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T Schlote

Publications and source records attributed to T Schlote.

At least 19 recordsLinked to original sources
PubMed2006

Real-time imaging of transscleral diode laser cyclophotocoagulation by optical coherence tomography.

PURPOSE: To present optical coherence tomography (OCT) for real-time imaging of cyclophotocoagulation effects. METHODS: In a pilot study, real-time transscleral OCT images were generated during diode laser cyclophotocoagulation in four eyes of four patients suffering from uncontrolled glaucoma using a specially designed contact applicator containing the OCT fiber, a focussing fiber optic and the fiber of the diode laser. RESULTS: When the contact system was used, two layers could be differentiated: a superficial thick hyperreflective complex representing conjunctiva, Tenon's capsule, episclera and sclera, and a thinner hyporeflective layer representing the ciliary body. During cyclophotocoagulation, real-time OCT showed a clear and sudden thickening of the ciliary body in the treated area. CONCLUSION: This new OCT device represents a first step towards visual, real-time imaging of cyclophotocoagulation. After further adaptation of the delivery system, further trials are needed to correlate OCT findings with aqueous production and intraocular pressure.

Ciliary Body↗
PubMed2005

[Blinking activity during visual display terminal work. Part 1: Ocular discomfort and pathophysiological principles].

Up to three-fourths of visual display operators complain about ocular discomfort after lengthy work at a monitor. The increase of displays at work has resulted in a problem area with growing impact for the economy and healthcare. Symptoms overlapping the complaints of dry eye disease point to the joint pathophysiological origin. In numerous studies the drastic decrease in blinking frequency was shown to be an essential cause of dry eye symptoms. Lid movements not only have the purpose of smoothing the precorneal tear film ("windshield effect"), but also affect the composition and stability of the different layers. Unfortunately, previous work has often been limited by the heterogeneity of measurement settings, leading to inconsistent results.

Blinking↗
PubMed2005

[Blinking activity during visual display terminal work. 2: reduced blinking and therapeutic approaches].

New findings based on a noninvasive, automated long-term measurement method revealed interindividual differences in lid movement behavior, existence of blinking patterns, and the dominance of cognitive influence in the regulation of blinking frequency during increased concentration and especially visual attention. The development of an individual blinking animation promises long-lasting increase and harmonization of lid movements during visual display work. Maintenance of the integrity of the ocular surface by preventing surface evaporation and providing sufficient precorneal environment eradicates important pathogenic factors of ocular discomfort. An animation program for stimulation of blinking has been developed. First results showed that an increase in blinking rate initiated by the computer itself is feasible in principle during work at a visual display terminal. Further improvement of this new approach is promising.

Blinking↗
PubMed2005

[Anticoagulative therapy in patients with exudative age-related macular degeneration: acute angle closure glaucoma after massive intraocular hemorrhage].

BACKGROUND: Acute secondary angle closure glaucoma after massive vitreous and subretinal hemorrhage from exudative age related macular degeneration is a seldom, but devastating complication of an anticoagulative therapy. PATIENTS: Four patients (age range 70-76 years) developed unilateral acute angle closure glaucoma after massive intraocular bleeding due to exudative age-related macular degeneration and anticoagulative therapy. Three patients received Phenprocomoun and one patient thrombolytic therapy with heparin. One eye had led to blindness at initial investigation. Pars plana vitrectomy was performed in the remaining three eyes. Within a few months, 2 of these 3 eyes were blind, one eye had light perception and all three eyes developed hypotonia. CONCLUSION: Acute angle closure glaucoma after intraocular bleeding may be the initial clinical manifestation of overtreatment with anticoagulants. Early pars plana vitrectomy probably will increase the surveillance rate of the eye but not the visual prognosis.

Acute Disease↗
PubMed2005

[Intraocular pressure difference in Goldmann applanation tonometry versus a transpalpebral tonometer TGDc-01"PRA" in glaucoma patients].

