Biomedical subjects

J Faulborn

Publications and source records attributed to J Faulborn.

At least 19 recordsLinked to original sources

PubMed2004

[Dose-volume histogram regression analysis of uveal melanomas after single fraction gamma knife radiosurgery].

BACKGROUND: To evaluate tumor regression and sequelae in 30 uveal melanomas treated with Gamma Knife radiosurgery between 1992 and 1995 at the Gamma Knife center in Graz. PATIENTS: A total of 30 uveal and ciliary body melanomas were treated with a single fraction of the Gamma Knife. The mean marginal dose was 52.1 Gy, (median 50 Gy). Of the tumors, 15 were large (higher than 8 mm), 14 were medium sized (3-8 mm) and one was a small melanoma (<3 mm). Among them were 6 juxtapapillary, 10 (juxta-) maculary melanomas, 5 tumors located in the midperiphery and 9 ciliary body melanomas. METHOD: Dose-volume histogram analysis. RESULTS: After a maximum follow up of 9 years and 7 months, 8 tumors regressed into a scar, 17 tumors into a residual prominence between 50% and 80% of the initial tumor height, 3 tumors showed no change and in 2 patients recurrence was obvious. Sequelae were classified as mild (in 3 patients), moderate (3), severe (5) and very severe (19). CONCLUSIONS: Significant factors for the development of severe sequelae were the tumor volume and the marginal dose, the mean dose proved to be more important than the marginal dose and the irradiated volume more important than the selective critical dose.

Adult↗

PubMed2002

[A clinico-pathological case report of necrotizing ulcerating keratopathy due to topical anaesthetic abuse].

BACKGROUND: Topical anesthetic abuse is rare, but difficult to diagnose since most patients deny its use and the clinical changes are very similar to other corneal diseases. CASE REPORT: A 45-year-old medical doctor with a 30-year history of soft contact lens wear and recurrent corneal erosion was admitted to our clinic with a ring-shaped keratitis and intense ocular pain. A corneal smear was negative for bacterial infections and acanthamoeba but the contact lens box contained a few dead acanthamoeba and many cocci. Due to the clinical findings and the acanthamoeba found in the contact lens box acanthamoeba keratitis was diagnosed and treatment with gentamycin, pentamidine isethionat (Brolene((R))) and hexamidine (Desomedine((R))) was started. The clinical appearance did not change for 6 weeks after onset of treatment and a perforating corneal transplantation was performed for pain relief and visual rehabilitation. An iris ectropion lacking iris motility and dense cataract developed within 5 weeks and the patient admitted on direct questioning to having taken topical anesthetic (oxybuprocain) by self-medication. The histological investigation revealed few inflammatory cells. The epithelium was largely missing and few vital cells could be found in the stroma and the endothelial cell layer. Acanthamoeba could not be detected in the tissue. CONCLUSION: Topical anesthetic abuse can mimic different corneal diseases and be difficult to diagnose if the patient denies its use. In cases of keratitis with no response to treatment and strong ocular pain, topical anesthetic abuse should be considered.

Acanthamoeba Keratitis↗

PubMed2002

[Intracorneal silicone oil deposits].

BACKGROUND: A patient with intraocular silicone oildeposits underwent paracentral corneal incision but the corneal sutures were never removed and 7 years later a perforating corneal transplantation was performed due to corneal opacification. METHODS: The corneal button was fixed in 10% buffered paraformaldehyde, embedded in celloidin and sections 200 microns thick were cut and stained with van Gieson. Some of these sections were embedded in paraffin and 5 microns thick sections were cut. RESULTS: Celloidin sections showed intrastromal silicone oil droplets located adjacent to defects in Descemets' membrane and corneal sutures but the endothelial cells contained no silicone oil droplets. CONCLUSION: Silicone oil can penetrate the corneal stroma in cases of defects in Descemets' membrane.

Chronic Disease↗

PubMed2001

[Malignant melanoma of the ciliary body. A diagnostic problem].

