corrected photodynamic therapy.

BACKGROUND: To present a method for performing photodynamic therapy (PDT) with a constant predictable light fluence based on actual laser spot magnification. METHODS: A calibrated Gullstrand-type model eye with a scale of half circles in the centre of the artificial fundus was used for this study. The axial length of the model eye was set to different values ranging from 20 to 31 mm, and the actual laser spot magnification of four indirect condensing laser lenses were determined using a PDT laser unit. RESULTS: Equations for determining the actual laser spot magnification were calculated for each laser lens. The total change in laser spot magnification from hyperopia (axial length 20 mm) to myopia (axial length 31 mm) was -20% to +24.8% for Mainster Standard lens (Ocular Instruments Inc, Bellevue, Washington, USA), -15.7% to +27.7% for Mainster Wide Field lens (Ocular Instruments Inc), -16.3% to +33.1% for Volk Transequator lens (Volk Optical Inc, Mentor, Ohio, USA), and -19.2% to +24.4% for Volk PDT Laser lens (Volk Optical Inc). CONCLUSIONS: Axial length of the eye has a considerable effect on PDT laser spot magnification when an indirect laser lens is used. By calculating the actual laser spot magnification in conjunction with knowledge of the true greatest linear dimension of the neovascular lesion, the clinician may be able to deliver a constant predictable amount of light fluence to the fundus independent of the axial length of the PDT treating eye.

Choroidal Neovascularization↗
PubMed2006

In-patient management and treatment satisfaction after intravitreous plasminogen activator injection.

AIMS: To assess patient satisfaction after intravitreous plasminogen activator injections for subretinal hemorrhages secondary to age-related macular degeneration (AMD) and to analyse how it relates to the patients' postoperative visual and functional abilities. Further, to suggest ways to improve in-patient management and thereby treatment satisfaction. METHODS: A consecutive series of 101 patients with a subretinal hemorrhage of at least one disk diameter were enrolled in this longitudinal prospective study conducted during 2001-2004. After complete preoperative eye examination all patients were treated with intravitreal injection of 25 microg recombinant tissue plasminogen activator (rTPA) and 0.5 ml sulphur hexafluoride gas (SF6), followed by face-down positioning for 1 week. Patient satisfaction was assessed using standardised questionnaires administered postoperatively at 4 and 12 months. Outcome measures were: (1) responses to the patient satisfaction survey, (2) degree of satisfaction with in-patient management, (3) subjective change in the patients' functional status, and (4) visual acuity results. RESULTS: Whereas the patients' actual functional status deteriorated from a median value of 2.4 at 4 months to 3.4 at 12 months, their recall of their preoperative functional status shifted from a median value of 4.2 to to 2.3, consecutively. Twelve months after treatment, 75% of patients reported an improved visual acuity, however, only 12% reported satisfaction with treatment. 67.4-87% of patients were dissatisfied with various areas of in-patient management. CONCLUSIONS: Satisfaction with plasminogen activator injection treatment is low even though patients experience an improved visual and functional status at 12 months. This suggests that the current system requires improvement in certain areas such as in-patient management.

Drug Therapy, Combination↗
PubMed2006

Photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration.

PURPOSE: To examine the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration (AMD). DESIGN: Retrospective, interventional case series. METHODS: Sixty eyes of 56 patients with neovascular AMD were treated with PDT with verteporfin followed by an intravitreal injection of 4 mg triamcinolone acetonide. The main outcome measures were visual acuity (VA), retreatment frequency with PDT (and triamcinolone), and frequency of side effects. RESULTS: Mean follow-up was 15.9 months (range 12 to 30 months, median 15 months). Twenty-three (38.3%) of 60 eyes had a stable result at 12 months' follow-up (that is, loss/gain <three lines) and 34 (56.7%) of 60 had a loss of 3 lines or more. Three patients (5%) had an improvement of 3 lines or more. Lesion type, patient age, and lesion size had no influence on the outcome, but baseline VA had a statistically significant effect (P = .006). The median number of PDT-intravitreal triamcinolone acetonide treatments was one. One-third (20 of 60) of all eyes had an increase in intraocular pressure (IOP) that required therapy. There were no cases of endophthalmitis, but 13 patients (21.6%) developed severe cataract that required surgery. CONCLUSIONS: The combination of PDT and intravitreal triamcinolone acetonide requires careful consideration as a treatment option for neovascular AMD. In our case series, this treatment combination did not prevent a considerable decrease in VA. The main benefit of this combination treatment was a low number of verteporfin treatments. Baseline VA was the main predictor of the final outcome.