PURPOSE: The object of this study was to compare intraocular pressure measurements obtained with the TGDc-01"PRA", a new, transpalpebral indentation tonometer, with those from Goldmann applanation tonometry in normal and glaucomatous eyes. METHODS AND PATIENTS: Forty healthy eyes and 185 eyes suffering from glaucoma were included in the study. For Goldmann tonometry three measurements and for the TGDc-01 ten measurements were performed in a random order. All participants were placed in an upright position for all measurements. RESULTS: In both groups a systematic increase of intraocular pressure was found within the TGDc-01-measurements. Therefore, the first 3 measurements of each device were used for further statistical analysis. No learning curve could be demonstrated for the TGDc-01-measurement with normal eyes. Within the group of normal eyes the mean IOD obtained with the TGDc-01 was 1.84 mmHg lower than the mean IOD obtained with Goldmann tonometry (two-sided Student's t-test; P = 0.003). In the group of glaucomatous eyes, the mean intraocular pressure obtained with the Goldmann tonometry was 19.7 +/- 10.1 mmHg, with the TGDC-01 18.1 +/- 7.1 mmHg (coefficient of correlation r = 0.64, P < 0.001). The mean standard deviation of intraocular pressure measurements with Goldmann tonometry was 1.2 +/- 0.9 mmHg, with the TGDc-01 3.1 +/- 2.1 mmHg. TGDc-01-measurements overestimated intraocular pressure compared to Goldmann tonometry up to values of 16 mmHg and underestimated intraocular pressure at values over 16 mmHg. The difference increased by 5.5 mmHg per 10 mmHg Goldmann tonometry. The probability of success, defined as TGDc-01-recordings within +/- 3 mmHg of the Goldmann tonometry recordings, was less than 53 % between 5 and 20 mmHg and less than 30 % between 20 and 30 mmHg. Intraocular pressure (Goldmann tonometry) over 30 mmHg was always accompanied by TGDc-01-measurements lower than 3 mmHg. CONCLUSION: In eyes with elevated intraocular pressure, the TGDc-01"PRA" significantly underestimated the intraocular pressure measurement when compared to the gold standard, Goldmann tonometry. At present, measurement of the intraocular pressure with the TGDc-01 should not be used for clinical management of patients with glaucoma.

Adult↗
PubMed2005

[Traumatic glaucoma--a survey].

Traumatic glaucomas represent a very heterogeneous group of entities due to a variety of pathomechanisms which increase the intraocular pressure in the early or late phase after traumatic injury (blunt or penetrating injury, acid or alkali burn). Little is known about the real prevalence of traumatic glaucoma. Angle recession, hyphema-associated and lens-associated mechanisms are the most common causes of traumatic glaucoma after blunt ocular trauma. Secondary angle closure due to peripheral anterior synechiae is the most common pathomechanism leading to glaucoma in patients with penetrating eye injury or acid or alkali burn. Early anti-inflammatory therapy for eye injuries is the most important step in the prevention of traumatic glaucoma. Although no general recommendations exist, topical potent corticosteroids significantly decrease the risk of glaucoma development. Medical and surgical treatment of traumatic glaucoma has often been disappointing. Therefore the visual prognosis of these eyes is often restricted. Antiglaucomatous drugs that reduce the secretion of aqueous humor (e. g., beta-blockers) should be preferred. Mitomycin-augmented trabeculectomy is the surgical method of first choice in patients with open angle traumatic glaucoma. Transscleral cyclophotocoagulation represents the method of first choice in secondary angle closure glaucoma due to anterior peripheral synechiae. New surgical techniques will increase the possibilities of an effective reduction of the intraocular pressure in secondary angle closure glaucoma. These new procedures are endoscopic cyclophotocoagulation, retinectomy, and the implantation of drainage devices via the pars plana. Further evaluation and modifications of these surgical techniques should markedly improve the visual prognosis of eyes with secondary angle closure glaucoma. For a few types of traumatic glaucoma (e. g., after epithelial ingrowth) no effective treatment modality is available at present.

