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C Jandeck

Publications and source records attributed to C Jandeck.

18 recordsLinked to original sources
PubMed2005

[Comparison of the anatomical and functional outcome after laser or cryotherapy for retinopathy of prematurity (ROP)].

PURPOSE: To analyze and compare the anatomical and functional outcome following cryotherapy or laser therapy for ROP. METHODS: Between April 1991 and February 2002, 127 eyes with ROP (65 patients) were treated after threshold ROP was reached. Ten additional eyes with zone I disease were treated with prethreshold. All patients were followed up until a stable retinal situation occurred. RESULTS: An "unfavorable outcome," as described in the Cryo ROP study, occurred in 1 of 91 (1%) eyes with laser treatment and in 3 of 46 (6.5%) eyes with cryotherapy. Temporal dragging of vessels was noticed in 6 of 91 eyes (6.6%) with laser treatment vs 7 of 46 eyes (15.2%) with cryotherapy, respectively. Visual acuity > or =20/25 was achieved in 39.2% in eyes with laser therapy and in 17.6% with cryotherapy (p<0.05). CONCLUSION: A strict screening protocol and treatment at onset of threshold disease results in an excellent anatomical and functional outcome. The results of laser therapy were superior over cryotherapy, indicating that laser treatment is the therapy of choice.

Birth Weight↗
PubMed2005

[Screening for retinopathy of prematurity: results of one centre between 1991 and 2002].

PURPOSE: The aim of this study was to analyse the results of retinopathy of prematurity (ROP) screening, stage of disease and time of treatment from one tertiary care centre. PATIENTS AND METHODS: Between 1991 and 2001, 666 infants with a gestational age (GA) < 33 weeks or birth weight (BW) less than < 1501 g were examined. Coagulation treatment was performed in accordance with the Cryo-ROP study, after reaching the threshold. All infants were followed-up until a stable retinal situation was reached. RESULTS: Mean GA of the 666 infants was 28.5 +/- 2.3 weeks. Mean BW was 1180 +/- 372 g. During the years of screening, the GA and BW significantly decreased, but no significant change in the yearly incidence of ROP was detected. 460 (69.1 %) of the infants did not develop any stage of ROP. Maximum stage of ROP in the worse eye was stage one in 51 (7.6 %) infants, stage two in 59 (8.9 %) infants and stage three below threshold in 62 (9.3 %) infants. 34 (5.1 %) infants were treated with coagulation treatment. Mean time of treatment was 36.5 weeks postmenstrual age, or 10.7 weeks postnatal age. Postnatal age showed a better correlation to treatment time than postmenstrual age. No infant was treated before seven weeks of life and not before 32 weeks postmenstrual age. CONCLUSION: In spite of the increasing survival of children with lower GA and BW the incidence of ROP has not increased, and the incidence of ROP in our centre appears to be comparable to other international studies. In contrast to the Cryo-ROP study, treatment time correlates better to postnatal age than to postmenstrual age. All infants who underwent treatment were detected at an appropriate time using German screening guidelines.

Age Factors↗
PubMed2004

[Retinopathy of prematurity].

This review summarizes the knowledge and highlights recent advances in clinical research of retinopathy of prematurity (ROP). This disease is still important, because improvements in neonatal intensive care during the last years have increased the survival of the most immature newborns, but did not diminish the ROP frequency. Ophthalmologic screening and, if applicable, laser treatment at the optimal time for advanced ROP prevents blindness in most cases. The history, classification and the modern concepts of ROP pathophysiology are described. The results of various multicenter treatment trials are summarized. The current German screening guidelines are discussed with the guidelines of other nations. The therapeutic treatment strategies and the treatment results are discussed. The ophthalmologic disorders of former preterm infants, as higher rates of amblyopia, strabismus, and refractive error, are mentioned. Possible future therapies, e. g. anti-angiogenic factors are discussed.

Amblyopia↗
PubMed2001

[Vitrectomy in advanced Coats disease].

BACKGROUND: Coats disease is a retinal vasculopathy of unknown cause. Untreated cases usually lead to an exudative retinal detachment and rubeosis iridis with secondary glaucoma. Photocoagulation and/or cryotherapy are generally the first interventions in treating the disease. Pars plana vitrectomy may be indicated in cases of vitreous hemorrhage or retinal detachment. METHODS: We performed pars plana vitrectomy in 9 eyes with Coats disease between 1992 and 1999. A retinal detachment was present in 3 cases, and three showed a vitreous hemorrhage. In two cases surgery was indicated because of paramacular localization of the pathological vessels with associated exudations. RESULTS: The two cases with paramacular involvement showed improvement in visual acuity of eight lines. In the remaining cases visual acuity remained within two lines compared to the initial visual acuity. All eyes except one could be saved. CONCLUSION: Pars plana vitrectomy is a useful option in treating advanced Coats disease, especially in cases associated with vitreous hemorrhage or retinal traction.