Aged↗
PubMed2006

Incidence of rhegmatogenous retinal detachment after vitrectomy in eyes of diabetic patients.

PURPOSE: To assess the incidence of rhegmatogenous retinal detachment (RRD) after pars plana vitrectomy (PPV) among diabetic patients with complications of proliferative diabetic retinopathy. METHODS: Ninety-three eyes of diabetic patients-who underwent PPV with or without intraocular gas tamponade for complications of proliferative diabetic retinopathy-were reviewed retrospectively. Indication for vitrectomy was vitreous hemorrhage in 80 patients (86.1%), tractional retinal detachment in 3 (3.2%), and vitreous hemorrhage associated with tractional retinal detachment in 10 (10.7%). RESULTS: Four (4.3%) of 93 eyes developed an RRD after vitrectomy. The primary reason for vitrectomy was recurrent or nonresolving vitreous hemorrhage. The retina was attached with one additional surgical procedure in two of these eyes; the other two had to undergo a third operation before attachment was achieved. CONCLUSION: RRD occurs in a small percentage of patients after PPV with or without gas tamponade for vitreous hemorrhage or tractional retinal detachment caused by proliferative diabetic retinopathy. Thorough postoperative follow-up is important to make early diagnosis and intervention possible.

Cataract Extraction↗
PubMed2006

Comparing polymethylmethacrylate implant with collagen implant in deep sclerectomy: a randomized controlled trial.

PURPOSE: To compare the intraocular pressure (IOP) lowering effect and safety of a new rigid, nonabsorbable polymethylmethacrylate implant (PMMA) with the commercially available cylindrical collagen implant used in deep sclerectomy procedure. INTERVENTION: Nonpenetrating deep sclerectomy was performed on all patients. Patients were randomly assigned to receive either a PMMA implant or a collagen implant. METHODS: The trial involved 60 patients (60 eyes) with medically uncontrolled primary and secondary open-angle glaucoma who were randomized to receive either a PMMA implant (30 eyes) or the collagen implant (30 eyes). The patients were examined before and after the operation 1 day before surgery and at day 1; weeks 1, 2 and 3; and months 1, 2, 3, 6, 9, 12, 18, 24, and 30. At each visit, the following examinations were performed: slit lamp examination, tonometry, visual acuity, and fundoscopy. RESULTS: The mean follow-up period was 20.4 (SD 12.4) months (PMMA) and 15.1 (SD 7.7) months (collagen) (P=NS). The mean preoperative IOP was 21.4 (SD 7.1) mm Hg (PMMA) and 21.0 mm Hg (SD 5.4) (collagen). The mean postoperative IOP was 7.4 (SD 4.5) mm Hg (PMMA) and 5.4 (SD 4.4) mm Hg (collagen) at day 1 (P=NS), 15.7 (SD 5.0) mm Hg (PMMA) and 14.7 (SD 5.0) mm Hg (collagen) at month 1 (P=NS), and 13.8 (SD 4.8) mm Hg (PMMA) and 13.3 (SD 2.4) mm Hg (collagen) at month 12 (P=NS). Seven patients had perforations of the trabeculo-Descemet membrane and were excluded from the analysis. At the last follow-up visit, 42% of PMMA patients and 44% of collagen patients achieved an IOP of 21 mm Hg or less without medication (P=NS). The number of medications was reduced from 2.4 (SD 1.0) to 0.6 (SD 0.6) (P<0.001) in the PMMA group, and from 2.4 (SD 1.1) to 0.7 (SD 0.8) (P<0.001) in the collagen group. There were no significant differences between the 2 groups in postoperative and transient complications. CONCLUSIONS: The new PMMA implant offered success and complication rates equal to those of the collagen implant. The new PMMA implant could serve as a low-cost alternative to the collagen implant and render the use of deep sclerectomy with an implant affordable for settings with limited financial resources.

