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Biomedical subjects

E Königsdörffer

Publications and source records attributed to E Königsdörffer.

At least 19 recordsLinked to original sources
PubMed2006

[Selenium and cataract--risk factor or useful dietary supplement?].

BACKGROUND: The exact role of selenium in cataract development is still unclear. Both protective and toxic effects and mechanisms have been postulated in the past. Accordingly, the selenium contents in human lenses and blood sera in different forms of cataract were investigated. METHODS: 123 patients (76 female and 37 male) with a mean age of 69.8 years (range: 17 to 91 years) were enrolled in this study. Overall, 84 lenses (after ECCE) and 110 blood serum samples were investigated by atomic absorption spectroscopy. Interpretation of data was accompanied by exact preoperative investigations including Scheimpflug techniques. RESULTS: A significant increase of selenium content of the lenses was found with increasing lens opacification and colouration. Lenses with a mature cataract showed the highest selenium contents in the lens compared to other cataract forms. Opposite results were detected in blood serum. Lenses of diabetics showed already at a younger age changes in selenium content. Smokers showed both decreased selenium contents in the lens and decreased selenium concentration in blood serum. CONCLUSIONS: An obvious correlation between the type of cataract and selenium content of the lens seems to exist. The question by which mechanism selenium acts directly or by selenium-dependent enzymes acts lens opacification remains speculative up to now.

Adolescent↗
PubMed2006

[Histological and immunohistological investigations in human epiretinal membranes].

BACKGROUND: The exact mechanisms involved in the development of epiretinal membranes are still poorly understood. This study aimed to investigate human epiretinal membranes with the help of different histological and immunohistological methods in order to find new concepts for the development of these membranes. METHODS: 79 epiretinal membranes of patients (28 male, 51 female) undergoing a pars plana vitrectomy were included in this study. The mean age of the patients was 67.3 +/- 12.1 years. Preoperative diagnosis was diabetic retinopathy (n = 57), panuveitis (n = 4), PVR-ablatio (n = 16) and Coats disease (n = 2). All epiretinal membranes were histological and immunohistological investigated (aquaporin and with smooth muscle actin [SMA]). RESULTS: Within the investigated membranes very different cell and tissue structures were found. They varied from extracellular matrix-rich membranes to membranes with high cell density and proliferative activity (fibroblasts). In immunohistological studies highly differentiated vessel structures were identified (aquaporin-endothelial cells). A typical characterisation and comparison to clinical findings is demonstrated with the help of selected samples. CONCLUSIONS: Human epiretinal membranes vary in their histological structure according to their underlying disease. Histological and immunohistological investigations may help to characterise these membranes and to understand the complex origin mechanism of these structures. This provides the basis for further studies with potential antiangiogenic drugs.

Aged↗
PubMed2006

[Advanced glycation end products and pseudoexfoliation--correlation between clinical outcome and histological findings].

BACKGROUND: Pseudoexfoliation syndrome (PXS) as a stress-induced microfibrillopathy often shows a prolonged postoperative course. Formation of advanced glycation end products (AGEs) might be also associated with an increased oxidative stress. This study investigated for the first time immunohistochemically lens capsules of PXS patients for the AGE carboxymethylysine (CML) and correlated the findings with the clinical outcome of the patients. METHODS: 55 patients (22 male, 33 female; mean age 73.9 +/- 14.1 years) with PXS and pseudoexfoliation glaucoma (PXG) after cataract extraction were included. All lens capsules could be investigated immunohistochemically for the AGE CML. Both preoperative biometric data as well as intra- and postoperative courses were included in the investigations, followed by a correlation analysis of the immunohistochemical findings. RESULTS: 29 PXS and 26 PXG patients with a mean axial length of 23.1 +/- 1.1 mm were explored. Both groups showed a postoperative decrease of intraocular pressure and a moderate increase of visual acuity. Intraoperatively, 6 zonulolyses occurred and postoperatively 11 patients showed problems like increases of intraocular pressure. Immunohistochemically, CML could be detected in most of the epithelial cells of the lens capsules but only in a small part of the pseudoexfoliation (PEX) fibrils. A correlation between positive CML immunoreaction and the clinical course was not detectable. CONCLUSIONS: Cataract extraction in patients with PEX glaucoma shows different specialities and risks. The AGE CML was detectable in human lens capsules. A direct correlation between clinical course and immunohistochemical reaction of the PEX fibrils could not be found. Overall, CML seems not to be a valuable predictive factor for the clinical course in patients with PXS and PXG.

Aged↗
PubMed2005

[Surgical treatment of cyclodialysis].

