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Susanne Binder

Publications and source records attributed to Susanne Binder.

18 recordsLinked to original sources
PubMed2007

25-gauge vs 20-gauge system for pars plana vitrectomy: a prospective randomised clinical trial.

AIM: To compare 25-gauge vs 20-gauge system for pars plana vitrectomy in a prospective, randomised, controlled clinical trial. METHODS: Three-port pars plana vitrectomy was performed in 60 patients belonging to 2 groups. Evaluations were performed preoperatively, intraoperatively, during the first three postoperative days, at 1 week, and at 1 and 3 months. The main outcome measure was time for surgery, divided into duration of wound opening, vitrectomy, retinal manipulation and wound closure. RESULTS: The total duration of surgery showed no significant difference between the groups (p = 0.67). The 25-gauge group showed significantly shorter duration of wound opening (p<0.001) and wound closure (p<0.001). In contrast, the vitrectomy duration was significantly longer in the 25-gauge group (p<0.001). Conjunctival injection and subjective postoperative pain showed significantly lower irritation in the 25-gauge group (p<0.001 for both). CONCLUSION: The 25-gauge vitrectomy system offered significantly improved patient comfort during the first postoperative week. The smaller surgical openings facilitated wound healing and minimised pain. Duration of surgery was comparable between the two systems-the shorter time needed for wound opening and closure in the 25-gauge group being equalised by the longer vitrectomy duration. Intraoperative as well as retinal manipulation and illumination caused more surgical difficulties using the 25-gauge system.

Epiretinal Membrane↗
PubMed2006

Prognosis of untreated occult choroidal neovascularization.

PURPOSE: The aim of this investigation was to evaluate prognostic factors influencing the short-term prognosis of occult choroidal neovascularization (CNV). METHODS: A consecutive series of 107 untreated occult CNV in 101 patients were evaluated in terms of the effect of their initial lesion characteristics, as determined with fluorescein angiography (FA), indocyanine green angiography (ICG-A) and optical coherence tomography (OCT), on the change in distance acuity, lesion size and retinal thickness over 1-3 months. Descriptive statistics, the Pearson Correlation Coefficient and a multiple linear regression analysis were applied to treat the data. RESULTS: A total of 107 eyes (101 patients) were examined. The study cohort consisted of 35 males and 66 females, with a mean age of 77.6 years. During the 3-month study period the mean distance acuity decreased from 67.0 to 63.2 letters; the mean size of the lesion increased from 16.1 to 18.4 mm(2); the mean maximum retinal thickness increased from 374.5 to 387.5 mum. Of the lesions, 59.8% included pigment epithelial detachments (serous or fibrovascular) and 29.9% retinal angiomatous proliferation. A better distance acuity at both visits for the entire study population correlated significantly with smaller lesions, as determined by FA and ICG-A (p < 0.0001), and a lower maximum retinal thickness, as determined by the OCT (p < 0.0001). CONCLUSIONS: A small and statistically insignificant change in distance acuity, lesion size and retinal thickness occurred over the 3 months of the study period. This reduced the ability of the study to examine the effect of baseline findings on outcome. Only two factors - the presence of a RAP lesion or the presence of CNV in the other eye - significantly and adversely affected the distance visual acuity at follow-up.

Aged↗
PubMed2006

The end of submacular surgery for age-related macular degeneration? A meta-analysis.

BACKGROUND: The aim of this meta-analysis was to summarize and to discuss the results of the four main submacular surgical procedures for age-related macular degeneration (AMD) as reported in the literature through 2004 and to compare them to the Submacular Surgery Trials (SST) data. METHODS: The existing data in the literature on submacular surgery for AMD from 1992 to 2004 were evaluated. The main outcomes were proportion of patients with two or more lines of improvement in visual acuity (VA) and proportion with two or more lines of deterioration in VA after surgery. RESULTS: Eighty-eight studies including 1,915 cases met the inclusion criteria. Estimates for the treatment outcome within the four groups of treatment based on a logistic regression model gave comparable results for removal of choroidal neovascularization (CNV) (improvement of VA 28%, deterioration of VA 25%), macular translocation (improvement of VA 31%, deterioration of VA 27%), and for transplantation of pigment epithelium (improvement of VA 22%, deterioration of VA 21%). Estimates for removal of subretinal hemorrhage were significantly different (improvement of VA 62%, deterioration of VA 13%). CONCLUSIONS: Selected case series showed superior results of VA compared to the SST. The question of whether this is due to selection bias that seems inevitable when dealing with medium-sized nonrandomized case series or due to better results in single centers cannot be answered. In our opinion there still seem to be indications for submacular surgery such as in patients with AMD with low preoperative VA due to large hemorrhagic or fibrotic membranes or nonresponders to photodynamic therapy (PDT).