Aged↗
PubMed2005

Biometry and refractive outcome of eyes filled with silicone oil by standardized echography and partial coherence interferometry.

BACKGROUND: We evaluated the validity of calculations for refractive outcome in cataract surgery in silicone oil-filled eyes. The retrosilicone space (RSS) was included in these calculations. METHODS: In a prospective study the axial length (AL) of silicone oil-filled eyes was measured. with standardized A-scan echography (SAE) and partial coherence interferometry (PCI). Meldrum's formula was used to transform the velocity of ultrasound within the vitreous cavity. To investigate whether refractive outcome can be calculated accurately, we assessed the difference between precalculated and final refractive outcome. Furthermore, we determined the advantages and disadvantages of SAE and PCI. A minor aim was to assess whether the AL of the two eyes differed significantly. RESULTS: In 85% of 117 eyes the difference between precalculated and postsurgical refraction was smaller than 1 diopter spherical and statistically not significant (p>0.2). The mean AL was 24.1 mm (range 20.0-31.4 mm). The difference in outcome between the two methods was without statistical significance: the AL difference was 0.4 (+/-2.6) mm on measurement with SAE and 0.04 (+/-0.46) mm with PCI. PCI has the advantage that it can be performed more easily, without contact, while echography is advantageous in the presence of advanced cataracts. In supine position an oil-free fluid space behind the silicone oil was detected with echography. The mean dimension of this space was 1.9 (+/-0.67) mm and it was taken into consideration for IOL calculation. The mean AL difference between the two eyes was 0.4 mm, but the difference was greater than 1 mm in 26% of the patients. CONCLUSION: The AL of eyes filled with silicone oil can be measured reliably with SAE and PCI. In supine position the RSS has to be considered to obtain more accurate IOL calculations.

Adolescent↗
PubMed2005

Intravitreal triamcinolone acetonide in patients with macular oedema due to central retinal vein occlusion.

PURPOSE: To evaluate treatment of macular oedema due to central retinal vein occlusion (CRVO) with intravitreal triamcinolone acetonide. METHODS: In a prospective case series, 13 patients with macular oedema due to non-ischaemic CRVO received an intravitreal injection of 4 mg triamcinolone acetonide. Examination included assessment of best corrected visual acuity (BCVA) for distance and reading, measurement of intraocular pressure (IOP), fluorescein angiography and high resolution imaging by optical coherence tomography, preoperatively and 1 week, 1 month, 3, 6 and 9 months postoperatively. RESULTS: Preoperative mean BCVA was 0.9 +/- 0.4 for distance vision and 1.0 +/- 0.3 for reading acuity, respectively. A significant improvement in distance VA (0.5 +/- 0.3, p < 0.001) and reading acuity (0.7 +/- 0.3, p = 0.03) was observed until 3 months and 6 months, respectively. Mean macular thickness was significantly reduced until 9 months postoperatively. CONCLUSION: Intravitreal injection of triamcinolone acetonide led to a significant improvement in mean VA in patients with macular oedema due to CRVO. However, the significant effect was not permanent and persisted for a maximum of 6 months.

Fluorescein Angiography↗
PubMed2005

Clinical outcomes of phacoemulsification cataract surgery in diabetes patients: visual function (VF-14), visual acuity and patient satisfaction.

