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Biomedical subjects

Jost B Jonas

Publications and source records attributed to Jost B Jonas.

At least 37 records · Page 2Linked to original sources
PubMed2006

Frequency of optic disk hemorrhages in adult chinese in rural and urban china: the Beijing eye study.

PURPOSE: To determine the frequency of optic disk hemorrhages in the adult Chinese population. DESIGN: Population-based prevalence survey. METHODS: The study included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4%) with an age of 40+ years. Mean age was 56.2 +/- 10.6 years. Color optic disk photographs (45 degrees) were morphometrically examined. RESULTS: Optic disk photographs were available for 8655 eyes of 4378/4439 (98.6%) subjects. Prevalence of disk hemorrhages was 107/8655 (1.24%; 95% confidence interval (CI): 1.00%, 1.47%) eyes. Occurrence of disk hemorrhages was significantly associated with glaucomatous optic nerve damage (P < .001; OR: 9.3; 95% CI: 5.6, 15.4) and age (P = .008; 95% CI: 1.01, 1.05). The occurrence of disk hemorrhages was not significantly associated with intraocular pressure (IOP) (P = .63; 95% CI: 0.97, 1.06), refractive error (P = .06; 5% CI: 0.87, 2.18), and visual field score (P = .81; 95% CI: 0.96, 1.03). Defining glaucoma as glaucomatous optic disk appearance, 20/107 (18.7%; 95% CI: 11.2%, 26.2%) disk hemorrhages were found in glaucomatous eyes. Out of 226 glaucomatous eyes, 20/226 (8.8%; 95%CI: 5.12%, 12.58%) eyes showed a disk hemorrhage. Hypertensive glaucoma eyes and normotensive glaucoma eyes did not vary considerably in frequency of disk hemorrhages (P = .44; OR: 1.82; 95% CI: 0.59, 5.68). CONCLUSIONS: Disk hemorrhages occur in a frequency of approximately 1.2% in adult Chinese. Major associated factors are glaucomatous optic neuropathy and age. Presence of a disk hemorrhage suggested glaucomatous optic nerve damage with a positive predictive value of approximately 20%. About 9% of glaucomatous eyes showed a disk hemorrhage at the time of examination.

Adult↗
PubMed2006

Retinal vascular abnormalities and prevalence of age-related macular degeneration in adult Chinese: the Beijing Eye Study.

PURPOSE: To evaluate whether retinal vessel abnormalities are associated with early or late age-related macular degeneration (AMD) in adult Chinese. DESIGN: Population-based prevalence study. METHODS: The Beijing Eye Study included 4439 (83.4%) subjects of 5324 living in a rural area or urban region of Greater Beijing, age older than 40+ years, and invited to participate. The participants underwent a detailed ophthalmic examination, including fundus photography. The photographs were graded using the Wisconsin Age-Related Maculopathy Grading system for evaluation of AMD, and using the Atherosclerosis Risk in Communities protocol for assessment of retinal vascular abnormalities. We examined focal and generalized arteriolar narrowing, arteriolar sheathing, and arteriovenous crossing abnormalities. RESULTS: Fundus photographs were available for 8655 eyes of 4376 (98.6%) subjects. Neither early nor late AMD was significantly (P > .15) associated with any of the retinal vascular abnormalities. CONCLUSIONS: Retinal vascular abnormalities are not markedly associated with the prevalence of early or late AMD.

Adult↗
PubMed2006

Retinal pigment epithelium tear after intravitreal bevacizumab for exudative age-related macular degeneration.

PURPOSE: To report on the development of retinal pigment epithelium tears after intravitreal injections of bevacizumab as treatment of exudative age-related macular degeneration (AMD). DESIGN: Interventional case series. METHODS: The study included 63 patients who received an intravitreal injection of 1.5 mg bevacizumab as treatment of a detachment of the retinal pigment epithelium attributable to AMD and who had a follow-up of at least two months. RESULTS: Four patients (6%) developed a tear of the retinal pigment epithelium in the parafoveal region. Compared with the baseline value, visual acuity at the end of follow-up remained stable in three patients and declined in the fourth patient. CONCLUSIONS: Intravitreal injections of bevacizumab may be followed by a tear of the retinal pigment epithelium in eyes with exudative AMD and a retinal pigment epithelium detachment.

Angiogenesis Inhibitors↗
PubMed2006

Prevalence and risk factors of lens opacities in urban and rural Chinese in Beijing.

