[Unilateral nocturnal glare sensitivity and photopsias].
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Female↗
Biomedical subjects
C Prünte
Publications and source records attributed to C Prünte.
Increased endothelin-1 plasma level in young adults with retinal vascular occlusive diseases.
BACKGROUND: Vascular occlusive diseases are usually seen in the elderly but can occur even in younger patients without arteriosclerosis. We assume a vascular dysregulation as a underlying pathogenetic mechanism. PATIENTS AND METHODS: In a prospective study we analysed the clinical findings of six patients under 55 years of age, three men with retinal vein occlusions and three women with branch retinal arterial obstructions. They were examined for signs of a vascular dysregulation and the endothelin-1 (ET-1) plasma level was measured. RESULTS: In all patients the ET-1 plasma level was markedly elevated. The mean value (3.72 +/- 0.8 pg/ml) was significantly increased compared to normal values for that age (1.52 +/- 0.24 pg/ml; p < 0.001). In all cases an increased tendency for vascular dysregulation could be demonstrated in nailfold capillaroscopy. Furthermore, frequent coldness of the extremities was mentioned by every patient and migraine was mentioned by four patients whereas neither changes of the vessels in carotis and ophthalmica region nor disturbances in the haemostasis and fibrinolysis could be found. CONCLUSIONS: All six patients with vascular occlusive diseases occurring before the age of 55 had a vascular dysregulation and increased ET-1 plasma levels. A relationship between the vascular dysregulation and the vascular occlusive diseases is therefore likely.
Acute Disease↗
Iris transillumination defects in patients with primary open angle glaucoma.
PURPOSE: To examine the incidence and pattern of iris transillumination defects in patients with primary open angle glaucoma (POAG) with and without vascular dysregulation, in comparison to controls. METHODS: We prospectively examined 24 patients with POAG (M/F 10:14; mean age 59 +/- 14, range 21-76 years) and 23 controls (M/F 10:13; mean age 52 +/- 15, range 25-86 years). Vascular dysregulation was presumed if patients had a typical medical history of vasospasm and a pathological result in nailfold capillaroscopy. Iris transillumination defects were visualized by video-taped, digitized diaphanoscopy and assessed by two blinded observers. RESULTS: We found significantly more iris transillumination defects in POAG than in controls (54.2% vs. 8.7%; chi2 = 8.85; df = 1; p = 0.002). The defects in POAG showed a characteristic radially-streaked pattern different from those described, for instance, in pigment dispersion syndrome, pseudoexfoliation syndrome, and acute glaucoma. Glaucoma patients with vascular dysregulation had a tendency to a higher incidence of transillumination defects than non-vasospastic patients, though this finding was not significant. CONCLUSIONS: Patients with POAG have a higher incidence of iris transillumination defects than controls. The underlying mechanisms are not yet clear and call for further investigation.
Adult↗
[GRIN (gradient-index) intraocular endoscopy--possibilities and limits--a review].
BACKGROUND: Microendoscope techniques got a more important role in intraocular diagnostic and therapy. The used optical systems are fiberbundle-endoscopes and gradient-index (GRIN)-endoscopes. This study is concerned with the possibilities and limits of GRIN-endoscopes in pig eye models and in clinical use. PATIENTS AND METHODS: Several simulated intraocular techniques (phacoemulsification, implantation of intraocular lenses, vitrektomie, extraction of lost lens parts out of the corpus vitreous, extraction of metal foreign bodies) were done on pig eyes under GRIN-endoscopic control (GRIN-endoscope with diameter of 0.89 mm, Volpi, Switzerland). 3 clinical patients with cornea or lens opacities were examined. RESULTS: The image quality of simulated operations on pig eyes in clear intraocular conditions with a GRIN-endoscope was good. Also the clinical intraocular examinations could be done well, although the additional information were different. The in vivo examinations gave in one case no information (vitreous opacities very tight), in one case a relative information (mild vitreous opacities) and in one case an additional information (vitreous opacities rare). CONCLUSIONS: GRIN-endoscopes could complement the intraocular endoscopic spectrum in selected cases. At clear intraocular conditions good pictures were possible. GRIN-endoscopes could be used in cases where endoillumination is necessary. Then additional visual informations to the illumination are possible. The possibility to get overview images is limited with the actual endoscope probes. Ultrasound examination should be done in all cases with opacities of the anterior parts of the eye to get informations about the conditions inside the eye. Working inside the eye is possible with experience in this technique although a GRIN-endoscope has no stereopsis. Future developments should be done in stereopsis, several endoscope-tips and better handling (footpedal-controlling, autofocus).