PURPOSE: To evaluate the visual outcomes (visual acuity [VA] and visual function) after phacoemulsification cataract surgery in patients with diabetic retinopathy (DR), and assess patient satisfaction with final surgical outcome. METHODS: This prospective study comprised 74 eyes of 74 patients with different stages of DR. One surgeon (AW) performed all cataract surgery in a standardized fashion. Patients were assessed using the VF-14 (Visual Function-14) questionnaire. The following groups of patients were compared: those with no apparent retinopathy; those with mild non-proliferative DR (NPDR); those with severe NPDR, and those with proliferative DR (PDR). Visual acuity and visual function questionnaire (VF-14) responses were recorded preoperatively and 3 months postoperatively, during which the non-operated fellow eye showed no progression in retinopathy. RESULTS: Improvements in visual outcomes were significantly higher in groups 1 and 2 compared to groups 3 and 4 (Tukey-Kramer, p < 0.001). Comparisons between groups 1, 2 and 3, 4 showed significant differences in improvements in VA (Tukey-Kramer, p < 0.01), yet no statistically significant differences in functional (VF-14) improvements emerged between these groups. CONCLUSIONS: Patients with more advanced levels of DR showed no functional improvements despite improvements in VA. This emphasizes the relevance of patient education prior to surgery. In particular, it should be explained to patients with more advanced DR that, although surgery may be required, their functional improvement may be limited.

Adult↗
PubMed2005

Photocoagulation for diabetic retinopathy: determinants of patient satisfaction and the patient-provider relationship.

PURPOSE: To assess satisfaction with photocoagulation treatment in diabetes patients and to investigate how it relates to patient-related characteristics and patients' visual ability. Further, to observe the interaction between physician and patient and suggest ways to improve the patient-provider relationship and, thereby, treatment satisfaction. METHODS: This open longitudinal study included 123 diabetes patients undergoing first photocoagulation treatment for diabetic maculopathy or proliferative retinopathy. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) was completed by all patients. Communication, scheduling and adherence scores were defined for each physician-patient pair. Outcome measures were: the patient's overall satisfaction with laser treatment; the patient's degree of satisfaction in relation to visual results; communication, scheduling and adherence scores, and visual acuity results. RESULTS: The level of satisfaction after initial photocoagulation treatment was high; 46.4% of patients with proliferative retinopathy and 53.1% with maculopathy scored 31 or higher. Although 69.5% of all patients reported that their expectations of treatment corresponded to their final 9-month visual results, only 8.7% of these patients reported an improvement in visual acuity after 9 months. The number of unwanted actions performed by the patients during treatment were significantly related to the number of unclear instructions given by the physician (Fisher's exact test P < 0.01). CONCLUSIONS: A high level of satisfaction was observed, despite the minimal improvements in visual acuity. Attempts to further improve patient satisfaction might focus on improved education of patients on the possible benefits of laser treatment, greater care in communicating information during treatment, additional nursing support, and additional clerical time to communicate with patients before each appointment.

Adult↗
PubMed2005

Intravitreal triamcinolone acetonide in patients with macular oedema due to branch retinal vein occlusion: a pilot study.

PURPOSE: To evaluate treatment of macular oedema due to branch retinal vein occlusion (BRVO) with intravitreal triamcinolone acetonide. METHODS: In a prospective case series, nine patients with macular oedema due to BRVO received an intravitreal injection of 4 mg triamcinolone acetonide. Examination included best-corrected visual acuity (BCVA) for distance and reading, intraocular pressure (IOP) measurement, fluorescein angiography and high resolution imaging by optical coherence tomography, preoperatively and at 1 week, 1 month, 3 and 6 months postoperatively. RESULTS: Preoperative mean BCVAs were 1.3 +/- 0.8 for distance vision, and 1.1 +/- 0.3 for reading acuity, respectively. A significant improvement in reading acuity was observed until 1 month (0.7 +/- 0.4, p = 0.02). No significant reduction in mean macular thickness was observed. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide led to a significant improvement in mean VA in patients with macular oedema due to BRVO. However, the significant effect was not permanent and persisted for only 1 month.