Eye Injuries↗
PubMed2005

[Neoplastic secondary glaucomas].

With few exceptions all intraocular tumours can principally induce elevation of intraocular pressure (IOP). The frequency of IOP-elevation is mainly dependent on the biologic behaviour of the neoplasm (benign / malignant), its dimensions, localization, and its ability to provoke secondary changes like retinal detachment, hemorrhages, inflammation, and necroses. There are many and diverse pathomechanisms which may cause a "neoplastic glaucoma". The leading mechanisms are direct invasion of the chamber angle by tumour cells, rubeosis iridis, and forward displacement of the iris-lens-diaphragm with (lens induced) pupillary block. As intraocular tumours may have pressure-lowering effects too, eyes bearing a tumour may also be hypotonic or normotonic inspite of a "glaucomatous chamber angle morphology". The therapy of the tumour-induced glaucomas is hardly validated and generally follows the treatment of the other secondary glaucomas. However, filtration procedures are contraindicated when a malignant tumour is diagnosed or suspected. Because of the progress of tumour therapy with salvation of eyes which had to be enucleated in former times and prolongation of survival in some tumour entities (like Non Hodgkin's lymphoma and metastases) the significance of tumour-induced glaucomas will probably further increase in the future.

Eye Neoplasms↗
PubMed2004

[Optical coherence tomography in the diagnosis and follow-up of patients with uveitic macular edema].

BACKGROUND: Optical coherence tomography (OCT) is a relatively new, noninvasive method and has been well established as an effective diagnostic procedure for the investigation of several macular diseases. Knowledge about the efficacy of OCT in the diagnosis and follow-up of macular edema in uveitis patients is still limited. PATIENTS AND METHODS: In the first part of the study, OCT was performed in 22 eyes of 18 patients with anterior or intermediate uveitis who showed angiographic and fundoscopic evidence of macular edema. The OCT results were compared with the visual acuity and fundoscopic and angiographic appearance of macular edema. In the second part of the study, the same patients were followed over a period of approximately 5 months (+/-2 months) and OCT was repeated at different time points during treatment of uveitic macula edema. RESULTS: OCT investigation also showed clear evidence of macular edema in all eyes and was not compromised by a low or medium degree of optical haze. Furthermore, OCT investigation revealed marked differences in the individual degree of macular edema (foveal heights 168-810 microm). Diffuse macular edema ( n = 4 ) and different types of cystoid macular edema (several distinguished cysts n = 6, partially or completely confluent cysts n = 11, one marked cyst n = 1) were observed. During the follow-up of the patients, OCT results, visual acuity, and fundoscopic appearance of the macula showed a comparable behavior. In some eyes, a stable visual acuity was accompanied by changes of foveal edema demonstrated by OCT. CONCLUSION: Optical coherence tomography is a safe and highly effective method in the diagnosis of macular edema in uveitis associated with low or medium haze of the optical media. Furthermore, OCT investigation seems to be useful in the follow-up of uveitic macular edema under treatment.

Fluorescein Angiography↗
PubMed2004

[Surgical management of secondary angle closure glaucoma after trauma].

Medical and surgical treatment of secondary angle closure glaucoma has often been disappointing. Therefore the visual prognosis of these eyes is mostly restricted. Transscleral cyclophotocoagulation is a relatively safe method for the treatment of advanced refractory glaucoma and represents the method of choice in secondary angle closure glaucoma due to anterior peripheral synechiae. In younger glaucoma patients and patients with traumatic glaucoma, long-term reduction of the intraocular pressure is only partially achieved. New surgical techniques will increase the possibilities of an effective reduction of the intraocular pressure in secondary angle closure glaucoma. On the other hand, data concerning the clinical efficacy and safety are still limited. These new procedures are endoscopic cyclophotocoagulation, retinectomy and the implantation of drainage devices via the pars plana. Further evaluation and modifications of these surgical techniques should markedly improve the visual prognosis of eyes with secondary angle closure glaucoma.