Humans↗
PubMed2006

Effect of grid laser photocoagulation in diffuse diabetic macular edema in correlation to glycosylated haemoglobin (HbA1c).

BACKGROUND: Glycosylated haemoglobin (HbA1c) correlates with the amount of hyperglycemia in diabetic patients. High HbA1c levels often predict clinically significant macular edema (CSME), which then needs to be treated with grid laser photocoagulation. The question asked in this study was whether there is a correlation between the effect grid laser photocoagulation in diffuse diabetic macular edema and HbA1c, using an optical coherence tomography (OCT) for the evaluation of the retinal thickness. METHODS: A prospective, non-comparative case series was performed to find a correlation between the effect of grid laser photocoagulation in diffuse diabetic macular edema and HbA1c. Thirty eyes with CSME of diabetic patients were included in the study. Complete ophthalmic examinations and OCT were performed at baseline, 1 month, 3, and 6 months after grid laser photocoagulation therapy. HbA1c was measured at the end of study. RESULTS: Significance level was set at P<0.05. A significant difference in the foveal (P=0.02) and superior (P=0.021) retinal thickness 6 months after laser therapy, no correlation between HbA1c and retinal thickness after photocoagulation, and an insignificant decrease in visual acuity (P=0.9) were found. The correlation between foveal retinal thickness and visual acuity was P=0.24 6 months after treatment. CONCLUSION: There was no significant correlation between HbA1c and the effect of grid laser photocoagulation therapy in diffuse diabetic macular edema. The retinal thickness decreased significantly in the foveal and superior area 6 months after therapy. No correlation between the foveal retinal thickness and the visual acuity was found. The visual acuity did not increase after treatment. There are many factors influencing the retinal thickness, such as the blood pressure and the attached posterior hyaloid.

Aged↗
PubMed2006

Endophthalmitis with retinal necrosis following intravitreal triamcinolone acetonide injection.

A 69-year-old man with heterozygote factor V Leiden mutation and a history of central retinal vein occlusion in his left eye complained of decreased visual acuity in his right eye. Macular edema and ischemic CRVO were diagnosed. Following an intravitreal injection of 4 mg triamcinolone acetonide, endophthalmitis and necrotizing retinopathy developed, clinically resembling necrotizing herpetic retinopathies as have been described in immuno-compromised patients. An endogenous viral infection due to a steroid-induced immune suppression may be another complication of intravitreal injections of corticosteroids.

Aged↗
PubMed2005

A new treatment regimen in combined intravitreal injection of triamcinolone acetonide and photodynamic therapy.

BACKGROUND: Combined photodynamic therapy (PDT) and intravitreal injection of triamcinolone acetonide is a new option in the treatment of the neovascular form of age-related macular degeneration. With the aim of increasing safety and efficacy we examined whether it is possible to administer the intravitreal injection prior to PDT. METHODS: Patients with retinal angiomatous proliferation, who have an unfavourable prognosis when treated with PDT alone, were recruited to this study. Intravitreal injection of triamcinolone acetonide was applied 1 day before PDT. Distance acuity testing, retinal thickness measurement and fluorescein angiography were performed before treatment and 6 weeks and 3 months thereafter. RESULTS: Twenty-five patients were included: 18 were female, 7 male. Their mean age was 79 years. The distance acuity was 68 letters before treatment and at the follow-up examinations. The retinal thickness decreased significantly from mean 470.8 microm to 335.4 microm at week 6 and 360.8 microm at month 3. At month 3, 48% showed signs of activity in the fluorescein angiography needing retreatment. Visualisation of the fundus was not reduced by the triamcinolone crystals. DISCUSSION: PDT was possible without difficulty after intravitreal injection of triamcinolone acetonide. Stabilisation of the visual acuity was possible, although only eyes with retinal angiomatous proliferation were included.