OBJECTIVE: To determine the prevalence of lens opacities in the elderly Chinese population in an urban and a rural region of Beijing. DESIGN: Population-based cross-sectional study. PARTICIPANTS: The study included 4439 subjects of 5324 subjects invited to participate (response rate, 83.4%). The subjects were divided into a rural part (1973 subjects [44.4%]) and an urban part (2466 subjects [55.6%]). The study was limited to participants age 40 and older, and the mean age was 56.2+/-10.6 years (range, 40-101 years). METHODS: Nuclear, cortical, and posterior subcapsular lens opacities were assessed based on standardized slit-lamp photographs of the lens using a modification of the grading score of the Age-related Eye Disease Study (AREDS). MAIN OUTCOME MEASURES: Grading score of the AREDS. RESULTS: Lens data were provided for 4378 subjects (98.6%) of 4439 persons examined, which consisted of 8724 eyes. Prevalence of any cataract surgery was 1.3% (95% confidence interval [CI]: 1.0-1.7), which was statistically independent of gender (P = 0.51; odds ratio [OR]: 0.86; 95% CI: 1.00-1.34), rural area versus urban region (P = 0.25), and level of education (P = 0.84). Prevalence of any nuclear lens opacity was 82.0% (95% CI: 80.8-83.2); prevalence of any cortical lens opacity was 10.3% (95% CI: 9.4-11.3); and prevalence of any posterior subcapsular opacity was 4.3% (95% CI: 3.7-4.9). If grade 2 of nuclear lens opacity was considered to be normal, prevalence of nuclear cataract was 50.3% (95% CI: 48.8-51.8), and the overall prevalence of any cataract was 53.1% (95% CI: 51.6-54.6), increasing from 6.5% (95% CI: 5.2-7.8) in those subjects 40 to 49 years of age to 52.3% (95% CI: 47.4-55.3) in those who were 50 to 59 years of age, and to 97.8% (95% CI: 96.4-99.2) in those 70 years and older (P<0.001). Frequencies of any cortical cataract and any subcapsular posterior cataract were 10.3% (95% CI: 9.4-11.3) and 4.3% (95% CI: 3.7-4.9), respectively. CONCLUSIONS: Cataracts are common among adult Chinese residents in Beijing, with age as the most important associated factor. In view of the relatively low rate of cataract surgery performed so far, one may expect a marked increase in the number of cataract surgeries to meet the visual needs of the growing elderly population in China.

Adult↗
PubMed2006

Duration of the effect of intravitreal triamcinolone acetonide in eyes with exudative age-related macular degeneration.

OBJECTIVE: The aim of this study was to evaluate the duration of the effect of an intravitreal injection of approximately 20 mg of triamcinolone acetonide (TA) on visual acuity and intraocular pressure (IOP) in patients with exudative age-related macular degeneration (AMD) with subfoveal choroidal neovascularization. PARTICIPANTS: The prospective, clinical, interventional, case series study included 69 patients (71 eyes) with exudative AMD who showed an increase in visual acuity by at least 2 Snellen lines after an intravitreal injection of approximately 20 mg TA. Mean follow-up was 11.5 +/- 7.4 months (3.3-35.7 months). The main outcome measure was visual acuity. RESULTS: Within the first week after the injection, visual acuity and IOP started to increase significantly (P < 0.001) by reaching a plateau-like maximum at 1-6 months after the injection. Visual acuity and IOP returned to baseline values 7-9 months after the injection. Increase of IOP was statistically (P = 0.72) independent of the change in visual acuity. CONCLUSIONS: In patients with exudative AMD, who have shown an increase of at least 2 Snellen lines in visual acuity, the effect of intravitreal TA (dosage approximately 20 mg) lasts 7-9 months with respect to an increase in visual acuity and IOP.

Aged↗
PubMed2006

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

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

Aged↗
PubMed2006

Triamcinolone acetonide-induced ocular hypertension.

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

Adult↗
PubMed2006

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

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

Aged↗
PubMed2006

Intravitreal triamcinolone acetonide for persisting cystoid macular edema after penetrating keratoplasty.

PURPOSE: The intravitreal application of triamcinolone acetonide as treatment of long-standing, therapy-resistant cystoid macular edema after penetrating keratoplasty is reported. METHODS: A 44-year-old patient showed therapy-resistant cystoid macular edema for 2 years after repeated penetrating keratoplasty was performed as treatment of keratoconus. The crystalline lens was clear. The patient received an intravitreal injection of approximately 20 mg of triamcinolone acetonide. Preinjection visual acuity measured 20/80. RESULTS: Within the first 4 weeks after the injection, dense cataract developed necessitating cataract surgery. After phakoemulsification, visual acuity improved to 20/50. Optical coherent tomography and fluorescein angiography showed an almost complete resolution of cystoid macular edema. Ten months after the injection, visual acuity remained at 20/50, and intraocular pressure measured 15 mm Hg without antiglaucomatous therapy taken. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide may be an additional tool in the treatment of therapy-resistant cystoid macular edema after penetrating keratoplasty. After intravitreal injection of triamcinolone acetonide, cataract may rapidly develop in eyes that have been intensively treated, topically and systemically, by corticosteroids for several years.

Adult↗
PubMed2006

Optical coherence tomography of the optic nerve head: interindividual reproducibility.