Eye Injuries↗
PubMed2004

[Angle closure glaucoma in association with relative anterior microphthalmus (RAM) after premature birth-retinopathy (ROP)].

BACKGROUND: The infantile angle-closure glaucoma is a common and well characterized complication of retinopathy of prematurity (ROP). Progressive shallowing of the anterior chamber by retrolental fibrous masses is mostly responsible for the pressure elevation during the first years of life. Apart of this pathogenesis, ROP-associated glaucoma is totally different in cases that do not manifest until adulthood. Only few cases are described in the literature. CASE REPORT: A 36-year-old female patient presented with symptoms of acute intraocular pressure (IOP) elevation and fundus results of a cicatricial ROP stadium II. Control of IOP was not achieved by systemic and topical drug treatment. The biometry showed a relative anterior microphthalmus (RAM) in myopia. After peripheral iridectomy, the IOP normalized and remained stable over a long-time period. CONCLUSION: Myopia induction after ROP and ROP treatment often lead to special anatomical conditions corresponding to the classical relative anterior microphthalmus. Shallowing of the anterior chamber and development of angle-closure glaucoma increase with age. Thus, a manifestation not before the third decade of life was a typical finding in the literature review. A detailed recording of history and consideration of the biometric data are of importance for diagnosis. Peripheral iridectomy was found to be the therapy with the highest success rate. The increase of a pupillary block mechanism can prevent further visual loss to the often pre-damaged eyes. Consideration of this entity is crucial in unilateral IOP elevation, because an increasing prevalence of these patients can be expected due to the increase of premature babies since 1970.

Adult↗
PubMed2002

[Cyclosporin A 2% eyedrops in therapy of atopic and vernal keratoconjunctivitis].

BACKGROUND: The efficacy of Cyclosporin A 2%eyedrops (CsA2%) as an additive treatment of atopic (AKC) and vernal keratoconjunctivitis (VKC) was evaluated. PATIENTS AND METHODS: The symptoms and findings of 26 patients with AKC and 12 patients with VKC with no improvement under conventional therapy, were additionally treated with CsA2% eyedrops and compared over a minimum follow-up period of 3 months to more than 24 months. RESULTS: The therapy with CsA2% eyedrops was well tolerated and evaluated as effective by the patients. Subtarsal papillae were reduced in 69.2% of the AKC group and in 66.6% of the VKC patients. Trantas dots were reduced or disappeared in about 50% of the AKC group and in the VKC group they had disappeared in more than 50%. Subjective symptoms (e.g. itching) had also been reduced or eliminated. CONCLUSION: CsA2% eyedrops are effective in the treatment of AKC and VKC, reducing objective and subjective signs as well as the need of adding topical steroids in affected patients.

Adolescent↗
PubMed2002

[Side-effects and risk profile of latanoprost 0.005% (Xalatan)].

BACKGROUND: Latanoprost, a prostaglandin F(2alpha)-analogue, has been widely in use in clinical practice for a period of over 5 years. The side-effects of latanoprost are analyzed and the clinical relevance is discussed. RESULTS: Hypertrichosis and increased pigmentation of eyelashes will develop in the majority of patients using latanoprost for more than 6 months. Increased pigmentation of the eyelids may also occur. Hyperpigmentation of the iris is seen in 12-18% of caucasians using latanoprost over a period of 1-2 years. Increased iris pigmentation seems more common in asian people and remains unchanged after discontinuation of therapy. Pigmentation of intra- and extraocular structures is caused by increased melanogenesis, not by melanocyte proliferation. Mild conjunctival hyperemia may develop in approximately 30% of patients, but is most often without clinical relevance. Further reported side-effects include anterior uveitis, reactivation of herpes-keratitis/-dermatitis and cystoid macular edema in pseudophakic and aphakic patients. A causal relationship has still not been proven for these side-effects. Systemic side-effects are rare (e.g. headache, facial rash, cardiovascular effects). No experience exists for treatment of glaucoma with latanoprost in childhood. CONCLUSION: Latanoprost represents a highly effective antiglaucomatous drug, rarely associated with vision-threatening complications. The most common complications are hypertrichosis of eyelashes and increased pigmentation of extra- and intraocular structures. A careful lifetime evaluation of these patients is recommended. Systemic side-effects are rare, but may occur.

