Kerstin Jandrasits

University of Vienna, Wien, Vienna, Austria

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Publications (19)36.86 Total impact

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    ABSTRACT: EinleitungDie Keratoconjunctivitis sicca (KCS) ist eine chronische Bindehautentzündung mit Beeinträchtigung des Tränenfilms. Deren Behandlung mit Tränenersatzmittel ist oft unbefriedigend. Vorversuche mit Akupunktur zeigten eine klinische Wirksamkeit auf die KCS, jedoch mit unbekanntem Hintergrund. Da Erb eine erhöhte Spannung bei KCS festgestellt hat, und Akupunktur empirisch einen beruhigenden Effekt hat, sollten nun die Spannungen sichtbar und die Veränderungen nach Akupunktur gemessen werden. MethodeBei vegetativer Dystonie mit Aktivierung des sympathischen Nervensystems kommt es zu vermehrter Schweißbildung und Mydriasis, bei parasympathischer Aktivität zu Abgeschlagenheit und Myosis. Beide Systeme haben Einfluss auf die Tränenbildung. Gemessen wurde der Haut-Kontakt auf der Handfläche mittels Silberchlorid-Elektroden, die Pupillenweite mit TV-Pupillometrie 1050 und die psychische Befindlichkeit mit Fragebogen nach Zerssen. Spaltlampenuntersuchung, Schirmer II, Tränenfilmaufrisszeit(BUT), Lipidinterferenz, Bengalrosa, Impressionszytologie und Tropfprotokoll bestimmten die KCS. Die Tests wurden nach 3 Monaten wiederholt. In der Zwischenzeit erhielt ein Teil der Patienten Akupunkturbehandlungen (10×). Statistisch wurden der Willcoxen Test, t-test und Withney-Mann-Test angewendet. Ergebnisse45 Patienten mit KCS (18 m : 27 w) wurden untersucht, davon 33 mit Akupunktur behandelt. Der Pupillendurchmesser änderte sich im Durchschnitt um 1,3 mm nicht signifikant, gegenüber der 1. Messung und gegenüber der Vergleichsgruppe. Die Schweißbildung verringerte sich, ebenso besserte sich die allgemeine Befindlichkeit (nach Zerssen) signifikant nach Akupunktur gegenüber der Voruntersuchung und gegenüber der Vergleichsgruppe. BUT, Lipidinterferenz und Tropfhäufigkeit verbesserten sich nach Akupunktur mit statistisch signifikantem Unterschied gegenüber der Ausgangslage und gegenüber der Vergleichsgruppe. Impressionszytologie, Bengalrosa-Färbung und Schirmer-Test blieben ohne Signifikaten Unterschied. Die Ergebnisse dieser Beobachtung zeigten einen ersten positiven Einfluss der Akupunktur auf die vegetativen und psychischen Spannungen bei KCS. IntroductionKeratoconjuctivitis sicca (KCS) treatment with artificial tears is unsatisfying in many cases. Therefore in previous studies acupuncture was used with success on Schirmers test, break up time and drop-frequency. The effect of acupuncture on the tear film is still unknown, but generally patients told of relaxation after the therapy. C. Erb observed elevated psychic tension in patients with KCS. This study was created to observe the influence of acupuncture on this tension. MethodTo observe the tension of the sympathetic system, we measured the skin contact level by attaching agcl electrodes on the tenar and antithenar of the untrained hand. For determination of skin contact level and habituation computer assisted measurement was used. For the computer assisted measurement of the pupillary diameter a TV pupillometer 1050 by whittaker cooperation was used. With a record by Zerssen the psychic condition was observed. For evaluation of mood the self rating well being scale by Zerssen has to be presented by the patients. The teat film was evaluated by slit lamp, Schirmer BUT and Bengal-Rosa staining. These observations were repeated after 3 month. In meantime part of patients was treated by acupuncture for 10 weeks, once weekly. For statistic analyses Wilcoxon matched pair test, withney Mann and t-test were carried out. Results45 patients with KCS (27 women, 18 men) have been observed, 33 of them with acupuncture treatment. After acupuncture the diameter of the pupil reduced 1.3 average and there was no statistical difference (p > 0.05), the habituation and the skin values changed like the emotional persistence (by Zerssen-record) with significant difference. Even the difference after acupuncture was significant more than that of the controll group in the skin reaction and in the psychic reaction. Changes of the BUT, the Lipid-interference and the drop frequency of artifical tears were significant too (p < 0.05). Rosa-Bengal staining, Schirmer test changed without satistical difference. ConclusionAfter this study we could observe a positive influence of acupuncture on the psychic and vegetative tension in patients with KCS. This may be a good usefull additional therapeutical approach in future.