PURPOSE: Optical coherence tomography may be a new technique for quantitative 3-dimensional assessment of the optic nerve head for diagnosis of optic nerve anomalies and diseases such as the glaucomas. The purpose of the present study was to examine its reproducibility. PATIENTS AND METHODS: The clinical noninterventional study included 10 randomly chosen eyes of 10 healthy individuals who underwent 24 optical coherence tomographic examinations with the high-resolution and fast scan program, interactively corrected or uncorrected. The pupils were not dilated. All examinations were performed by 3 examiners independently of one another. The coefficient of variation was calculated as the ratio of the mean of the standard deviations divided by the mean of the means. RESULTS: The coefficients of variation for redetermination of optic disc area, ranging between 0.047 and 0.119, were lowest for the manually corrected fast scan mode and highest for the uncorrected fast scan mode. For remeasurements of the neuroretinal rim area, the best mean coefficient of variation was 0.073+/-0.026 (corrected fast scan mode). CONCLUSIONS: In healthy eyes, the morphometric measurements of the optic nerve head by optical coherence tomography show a relatively high reproducibility with mean coefficients of variation lower than 10% for remeasurements of the optic disc and neuroretinal rim area. With undilated pupils, reproducibility is better with the fast scan mode with interactive correction of the outlining of the optic disc border than it is with the high-resolution mode.

Adult↗
PubMed2006

Keratometry, optic disc dimensions, and degree and progression of glaucomatous optic nerve damage.

PURPOSE: To evaluate whether keratometric readings as a measure of corneal shape are associated with optic disc dimensions and with the degree and rate of perimetric progression of chronic open-angle glaucoma or ocular hypertension. METHODS: The hospital-based observational study included 1826 eyes of 936 patients with ocular hypertension, patients with chronic open-angle glaucoma, or normal individuals. For 733 ocular hypertensive or glaucomatous eyes, follow-up examinations were performed with a mean follow-up time of 58.0+/-34.7 months. Observation procedures were keratometry, morphometric optic disc analysis, tonometry, and perimetry. RESULTS: In the normal study group, area of the neuroretinal rim, alpha zone and beta zone of parapapillary atrophy, and retinal vessel diameter were not significantly associated with keratometric readings. In the entire study population, the optic disc area was significantly (P<0.001; r=-0.27) correlated with low keratometric readings as expressed in diopters. Keratometric readings were significantly (P<0.001 adjusted for age, intraocular pressure, baseline damage, and corneal asphericity) smaller in the normal-pressure glaucoma group than in the normal study group and in the groups with ocular hypertension or primary and secondary open-angle glaucoma. Rate of perimetric progression was not significantly associated with low keratometric readings, either in simple or in multiple Cox regression analysis, controlling for baseline damage, ocular hypertension, age, corneal asphericity, and intraocular pressure. CONCLUSIONS: Large optic disc area is statistically significantly, but clinically weakly, correlated with low keratometric readings (diopters). In Caucasian individuals with ocular hypertension and patients with chronic open-angle glaucoma, the rate of development or progression of glaucomatous visual field defects is not significantly associated with keratometric readings.

Adolescent↗
PubMed2005

Frequency of under-corrected refractive errors in elderly Chinese in Beijing.

PURPOSE: The aim of the study was to evaluate the prevalence of under-corrected refractive error among elderly Chinese in the Beijing area. METHODS: The population-based, cross-sectional, cohort study comprised 4,439 subjects out of 5,324 subjects asked to participate (response rate 83.4%) with an age of 40+ years. It was divided into a rural part [1,973 (44.4%) subjects] and an urban part [2,466 (55.6%) subjects]. Habitual and best-corrected visual acuity was measured. Under-corrected refractive error was defined as an improvement in visual acuity of the better eye of at least two lines with best possible refractive correction. RESULTS: The rate of under-corrected refractive error was 19.4% (95% confidence interval, 18.2, 20.6). In a multiple regression analysis, prevalence and size of under-corrected refractive error in the better eye was significantly associated with lower level of education (P<0.001), female gender (P<0.001), and age (P=0.001). CONCLUSIONS: Under-correction of refractive error is relatively common among elderly Chinese in the Beijing area when compared with data from other populations.

Adult↗
PubMed2005

Intravitreal triamcinolone acetonide for treatment of intraocular proliferative, exudative, and neovascular diseases.

Within the last three years, triamcinolone acetonide has increasingly been applied intravitreally as treatment option for various intraocular neovascular edematous and proliferative disorders. The best response in terms of gain in visual acuity after the intravitreal injection of triamcinolone acetonide was found in eyes with intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. Visual acuity increased and degree of intraocular inflammation decreased in eyes with various types of non-infectious uveitis including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal triamcinolone may be helpful as adjunct therapy for exudative age-related macular degeneration, possibly in combination with photodynamic therapy. In eyes with chronic, therapy resistant, ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and non-infectious endophthalmitis, and pseudo-endophthalmitis. Intravitreal triamcinolone injection can be combined with other intraocular surgeries including cataract surgery. Cataract surgery performed some months after the injection does not show a markedly elevated rate of complications. If vision increases and eventually decreases again after an intravitreal triamcinolone acetonide injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone depended on the dosage given. Given in a dosage of about 20mg to non-vitrectomized eyes, the duration of the effect and of the side-effects was 6-9 months. Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular edematous and neovascular disorders. One has to take into account the side-effects and the lack of long-term follow-up observations.

Exudates and Transudates↗