Adolescent↗
PubMed2000

Open globe injuries in children.

BACKGROUND: Eye injuries are the leading cause of monocular blindness in children. At present, however, only limited follow-up studies exist. METHODS: The files of 38 consecutive patients aged 16 years or younger who had been treated for open globe injuries were examined. The type of injury was classified and the severity of injury was categorized in four grades. RESULTS: Our series included 5 eyes (13%) with a rupture, 30 (79%) with a penetrating and 3 (8%) with a perforating injury. Follow-up varied from 3 days to 7 years (mean 15.5 months). The macula was attached at the last follow-up in all eyes. The final visual acuity ranged between 1.0 and light projection. In 47% of cases (18 eyes), the visual acuity was > or =0.5; 74% (28 eyes) achieved at least 0. 1. Eighteen of 38 eyes (47%) had severe injury with posterior segment involvement. Visual acuity of at least 0.5 was achieved in 44% (8/18) of these. Eyes with grade 2-4 injury treated with early vitrectomy had a final visual acuity of > or =0.5 in 58% of cases (7/13). Twenty-one (55%) of 38 children were < or =8 years of age and eight of them (38%) had a final visual acuity of > or =0.5. CONCLUSION: Salvage of the eye with an attached macula was possible in all eyes. Even in severely injured eyes good visual acuity can be established in about 50% of cases.

Adolescent↗
PubMed1999

A pedigree of Leber's hereditary optic neuropathy with visual loss in childhood, primarily in girls.

BACKGROUND: Leber's hereditary optic neuropathy (LHON) mostly affects young males. In patients carrying one of the primary mutations the risk to develop LHON is 50% for males and 10% for females. We report a family with predominantly young girls affected. METHODS: In a family with 14 known maternal relatives (11 females, 3 males) 9 patients in 4 generations developed LHON. Eight of the 9 patients were females. Three affected females could be examined and followed. RESULTS: The only affected male showed the typical course of LHON with acute visual loss in both eyes (20/400-20/800) within 6 weeks at 20 years of age. Eight of 9 females developed signs of LHON. In these females acute visual loss occurred at about 10 years of age. Final visual acuity was about 20/200. Central or paracentral scotomata, color vision defects and delayed P100 latencies in the VEP were seen. Ophthalmoscopy showed hyperemic discs in the acute stage and optic atrophy in later stages. Molecular genetic analysis revealed the presence of the mtDNA ND4/np11778 mutation in this family. Specific clinical or additional molecular genetic risk factors could not be detected. CONCLUSION: Families with LHON may show considerable variations of the clinical course and the gender- or age-specific risk. We present a family with a high disease penetrance of 64% and a 2 times higher risk for young females than for males. Furthermore, early visual loss in this family is permanent.

Adult↗
PubMed1998

[Septo-optic dysplasia (de Morsier syndrome)].

Septo-optic dysplasia (or de Morsier syndrome) is a congenital disorder characterised by anomalies in cerebral midline structures, optic nerve hypoplasia, and hormonal deficiencies. Diagnosis should be made early, due to the possibility of treating the hormonal disturbances. We describe here a case with decreased visual acuity, one-sided hemianopia, nystagmus und agenesis of the septum pellucidum and discuss the heterogeneous appearance of this syndrome. There are two theories regarding its pathogenesis. The first postulates simultaneous damage to both cerebral structures and optic nerve development around the 6th week of gestation, while the other favours secondary degeneration of optic nerve fibres due to a cerebral lesion.

Adolescent↗
PubMed1998

[Hereditary macular dystrophies].

PURPOSE: Analysis of a consecutive series of patients suffering from hereditary macular dystrophies. PATIENTS AND METHODS: Between 1991 and 1997, 136 patients underwent clinical and electrophysiologic examinations (Ganzfeld ERG, EOG or multifocal ERG). RESULTS: The time of first examination was similar to the onset of clinical signs in most patients. In half of the patients onset was not before 40 years of age. In younger patients, Stargardt disease, X-linked retinoschisis and Best disease were the most frequent disorders. In patients aged 40 year and older, pattern dystrophies and central areolar choroidal dystrophy were more frequent. In 41 cases (30.2%) a specific diagnosis could not be made. Color vision and multifocal ERG were abnormal in all patients examined. Ganzfeld ERG was important for the diagnosis of X-linked retinoschisis, as was the EOG for Best disease. CONCLUSIONS: Hereditary macular dystrophies are a heterogeneous group of disorders. In several cases a definite diagnosis could not be made. Pattern dystrophies are the most frequent hereditary macular dystrophies in patients older than 40 years of age.