Aged↗
PubMed2005

Vitrectomy for persistent diffuse diabetic macular edema.

PURPOSE: To evaluate the potential benefit of vitrectomy in eyes with persistent diffuse macular edema. DESIGN: Prospective randomized comparative clinical trial. METHODS: Eyes with diffuse diabetic macular edema for 6 to 18 months, an attached posterior hyaloid, and grid laser photocoagulation performed at least 4 months before were included. Patients were randomized either to a vitrectomy group or to a control group. MAIN OUTCOME MEASURES: Evaluations of Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, reading vision, and retinal thickness were carried out at baseline and 1, 3, and 6 months after enrollment. RESULTS: Fifty-six eyes (100%) were enrolled in this study. Twenty-five eyes (44.6%) were randomized into Gr I (vitrectomy group) and 31 eyes (55.4%) into Gr II (controls). Both groups were comparable in mean age (62.7 years and 63.9 years) and distribution of gender (one third male, two thirds female). ETDRS visual acuity showed a statistical significance in favor of Gr I at all time points (P = .035 to .005 Fisher's exact test). With Jaeger charts a significance for Gr I was found only at the 6-month examination (P = .01). With optical coherence tomography, the different behavior of retinal thickness changes in both groups during follow-up was statistically significant; P values were <.0001 for month 1, 3, and 6, preferring Gr I. CONCLUSIONS: We provide evidence that vitrectomy with internal limiting membrane peeling is superior to observation alone in eyes with persistent diffuse diabetic macular edema for 6 to 18 months. Longer follow-up periods and larger series might be needed to confirm these results and gain additional information.

Adult↗
PubMed2005

Choroidal neovascularization in pathologic myopia: three-year results after photodynamic therapy.

PURPOSE: To examine whether the encouraging functional results one year after photodynamic therapy (PDT) can be maintained up to three years. DESIGN: Prospective interventional case series. METHODS: Highly myopic eyes that had been treated with PDT for subfoveal choroidal neovascularization and had been observed at least 36 months were included. Distance acuity (Early Treatment of Diabetic Retinopathy charts), reading acuity (Jaeger charts), 10-degree static threshold perimetry, fluorescein angiography, and optical coherence tomography were performed. The main outcome measures were the differences of the values among the baseline and the month 12 and the month 36 examinations. RESULTS: Twenty eyes of 18 patients were included: 15 patients were female, and 3 patients were male. The average age was 64 years (range, 36 to 85 years). The mean distance acuity was 43 letters at baseline and 53 letters after 12 months and after 36 months. The mean reading acuity changed from mean J10.8 to mean J8.1 after 12 months and to mean J9.85 after 3 years. The mean defect decreased from mean 13.5 dB at baseline to mean 12.5 dB after 12 months and mean 11.2 dB after 36 months. The maximum retinal thickness decreased from mean 360 mum at baseline to mean 259 mum after one year and mean 238 mum after 36 months. CONCLUSION: Distance acuity and central visual field showed stabilization after the month 12 examination up to the month 36 examination. The reading acuity decreased between the month 12 and the month 36 examinations, which might be related to an increase of retinal atrophy.

Adult↗
PubMed2005

Amniotic membrane maintains the phenotype of rabbit retinal pigment epithelial cells in culture.