Aged↗
PubMed2004

The effect of intravitreal triamcinolone on diabetic macular oedema.

BACKGROUND: Diabetic macular oedema is a frequent cause of visual loss in patients with diabetic retinopathy. The purpose of this study was to assess the efficacy of intravitreal triamcinolone acetonide in reducing diabetic macular oedema and improving visual acuity. METHODS: In this prospective study 12 eyes of 12 patients with diabetic macular oedema unresponsive to prior laser treatment received an intravitreal injection of 4 mg triamcinolone acetonide. Examinations were performed 1 day preoperatively and at 1 week and 1, 3, 6, and 9 months after surgery and included slit-lamp examination, measurement of IOP, assessment of distance as well as reading visual acuity and assessment of macular thickness using optical coherence tomography (OCT). RESULTS: Mean age of the patients (mean+/-SD) was 66.6+/-8.6 years. Mean best-corrected visual acuity (BCVA) for distance (LogMAR using ETDRS charts) improved from 1.0+/-0.4 preoperatively to 0.9+/-0.4 (p=0.01) 1 week and to 0.9+/-0.4 (p=0.02) 1 month postoperatively. Mean BCVA for reading vision (LogRAD using Radner Reading Charts) improved from 1.1+/-0.4 preoperatively to 0.9+/-0.4 (p=0.002) 1 month postoperatively. Mean macular thickness decreased from 450+/-190 (microm) preoperatively to 305+/-153 (p=0.02) 1 month postoperatively. No significant improvement in VA and no significant reduction of macular thickness could be observed 3, 6, and 9 months postoperatively. Mean intraocular pressure significantly increased from 14.7+/-2.7 mmHg preoperatively to 16.9+/-3.0 mmHg at 1 month (p=0.02). CONCLUSION: A single intravitreal injection of triamcinolone acetonide led to a significant improvement in mean VA in patients with diabetic macular oedema. However, the significant effect was not permanent and persisted for only 1 month.

Aged↗
PubMed2004

[Diagnosis, therapy and follow-up of diabetic eye diseases].

Diabetes mellitus causes diabetic retinopathy and maculopathy, optical nerve neuropathy, cataract and defects of the eye muscles. The incidence of these defects correlates with duration and quality of the metabolic control. The recommendations of the Austrian Diabetes Association for the diagnosis, the therapeutic measures and requirements for adequate follow-up depending on the stages of the different forms of diabetic eye diseases are summarized.

Austria↗
PubMed2003

The role of the carotenoids, lutein and zeaxanthin, in protecting against age-related macular degeneration: a review based on controversial evidence.

PURPOSE: A review of the role of the carotenoids, lutein and zeaxanthin, and their function in altering the pathogenesis of age-related macular degeneration (AMD). METHODS: Medline and Embase search. RESULTS: Recent evidence introduces the possibility that lutein and zeaxanthin, carotenoids found in a variety of fruits and vegetables may protect against the common eye disease of macular degeneration. This potential and the lack to slow the progression of macular degeneration, has fueled high public interest in the health benefits of these carotenoids and prompted their inclusion in various supplements. The body of evidence supporting a role in this disease ranges from basic studies in experimental animals to various other clinical and epidemiological studies. Whilst some epidemiological studies suggest a beneficial role for carotenoids in the prevention of AMD, others are found to be unrelated to it. Results of some clinical studies indicate that the risk for AMD is reduced when levels of the carotenoids are elevated in the serum or diet, but this correlation is not observed in other studies. Published data concerning the toxicity of the carotenoids or the optimum dosage of these supplements is lacking. CONCLUSION: An intake of dietary supplied nutrients rich in the carotenoids, lutein and zeaxanthin, appears to be beneficial in protecting retinal tissues, but this is not proven. Until scientifically sound knowledge is available we recommend for patients judged to be at risk for AMD to: alter their diet to more dark green leafy vegetables, wear UV protective lenses and a hat when outdoors. Future investigations on the role of nutrition, light exposure, genetics, and combinations of photodynamic therapy with intravitreal steroid (triamcinolone-acetonide) injections hold potential for future treatment possibilities.

