K. E. Schmid

Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Wien, Vienna, Austria

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Publications (6)7.87 Total impact

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    ABSTRACT: BACKGROUND: To examine macular thickness changes after uncomplicated cataract surgery in healthy patients and patients with diabetes mellitus and/or arterial hypertension without ocular manifestation. SETTING: Department of Ophthalmology, Rudolf Foundation Clinic, Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Vienna, Austria. METHODS: Prospective study with uneventful cataract surgery. Patients were subdevided into two groups. In group one, we included 10 patients without any general internal disease, in group two 15 patients with diabetes and/or arterial hypertension without ocular pathologies. Patients were examined preoperatively, one day, 1, 4 and 12 weeks postoperatively. At each visit a complete ophthalmic evaluation, best corrected Snellen visual acuity and optical coherence tomography of the macula were performed. RESULTS: Twenty-five eyes of 25 patients were recruited. The mean age was 70 ± 10 years. The average preoperative foveal thickness in both groups was 164 µm ± 12. The foveal thickness four weeks after surgery was 167 ± 14 (p = 0.64) in group 1 and 173 µm ± 14 (p = 0.08) in group 2. One eye in each group had decreased visual results 1 week postoperatively with subclinical thickening of the central macula in OCT measurement. CONCLUSION: We found no significant increase of foveal thickness after uneventful cataract surgery in both groups and there was no significant difference between these groups. However the percentage of eyes with foveal thickening was higher in group 2 than in group 1 (60% to 20% after 4 weeks and 47% to 30% 12 weeks after surgery).
    Spektrum der Augenheilkunde 10/2008; 22(5):301-304. · 0.18 Impact Factor
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    ABSTRACT: 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. 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. 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. 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.
    Albrecht von Graæes Archiv für Ophthalmologie 12/2006; 244(11):1446-52. · 1.93 Impact Factor
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    ABSTRACT: 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.
    Survey of Ophthalmology 01/2006; 51(1):19-40. · 2.86 Impact Factor
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    ABSTRACT: To evaluate the results of a retreatment modality of photodynamic therapy (PDT) based on optical coherence tomography (OCT) and fluorescein angiography (FA). To quantify the effect of PDT with the help of measurement of the retinal thickness. Eyes with predominantly classic subfoveal choroidal neovascularisation (CNV) due to age related macular degeneration were included. PDT was performed every three months, when needed. OCT, FA, and measures of distance acuity were performed at baseline, after 6 weeks, 3 months, and from then on every 3 months. A control group of a consecutive series of eyes that had been retreated based only on FA results was installed. Forty eyes of 38 patients were included. The average age was 73 years. The maximum retinal thickness decreased from 404 mum at baseline to 281.6 mum at month 12. Furthermore there was a significant decrease of retinal thickness in both subgroups. The number of retreatments was reduced, when activity was diagnosed using OCT and FA. (2.4 v 4.0). The distance acuity correlated significantly with the maximum retinal thickness (p=0.0042). Information about the activity of a neovascular lesion can be obtained with the help of OCT. The retreatment modalities can be optimised by using OCT and FA and the number of retreatments can be reduced.
    British Journal of Ophthalmology 10/2005; 89(9):1184-7. · 2.73 Impact Factor
  • K. E. Schmid, S. Binder
    Spektrum Der Augenheilkunde - SPEKTRUM AUGENHEILKD. 01/2005; 19(4):210-220.
  • K. E. Schmid, S. Binder
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    ABSTRACT: ProblemstellungDie ständig wachsende Liste an Chemotherapeutika veranlasste uns eine aktuelle Übersichtsarbeit, welche die Nebenwirkungen im Augenbereich darstellt, zu verfassen. Da das Sehvermögen eine Lebensqualität ist, die im Rahmen von Voruntersuchungen und eventuellen regelmäßigen Kontrollen erhalten werden kann, ist es für den Onkologen als auch für den Ophthalmologen wichtig, dass beide über die Augennebenwirkungen der geläufigen Chemotherapeutika Bescheid wissen. Eine Früherkennung und rechtzeitige Behandlung der Nebenwirkungen im Augenbereich kann oftmals den Sehverlust oder bleibende Folgeschäden verhindern. Methoden und/oder PatientenEs wurde eine Übersichtsarbeit verfasst, die alle Augennebenwirkungen der heute verwendeten Chemotherapeutika zusammenfasst. Die Literatursuche wurde im MEDLINE durchgeführt und die Übersichtsarbeit beinhaltet alle beschriebenen Augennebenwirkungen von 1966 bis August 2003. Die Chemotherapeutika wurden nach ihren verschiedenen Wirkungsmechanismen in folgende Gruppen eingeteilt: Alkylantien, Antimetabolite, Mitose Inhibitoren, Antibiotika und hormonelle Antagonisten. Bei jeder Substanz wird kurz die Verwendung und der Wirkmechanismus beschrieben, bevor auf die Augennebenwirkungen eingegangen wird. ErgebnisseGeringgradige Nebenwirkungen im Augenbereich kommen häufig bei niedrig dosierten Chemotherapien vor. Diese sind aber meist reversibel und verschwinden auch schnell wieder nach Beendigung der Therapie. Hochdosierte Chemotherapien, starke Kombinationstherapien und intraarterielle Verabreichung mancher Substanzen kann hingegen irreversible Schäden zur Folge haben. Bei der rechtzeitigen Erkennung solcher Nebenwirkungen muss eine Dosisreduzierung oder sogar Therapieunterbrechung in Betracht gezogen werden, um den Sehverlust zu verhindern. SchlussfolgerungenOnkologen und Ophthalmologen sollten sich über die Augennebenwirkungen von Chemotherapien bewusst sein. Durch eine ophthalmologische Voruntersuchung, vor Beginn der Chemotherapie, können gefährdete Patienten ermittelt und zu Kontrolluntersuchungen wiederbestellt werden. Bei manchen Chemotherapieschemen sind laufende Kontrolluntersuchungen ohnehin zu empfehlen. Bei Auftreten von gravierenden Augennebenwirkungen soll auf jeden Fall an eine Dosisreduzierung, oder sogar an eine Therapieunterbrechung gedacht werden, da es bei der Tumorbekämpfung auch zum Sehverlust kommen kann. BackgroundThe constantly growing list of cytotoxic chemotherapeutics affords a new survey of ophthalmic complications, which are often underestimated. Vision is a quality of life, which needs to be taken care of, 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. MethodsA review of the literature reporting ophthalmic complications of currently used cytotoxic chemotherapeutics in oncology was conducted. Literature was searched in Medline from 1995 until August 2003. Further literature was then found in the references of the pre-selected literature. ResultsOphthalmic complications of low-grade, induced by cytotoxic chemotherapy, are very common and reversible after cessation of anticancer therapy. Some major ocular toxicities may even afford a dose reduction or discontinuation of cytotoxic chemotherapy, in order to impede loss of vision. ConclusionOncologists and ophthalmologists must be aware of potential ophthalmic complications during cytotoxic chemotherapy. Ocular toxicities can be treated or even prevented, if detected on time, which is why immediate consultation of an ophthalmologist seems to be necessary, as soon as symptoms are recognized. An ophthalmic baseline examination, prior to anticancer treatment, may also lead to a reduction of ocular side effects.
    Spektrum der Augenheilkunde 19(4):210-220. · 0.18 Impact Factor

Publication Stats

67 Citations
7.87 Total Impact Points

Institutions

  • 2006–2008
    • Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery
      Wien, Vienna, Austria