The success of surgical removal of choroidal neovascularisation followed by transplantation of autologous retinal pigment epithelial cells (RPE) for age-related macular degeneration (ARMD) may be limited by damage in Bruch's membrane. We investigated whether amniotic membrane (AM) might be used as an alternative basement membrane-containing matrix to support RPE growth and differentiation. Primary RPE plastic cultures were established from freshly enucleated Dutch belted rabbit eyes in DMEM/F12 containing 0.1 mM Ca(++) and 10% dialysed FBS. Upon subconfluence, cells were subcultured at 5000-9000 cells cm(-2) in the above-mentioned culture medium on intact AM (iAM), epithelially denuded AM (dAM) or plastic. After confluence, the Ca(++) concentration in the medium was increased to 1.8 mm for 4 weeks. Growth and morphology were monitored by phase contrast microscopy, and the phenotype by immunostaining with antibodies against cytokeratin 18, tight junction protein ZO-1, and RPE65 protein, and by transepithelial resistance (TER) measurement. Immunostaining to cytokeratin 18 confirmed the epithelial origin of isolated cells in both primary culture and subcultures. Compared to plastic cultures, RPE increased pigmentation within 24 hr after seeding on AM, with iAM being more pronounced than dAM. RPE adopted a hexagonal epithelial phenotype with more organised pigmentation, strong expression of ZO-1 and RPE65, and a significantly higher TER 4 weeks after Ca(++) switch on dAM. Our results indicate that AM may be used as a basement membrane-containing matrix to maintain RPE phenotype in vitro, and may facilitate subsequent transplantation to treat ARMD.

Amnion↗
PubMed2004

The effect of specific gravity of perfluorocarbon liquid on the retina after experimental vitreous substitution.

PURPOSE: To evaluate the histological changes in the retina after experimental vitreous substitution with various amounts of perfluorophenanthrene (PFPH). METHODS: Thirty-two rabbit eyes were mechanically vitrectomized and filled up with 0.8 cc or 0.2 cc highly purified PFPH. The substance remained for 1 week (4 eyes), 2 weeks (8 eyes), 4 weeks (10 eyes) or 8 weeks (10 eyes). Eight eyes underwent the same surgical procedure without PFPH exchange to serve as a control group. A histological comparison of corresponding areas in the center and in the periphery of the inferior retina ensued. RESULTS: After 2 weeks, nuclear drop-downs and irregularities of the outer plexiform layer and of both nuclear layers were observed centrally in the eyes with a 0.8 cc substitution. The changes proceeded to irregularities and cell loss of all retinal layers with focal areas of complete destruction of the retinal architecture after 8 weeks. In contrast, single nuclear drop-downs, wrinkling of the outer nuclear layer and cell loss in the photoreceptor layer were observed in the peripheral retina at the end of the observation period. In those eyes where 0.2 cc PFPH was exchanged nuclear drop-downs were found after 2 weeks, leading to focal thinning of the outer plexiform layer and irregularities of the outer nuclear layer after 4 weeks with an insignificant increase after 8 weeks. At this time these histological alterations were comparable with those that we observed after 2 weeks in the eyes with a 0.8 cc tamponade in a corresponding area. CONCLUSIONS: Even high purification of PFPH does not prevent retinal damage. The different results in different areas after vitreous substitution with 0.2 cc and with 0.8 cc demonstrate that the high specific gravity of the substance may also play a role in the development of histological changes after extended tamponade.

Animals↗
PubMed2004

Proliferative vitreoretinopathy--at what risk is the fellow eye?

PURPOSE: To find out if patients with proliferative vitreoretinopathy (PVR) due to complicated retinal detachment are at risk to acquire the same disease or other vision-threatening retinal abnormalities in the fellow eye. To furthermore assess in what time-period they appear and if subgroups of patients have special risks. METHODS: 100 consecutive PVR-patients were studied retrospectively. 21 patients with PVR graded lower than C3, traumatic PVR, diabetic retinopathy or congenital vitreoretinal diseases were excluded. Age, gender, best-corrected visual acuity at the first and last visit, refraction, ocular disease in both eyes and observation-time were recorded. RESULTS: After a mean follow-up of 8.5 years, 42 of 79 patients (53.4%) showed vision-threatening abnormalities in their fellow eyes: among them, 9 patients (11.4%) had PVR, 13 (16%) simple retinal detachments and 14 (17.3%) retinal breaks. Abnormalities in the fellow eye did not develop after a certain time following surgery of the primary eye; 71.4% appeared within 5 years. Aphakic and pseudophakic patients had retinal breaks significantly more often (p = 0.011) than phakic patients. Myopia did not increase the risk for any abnormality. Men developed retinal detachment (p = 0.037) and PVR (p = 0.025) significantly more often than women. CONCLUSION: Patients with PVR have a greater than 50% risk of developing vision-threatening retinal abnormalities in their fellow eye. Because of this increased risk, these patients need regularly-scheduled long-term follow-up. SUMMARY STATEMENT: Patients with PVR have a greater than 50% risk of developing vision-threatening retinal abnormalities in their fellow eye and a 37% risk to develop PVR from rhegmatogenous retinal detachment. More than two thirds of abnormalities in the fellow eye developed within five years of surgery of the primary eye.