BACKGROUND: Ciliary body melanoma is often diagnosed too late and therefore has a poor prognosis. The circular infiltration of the iridocorneal angle by malignant cells can lead to secondary glaucoma, often misdiagnosed as pigmentary glaucoma. MATERIAL AND METHODS: In a 40-year-old patient the diagnosis "atypical pigmentary glaucoma" was made due to elevated intraocular pressure and pigmentation of the iridocorneal angle; no changes were present in the iris. In a second case pronounced pigmentation of the chamber angle and secondary glaucoma led to the clinical diagnosis of a ring melanoma and resulted in enucleation of the globe. RESULTS: In the first case, increasing pigmentation of the chamber angle over 4 weeks led to the presumed diagnosis of a ring melanoma. Histopathological evaluation confirmed the diagnosis of a ring melanoma of the ciliary body. In the second case histology revealed retinal detachment with intraocular bleeding without intraocular melanoma. The pigmentation in the lower part of the chamber angle was due to hemosiderosis. CONCLUSION: Diagnosis of ciliary body melanomas may be difficult in some cases due to its similarity to other eye diseases. The differential diagnosis of malignant melanoma of the ciliary body should be considered in cases of unilateral pigmentary glaucoma.

Adult↗

PubMed2000

[Candida endophthalmitis in drug abuse. case report.

BACKGROUND: Endogenous fungal endophthalmitis is mostly seen as opportunistic infection, particularly in immunocompromised patients and under special risk factors. The therapeutical approach and the value of vitrectomy in diagnosis and therapy are discussed. PATIENT: A 42-years-old intravenous heroin addicted male patient with unilateral Candida albicans endophthalmitis, determined by cultivation is presented. The visual acuity at initial was 20/25 but decreased to hand-movements within 14 days despite systemic therapy. Treatment with systemic Fluconazole was extended and vitrectomy performed. The infection resolved but left a scar in the macula. The patient recovered a visual acuity of 20/80. CONCLUSION: Candida albicans endophthalmitis is a dreaded situation in ophthalmology. It has poor visual prognosis if left untreated. Therefore immediate diagnosis and aggressive therapy, if necessary vitrectomy are required.

Adult↗

PubMed2000

Tractional retinoschisis in proliferative diabetic retinopathy: a histopathological study.

BACKGROUND: Proliferative diabetic retinopathy (PDR) often results in a tractional elevation of the retina. This study investigates the anatomical and histopathological structures of the vitreous body and the elevated retina in PDR. METHODS: Four globes (three patients) with PDR and known retinal elevation were analysed histologically. The tissues were embedded in celloidin and a special thick section technique (250 microm) was used for analysis under a stereomicroscope. RESULTS: All four cases showed adherence of the vitreous body with the retina and a tractional elevation of the retina at that site. In two cases retinoschisis was combined with retinal detachment and in the other two cases the retinal elevation was a pure retinal schisis. CONCLUSION: Our histopathological investigations of PDR show that traction of the retina by shrinking of the vitreous body may result in a combination of retinoschisis and retinal detachment at the same area. These cases are clinically often diagnosed as retinal detachment, but because of the additional retinal schisis they are of poor functional prognosis.

Adult↗

PubMed2000

Morphologic characteristics of disciform scarring after radiation treatment for age-related macular degeneration.

OBJECTIVE: To investigate the influence of radiation therapy on the development of disciform lesions in patients with age-related macular degeneration (AMD). DESIGN: A prospective, nonrandomized, comparative trial (patient self-controlled). PARTICIPANTS: Forty eyes with exudative AMD involving the central fovea in 40 consecutive patients were enrolled in this study. INTERVENTION: Radiation was administered to the posterior pole with an 8-mV photon beam from a linear accelerator. A dose of 14.4 Gy, 1.8 Gy per day, five fractions per week was delivered through a single port. MAIN OUTCOME MEASURES: The visual acuity and the morphologic characteristics, demonstrated by fundus photography, fluorescein, and indocyanine green angiography, were investigated before treatment and every 3 months after treatment over a period of 24 months. In 10 patients with bilateral disease the disciform lesions were compared. RESULTS: Twenty five patients could be followed regularly over the period of 24 months. The disciform lesions occurring after radiation were classified in three types. Type I (10 patients) was characterized by being smaller than 2 DD in size, with little fibrotic tissue underneath the retina, but pronounced retinal pigment epithelial changes. Type II (seven patients) showed extensive growth of the choroidal neovascularization (CNV) extending to and beyond the arcades with angiographically active loops in the peripheral parts. Eight patients had type III lesions develop characterized by a size greater than 2 DD but fewer than 6 DD and by a different amount of fibrotic tissue, hemorrhage, and lipid. Type I scarring was significantly associated with occult CNV without pigment epithelial detachments, whereas type II scarring was associated with classic CNV at the initial presentation (P<0.05). CONCLUSIONS: Although no severe side effects have been reported after radiation therapy for AMD, a subgroup of patients may experience extensive growth of CNV after radiation, causing greater functional damage than occurs spontaneously.

