Biomedical subjects

Andreas Wedrich

Publications and source records attributed to Andreas Wedrich.

25 records · Page 2Linked to original sources

PubMed2002

Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema.

BACKGROUND: Compared to non-diabetic patients, outcome after cataract surgery was reported to be worse in diabetic patients--especially in those with diabetic retinopathy. This prospective study was planned to evaluate visual outcome, progression of diabetic retinopathy, and incidence of clinically significant macular oedema (CSME) in a homogenous group of patients with non-proliferative diabetic retinopathy (NPDR) without CSME at baseline 1 year after cataract surgery. METHODS: Over a period of 18 months, all consecutive patients with mild-to-moderate diabetic retinopathy who had cataract surgery with phacoemulsification and posterior chamber lens implantation were prospectively followed up. Outcomes were assessed 1 year postoperatively and included visual acuity (VA), progression of retinopathy, and incidence of CSME. Progression of retinopathy and incidence of CSME were compared to the non-operated fellow eyes. RESULTS: Of 50 patients included, 42 completed the 1-year follow-up. VA improved in 85% of patients, and was better than 0,5 in 71%. Progression of retinopathy occurred in 12% of eyes after cataract surgery and in 10.8% of non-operated fellow eyes. No patient developed proliferative diabetic retinopathy in the operated eye. CSME occurred in 13 operated eyes (31%), five of them with retinal ischemia, and in five non-operated eyes (13.5%). Patients with ischemic macular oedema had the worst prognosis regarding VA. CONCLUSION: Modern cataract surgery seems to have no influence on the progression of diabetic retinopathy. A visual improvement is achieved in the majority of patients with NPDR, but poorer visual outcome is observed in patients developing macular oedema.

Aged↗

PubMed2002

Long-term effect of phacoemulsification on intraocular pressure after trabeculectomy.

PURPOSE: To evaluate the effect of temporal clear corneal phacoemulsification on intraocular pressure (IOP) in eyes that have had trabeculectomy. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This retrospective study evaluated the IOP in 48 eyes (35 patients) that had temporal clear corneal phacoemulsification after trabeculectomy. The mean interval between trabeculectomy and phacoemulsification was 27 months +/- 21 (SD) and the mean follow-up after phacoemulsification, 23 +/- 12 months. Intraocular pressure and antiglaucoma therapy before cataract surgery and at the end of follow-up were evaluated. For statistical analysis, the paired t test, Wilcoxon test, and chi-square test were used. RESULTS: Thirty-five eyes (73%) preoperatively and 25 eyes (52%) postoperatively were controlled (IOP < 22 mm Hg) without antiglaucoma therapy. The difference was statistically significant (P =.04, chi-square test). At the end of follow-up, the increase in mean IOP (1.6 mm Hg) and in mean number of antiglaucoma medications (0.4) was statistically significant (P =.002 and P =.05, respectively). CONCLUSIONS: Temporal clear corneal phacoemulsification after trabeculectomy was followed by a slight but statistically significant increase in IOP and the need for antiglaucoma medication after 2 years. However, the impairment in IOP control is comparable to that in the natural course of trabeculectomy.

Aged↗

PubMed2002

Is acupuncture an useful tool for pain-treatment in ophthalmology?

Pain that does not respond to conventional treatment procedures makes it necessary to look for alternative methods. Acupuncture is an ancient procedure with empirical effects on pain. Previous studies established the increased output of messengers at neuronal junctions in spinal cord and hypothalamic locations, especially of endorphins which inhibit the perception of pain. We treated several painful symptoms with acupuncture and evaluated the outcome of the treatment. Patients with various kinds of therapy-refractory pain and patients in whom conventional treatment methods could not be applied were included in the study. The diagnoses included glaucoma. Tolosa-Hunt-Syndrome, ophthalmic migraine, blepharospasm, and dry eyes. In one case acupuncture was used for analgesia during surgery. Acupuncture was performed with sterile disposable needles, at points known to have an empirical analgesic effect. The stimulation was adapted to the patient's individual needs. VAS assessments before and after acupuncture were compared. The t-test was used for statistical evaluation. Acupuncture had no side effects, but reduced pain to a variable extent. Especially in cases of severe pain and in surgery, very effective pain reduction was achieved. In general, pain was significantly reduced in all patients by the use of acupuncture. A statistically significant effect was noted (p < 0.05). Further studies should be conducted to demonstrate the specific effect in larger patient populations. Monitoring neurotransmitter activity will possibly help to illustrate the effect.

Acupuncture Analgesia↗

PubMed2002

Identification of estrogen and progesterone receptor mRNA expression in the conjunctiva of premenopausal women.