Journal Article↗
PubMed2003

Ocular surface changes and tear film alterations associated with sun gazing during a solar eclipse.

PURPOSE: A solar eclipse occurred in central Europe on August 11th, 1999. Following the eclipse, patients with ocular symptoms were investigated. Gazing at the sun without protection is liable to damage the retina. Our attention was focused on changes of the ocular surface and the tear film. METHODS: Forty-three patients were investigated within one week after the solar eclipse as baseline. 33 of them were followed up one year later. Visual acuity and the central visual-field were measured, and the ocular surface and the fundus were examined using a slit lamp. The quality of the lacrimal tear film was examined using Schirmer's test for the aqueous layer, break-up time for the mucous layer and interference observation for the lipid layer, measured by a slit lamp and a tearoscope. RESULTS: At the baseline 19 patients had non-specific visual problems. Pathological alterations of the tear film were seen in all three tear-film layers: Schirmer's test was pathological in 87%, break-up time decreased in 85%, the interference pattern of the lipid layer changed in 67% and there were changes in 87% using the tearoscope. One year later the non specific visual disorders had disappeared. Schirmer's test did not reveal much change from the baseline: 51% pathological, 24% remained pathological in break-up-time and the lipid layer was normalized except in 9%. Using the tearoscope, lipids were better than grade 3 in all patients. CONCLUSION: After gazing at a solar eclipse the ocular surface and tear film changed. While the aqueous layer remained pathological in many patients, the lipid layer and the mucous layer recovered spontaneously.

Adult↗
PubMed2003

Ocular blood flow parameters after pars plana vitrectomy in patients with diabetic retinopathy.

BACKGROUND: Whereas the anatomic result of vitrectomy in patients with vitreoretinal complications due to diabetes is usually satisfying, the functional outcome is sometimes poor. The authors investigated whether this may be related in part to effects of vitrectomy on ocular perfusion. METHODS: Ocular hemodynamics were measured before vitrectomy and 1 and 4 weeks postoperatively in 13 consecutive diabetic patients. Pulsatile choroidal blood flow was assessed with laser interferometric measurement of fundus pulsation amplitude. In addition, mean blood flow velocity and resistive index in the ophthalmic artery, the central retinal artery, and the posterior ciliary arteries were measured with color Doppler imaging. RESULTS: Fundus pulsation amplitude was significantly reduced after surgery as compared to baseline (baseline: 3.7 +/- 1.0 microm; 4 weeks: 3.1 +/- 0.8; P < 0.001). Postoperatively, mean blood flow velocity in the central retinal artery (P = 0.009) and the posterior ciliary arteries (P = 0.0006) was significantly reduced, whereas resistive index was increased in the central retinal artery (P = 0.028) but not in the posterior ciliary arteries. CONCLUSIONS: The current data suggest that vitrectomy induces significant reductions in ocular blood flow in patients with diabetic retinopathy. Whether this may affect the visual outcome after vitrectomy or whether this reflects improved retinal oxygenation after vitrectomy remains to be established.

Adult↗
PubMed2003

Cataract surgery and silicone oil removal: visual outcome and complications in a combined vs. two step surgical approach.