Adolescent↗
Immunosuppressive therapy in serpiginous choroiditis--case report and brief review of the literature.
BACKGROUND: At present there is no consensus regarding the efficacy of the immunosuppressive therapy in serpiginous choroiditis. PATIENT AND METHODS: We describe the case of a patient with a macular serpiginous choroiditis. Despite corticosteroid therapy the choroiditis was progressive and threatened the central vision. Therefore a triple immunosuppressive therapy with prednisone 1 mg/kg body weight/day (mg/kg/d), azathioprine 1.5 mg/kg/d, and low-dose cyclosporine A 4.5 mg/kg/d was introduced. RESULTS: Under this triple immunosuppressive therapy a prompt stabilisation of the chorioretinal process could be observed in fluorescein angiography. After five months of therapy the examination of the visual field shows an impressive recovery. No significant side effects have been noted. CONCLUSIONS: In the literature, until now only six patients with serpiginous choroiditis treated with a triple agent immunosuppressive therapy have been reported. In all cases this regimen seemed to have a positive influence on the disease. Our present observation corroborates the beneficial effect of a triple agent immunosuppressive therapy on the course of serpiginous choroiditis. However, the beneficial effect of such a therapeutic approach needs to be confirmed by further observations.
Adult↗
Interocular differences in optic disc topographic parameters in normal subjects.
PURPOSE: To test the interocular differences in optic disc topography in normal subjects by means of confocal scanning laser ophthalmoscopy. METHODS: Topographic measurements of the optic disc were evaluated by means of confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph) in 314 eyes of 157 healthy volunteers. The examination was started randomly either with the right eye or the left eye. Differences between right and left eyes in disc area, cup area, cup volume, cup/disc area ratio, rim area, rim volume, maximum cup depth, cup shape measure, retinal nerve fiber layer thickness, and retinal nerve fiber cross section area for 360 degrees and for the temporal and nasal regions of the optic nerve head were evaluated by means of Student t-test. The same parameters were assessed in a subgroup of 80 elderly (age> 50 years) healthy subjects. Holm's sequentially rejective method was used for significance correction of multiple comparisons. RESULTS: Significant interocular differences in the average retinal nerve fiber layer thickness (p = 0.0010) and retinal nerve fiber layer cross section area (p = 0.0036) were found, with the right eye showing, on the average, lower values. The left eye showed a larger retinal nerve fiber layer thickness in 94 subjects (59.87%) and a larger retinal nerve fiber cross section area in 101 subjects (64. 33%). In the temporal optic disc area there were no statistically significant differences in topometric data (p> 0.05). In the nasal area, significant interocular differences in the retinal nerve fiber layer thickness (p = 0.0002) and retinal nerve fiber layer cross section area (p = 0.0003) were found. Similar results were found when the group of subjects older than 50 years was considered. CONCLUSIONS: This study demonstrates systematic interocular differences in optic disc topometric data. Such a finding, be it due to methodological or biological reasons, should be taken in consideration in clinical trials.
Adolescent↗
Potential role of nitric oxide and endothelin in the pathogenesis of glaucoma.
Glaucoma is an optic nerve head neuropathy in which retinal ganglion cells are lost. A clear association exists between glaucoma and different risk factors, such as high intraocular pressure (IOP) or blood-flow dysregulation. Nitric oxide (NO) and endothelin, two recently identified cellular mediators, appear to be involved in the regulation of IOP as well as in the modulation of ocular blood flow. To some extent, NO is also involved in apoptosis, a mechanism of cell death that can lead to retinal ganglion cell loss in glaucoma. This article provides a short and simplified overview of the biochemistry of NO and endothelin and highlights the potential role of these two mediators in certain important aspects related to the pathogenesis of glaucoma.
Apoptosis↗
Relationship between blood flow velocities in retrobulbar vessels and laser Doppler flowmetry at the optic disk in glaucoma patients.