PURPOSE: The purpose of the present study was to identify the expression of estrogen and progesterone receptor mRNA and of estrogen and progesterone receptor protein in the conjunctiva of healthy women. METHODS: Specimens of conjunctival tissue of 10 premenopausal women (age range, 13-38 years) were obtained during ophthalmic surgery in patients under general anesthesia. Specimens of approximately 4 mm(2) were taken from superior, nasal, or temporal bulbar conjunctiva adjacent to the bulbus and were immediately deep frozen with liquid nitrogen. Four women underwent strabismus surgery, two had phacoemulsification, and four had vitrectomy. Only three women were taking oral contraceptives. The expression of estrogen receptor (ER)-alpha, ERbeta, and progesterone receptor (PR) mRNA was analyzed by RT-PCR. Western blot analysis on nuclear extracts was performed with the anti-ERalpha mouse monoclonal antibody AB-15, the anti-ERbeta mouse monoclonal antibody 6B12, and the anti-PR mouse monoclonal antibody PgR 636. RESULTS: In two samples, ERalpha, ERbeta, and PR mRNAs were not accessible because of highly degraded RNA. In the remaining eight samples, an appearance rate of 100% was obtained for all three mRNAs. Similarly, an appearance rate of 100% was obtained for ERalpha, ERbeta, and PR protein in nine tissue samples accessible for analysis; one sample could not be analyzed due to a low amount of tissue. CONCLUSIONS: This study confirms the existence of estrogen and progesterone receptors in the human conjunctiva of premenopausal females. Because the proteins of estrogen and progesterone were also found in this study's specimens, the data indicate that the conjunctiva is a target site for sex steroids. Future studies are needed to elucidate the role of these receptors in ocular diseases involving the conjunctiva.

Adolescent↗

PubMedDate not supplied

Seven years of HAART impact on ophthalmic management of HIV-infected patients.

PURPOSE: The widespread use of highly active antiretroviral therapy (HAART) has changed the clinical picture of HIV-associated eye disease. We evaluated the incidence of ocular manifestations of HIV infection since the introduction of HAART. METHODS: Between January 1996 and December 2002, we examined 539 HIV-infected patients in our hospital. Follow-up of the patients was performed in case of ophthalmologic symptoms, regardless of current immunologic status, or for screening. RESULTS: A total of 217 patients (40.3%) had HIV-associated eye disease. Of these patients, 42.0% had no eye symptoms. Fifty-eight (10.8%) of the 539 patients had cytomegalovirus (CMV) retinitis, most of whom had CMV retinitis before receiving HAART. Four patients developed immune-recovery uveitis. A total of 145 patients (26.9%) had HIV-related microangiopathy and 96 (17.8%) had dry-eye syndrome. CONCLUSION: The introduction of HAART had a major impact on the medical history of patients with HIV-related eye disease with improved survival time and decreased morbidity.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Aqueous flare and macular edema in eyes with diabetic retinopathy.

BACKGROUND: The breakdown of the blood-retina barrier in diabetic patients is correlated with a dysfunction of the blood-aqueous barrier. In our study, we wanted to investigate the effect of grid photocoagulation in diabetic macular edema on the aqueous flare. METHODS: Modified grid pattern photocoagulation was performed on 20 patients with diabetic macular edema. The aqueous flare intensity was measured by the laser flare cell meter before and 4 months after laser treatment. RESULTS: The mean flare value was 9.8 +/- 4.7 photons/ms before laser treatment. After grid photocoagulation, the flare value was 7.1 +/- 3.6 photons/ms. Flare values were significantly decreased after laser treatment. CONCLUSION: Our results suggest a correlation between the effect of grid photocoagulation on the blood-retina barrier and the permeability of the blood-aqueous barrier. The laser flare intensity seems to be a quantitative indicator for the diabetic dysfunction of the blood-retina barrier.

Aged↗

PubMedDate not supplied

Visual function, quality of life and patient satisfaction after ophthalmic surgery: a comparative study.

PURPOSE: To compare visual acuity, functional visual performance (VF-14), quality of life (QOL) gain (VF-14 gain) and patient satisfaction in a series of patients undergoing common types of ophthalmic surgery. METHOD: In a prospective trial, the VF-14 QOL questionnaire was administered to 100 patients who underwent surgery by one surgeon between May 2001 and April 2002. The following surgeries were compared: (1) cataract surgery (non-diabetic patients), (2) cataract surgery (diabetic patients), (3) retinal detachment cryo-buckle procedure, (4) pars plana vitrectomy, (5) silicone oil removal. VF-14 questionnaire responses, visual function and clinical data of all patients were recorded pre-operatively and 1 and 3 months postoperatively. RESULTS: In comparison to vitreoretinal surgery, patients who underwent cataract surgery achieved higher VF-14 scores and required less time to recover from the procedure (1 month). The QOL gain (VF-14 gain) was significantly higher in patients who had undergone retinal detachment surgery and vitrectomy (p < 0.0001). The lowest QOL gain was registered in diabetic patients after cataract surgery. Patients with pre-existing eye disease, including patients with improved visual acuity, were least satisfied with the final outcome of surgery. CONCLUSIONS: The highest VF-14 score was achieved by patients with no pre-existing ocular disease, who had undergone cataract surgery. The QOL gain was greater in patients with severer initial ocular conditions. Better patient satisfaction can be achieved in patients with pre-existing eye disease by improving pre-operative patient education.

Cataract↗