Adult↗
PubMed2004

Outcome of transplantation of autologous retinal pigment epithelium in age-related macular degeneration: a prospective trial.

PURPOSE: To present the outcome of a consecutive series of patients who had foveal choroidal neovascularization (fCNV) in age-related macular degeneration (AMD) and were treated with subretinal surgery combined with simultaneous transplantation of autologous retinal pigment epithelial (RPE) cells. METHODS: Patients with fCNV who were not eligible for laser or photodynamic therapy were included in the study. They underwent subretinal membrane excision with simultaneous transplantation of autologous RPE cells. Eyes with membrane excision alone served as the control. Tests included best corrected visual acuity for far and near with Early Treatment Diabetic Retinopathy Study (ETDRS) and Jaeger charts, multifocal (mf)ERG, central visual field analysis, optical coherence tomography (OCT), and angiography, before surgery, and 1 month and 3 months after treatment, and at 3-month intervals thereafter. RESULTS: The results of final examinations of 53 eyes are presented. In 39 eyes, RPE transplantation was performed (group 1); 14 eyes had membrane excision alone (group 2). In group 1, visual acuity improved significantly, two or more lines in 21 (53.8%) patients; remained stable in 12 patients (30.8%); and decreased two or more lines in 6 patients (15.4%; P=0.0062). In group 2, the corresponding values were 21.1%, 57.8%, and 21.1% (P=0.5377 NS). Statistical analysis of results in the two groups showed a trend in favor of group 1 (P=0.9714). The difference in reading acuity was significant between the two groups (mean change in group 1: 1.85 +/- 0.42 vs. 0.43 +/- 0.47 in group 2; P=0.0001). mfERG response density changes were significantly different between groups 1 and 2 (P=0.0094). No significant decreases in central visual field defects were detected. OCT showed the postoperative median retinal thickness in the lesion area in group 1 to be higher (242.31 +/- 12.30 microm) than in group 2 (202.07 +/- 10.68 microm), showing a trend (P=0.0682). CONCLUSIONS: Patients undergoing fCNV removal with autologous transplantation of RPE reached significantly better reading acuity and higher mfERG-response density than control subjects. The results provide evidence that autologous transplantation of RPE is a beneficial supplement to membrane excision alone in patients with fCNV in AMD and may be regarded as a reasonable treatment option.

Aged↗
PubMed2003

Autologous transplantation of retinal pigment epithelium after mechanical debridement of Bruch's membrane.

PURPOSE: To determine whether transplantation of autologous retinal pigment epithelium (RPE) will prevent atrophy of the choriocapillaris and loss of photoreceptors in an area in which the RPE has been mechanically debrided from Bruch's membrane. METHODS: Abrasive debridement of RPE was performed with a metal cannula after localized retinal bleb detachments in two separate areas of the rabbit retina. The RPE cell suspension aspirated from one of the debridement sites was transplanted to the other. The debridement-only site served as control. The transplant and control sites were evaluated after 30 days by color fundus photography, fluorescein angiography, light microscopy and transmission electron microscopy. RESULTS: Compared with debridement only, debridement plus transplantation of RPE resulted in more complete repopulation of the bare Bruch's membrane surface with relative preservation of choriocapillaris and photoreceptors. CONCLUSION: Autologous transplantation of RPE onto an abrasively debrided Bruch's membrane decreases choriocapillaris atrophy and photoreceptor loss.

Animals↗
PubMed2002

Transplantation of autologous retinal pigment epithelium in eyes with foveal neovascularization resulting from age-related macular degeneration: a pilot study.

