Biomedical subjects

Bjoern Harder

Publications and source records attributed to Bjoern Harder.

7 recordsLinked to original sources

PubMed2006

Ophthalmodynamometric differences between ischemic vs nonischemic retinal vein occlusion.

PURPOSE: To estimate the central retinal vein pressure in patients with ischemic vs nonischemic central retinal vein occlusion (CRVO). DESIGN: Prospective clinical observational comparative study. METHODS: The study included 28 patients with CRVO, either of the ischemic type (n = 7) or the nonischemic type (n = 21). The control group consisted of 38 subjects without retinal disease. A new ophthalmodynamometer consisting of a Goldmann contact lens fitted with a pressure sensor into the holding grip of the contact lens, was used to indirectly estimate the central retinal artery and vein pressure. RESULTS: Central retinal vein pressure was significantly higher in the ischemic CRVO group than in the nonischemic CRVO group (91.5 +/- 30.1 arbitrary units vs 52.4 +/- 32.5 arbitrary units; P = .014), in which it was significantly (P < .001) higher than in the control group (4.8 +/- 8.1 arbitrary units). Central retinal vein pressure was higher than the diastolic central retinal artery pressure significantly (P = .039) more frequently in the ischemic CRVO group (7/7 or 100%) than in the nonischemic CRVO group (8/21 or 38%) or the control group (0/38; P < .001). Central retinal artery pressure was significantly (P = .017) lower in the ischemic CRVO group (46.0 +/- 10.6 arbitrary units) than in the nonischemic CRVO group (64.5 +/- 22.8 arbitrary units), in which it was significantly (P = .016) lower than in the control group (79.9 +/- 22.3 arbitrary units). CONCLUSIONS: Ophthalmodynamometric estimation of the retinal vein pressure may be helpful for the differentiation between the ischemic vs nonischemic type of CRVO. In the ischemic type, vein pulsations were usually observed at supradiastolic arterial values.

Adult↗

PubMed2006

Repeated intravitreal injection of triamcinolone for exudative age-related macular degeneration.

BACKGROUND: Intravitreal triamcinolone acetonide has been discussed as treatment for exudative age-related macular degeneration (AMD). OBJECTIVES: To give an updated report on repeated intravitreal injections of triamcinolone acetonide (IVTA) for the treatment of exudative AMD. METHODS: The case-series study included 24 patients (24 eyes) with progressive exudative AMD who had shown an increase in, or stabilization of, visual acuity after a first IVTA, and who eventually experienced a deterioration of visual acuity. The 24 (6.5%) eyes were selected out of a total group of 369 eyes who had received IVTA for exudative AMD within the last 5 years. All patients of the study received a second IVTA (approximately 20 mg) 3.7-38.5 months after the first injection. Main outcome measure was visual acuity. RESULTS: After the first injection, best corrected visual acuity improved significantly (p = 0.001) from 0.75 +/- 0.34 logMAR to a minimum of 0.58 +/- 0.30 logMAR during follow-up, with 10 (42%) eyes improving in visual acuity by two or more Snellen lines. Towards the end of follow-up after the first injection, best corrected visual acuity decreased significantly (p = 0.03) compared with the baseline value. After the second injection, visual acuity did not change markedly from baseline to a mean maximal visual acuity during follow-up. Comparing the last postoperative examination at the end of the follow-up after the second IVTA with the preoperative examination, a significantly (p = 0.001) higher number of eyes lost in visual acuity [19 (79%) eyes] than gained in visual acuity [3 (12%) eyes]. CONCLUSIONS: In selected eyes with an increase in visual acuity after a first IVTA (20 mg), repeated IVTA temporarily stabilizes visual acuity with a drop in visual acuity towards the end of follow-up.

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PubMed2006

Intravitreal triamcinolone acetonide for treatment of acute nonarteritic anterior ischemic optic neuropathy.

PURPOSE: To report on the use of intravitreal triamcinolone acetonide as treatment for nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: The interventional clinical case series included three patients with acute NAION who received an intravitreal injection of about 20 mg triamcinolone acetonide. RESULTS: At the end of follow-up at 3 months, 3.5 months and at 5 months after the injection, visual acuity had changed from 0.10 at baseline to 0.20 in the first patient, from 0.50 to 0.20 in the second patient, and from 0.16 to 0.20 in the third patient. One eye developed triamcinolone-induced ocular hypertension which was treated by topical antiglaucomatous medication. CONCLUSIONS: The clinical courses of all three patients presented suggest that an intravitreal high-dosage injection of triamcinolone acetonide may not be markedly effective in increasing visual acuity after acute NAION.

Acute Disease↗

PubMed2006

Infectious and noninfectious endophthalmitis after intravitreal high-dosage triamcinolone acetonide.