PURPOSE: Cyclodialysis is a rare complication following blunt traumatic bulb injuries or surgical interventions. When treatment with cycloplegics or steroids is ineffective in attaching the ciliary body, cyclodialysis should be surgically treated. However, for reliable diagnosis and surgical therapy, an exact identification (size and extent) of the cyclodialysis cleft is imperative. Ultrasound biomicroscopy (UBM) provides the appropriate information. CASE REPORT: Four patients (19 to 65 years old, mean 45 years) with a detached ciliary body are described. Three patients had suffered an injury, and one patient presented with a prior trabeculotomy. The diagnosis was established with UBM. The location of the cyclodialysis cleft ranged between 2 and 3 o'clock (mean 2.4 o'clock). In spite of an intense treatment with cycloplegics and steroids no reattachment of the cyclodialysis took place. Therefore, a surgical intervention was performed. The span between the injury and trabeculotomy, respectively, and the cyclodialysis operation ranged from 3 to 30 months (mean 12 months). On average, visual acuity was increased from 0.3 preoperatively to 0.6 postoperatively, and the intraocular pressure was 6 mm Hg before and 15 mm Hg after operation. Symptoms preoperatively found without exception (choroidal detachment, papilledema "e vacuo", macular edema) had a complete recovery after operation. CONCLUSION: In cases where drug therapies are unsuccessful in attaching the ciliary body, an operative fixation is recommended. UBM is a very useful tool for making an exact diagnosis and defining the location of cyclodialysis as well as for follow-up of surgical treatment.

Adult↗
PubMed2004

[Spectral separation in ocular fundus autofluorescence images in patients suffering from age-related macular degeneration].

INTRODUCTION: Alterations in the intrinsic ocular fundus fluorescence are under discussion particularly in connection with age-related macular degeneration. However, further knowledge of the chemical substrate of fluorescence is necessary. METHOD: Ocular fundus autofluorescence was observed using a fundus camera. The fluorescence emission was recorded using a 3-chip CCD camera. For comparison, the fluorescence spectra of lipofuscin, A2-E, FAD, NADH(2) and AGE's were recorded by the Jena ophthalmo-spectrometer. RESULTS: In contrast to the homogeneous intrinsic fluorescence of a normal fundus, the fluorescence images of patients suffering from AMD showed remarkable local differences. The detected fluorescence spectra showed remarkable overlaps. DISCUSSION: We introduced a new technique enabling the detection of spectral differences in images of ocular fundus autofluorescence. Besides the fluorescence of lipofuscin, we found a green one in patients suffering from nonexudative AMD.

Adult↗
PubMed2004

[Listeria monocytogenes endophthalmitis].

PURPOSE: Listeria monocytogenes is a rare cause of endogenous endophthalmitis. Controversy exists concerning clinical progress and prognosis in this bacterial infection. However, only a few reports about the clinical features have been previously published in the literature. CASE REPORT: The case of a 24-year-old woman is reported. She developed an endogenous endophthalmitis within 3 weeks. The patient received a pars-plana vitrectomy showing Listeria monocytogenes in the vitreous body. An intensive antibiotic therapy was initiated (local, subconjunctival, intravitreal and systemic). Visual acuity was increased from hand motion to 0.5 by the end of the clinical attendance and to 1.0 three months later. There were no hints concerning systemic manifestation of listeriosis or granuloma formation. CONCLUSION: Frequently, endogenous endophthalmitis has a very poor prognosis. However, the presented case report describes a very prosperous progress of endogenous endophthalmitis caused by an infection with Listeria monocytogenes.

Adult↗
PubMed2001

[The optics of retinal blood vessels and their significance for scanning laser Doppler flowmetry].

Recently, the scanning laser Doppler flowmetry (SLDF) has been developed as a standard method for the quantification of retinal blood flow. However, the measured quantities flow, volume, and velocity depend on the angle between the direction of the blood flow and of the light. The underlying theory assumes isotropic illumination of the vessel. This assumption, however, is not valid for light back-scattered from retinal vessels. This paper investigates the contribution of different pathways of the light to the SLDF signal by a Monte Carlo simulation. It is shown that the light measured on a vessel having a thickness of 50 microns is predominantly back-scattered from the blood inside the vessel, whereas the measurement on vessels 20 microns in diameter or less also includes light transmitted through the vessel.

Blood Flow Velocity↗
PubMed2000

[Prognosis of postoperative endophthalmitis].