Adolescent↗
PubMed1998

Autosomal dominant vitreoretinochoroidopathy with normal electrooculogram in a German family.

BACKGROUND: Autosomal dominant vitreoretinochoroidopathy (ADVIRC) is a rare disorder previously described in four families residing in the USA and one family residing in Germany. We report the clinical and unexpected electrophysiological findings in a sixth family, residing in Germany. METHODS: An affected 23-year-old man, his 52-year-old affected mother and his 55-year-old unaffected father were examined by testing visual acuity, fluorescein angiography, visual fields, dark adaptation, electrooculography (EOG) and electroretinography (ERG). RESULTS: The 23-year-old man showed a circumferential retinochoroidal dystrophy extending from the mid-periphery to the ora serrata. There was a sharp demarcation between affected and nonaffected retina. Peripheral to the damarcation, bone spicules and yellow-white deposits were present, and the retinal vessels were severely attenuated. In addition, vitreous opacities were present. The EOG light rise was normal. The ERG amplitudes were reduced to 35% of the normal in all recording conditions. The 52-year-old mother showed marked peripheral pigmentation, but no bone spicules, deposits or vitreous opacities. Her EOG and ERG recordings were normal. CONCLUSIONS: Expression of ADVIRC can be very variable within the same family. A reduced EOG light rise, previously suggested as a characteristic sign for ADVIRC, is not a typical sign for all affected patients.

Adult↗
PubMed1998

Diffuse mesangial sclerosis: association with unreported congenital anomalies and placental enlargement.

A case of diffuse mesangial sclerosis (DMS) associated with a number of undescribed congenital anomalies is reported. The occurrence of additional anomalies, especially ocular anomalies, is a common finding in DMS. However, neither megalocornea, Dandy-Walker malformation, postaxial hexadactyly, rocker-bottom feet, nor atrial septal defect, as observed in our patient, has been reported previously in association with DMS. This case might be considered an atypical manifestation of the Galloway-Mowat syndrome. In contrast to most cases of DMS, the patient revealed intrauterine proteinuria as the placenta was enlarged to 31% of birth weight. This case demonstrates that the large placenta, >25% of birth weight, is not only pathognomonic of the congenital nephrotic syndrome of the Finnish type but can also occur in DMS.

Abnormalities, Multiple↗
PubMed1997

[Electrophysiologic studies according to ISCEV (International Society for Clinical Electrophysiology of Vision) standards in children under 10 years of age].

PURPOSE: To analyze the value of electrophysiologic testing according to standards of the International Society for Clinical Electrophysiology of Vision (ISCEV) in infants less than 10 years of age. PATIENTS AND METHODS: In 64 infants less than 10 years, the results from of age electroretinograms (n = 47), visual evoked potentials (n = 30), or electro-oculograms (n = 1) were recorded. Twenty-nine infants were less than 6 years of age, and 17 infants were less than 3 years of age. Indications for examination were unexplained visual loss in 54 infants and familial hereditary retinal dystrophies in ten infants. Sedation with chloral hydrate was performed in seven children. RESULTS: In 40/64 infants (62%), the results of electrophysiologic examination were pathologic. In 29 infants visual loss was due to retinochoroidal dystrophies, and in 11 infants it was due to disturbances in the optic pathway. In 7/64, infants the suspected retinochoroidal dystrophy could be excluded. Therefore electrophysiologic testing was diagnostically accurate in 47/64 (73%) of cases. CONCLUSION: Electrophysiologic testing according to TSCEV standards can be reliably performed in infants less than 10 years of age. When the indication for electrophysiologic testing is made following meticulous ophthalmologic examination, diagnostic accuracy is given in at least 73% of cases.

Child↗
PubMed1996

Retinopathy of prematurity in infants of birth weight > 2000 g after haemorrhagic shock at birth.

