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Biomedical subjects

S Hörle

Publications and source records attributed to S Hörle.

8 recordsLinked to original sources
PubMed2005

[Transient visual decrease after photodynamic therapy].

BACKGROUND: After photodynamic therapy (PDT) some patients complain about a transient decrease of visual acuity during the first postoperative week. PATIENTS AND METHODS: Prior to and at 2 days and 1 week after PDT the following parameters were measured: (1) best corrected visual acuity (VA), (2) changes in refraction, and (3) A scan ultrasound biometry was carried out. Linear and 3-D optical coherence tomography was performed in three cases. A total of 53 PDT treatments were followed-up in 24 patients. RESULTS: Comparison of the pre- and postoperative refraction demonstrated a mean hyperopic shift of +0.35 diopters (dpt) in 43% of treatments (23/53) on the second postoperative day. The hyperopic shift reduced to +0.07 dpt after 1 week. The best corrected VA remained stable or was even better in 68% (36/53) on the second postoperative day. A decrease in VA could be noticed in 32% (17/53) at this time which declined to 23% (12/53) after 1 week. Measurement of the cornea-retina distance using A-scan ultrasound biometry disclosed a mean axial reduction of 0,13 mm at the second postoperative day. This correlates closely with an average hyperopic shift of 0,35 dpt. OCT examination disclosed a transient macular edema in the treated retinal areas. CONCLUSIONS: A transient hyperopic shift can be measured in 43% on the second postoperative day. The subjective decrease in visual acuity measured over the postoperative days was mainly due to a transient hyperopic shift in our patients. OCT findings disclosed a transient macular edema of the retina treated with PDT, which may relate to a hyperopic shift.

Aged↗
PubMed2004

[Massive subretinal hemorrhages. A challenge for vitreous body surgeons].

BACKGROUND: In patients with advanced age-related macular degeneration (AMD), massive subretinal hemorrhage may sometimes be the reason for a loss of peripheral vision, leading to a significantly reduced quality of life. PATIENTS AND METHODS: During the years 1995-2001 we operated five eyes (five consecutive patients) with acute massive subretinal hemorrhage extending into all four quadrants and profoundly reduced vision in the fellow eye due to a Junius-Kuhnt macular scar. Within an interval of 1-2 weeks after the bleeding, pars plana vitrectomy with peripheral retinotomy was performed. After the retina was turned upside down and the partially liquified blood was removed, the underlying subfoveal CNV membrane was removed with a vitrectome. Three phakic eyes required additional cataract surgery and IOL implantation. The retina reattached under PFCL and a silicone oil tamponade applied for 3-6 months. RESULTS: The removal of the subretinal hemorrhage was without complications. The size of the subretinal membrane was between 4 and 6 PD with partially fibrovascular tissue. After the membrane was removed, a large central pigment epithelium defect made a macular rotation impossible. Visual acuity of hand motion improved from preoperatively 0.05 to postoperatively 1/35 to 0.1 after a follow-up of 3-6 months. CONCLUSION: In patients with such an extremely reduced visual acuity and visual field, subretinal surgery with removal of the subretinal blood may achieve sufficient vision for the patients' orientation.

Aged↗
PubMed2004

[Prophylaxis and treatment of nausea and vomiting after outpatient ophthalmic surgery].

Postoperative nausea and vomiting (PONV) are the most common side effects following anesthesia. It is unpleasant for the patients and has significant impact on postoperative well-being. After ophthalmic surgery arterial hypertension caused by retching and vomiting can cause intraocular bleeding with detrimental effects on the result of surgery. It is possible to identify risk patients who are likely to develop PONV. In these patients antiemetic prophylaxis is indicated, but the extreme age of patients (geriatric patients with relevant comorbidity and children) undergoing (ambulatory) ophthalmic procedures must be considered. Furthermore, antiemetics should be free from side effects, especially sedating effects, since these procedures are often performed on an outpatient basis. Regional or local anesthesia is the method of choice. However, when general anesthesia is necessary avoidance of volatile anesthetics, nitrous oxide, and administration of 5-HT(3) antagonists is recommended. Also, dexamethasone is a potent antiemetic drug that can favorably be combined with the 5-HT(3) antagonists. Dimenhydrinate is well accepted and an effective antiemetic for pediatric patients. By combining these antiemetic measures PONV can be lowered to a clinically satisfying level even in high-risk patients.

Adult↗
PubMed2002

[Complications following eyebrow piercing].