Aged↗

PubMed2000

Synthesis pattern of matrix metalloproteinases (MMPs) and inhibitors (TIMPs) in human explant organ cultures after treatment with latanoprost and dexamethasone.

PURPOSE: To determine changes in production of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in the ciliary body, the trabecular meshwork and the retinal pigment epithelium induced by both prostaglandins and corticosteroids. METHODS: Explant organ cultures were removed by a scleral incision 3 mm posterior to the limbus. Retinal pigment epithelium was grown to confluence. Organ and cell cultures were treated with latanoprost and/or dexamethasone for 72 h. The activity of MMP-2, -3 and -9 was assessed using zymography. The synthesis pattern of MMPs and TIMP-1 and -2 was identified using immunostaining. RESULTS: Treatment of explant organ cultures with 10 micrograms/ml of latanoprost induced a mean upregulation of MMP-2 by 36%, MMP-3 by 112% and MMP-9 by 156% as seen by zymography. Dexamethasone 500 nm reduced the amounts of secreted MMP-2 by 13%, MMP-3 by 69%. MMP-9 was not detectable in the media of corticosteroid-treated explant organ cultures. The addition of 10 micrograms/ml of latanoprost to dexamethasone-treated cultures increased MMP-2 by 14%, MMP-3 by 43% and MMP-9 by 49%. Using immunohistochemistry we found staining with antibodies against MMP-2, -3, -9 and TIMP-1 and -2 within the ciliary body, and only to a lesser degree in the trabecular meshwork. Latanoprost treatment caused an increase of 29% in MMP-2 (p < 0.0001), 98% in MMP-3 (p < 0.0001) and 108% in MMP-9 (p < 0.0001). Dexamethasone reduced the staining for MMP-2 by 32% (p < 0.0001), for MMP-3 by 33% (p < 0.0001) and for MMP-9 by 83% (p < 0.0001). Almost no change in staining for MMPs was detectable in the trabecular meshwork. Neither latanoprost treatment nor dexamethasone induced significant changes (p < 0.93) in the secretion of TIMPs. In the media of non-treated retinal pigment epithelium (RPE) cells the only MMP detected was MMP-2. RPE cells in culture did not respond to either treatment with a change in their MMP secretion. CONCLUSION: We detected a profound upregulation of both MMP-3 and MMP-9 and a mild induction of MMP-2 through latanoprost in the ciliary body, but not the trabecular meshwork or RPE cells. Corticosteroids, on the other hand, downregulated MMP expression in both tissues. This inhibiting effect of corticosteroids on MMP production was reversed by latanoprost.

Aged↗

PubMed2000

[Hospital data management at the Graz University Ophthalmology Clinic].

In 1991, the eye hospital at the University of Graz initiated the development of a system for the documentation of patient data and services provided. The starting point of the hospital data management system was the surgical documentation system. This made it possible for the patient to be transferred to the ward accompanied by the completed and signed surgical report. In the subsequent steps we developed a complete client server system adapted to the different specific needs of all the various sections of the eye hospital. A further important feature is the fact that all the data are available for access at every part of the hospital. The current version has been in use since 1996, and will be discussed below. The main features of our hospital data management system are automated coding of medical services provided in the diagnostic, surgical and outpatient areas, and guaranteed authenticated data. Automatic generation of findings, reports, etc, allows the physician to concentrate fully on medical concerns. For a modern, service-oriented hospital, complete records of the services provided are indispensable. Complete recording of services is, however, possible only via automation. In our case, this means not only that the available data are always correct (up to date), but also that there is wide acceptance of and reliance on these data by the medical staff. Since the system is an in-house development, it is possible to react rapidly to suggestions for improvement and to eliminate possible errors immediately. The hospital data management system of the eye hospital at the University of Graz is a well-functioning example that makes it worthwhile discussing the greater use of subsystems.