PURPOSE: To evaluate the rate of infectious and noninfectious endophthalmitis after intravitreal injection of a high-dosage of triamcinolone acetonide. DESIGN: Clinical interventional case-series study. METHODS: The study included 1135 intravitreal injections of approximately 20 mg triamcinolone performed for 915 eyes with diabetic macular edema (n = 257), exudative age-related macular degeneration (n = 561), retinal vein occlusions (n = 82), and other reasons. Among the injections were 220 reinjections. Triamcinolone was filtered to remove the solvent agent. Mean follow-up was 8.1 +/- 7.4 months. RESULTS: In none of the eyes, signs of an infectious or noninfectious endophthalmitis were observed such as noncrystalline hypopyon, cellular infiltration, or amorphous opacification of the vitreous, retinal infiltration, or pain. One patient developed infectious endophthalmitis 2 days after a traumatic rupture of a previous corneoscleral cataract incision. CONCLUSIONS: The rate of infectious or noninfectious endophthalmitis after an intravitreal high-dosage triamcinolone injection may be approximately 1:1000, if the solvent agent was removed.

Diabetic Retinopathy↗

PubMed2006

Intravitreal triamcinolone acetonide for diabetic macular edema: a prospective, randomized study.

PURPOSE: The aim of this study was to examine the visual outcome of patients receiving an intravitreal injection of triamcinolone acetonide (TA) as treatment of diffuse diabetic macular edema (DDME). METHODS: This prospective, placebo-controlled, randomized, clinical interventional study included 40 eyes (38 patients) with DDME, with 28 (70%) eyes randomized to treatment and 12 (30%) eyes randomized to receive a placebo injection. Thirty-six (36) (90%) eyes completed the 3-month study visit, and 32 (80%) eyes completed the 6-month study visit. The treatment group received an intravitreal injection of approximately 20 mg of TA. RESULTS: Visual acuity increased significantly (P < 0.001) in the study group by 3.4 +/- 2.5 Snellen lines. In the control group, visual acuity did not change significantly (P = 0.07) during follow-up. Difference in change of best visual acuity was significant (P < 0.001) between both groups. At 3 months after baseline, 11 (11/26; 42%) eyes and 10 (10/26; 39%) eyes, respectively, improved by at least 2 and 3 lines, respectively, in the study group, versus 2 (2/10; 20%) eyes and 1 (1/10; 10%) eye in the control group. At 6 months after baseline, 11 (11/23; 48%) eyes and 9 (9/23; 39%) eyes, respectively, improved by at least 2 and 3 lines, respectively, in the study group, versus 0 (0%) eyes and 0 (0%) eyes in the control group. The difference was significant for the 2-line improvement (P = 0.01) and 3-line improvement (P = 0.03). CONCLUSIONS: Using a dosage of approximately 20 mg of intravitreal TA, visual acuity temporarily increases for 6 months after injection.

Aged↗

PubMed2006

Triamcinolone acetonide-induced ocular hypertension.

PURPOSE: The aim of this study is to report on the clinical course of a patient showing markedly increased intraocular pressure (IOP) caused by intravitreal triamcinolone acetonide. METHODS: A 33-year-old patient received an intravitreal injection of approximately 20 mg of triamcinolone acetonide (TA) as treatment of otherwise therapy-resistant uveitis. She experienced an IOP rise to values over 40 mmHg for a period for more than 3 months, despite maximal antiglaucomatous medical therapy. Peak IOP was 55 mmHg. RESULTS: Neither confocal scanning laser tomography nor qualitative assessment of optic disc photographs nor perimetry showed development of glaucomatous changes. Scanning laser polarimetry of the retinal nerve fiber layer suggested a slight loss in the nasal upper fundus quadrant. CONCLUSIONS: Relatively young patients with a pronounced TA-induced rise in IOP, unresponsive to maximal antiglaucomatous medication, may not necessarily undergo antiglaucomatous surgery if the rise in IOP does not last longer than approximately 3 months.

Adult↗

PubMed2006

Visual acuity change after intravitreal triamcinolone in various types of exudative age-related macular degeneration.

OBJECTIVE: The aim of this study was to compare the visual acuity change after an intravitreal high-dose injection of triamcinolone acetonide (TA) in various types of exudative age-related macular degeneration (AMD). PARTICIPANTS: The interventional comparative case series study included 142 patients (146 eyes) with progressive exudative AMD differentiated into the occult type (n = 78; 53.4%), minimal classic type (n = 45; 30.8%), predominantly classic type (n = 17; 11.6%), and the purely classic type (n = 6; 4.1%). Mean follow-up was 9.7 +/- 7.0 months (3-35.7 months). METHODS: Single intravitreal injection of approximately 20 mg of TA. OUTCOME MEASURES: Visual acuity, intraocular pressure (IOP). RESULTS: Gain in visual acuity measured at 1 month (P = 0.20), 2 months (P = 0.43), and at 3 months (P = 0.38) after the intravitreal injection of triamcinolone and maximal gain in visual acuity during the whole follow-up (P = 0.81) did not vary significantly between the 4 study groups. Correspondingly, the size of a retinal pigment epithelium detachment was not significantly associated with the change in visual acuity at 1 month (P = 0.62), 2 months (P = 0.24), 3 months (P = 0.96), or the maximal gain in visual acuity during follow-up (P = 0.93). The amount of rise in IOP, compared with the baseline value (6.5 +/- 7.4 mmHg), was statistically not associated with the type of subfoveal membrane (P = 0.20; 95% confidence interval: -0.52, 2.45). CONCLUSIONS: The change in visual acuity and the rise in IOP in patients with exudative AMD receiving an intravitreal triamcinolone monotherapy is statistically independent of the type of subfoveal membrane, including the size of a retinal epithelium detachment.

Aged↗