The relationship between blood flow velocities in retrobulbar vessels and blood flow at the optic nerve in glaucoma patients was assessed in a prospective study. The Heidelberg retina flowmeter (HRF) was used to assess optic nerve head blood flow in 13 open-angle glaucoma patients. In the same patients, color Doppler imaging (CDI) measurements were obtained from the ophthalmic artery, the central retinal artery and the posterior ciliary arteries. Using data for one randomly selected eye per subject, correlations between HRF recordings and CDI measurements were evaluated by means of Spearman's rank correlation factor. All three HRF parameters correlated with CDI measurements obtained from retrobulbar vessels. The most marked correlations were those of the HRF parameter 'volume' with the end-diastolic velocity in the ophthalmic artery and the medial posterior ciliary artery (R = 0.79, p = 0.0012 and R = 0.81, p = 0.0007, respectively), and the peak systolic velocity in the lateral posterior ciliary artery (R = 0.82, p = 0.0006). The present study suggests that glaucoma patients with altered blood flow in retrobulbar vessels are likely to show an alteration in optic nerve blood flow as measured with the HRF.
Aged↗
[The cataract, an unavoidable sign manifestation of aging?].
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Aged↗
29Si imaging of silicone breast implants and intraocular silicone oil.
Silicon-29 (29Si) imaging was investigated as a potential imaging modality for monitoring silicone prostheses in humans. The 29Si relaxation times of several silicone gels were measured and found to average T1 = 21.2 +/- 1.5 s and T2 = 207 +/- 40 ms, with no significant difference between virgin and explanted gels. A single-shot half-Fourier rapid acquisition with relaxation enhancement (RARE) and a refocused gradient-echo sequence were used for acquiring 29Si images with 5 x 5 mm2 resolution and no slice selection. Three volunteers with silicone-gel-filled breast implants and one subject with an intraocular silicone oil injection were thus examined in a total acquisition time of 10-15 min per image. On all 29Si images, the shape of the silicone object was well depicted. Although at present, conventional proton images are superior in resolution and signal-to-noise ratio, 29Si imaging has the advantage of optimal specificity, since only the silicone itself is visible.
Biocompatible Materials↗
Abnormalities of microcirculation in glaucoma: facts and hints.
Many risk factors associated with glaucoma have been identified recently. The best known of these is increased intraocular pressure (IOP). Among the others, however, vascular risk factors play a major role. Although such vascular factors were already postulated more than 100 years ago, only recent technical developments have afforded systematic investigations of associated microcirculatory disturbances and basic principles of blood flow regulation. In glaucoma, besides IOP, vascular dysregulation (such as local vasospasm and systemic hypotension, resulting in impaired autoregulation of blood flow in the optic nerve head, the choroid, and other ocular tissues) seems to be a major risk factor. However, multiple coacting factors, which are not limited to the eye but are, rather, symptoms of a systemic disease, seem to be involved in the damaging process.
Choroid↗
Endothelium-derived vasoactive substances relevant to normal-tension glaucoma.
Glaucoma is a progressive optic neuropathy that has a multi-factorial etiology. The most important risk factor is certainly an increased intraocular pressure. However, clinical observations have indicated that factors other than increased intraocular pressure also damage the neural tissue in glaucomatous optic neuropathy. The most prominent of these to be vascular dysregulation. Vascular tone is permanently regulated by a number of regulatory systems and factors, and the endothelial cell layer acts as an important mediator for the response to these factors. According to recent evidence, glaucomatous optic neuropathy may be associated with changes in endothelium-dependent vascular regulation. Consequently, therapeutic approaches based on vasodilator drugs acting via endothelium-derived substances are being developed. Although promising preliminary studies have been performed, the clinical relevance of such treatment remains to be clarified.
Animals↗
Influence of acquisition parameters on hemodynamic measurements with the Heidelberg Retina Flowmeter at the optic disc.