Austria↗

PubMed1999

[Quantifying the damage to conjunctival and corneal cell cultures caused by uv light using CASY (Cell Analysis System). A method for reducing animal experiments].

BACKGROUND: By depletion of stratospheric ozone, enhanced levels of UV radiation reach the surface of the earth. Exposure of the anterior parts of the eye to UV radiation leads to irritation of the conjunctival and corneal cells. METHOD: By the CASY (cell analysis) system the influence of UV radiation on cultures of conjunctival and corneal cells was observed by determination of the cell counts, cell diameter, and the cell volume. RESULTS: By comparing these parameters with the control, damage of the conjunctival and corneal cells by UV radiation can be determined within 2 s of exposure of the cells in quartz glass vials to the UV light. CONCLUSION: By the CASY system the dramatic influence of UV radiation on cells of the anterior parts of the eye can be determined. This system enables objective statements on the cytotoxicity of radiation, chemical substances and drugs on cell cultures without the use of radioactive methods, complicated determination of cell metabolism or staining methods which are difficult to standardize. Also, studies on animals can be reduced by the CASY system.

Animal Testing Alternatives↗

PubMed1999

Sclerotomy in uveal effusion syndrome.

PURPOSE: To report visual and anatomic outcomes after modified scleral surgery in patients with uveal effusion syndrome with retinal and choroidal detachment. METHODS: In five eyes of four patients with retinal and choroidal detachment and uveal effusion syndrome due to nanophthalmos, we performed pars plana full-thickness unsutured sclerotomies without sclerectomy. RESULTS: In all cases, uveal effusion with choroidal and retinal detachment resolved within 3 weeks, and all patients showed improved vision. The functional and anatomic results remained stable for over 2 years. CONCLUSIONS: Uveal effusion syndrome that is refractory to medical treatment (high-dose systemic corticosteroids) can be managed effectively by pars plana full-thickness unsutured sclerotomy without sclerectomy.

Adult↗

PubMed1998

[Immunohistologic studies of the vitreous humor].

BACKGROUND: Immunohistological staining of the vitreous is difficult because of its high water content. We present a method for immunohistological staining of celloidin-embedded eyes. Results from diabetic and non-diabetic eyes are demonstrated. METHOD: Diabetic and non-diabetic eyes were firstly immersed in formol and then slowly dehydrated using rising concentrations of glycerine (sink method). Subsequently, the whole globe was embedded in celloidin and cut into 200-micron sections. Control areas of interest were dissected from the 200 microns sections under a lightmicroscope. These specimens were then embedded in paraffin and cut into 7-micron sections. The 7-micron sections were immunohistochemically stained for type I-collagen, type IV-collagen, fibronectin and laminin. RESULTS: This method makes immunohistochemical staining of the vitreous possible. Type IV collagen, laminin and fibronection were found at higher concentrations in diabetic eyes than in normal eyes. Type I collagen was detected in neither diabetic nor in normal eyes. CONCLUSIONS: Our method of examination allows immunohistological staining of the vitreous in its place of origin. Although our method is time consuming, it has some advantages over biochemical analysis: Even minimal changes and their exact distribution can be detected. Our first results show that the vitreous is built up inhomogeneously and that pathological influence can cause structural changes.

Aged↗

PubMed1998

Echographic findings in uveal melanomas treated with the Leksell gamma knife.