BACKGROUND: The outcome of 20 patients is summarized in a retrospective study to identify clinical findings that influence the long-term prognosis of postoperative endophthalmitis. PATIENTS: Between 1991 and 1997 a total of 20 patients with postoperative endophthalmitis were admitted. Median age was 80 years (range: 9-95), 11 patients were male, 9 female. Sixteen pars-plana vitrectomies, 2 anterior vitrectomies and 2 rinsings of the anterior chamber without vitrectomy were performed. Furthermore, all patients received intraocular and systemic antibiotic treatment. For microbiological investigation, specimens from vitreous, anterior chamber and conjunctiva were sent in. Long-term outcome was controlled for an average of 14 months after treatment of the endophthalmitis (range: 4-36 months). RESULTS: At the end of treatment, 40% of patients had a visual acuity of 0.4 or better, 80% had 1/20 or better. Patients with a preoperative visual acuity of at least hand movement had a better postoperative visual outcome than patients with only light perception. Visual acuity was better in patients with chronic endophthalmitis than in patients with acute or subacute endophthalmitis. In patients with chronic or subacute endophthalmitis, improvement of visual acuity was found some months after the operation more often than in patients with acute endophthalmitis. However, in 40% of cases with an acute onset, no improvement or even worsening of the visual acuity was documented. Best postoperative results were found after infection with Staphylococcus epidermidis and Propionibacterium acnes. CONCLUSION: Important prognostic factors of postoperative endophthalmitis are visual acuity, the onset of the endophthalmitis (acute, subacute or chronic) and the microbiological findings. At the time of surgery and antibiotic treatment, visual acuity should be at least hand motion to expect an improvement in the visual outcome.

Adolescent↗
PubMed1999

In vivo measurement of the oxygen saturation of retinal vessels in healthy volunteers.

A new method for the spatially resolved measurement of the oxygen saturation of retinal vessels is described. Imaging spectrometry was used for both measurements of transmission and reflectance spectra of whole blood in cuvettes as well as for fundus reflectance spectra. A model was developed for the calculation of the oxygen saturation, valid in the wavelength range between 510 nm and 586 nm, in that the internal reflectance is constant and only the transmitted light depends on layer thickness and hematocrit. Altogether 265 measurements were performed in different number at 30 eyes. In each measurement, the oxygen saturation was simultaneously determined for 193 locations along a line of 1.5 mm at the fundus. The mean oxygen saturation in retinal arteries was (92.2 +/- 4.1)% and (57.9 +/- 9.9)% in retinal veins. The mean retinal arterio-venous difference of the oxygen saturation was (35.1 +/- 9.5)%. The venous oxygen saturation depended on distance from the optic disc. The measured mean of the arterio-venous difference of the oxygen saturation corresponded well to the value of the brain (34%). The utilization of oxygen in the temporal quadrants (inferior: 39.4 +/- 10.4%) is significantly (p = 0.05) higher than in the nasal quadrants (inferior: 31.3 +/- 6.7%).

Adolescent↗
PubMed1998

[Bilateral endogenous endophthalmitis].

BACKGROUND: The endogenous endophthalmitis is a septic-metastatic late complication of a generalized bacterial or fungal infection or an asymptomatic fungaemia. Aspergillus organisms are a rare cause of endophthalmitis. Aspergillus ocular manifestations have been mostly reported in connection with immunosuppression, severe diseases or drug abuse. PATIENT AND METHODS: A 51-year-old man underwent a kidney transplantation, an immunosuppressive therapy, and, in addition, treatments for some other generalized diseases. Endogenous endophthalmitis was diagnosed in both eyes at an interval of about eight weeks. The treatment included pars-plana-vitrectomy on both eyes. RESULTS: At first, an endogenous endophthalmitis was found in the right eye which was assumed to be induced by bacteria. About eight weeks later, however, an endogenous endophthalmitis was diagnosed in the left eye, also, which was caused by Aspergillus. The patient received an intensive medical care including operative, antibacterial and antimycotic treatments. The bacterial endophthalmitis in the right eye was healed, and the state of the left eye was found to be post-operatively stabilized. Unfortunately, the patient died of a septic shock in systemic Aspergillus infection. CONCLUSION: Endogenous endophthalmitis has a very poor prognosis. To our knowledge, the described medical history seems to be the first reported case of an endophthalmitis on both sides, apparently caused by bacteria in one eye and by fungi in the other one.

Aspergillosis↗
PubMed1998

Nonproliferative diabetic retinopathy-reflection spectra of the macula before and after laser photocoagulation.

This study examines the influence of diabetic and laser photocoagulation on the reflection spectra of the macula. In the investigation 43 patients with type II diabetes mellitus and 33 normals were included. It was shown that the optical density in diabetics is increased compared to normals. After laser photocoagulation the reflection spectra have changed, suggesting a decrease in optical density. It is proposed that the therapeutic effect of photocoagulation in diabetic retinopathy is related to an alteration in blood flow in the choroid.