PURPOSE: The Heidelberg Retina Flowmeter (HRF; Heidelberg Engineering GmbH, Heidelberg, Germany) is a new instrument that determines hemodynamic variables at discrete locations of the retina and the optic disc. The objective of this study was to evaluate the influence of various HRF recording settings on the long-term variability of the HRF parameter. "Flow," computed at the optic nerve head in healthy individuals. METHODS: The authors obtained 2 sets of 5 HRF recordings in 10 healthy individuals (age range, 23-60 years). The HRF recordings were obtained within a scan area of 10 degrees x 2.5 degrees (set 1) and 20 degrees x 5 degrees (set 2). For each set, the HRF recordings were obtained on 5 consecutive days. Respective HRF recordings for both sets were obtained on the same days. On these recordings, the HRF parameter, "Flow," was computed at 3 different regions of interest (temporal superior, temporal inferior, and temporal rim of the optic disc). At all three locations, Flow was computed within windows of measurement of 10 pixels x 10 pixels and 20 pixels x 20 pixels. The effect of larger windows (30 pixels x 30 pixels, 40 pixels x 40 pixels, and 50 pixels x 50 pixels) was tested at the temporal rim of the optic disc. RESULTS: The highest reliability coefficient was reached with a scan area of 20 degrees x 5 degrees at the temporal superior rim of the optic disc (r = 0.93). Within a scan area of 20 degrees x 5 degrees, the size of the user-defined measuring window did not influence the reliability. Two models of analysis of variance disclosed that the only effect on the computed value of Flow that reached statistical significance was that because of the scan area (F = 11.172; p = 0.001). The location of the window of measurement and its size had no statistically significant effect. CONCLUSION: The present results show that the location of the window of measurement has an important effect on the long-term variability of the HRF parameter, Flow. In addition, different scan areas influence significantly the computed values of this parameter.
Adult↗
Descriptive information of topographic parameters computed at the optic nerve head with the Heidelberg retina tomograph.
PURPOSE: To analyze the frequency distribution and descriptive information of topometric data obtained with the Heidelberg Retina Tomograph (HRT) in a normal population. METHODS: Topographic measurements of the optic disc were acquired and evaluated using the HRT in 225 subjects between 12 and 90 years of age. After randomly selecting one eye per subject, the frequency distributions, mean values, minima, maxima, and first, fifth, fiftieth, ninety-fifth, and ninety-ninth percentiles were evaluated for topographic parameters computed by the HRT. The influence of age, intraocular pressure (IOP), disc size, and disc shape on optic disc topometric data was analyzed. A principal component analysis of the topometric parameters was performed. The frequency distributions, mean values, minima, maxima, and first, fifth, fiftieth, ninety-fifth, and ninety-ninth percentiles of the interocular difference in topographic parameters were evaluated. RESULTS: All topographic parameters showed a unimodal but not necessarily normal distribution. None of the parameters showed a relevant correlation with age, IOP (in the normal range), and overall shape of the anterior optic nerve, but a few parameters showed a clinically significant correlation with disc size. A principal component analysis identified four relevant factors (optic nerve cup, retinal nerve fiber layer, optic disc size, and optic nerve cup shape) in the entire data set of optic nerve topometric data. The absolute value of all interocular differences in topographic parameters showed an asymmetric but unimodal distribution. CONCLUSION: The mathematical description of the optic nerve cup shape provides information on optic nerve head topography independently from cupping, nerve fiber layer thickness, and disc size. Potentially, quantification of further aspects in optic nerve head topography might improve the discriminatory power of computerized quantitative optic nerve head analysis.
Adolescent↗
Effects of dopamine D-1 and D-2 receptors on intraocular pressure in conscious rabbits.
This investigation was designed as a randomized, placebo-controlled, double-masked, crossover study in NZW rabbits with normal intraocular pressure (IOP) to investigate dopaminergic effects on IOP. SKF 38393, a selective D1-receptor agonist, increased, and SDZ PSD-958, a selective D1-receptor antagonist, decreased IOP, respectively. The selective D2-receptor agonist quinpirole decreased IOP, whereas the selective D2 receptor antagonist metoclopramide had no significant effect. Combinations of quinpirole with SDZ PSD-958 decreased IOP in an additive manner. SDZ GLC-756, a mixed D1-receptor antagonist/D2-receptor agonist, decreased IOP in a dose-dependent manner with a maximum effect greater than the maximum effects produced either by the D1-receptor antagonist SDZ PSD-958 and the D2-receptor agonist quinpirole. The effect of SDZ GLC-756 could only be partially blocked by the selective D2-receptor antagonist metoclopramide suggesting that both D1-receptor blockade and D2-receptor stimulation participate in its IOP-lowering effect. Tonography suggests that SDZ GLC-756 has no significant effect on outflow facility. Furthermore, the results suggest that both D1 and D2 receptors each play an independent role in the regulation of IOP in rabbits. Thus, simultaneous blockade of D1 receptors and stimulation of D2 receptors may provide a new pharmacological approach for the treatment of ocular hypertension frequently associated with glaucoma.