BACKGROUND: The risk of retinopathy of prematurity (ROP) is associated with low birth weight and low gestational age. For ROP screening examination is recommended in infants weighing < or = 1500 g or of less than 32 weeks' gestational age. METHODS: From 1991 ROP screening was performed in 452 premature infants with either a birth weight < or = 1500 g (n = 303) or a birth weight > 1500 g (n = 149) and who required additional oxygen supplementation or underwent surgery with general anaesthesia before estimated term. RESULTS: Unexpectedly, three infants with birth weights between 2080 and 2325 g and a gestational age of 32 or 33 weeks developed stage 2 or 3 ROP. One of these underwent cryocoagulation. In three infants, preterm birth was induced by sudden placental abruption with severe prenatal blood loss followed by haemorrhagic shock. The umbilical cord packed cell volume was reduced to 0.14-0.19 (normal 0.43-0.63). All three infants underwent surgery with general anaesthesia within the first weeks of life. Of the remaining 449 infants none with a birth weight > 1650 g developed any stage of ROP. CONCLUSION: Severe prenatal blood loss requiring blood transfusions and surgery with general anaesthesia may induce higher stages of ROP even in infants with birth weights exceeding the usual screening criteria.

Abruptio Placentae↗
PubMed1995

Natural course of retinal development in preterm infants without threshold retinopathy.

In a consecutive series, 209 preterm infants with birth weights below 1501 g or a gestational age of < or = 32 weeks were observed. Stage 3 retinopathy of prematurity (ROP) developed in 48 infants (23%) of between 32 and 46 weeks postconceptional age (PCA; mean, 37 weeks). Stage 3 ROP was not seen before 6 weeks after birth. Threshold ROP was seen and treated at between 34 and 42 weeks PCA (mean, 38 weeks PCA; n = 22, 10.5%). A subgroup of 126 untreated infants were followed until complete retinal vascularisation. At estimated term, 38.7% of eyes with vessels ending in zone 3 at the first examination showed complete vascularisation as compared with 17.6% of eyes with vessels ending in peripheral zone 2 and none of those with vessels ending in central zone 2. Occurrence of ROP delayed retinal development. At estimated term, no eye with any stage of ROP showed complete vascularisation as compared with 35.4% of eyes without ROP. Regression of stage 3 ROP below threshold started in all cases before 56 weeks PCA.

Cryosurgery↗
PubMed1995

[Evaluation of published recommendations for screening studies of retinopathy of prematurity].

PURPOSE: Evaluation of different and partially contradictory guidelines for screening for retinopathy of prematurity published in Germany. PATIENTS: The data on 1219 preterm infants examined in Bern (n = 900) and Berlin (n = 319) were analyzed. A total of 680 preterm infants (56%) had a birth weight below 1500 g. The remaining infants were examined because oxygen had to be supplied or surgery done before or around the estimated delivery time. RESULTS: Stage 3 retinopathy was found in 88/1219 (7.2%) preterm infants. Only 5/88 infants weighed more than 1500 g at birth. Three of these infants had a birth weight below 2000 g and needed supplemental oxygen for a prolonged period of time. The other 2 infants had birth weights of more than 2000 g and were severely ill. Of 1219 preterm infants, 37 (3%) developed threshold retinopathy (according to the criteria of the multicenter trial); 35/37 infants weighed less than 1230 g at birth. The remaining 2 children (1650 g and 2185 g birth weight) were severely ill. CONCLUSIONS: Preterm infants should be screened for retinopathy of prematurity: (1) if the birth weight is below 1500 g; (2) if the birth weight is below 2000 g and oxygen supply was necessary for more than 30 days; (3) if infants are very sick or must undergo multiple surgery before term. The first examination should be scheduled for the 6th week postnatal and not before 31 weeks postmenstrual age.

Berlin↗
PubMed1991

[Revision operations in retinal redetachment].

We analyzed retrospectively 239 consecutive patients who had undergone reoperation for repeat retinal detachment; 441 repeat operations were performed. The average follow-up was 2.1 years, and on average we noted 1.8 retinal redetachments per patient. At the last follow-up examination in 173 eyes (72.4%), the retina was reattached; 10.5% of the eyes had a partially detached retina and in 15.9% the retina was again completely detached. Enucleation was necessary in 3 eyes (1.2%). Visual improvement occurred in 45% of the eyes with reattachment of the retina. When the first retinal detachment occurred, 74 eyes were aphakic. Compared to the other 165 eyes there was no difference in anatomic or visual outcome. Aphakic eyes needed fewer additional reoperations (39%) compared to the phakic group (50%, p less than 0.01). One important reason for the surgery being unsuccessful was poor placement of the scleral buckle. In both groups equatorial placement of the scleral buckle led to anatomical success in more than 50%. The eyes in the aphakic group required more vitrectomies (47%) compared to the phakic eyes (34%, p less than 0.01).

Adolescent↗