PURPOSE: To describe the indications, surgical technique, and clinical results of 14 eyes in 13 patients with age-related macular degeneration and foveal choroidal neovascularization, in which subretinal surgery was combined with simultaneous transplantation of autologous retinal pigment epithelial cells. METHODS: Between March 1999 and February 2000, in a prospective study, 14 eyes (13 patients) with age-related macular degeneration underwent subretinal surgery because of foveal choroidal neovascularization with simultaneous transplantation of retinal pigment epithelium harvested from the nasal subretinal area of the same eye. Preoperatively, 1 month postoperatively, 3 months postoperatively and at 3-month intervals thereafter, examinations were performed including best-corrected visual acuity, visual field, biomicroscopy of anterior and posterior segment, tonometry, fluorescein and indocyanine angiographies, autofluorescence, scotometry, and fixation tests. RESULTS: Postoperatively, after median observation of 17 months (range, 12 to 24 months) best-corrected visual acuity was improved 2 or more lines in eight eyes (57.1%), remained the same (+/- 1 line) in five eyes (35%), and decreased by more than 2 lines in one eye (7.1%). Pairwise t test showed significant improvement after 1 month (P = .0031, P = .0062) as well as 1 year (P = .0066, P = .0105). Satisfactory reading vision between Jaeger 1 and 4 was achieved in three eyes (21.2%). No significant intraoperative or postoperative complications occurred in any eye. No recurrence of choroidal neovascularization was observed during the observation period. CONCLUSIONS: In eyes with age-related macular degeneration and foveal choroidal neovascularization, autotransplantation of retinal pigment epithelium was performed in addition to conventional removal of the choroidal neovascularization without significant intraoperative or postoperative complications. Visual acuity improvement of 2 or more lines in 57% of the eyes was achieved. No recurrent choroidal neovascularization formation was observed during the observation period. The results of this pilot study suggest that autologous transplantation of retinal pigment epithelium combined with submacular surgery might be a reasonable treatment option for patients with foveal choroidal neovascularization secondary to age-related macular degeneration.

Aged↗
PubMedDate not supplied

Update on ocular complications of systemic cancer chemotherapy.

The constantly growing list of cytotoxic chemotherapeutics requires a new survey of ophthalmic complications, which are often underestimated. Based on the review by Imperia et al (1989), an update on ophthalmic complications of currently used cytotoxic chemotherapeutics in oncology was written. Vision is a quality of life issue, which must be nurtured, especially if loss of vision can be prevented. The broad spectrum of ophthalmic complications induced by cytotoxic chemotherapy includes reversible and irreversible acute and chronic disorders. Mild to moderate ophthalmic complications are very common and reversible after cessation of anti-cancer therapy. Some major ocular toxicities may require a dose reduction or the discontinuation of cytotoxic chemotherapy in order to prevent visual loss. Ocular toxicities can be treated or even prevented, if detected early enough. That is why an ophthalmic baseline examination for patients receiving cytosine arabinoside, 5-fluorourocil, methotrexate, or docetaxel should be taken into consideration, and a consultation with an ophthalmologist has to be done as soon as symptoms are recognized. Oncologists and ophthalmologists must be aware of potential ophthalmic complications during cytotoxic chemotherapy, and should work together.

Antineoplastic Agents↗
PubMedDate not supplied

Reading ability and central visual field after photodynamic therapy.

PURPOSE: We examined whether photodynamic therapy (PDT) can prevent severe loss of reading acuity and further depression of the visual field in cases of predominantly classic subfoveal neovascularization due to age-related macular degeneration. PATIENTS AND METHODS: Sixty eyes of 52 patients underwent biomicroscopy, assessment of reading and distance acuity, 10 degrees static threshold perimetry, distance acuity, and fluorescein angiography at baseline, after 6 weeks, 3 months and then every 3 months after therapy. RESULTS: After 18 months only 16.7% had lost more than 3 levels of reading acuity, 23.3% had lost less than 3 levels, 6.7% had remained unchanged and 53.3% had gained reading acuity, 18.7% of these more than 3 levels. 81.7% of the eyes lost less than 3 lines of distance acuity. 78.3% did not show any increase of the mean defect in the central visual field. CONCLUSION: PDT can prevent severe loss of distance and reading acuity and further deterioration of the central visual field in about 80% of the eyes. The baseline reading acuity was poor and the patients should be aware of the fact that loss of reading acuity cannot be regained even after successful PDT.

Aged↗