BACKGROUND/AIMS: Between June 1992 and July 1995, 29 uveal melanomas were treated radiosurgically with the Leksell gamma unit at the University of Graz. The aim of this retrospective study was to examine the pattern of regression and the extent and time period of the decrease in tumour size. METHODS: The Leksell gamma knife, model B, was used. Patients were divided into three groups according to marginal dose: group 1: eight patients with a marginal dose > 50 Gy, group 2: 15 patients with a marginal dose = 50 Gy, and group 3: six patients with a marginal dose = 45 Gy. For the retrospective study two groups were examined: group A, tumours < 5 mm and group B, tumours > or = 5 mm. RESULTS: No significant correlation was found between tumour regression and the marginal dose. Tumour shrinkage depends on the pretreatment height. In the group of eight patients with an initial tumour prominence of less than 5 mm, no prominence was found after therapy. In the group of patients with an original tumour prominence of 5 mm and more, only two tumours formed a flat scar while a residual prominence was found in 18 patients. Increase in reflectivity combined with a decrease in size appears to be a good criterion for the effectiveness of the treatment. In five patients with tumours showing low reflectivity, over a longer period of time metastases were found. An enucleation was performed in two patients because of uncertain tumour regression and in one patient as a result of an increase in tumour size. CONCLUSION: The pattern of echographic reflectivity and decrease in size is similar to brachytherapy and is one of the most important diagnostic variables for evaluation of tumour regression. An increase in reflectivity as well as a decrease in tumour size in the first 6-8 months can be considered a therapeutic success.

Adult↗

PubMed1998

Diabetic vitreopathy--findings using the celloidin embedding technique.

BACKGROUND: To evaluate the role of the vitreous in diabetic eyes, autopsy eyes from diabetic patients have been examined by means of light and electron microscopy. METHODS: Twenty-five eyes were obtained from 19 patients. The duration of diabetes was from 8 to 26 years (average 17 years). All patients had type II diabetes. The glycerol-dehydrated globes were embedded in celloidin and hardened with chloroform. For light microscopy, areas of interest were cut from 200-microm-thick celloidin sections and embedded in paraffin, and 10-microm sections were cut. Such 200-microm and 10-microm sections were also used for scanning electron microscopy. For transmission electron microscopy, areas of interest were cut from thick celloidin sections and embedded in Epon for thin sectioning. RESULTS: The vitreous in diabetic eyes exhibits delayed senile degeneration in case of early onset of diabetes. It shows intensified staining of the vitreous cortex. Posterior detachment is often incomplete without collapse. The vitreous collagen fibers are coarse and aggregated in the centrally located cortical region of the vitreous. Hyalocytes in diabetic eyes have a different shape than normally, and their number seems to be increased. All these structural changes were not demonstrated in nondiabetic eyes. CONCLUSION: The vitreous in diabetic patients is morphologically different from normal vitreous. Features of the diabetic vitreous are aggregated collagen fibers, increased density of the vitreous cortex and morphological changes of hyalocytes. It is discussed whether these findings arise from nonenzymatic glycosylation of collagen molecules resulting in diabetic vitreopathy.

Adolescent↗

PubMed1997

Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study.

BACKGROUND: Heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) eliminates selectively fibrinogen, LDL, cholesterol, triglycerides and LP(a) from blood plasma using extracorporeal circulation. The reduction of fibrinogen and LDL by about 50% after only one procedure immediately improves the hemorheological situation. METHOD: In a prospective, randomized, controlled study over a period of 3 months, 40 patients with nonarteritic ischemic optic neuropathy (NAION) were randomly assigned to either HELP or hemodilution therapy to determine the efficacy of these two treatments on visual acuity and fields. RESULTS: After transformation of the Snellen acuity into logMAR units the statistical analysis did not show a significant difference between the two groups (P = 0.48). An increase of the visual acuity by two or more lines was obtained in 9 patients (47.4%) of the HELP group, 10 (52.6%) remained stable and none got worse. In the hemodilution group, visual acuity increased in patients (33.4%), 9 (42.8%) remained stable and 5 (23.8%) experienced a decrease. The calculated mean sensitivity of visual fields at baseline improved statistically significantly (P < 0.01) in the HELP group from 6.83 +/- 4.52 dB to 8.27 +/- 4.89 dB, but did not change significantly in the hemodilution group (6.25 +/- 4.12 dB to 6.12 +/- 3.92 dB). CONCLUSION: The HELP system seems to be safe and more effective than hemodilution in improving the hemorheological and the functional situation in NAION and could be a promising regimen in the treatment of NAION.

Aged↗

PubMed1997

Morphologic studies of the peripheral vitreoretinal interface in humans reveal structures implicated in the pathogenesis of retinal tears.