Dose-Response Relationship, Drug↗
PubMed2001

Alteration of the vascular supply in the rabbit ciliary body by transscleral diode laser cyclophotocoagulation.

BACKGROUND: Besides the direct destruction of the non-pigmented ciliary epithelium by cyclodestructive procedures, further mechanisms are responsible for the decrease of intraocular pressure. This study evaluates the alteration of the ciliary body vascularization by contact transscleral diode laser cyclophotocoagulation in rabbit eyes. METHODS: Pigmented chinchilla bastard rabbits were used. Preliminary experiments were conducted to determine the parameters for diode laser cyclophotocoagulation of the pars plana or pars plicata. Then, treatment of the pars plicata (three rabbits) or pars plana (three rabbits) was performed in the right eye of six rabbits. After 2, 6 and 12 weeks histologic and transmission electron microscopic studies were performed. Furthermore, three rabbits received pars plicata cyclophotocoagulation of the right and pars plana cyclophotocoagulation of the left eye. After 2, 6 and 12 weeks, vascular casts of the ciliary body were investigated by scanning electron microscopy. RESULTS: Histologic and transmission electron microscopic studies showed a marked coagulation necrosis with subsequent ciliary body atrophy, destruction of the ciliary epithelium, pigment dispersion in the ciliary body stroma and peripheral anterior synechiae. Examination of vascular casts of the ciliary body revealed a marked rarefication of the capillary network within the treated areas of the ciliary body in all eyes and at every time of investigation. Anterior to the laser burns the capillary network was not markedly affected in the eyes with cyclophotocoagulation of the pars plana. After 3 months short vessel sprouts were seen, but regeneration was mostly incomplete. CONCLUSIONS: The vascular casting technique is an excellent method for the investigation of changes in ciliary body vascularization after cyclodestruction. This study is the first to demonstrate a marked rarefication of the ciliary body vascularization after diode laser cyclophotocoagulation using vascular casts. The results suggest that alteration of vascularization probably acts as a strong synergistic mechanism in the decrease of intraocular pressure after cyclophotocoagulation of the pars plicata.

Animals↗
PubMed2001

[Massive intraocular invasion of conjunctiva by squamous cell carcinoma--a case report].

BACKGROUND: Squamous cell carcinoma of the conjunctiva is a mostly solitary growing tumor located at the limbus region, which seldom invades the eye. We present an unusual case of conjunctival carcinoma with marked intraocular involvement, which appeared primarily as a chronic inflammation with corneal ulcer. CASE REPORT: A 89-year-old female patient was referred to our institution with a suspected ulcus rodens of the cornea. Since one year a refractory conjunctivitis persisted despite of different local treatment. At first presentation, a marked bacterial keratoconjunctivitis with circular necrosis of the conjunctiva, corneal infiltration and perforation was seen. Visual acuity of the right eye was light perception. The left eye was unremarkable. Enucleation of the right eye was performed. Histopathologic examination revealed the diagnosis of squamous cell carcinoma of the conjunctiva with intraocular involvement. There was a marked infiltration of the choroid even behind the equator. No metastases were found. CONCLUSION: Advanced squamous cell carcinoma associated with superinfection may present as a primary inflammatory process. There may be extensive involvement of the choroid. Metastases are probably rare even in advanced cases of this type of carcinoma.

Aged↗