    Spektrum der Augenheilkunde 04/2012; 14(5):244-248. · 0.18 Impact Factor
  • Focus on Alternative and Complementary Therapies 01/2010; 7(1):102-102.
  • Focus on Alternative and Complementary Therapies 01/2010; 8(4):525-525.
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    ABSTRACT: Angiotensin II and endothelin-1 are potent vasoconstrictors that appear to play a role in retinal blood flow regulation. In the present study, we investigated the possible role of the angiotensin and the endothelin system in the regulation of retinal vessel diameters during isometric exercise in healthy humans. The study design was randomized, double-masked, placebo-controlled, and three-way cross over. Twelve healthy subjects performed squatting exercises for 6 min during infusion of either an angiotensin-converting enzyme inhibitor (enalapril), an ET(A)-receptor antagonist (BQ-123), or placebo. Retinal vessel diameters were measured continuously with the Zeiss retinal vessel analyzer. Systemic hemodynamics were assessed noninvasively, and intraocular pressure was measured with applanation tonometry. Squatting induced a significant increase in blood pressure and pulse rate, which was paralleled by a vasoconstriction in retinal arteries and veins. Intraocular pressure was only slightly increased during the squatting periods. BQ-123 significantly blunted the exercise-induced decrease in venous (P < 0.01) and arterial (P < 0.02, ANOVA) vessel diameters but had no effect on basal retinal diameters. By contrast, enalapril did neither influence vessel diameter at baseline conditions nor in response to isometric exercise. The data of the present study indicate that retinal vasoconstriction during isometric exercise is modified by ET(A)-receptor blockade, whereas it is not altered by angiotensin-converting enzyme inhibition. Hence, the present data indicate that endothelin-1, but not angiotensin II, is involved in retinal blood flow regulation during isometric exercise.
    AJP Heart and Circulatory Physiology 04/2006; 290(4):H1693-8. · 3.63 Impact Factor
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    ABSTRACT: We evaluated the validity of calculations for refractive outcome in cataract surgery in silicone oil-filled eyes. The retrosilicone space (RSS) was included in these calculations. In a prospective study the axial length (AL) of silicone oil-filled eyes was measured. with standardized A-scan echography (SAE) and partial coherence interferometry (PCI). Meldrum's formula was used to transform the velocity of ultrasound within the vitreous cavity. To investigate whether refractive outcome can be calculated accurately, we assessed the difference between precalculated and final refractive outcome. Furthermore, we determined the advantages and disadvantages of SAE and PCI. A minor aim was to assess whether the AL of the two eyes differed significantly. In 85% of 117 eyes the difference between precalculated and postsurgical refraction was smaller than 1 diopter spherical and statistically not significant (p>0.2). The mean AL was 24.1 mm (range 20.0-31.4 mm). The difference in outcome between the two methods was without statistical significance: the AL difference was 0.4 (+/-2.6) mm on measurement with SAE and 0.04 (+/-0.46) mm with PCI. PCI has the advantage that it can be performed more easily, without contact, while echography is advantageous in the presence of advanced cataracts. In supine position an oil-free fluid space behind the silicone oil was detected with echography. The mean dimension of this space was 1.9 (+/-0.67) mm and it was taken into consideration for IOL calculation. The mean AL difference between the two eyes was 0.4 mm, but the difference was greater than 1 mm in 26% of the patients. The AL of eyes filled with silicone oil can be measured reliably with SAE and PCI. In supine position the RSS has to be considered to obtain more accurate IOL calculations.