PURPOSE: The ultrastructural nature of the preequatorial vitreoretinal interface was studied to elucidate the predisposing role for peripheral retinal tear formation. METHODS: Fourteen enucleated globes from seven decreased patients were examined. The patients ranged in age from 16-88 years, with an average age of 40 years. None of the patients had a history of ocular or systemic disease that could have affected the eyes. Globes were examined by stereomicroscopy and by light and electron microscopy using the celloidin embedding method. RESULTS: On examination we found several structures in addition to tufts and rosettes. In the vitreous cortex, fibrillar structures with no vitreoretinal attachment to the retina frequently were found. We propose that these structures be called "tubuli" because of their spiral appearance. Mushroom-like structures, which we propose be referred to as "spiculae," were found to arise from the intact internal limiting lamina of the retina and to insert into the vitreous cortex, constituting foci of vitreoretinal adhesion. Other structures, which we propose be called "verrucae," arose from the disrupted internal limiting lamina of the retina and inserted into disrupted areas of vitreous cortex. CONCLUSIONS: Tubuli appear to be remnants of the embryonic vasculature with no clinical or pathologic significance. Because of their pattern of inserting into the internal limiting lamina of the retina and the peripheral vitreous cortex, spiculae and verrucae may play an important role in the formation of retinal breaks.

Adolescent↗

PubMed1997

The effect of retinal cryoapplication on the vitreous.

PURPOSE: The effect of retinal cryopexy on the vitreous was studied morphologically in an animal model. METHODS: The retina and vitreous were frozen with single cryolesions on one eye and 24 contiguous cryolesions on the contralateral eye in 16 rabbits. The cryoprobe was applied to the sclera from 3 mm to 6 mm posterior to the limbus at -60 degrees C until ophthalmoscopically visible whitening occurred. Two animals were killed on the first day; the third day; after 1, 2, and 4 weeks; and after 2, 3, and 6 months after surgery. The eyes were enucleated and prepared by the celloidin embedding method. Each 200-microgram section was examined by light microscopy. Areas of the specimens were dissected and studied by scanning and transmission electron microscopy. RESULTS: Single cryolesions did not have a significant generalized effect on the vitreous. Evidence of local collagen destruction and dispersion of cells was found near the area of cryoapplication. Contiguous cryoapplication led primarily to increased density in the vitreous and subretinal edema. The vitreoretinal border was invaded by mononuclear cells containing pigment granules. Thickened collagen fibers were attached to the coagulated retina in a perpendicular manner and traversed the whole vitreous body. After 4 weeks the increased vitreous density slowly diminished, and preretinal capillaries surrounded by vitreous collagen started to proliferate from the vitreoretinal interface. After 6 months central vitreous collagen fibers looked normal. In the area of cryoapplication, vitreoretinal membrane formation had occurred. CONCLUSION: Single cryolesions have no significant effect of the vitreous. Multiple cryolesions lead to neovascularization soon after the procedure (1 month) and membrane formation later (6 months after the procedure). This supports the concept that the extensive use of cryopexy in human retinal surgery could contribute to the development of proliferative vitreoretinopathy.

Animals↗

PubMed1996

Influence of a single HELP application on hemorheology and retinal hemodynamics.

The heparin-induced extracorporeal low-density lipoprotein precipitation (HELP) eliminates selectively fibrinogen, total cholesterol, low-density lipoproteins (LDL) and triglycerides and improves hemorheology. We investigated the hemodynamic changes in 10 patients without ocular diseases performing a video fluorescein angiography after a single HELP procedure measuring the arm-retina time (ART) and the arteriovenous passage time (AVP). Laboratory parameters such as fibrinogen, cholesterol, LDL, triglycerides, red cell transit time, plasma and whole-blood viscosity were determined and retinal circulation was measured immediately before and after the HELP application. All of the laboratory parameters were lowered significantly. The ART was unaffected by the HELP procedure; however, there was a significant AVP reduction from 2.41 +/- 0.49 to 1.97 +/- 0.47 (p < 0.005). These results support the hemorheological and hemodynamic efficiency of the HELP system in microcirculatory diseases.

Adult↗