Adult↗
PubMed1997

[Endogenous endophthalmitis in severe generalized diseases].

BACKGROUND: In spite of modern antibacterial, antimycotic and operative therapies, endogenous endophthalmitis connected with other severe diseases and an impaired state of health is an eye complication with a very poor prognosis. PATIENTS: The study presents observations about the progress of the endogenous endophthalmitis in five eyes of four patients. The age of the patients ranged from 58 to 71 years. The span between the appearance of the first eye symptoms and hospital treatment amounted to 1 week and 3 months. The general diseases have been diagnosed as endometrium cancer, colon cancer, corpus uteri cancer (with intestinal fistula) and pancreatic insufficiency (with subclavian catheter) as well as diabetes mellitus. RESULTS: In regard to the infections we analyzed (Candida albicans in 3 eyes, bacteria in 2 eyes), very intensive medical treatment was initiated, including antibacterial or antimycotic therapy (local, subconjunctival, intraocular and systemic) as well as pars plana vitrectomy and/or vitreous puncture. Nevertheless, by the end of the clinical attendance, the following statements were established: one-eye enucleation, one-eye evisceration, two eyes perception of light, one eye visual acuity 0.2. CONCLUSION: The patients should be immediately admitted to a hospital with a department for vitreous surgery. Only with this option is it possible to initiate adequate therapy.

Aged↗
PubMed1997

Influence of laser coagulation therapy on untreated fellow-eyes in severe nonproliferative diabetic retinopathy-spectrometric results.

PURPOSE: The aim was to examine the influence of laser treatment on untreated fellow-eyes. METHODS: The effectiveness of the laser photocoagulation was investigated in 24 patients with type II diabetes mellitus and severe nonproliferative diabetic retinopathy. Using a spectrometric technique, the measurements in the macula were performed one day before laser coagulation and on the day directly following laser treatment. Further investigations took place 14 days and 6 weeks later. RESULTS: One day after coagulation, the reflection of the untreated fellow-eyes was found to be significantly increased between 530 and 600 nm, compared to the same eyes before coagulation. However, 14 days and 6 weeks after laser treatment alterations in the untreated eyes were no longer detectable. CONCLUSION: The choroidal blood volume seems to be decreased not only in coagulated eyes, but also in untreated fellow-eyes, and, presumedly, the choroidal blood flow is improved. Considering the short duration of these effects, a therapeutic consequence is not supposed.

Adult↗
PubMed1996

[Argon laser therapy of multiple eccrine cysts of sweat gland efferent ducts (eccrine hidrocystomas)].

BACKGROUND: Eccrine hidrocystomas are usually benign, solitary cystic tumors which are mainly treated by surgical measures. Treatment of the rare multiple lesions gets into difficulties because of complications. PATIENT AND METHODS: A 74-year-old woman showed multiple bilateral lesions on the eyelids. Histology revealed eccrine hidrocystomas. The lesions were treated by Argon laser. Laser parameters were as follows: 600-1000 microns spot size, 500-600 mW power, 0.1-0.2 s time. RESULTS: After 6 months follow up no recurrence of any of the tumors was observed. CONCLUSION: Argon laser proved to be successful to treat multiple eccrine hidrocystomas.

Aged↗
PubMed1993

[Substance analytic studies of the effectiveness of laser coagulation in diabetic retinopathy].

An order to optimize photocoagulation in diabetic retinopathy, it is necessary to have objective criteria concerning substance-specific fundus changes like blood, melanin, xanthophyl, cytochrome aa3, and light scattering. By means of fundus reflectometry macular reflectance spectra can be measured and are different in normals and in diabetics before or after treatment. If logarithmic difference spectra are used only pathological alterations or changes caused by the coagulation are demonstrable. These difference spectra can be approximated by a linear model function containing the extinction spectra of the substances mentioned above and a term for light scattering. Spectra deconvolution delivers coefficients, describing differences in the substance concentrations between diabetics before and after treatment and age-matched normals. When we examined these coefficients, we found that neither their behavior in diabetic retinopathy nor their reaction to photocoagulation is unique. Thus, it might be possible to obtain references to patient-specific adapted coagulation by deconvolution of the macular reflectance spectra measured before treatment. Classification of the patients in specific types of reaction, according to the shape of the logarithmic difference spectra or the results of the spectra deconvolution, could be a step in deciding on the success of the therapy on a case-to-case basis.

Adult↗