2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
Choroidal capillary and venous congestion in central serous chorioretinopathy.
PURPOSE: Abnormalities in choroidal perfusion have been hypothesized to be causative factors in central serous chorioretinopathy. This prospective study was performed to evaluate changes in the choroidal circulation in cases of central serous chorioretinopathy. METHODS: In 32 consecutive patients with acute or chronic recurrent central serous chorioretinopathy, complete clinical ophthalmologic examinations, fluorescein angiography, and indocyanine green angiography with a scanning laser ophthalmoscope and a digital imaging system were performed. RESULTS: All patients with acute and chronic recurrent central serous chorioretinopathy demonstrated a localized delay in arterial filling followed by choroidal hyperperfusion in the area of the damaged retinal pigment epithelium, frequently associated with dilated capillaries and dilated draining venules in one or more choroidal lobules. These changes corresponded to areas with pigment epithelial detachment or focal leakage from the retinal pigment epithelium found in fluorescein angiography. Furthermore, in some patients, localized choroidal ischemia could be observed in additional areas throughout the central fundus in both diseased eyes and normal fellow eyes. CONCLUSIONS: Delayed arterial filling followed by capillary and venous hyperemia, angiographically appearing as capillary and venous congestion, can be observed frequently in eyes with central serous chorioretinopathy. The results suggested that capillary or venous congestion after ischemia in one or more choroidal lobules might be the reason for the choroidal hyperpermeability associated with central serous chorioretinopathy.
Acute Disease↗
[Circulatory disorders of the choroid in patients with central serious chorioretinopathy].
BACKGROUND: Advanced methods for indocyanine green (ICG) video-fluorescence angiography provide improved evaluation of choroidal blood flow disturbances in patients with central serous chorioretinopathy (CSC). MATERIAL AND METHOD: Fluorescein ICG video-fluorescence angiography using a laser scanning ophthalmoscope and digital image processing were performed in patients with acute or chronic recurrent CSC. RESULTS: In all eyes examined delayed arterial filling followed by capillary and/or venous congestion were found in the areas of retinal pigmentepithelial detachment or leakage. Furthermore, additional ischemic choroidal capillary lobuli could be observed throughout the fundus of diseased eyes and "normal" fellow eyes. CONCLUSIONS: Our results suggest that symptomatic changes in CSC, like RPEdetachment or leakage from the outer blood-retinal barrier, may be caused by capillary and venous congestion, possibly due to stress-related arterial hypoperfusion.
Acute Disease↗
Topical SDZ GLC-756, a novel dopamine D-1 antagonist and D-2 agonist, lowers intraocular pressure in conscious rabbits.
This investigation was carried out to evaluate the effect of SDZ GLC-756, a novel dopamine D-1 antagonist and D-2 agonist, on intraocular pressure (IOP) in rabbits. A randomized, placebo-controlled, double-masked, crossover study with topical application of SDZ GLC-756 eyedrops [0.015% (n = 10), 0.03% (n = 10), 0.0625% (n = 10), 0.125% (n = 9), 0.25% (n = 10), 0.5% (n = 14)] and vehicle alone (placebo-control) to the right eye was performed in New Zealand White rabbits. The contralateral eye received no treatment. IOP was measured using a pneumatonometer. Topical SDZ GLC-756 significantly lowered IOP in a dose-dependent manner (maximal IOP-lowering effect 1 approximately 2 hours after administration) in the treated eye and, to a lesser extent, in the contralateral eye. The duration of action was approximately 4 hours. The simultaneous D-1 antagonistic and D-2 agonistic properties of SDZ GLC-756 may provide a new pharmacological approach to the treatment of glaucoma, which deserves further investigation.
Administration, Topical↗