PURPOSE: To compare visual outcome and complications of two surgical strategies for patients who needed cataract surgery and silicone oil removal. METHODS: A prospective, nonrandomized study was performed to compare two groups of patients who had cataract surgery and silicone oil removal from April 1998 to January 2002. From April 1998 to November 1999, patients had two surgical sessions with cataract surgery before silicone oil removal (Group 1), and from December 1999 to January 2002, patients underwent combined cataract surgery and silicone oil removal in a single session (Group 2). RESULTS: Thirty-five patients were included in each group. The postoperative visual acuity improved by at least two lines of Snellen in 13 patients (37.1%) in Group 1 and 15 (42.8%) patients in Group 2 (P=0.63). The mean visual improvement was 0.12 lines and 0.13 lines in groups 1 and 2 (P=0.62). Complications in groups 1 and 2 included transient intraocular pressure rise (25.7% versus 28.5%), retinal detachment (14.2% versus 11.4%), fibrin reaction (5.7% in both groups), and persistent intraocular pressure rise (2.8% in both groups). CONCLUSION: The visual outcome and complication rates were similar in both groups. Combined surgery offers the advantages of a single surgical event and a faster visual rehabilitation. We therefore suggest a surgical approach with combined cataract surgery and silicone oil removal in selected patients with a stable retinal situation.

Capsulorhexis↗
PubMed2003

Orbital scintigraphy with the somatostatin receptor tracer 99mTc-P829 in patients with Graves' disease.

UNLABELLED: Receptors for somatostatin (SST) (SSTR) are expressed on various tumor cells as well as on activated lymphocytes. Previous data have shown that (99m)Tc-P829 binds with high affinity to many different types of tumor cells as well as to leukocytes via the human hSSTR2, hSSTR3, and hSSTR5 target receptors. Consequently, (99m)Tc-P829 was successfully introduced as a peptide tracer for tumor imaging. In this study, we evaluated the orbital uptake of (99m)Tc-P829 in patients with active and inactive thyroid-associated orbitopathy (TAO), accompanied by lymphocyte infiltration in the acute stage and by muscle fibrosis in the chronic stage of the disease. METHODS: To evaluate its clinical usefulness in Graves' disease, (99m)Tc-P829 scintigraphy (approximately equal to 740 MBq) was performed in 44 patients with TAO (median duration, 19 mo; range, 1-360 mo). The clinical activity of the orbital disease was graded by the NOSPECS (no signs or symptoms; only signs, no symptoms; signs only; proptosis; eye muscle involvement; corneal involvement; sight visual acuity reduction) classification of the American Thyroid Association, the clinical activity score (CAS), and the superonasal index (SNI). SPECT (360 degrees ) and planar studies were completed within 3 h after injection. Orbital (O) regions of interest (ROIs) were compared with temporoparietal and occipital (OCC) ROIs. Orbital uptake ratios in Graves' disease were compared with data obtained from lung cancer patients with no eye disease (n = 22). RESULTS: Overall, (99m)Tc-P829 biokinetics were the same in Graves' disease patients as in lung cancer patients, showing a rapid blood clearance and visualization of the facial bones within minutes of injection. In all control patients, the orbit appeared as a "cold area," whereas visual orbital accumulation of (99m)Tc-P829 was found in patients with active TAO (O/OCC ratios: 1.26 +/- 0.04 vs. 1.69 +/- 0.04; P < 0.01, respectively). Patients with active eye disease (n = 25) presented with an increased orbital uptake of (99m)Tc-P829 compared with patients with inactive disease (n = 19; O/OCC ratio: 1.12 +/- 0.05; P < 0.01). A statistically significant correlation was found between CAS and the orbital uptake (O/OCC ratio) values (r = 0.90), whereas no correlation could be documented regarding the NOSPECS classification as well as the SNI. CONCLUSION: In TAO, (99m)Tc-P829 yields high orbital binding with good clinical correlation. The better image quality due to the high energy of technetium, the lower radiation dose for patients and personnel, and the short acquisition protocol favor SSTR scintigraphy with (99m)Tc-P829 over (111)In-labeled compounds. The in-house availability of the radiotracer and cost-effectiveness are further advantages.

Cornea↗