BACKGROUND: Piercing as a new form of "body art" is becoming more frequent in western industrialised countries and has achieved a certain social acceptance. Materials used are mainly surgical steel and, less frequently due to higher costs, titanium, gold, silver and niobium. The current literature reports complications such as infections, swellings, allergies, wound healing problems, dental damage and hepatitis following piercing in oral and facial regions. PATIENT: A 22-year-old nurse underwent piercing of her right eyebrow 4 months previously. While piercing of her tongue and nipples had not caused any problems, she first complained of a local inflammation about 3 months after the piercing procedure, which healed spontaneously. Now she complained again about pain, pressure, redness and swelling of her right cheek and face. A dermatologist had recommended tea compresses. On her first visit she presented with a solid, movable, tender, cherry-size swelling of the lateral third of the right eyebrow, a redness of the eyelid and a large swelling of the cheek. Following a systemic antibiotic therapy she underwent surgery and the inflammatory tissue was removed. Histologically, muscle tissue and a piercing canal were visible as well as histiolymphocytotic infiltrates with epitheloid and solitary giant cells. CONCLUSIONS: With an increasing frequency of piercing, the number of complications in the field of ophthalmology is also likely to increase. Considerable costs may arise for the social health care system depending on the severity of the complications.

Adult↗
PubMed2000

[Vitreoretinal surgery in complicated retinal detachment in children and adolescents].

BACKGROUND: The purpose of this study was to evaluate anatomical and functional results of vitreoretinal silicone oil surgery for complicated retinal detachments due to trauma and myopia in children and juveniles. METHODS: We retrospectively reviewed the records of children and juveniles up to 17 years of age who had undergone vitreoretinal surgery with silicone oil instillation for the above causes between 1990 and 1997. A total of 30 eyes of 29 patients were operated on, 24 because of trauma and the remaining 6 because of retinal detachment in high myopia. There was a mean postoperative follow-up period of 1.7 years. Silicone oil could be removed from 18 of the 30 eyes after a mean of 4.7 months. The median number of vitrectomies performed per eye was two (range one to five). RESULTS: In 21 of 30 eyes (70%) the retina could be reattached after one or more surgeries. Silicone oil was removed from 16 of these 21 eyes (53%) which was defined as anatomical success. Visual acuity increased (14 eyes, 48.3%) or remained unchanged (9 eyes, 31%) in 23 of 29 eyes (79.3%). Visual acuity decreased in 6 of 29 eyes (20.7%) despite surgery. Two eyes (6.7%) had to be enucleated due to bulbar phthisis. Seventeen eyes reached a postoperative visual acuity of at least counting fingers. In one child functional tests could not be performed due to young age. CONCLUSION: Vitreoretinal surgery with silicone oil endotamponade has become a standard procedure in treating complicated retinal pathologies in children and juveniles. In very young patients it is thought that silicone oil instillation has advantages over gas endotamponade since it is very difficult for children to keep the proper face-down positioning after the procedure. The retinal reattachment rate is encouraging. In the majority of cases visual acuity greater than or equal to counting fingers and thus orienting vision was reached postoperatively. In few cases even reading vision was regained.

Adolescent↗
PubMed2000

Pigment epithelium defects after submacular surgery for choroidal neovascularization: first results.

It was the aim of this study to compare postoperative pigment epithelium defects after submacular surgery for well-defined choroidal neovascularization (CNV) with preoperative fluorescein angiogram (FAG), indocyanine green angiogram (ICG), and intraoperative findings of the excised neovacularization. Surgical removal of the CNV was videotaped. By means of a gauge the absolute size of an anatomic structure was determined which was visible on video, FAG, and ICG as well. Postoperatively another FAG was performed to further examine the funduscopically visible pigment epithelium defect. By comparison with the above-mentioned anatomic structure it was thus possible to determine the exact size of CNV and pigment epithelium defect. The extent of the pigment epithelium defect as determined on postoperative FAG after submacular surgery surpasses the size of CNV as measured in FAG, ICG, and anatomical preparation.

Adult↗
PubMedDate not supplied

Central retinal vein occlusion and nonarteritic ischemic optic neuropathy in 2 patients with mild iron deficiency anemia.

We report on 2 patients with ophthalmologic complications associated with mild iron deficiency anemia. Case 1, a 37-year-old female patient, presented after 4 days of blurred vision in her left eye. Ophthalmoscopic and angiographic findings were consistent with the diagnosis of central retinal vein occlusion (CRVO). Further hematologic investigation into possible causes disclosed mild iron deficiency anemia (Hb 9.4 g/dl, hematocrit 30.5%). After the patient's visual acuity had worsened progressively to 20/50, an initial thrombolytic treatment and continuous intravenous heparinization was started on day 8, followed by oral substitution therapy with ferrous sulfate. On day 14, her visual acuity recovered to 20/20 OS and remained stable during follow-up. Case 2, a 50-year-old female patient, presented with a 1-week-history of blurred vision and metamorphopsia. Her visual acuity was 20/200. Further examination revealed a nonarteritic ischemic optic neuropathy and an iron deficiency anemia as the underlying disease (Hb 7.3 g/dl, hematocrit 25%). Despite intravenous heparinization and systemic treatment with steroids, there was no improvement in visual acuity. Clinicians involved in the management of chronic iron deficiency anemia should be aware of possible ophthalmic manifestations in this disease.

Adult↗