    Albrecht von Graæes Archiv für Ophthalmologie 10/2005; 243(10):967-72. · 1.93 Impact Factor
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    ABSTRACT: There is evidence from in vitro and animal studies that endothelin is a major regulator of retinal blood flow. We set out to characterize the role of the endothelin-system in the blood flow control of the human retina. Two studies in healthy subjects were performed. The study design was randomized, placebo-controlled, double-masked, balanced, two-way crossover in protocol A and three way-way crossover in protocol B. In protocol A 18 healthy male subjects received intravenous endothelin-1 (ET-1) in a dose of 2.5 ng kg (-1)min(-1) for 30 min or placebo on two different study days and retinal vessel diameters were measured. In protocol B 12 healthy male subjects received ET-1 in stepwise increasing doses of 0, 1.25, 2.5 and 5 ng kg (-1)min(-1) (each infusion step over 20 min) in co-infusion with the specific ET(A)-receptor antagonist BQ123 (60 microg min (-1)) or placebo or BQ123 alone investigating retinal vessel diameters, retinal blood velocity and retinal blood flow. Measurements of retinal vessel size were done with the Zeiss retinal vessel analyzer. Measurements of blood velocities were done with bi-directional laser Doppler velocimetry. From these measurements retinal blood flow was calculated. In protocol A exogenous ET-1 tended to decrease retinal arterial diameter, but this effect was not significant versus placebo. No effect on retinal venous diameter was seen. In protocol B retinal venous blood velocity and retinal blood flow was significantly reduced after administration of exogenous ET-1. These effects were significantly blunted when BQ-123 was co-administered. By contrast, BQ-123 alone had no effect on retinal hemodynamic parameters. Concluding, BQ123 antagonizes the effects of exogenously administered ET-1 on retinal blood flow in healthy subjects. In addition, the results of the present study are compatible with the hypothesis that ET-1 exerts its vasoconstrictor effects in the retina mainly on the microvessels.
    Experimental Eye Research 06/2003; 76(5):633-40. · 3.03 Impact Factor
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    ABSTRACT: A solar eclipse occurred in central Europe on August 11th, 1999. Following the eclipse, patients with ocular symptoms were investigated. Gazing at the sun without protection is liable to damage the retina. Our attention was focused on changes of the ocular surface and the tear film. Forty-three patients were investigated within one week after the solar eclipse as baseline. 33 of them were followed up one year later. Visual acuity and the central visual-field were measured, and the ocular surface and the fundus were examined using a slit lamp. The quality of the lacrimal tear film was examined using Schirmer's test for the aqueous layer, break-up time for the mucous layer and interference observation for the lipid layer, measured by a slit lamp and a tearoscope. At the baseline 19 patients had non-specific visual problems. Pathological alterations of the tear film were seen in all three tear-film layers: Schirmer's test was pathological in 87%, break-up time decreased in 85%, the interference pattern of the lipid layer changed in 67% and there were changes in 87% using the tearoscope. One year later the non specific visual disorders had disappeared. Schirmer's test did not reveal much change from the baseline: 51% pathological, 24% remained pathological in break-up-time and the lipid layer was normalized except in 9%. Using the tearoscope, lipids were better than grade 3 in all patients. After gazing at a solar eclipse the ocular surface and tear film changed. While the aqueous layer remained pathological in many patients, the lipid layer and the mucous layer recovered spontaneously.
    Wiener klinische Wochenschrift 02/2003; 115(1-2):47-52. · 0.81 Impact Factor
  • Wiener Klinische Wochenschrift - WIEN KLIN WOCHENSCHR. 01/2003; 115:47-52.
  • Kerstin Jandrasits, Katharina Krepler, Andreas Wedrich
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    ABSTRACT: The breakdown of the blood-retina barrier in diabetic patients is correlated with a dysfunction of the blood-aqueous barrier. In our study, we wanted to investigate the effect of grid photocoagulation in diabetic macular edema on the aqueous flare. Modified grid pattern photocoagulation was performed on 20 patients with diabetic macular edema. The aqueous flare intensity was measured by the laser flare cell meter before and 4 months after laser treatment. The mean flare value was 9.8 +/- 4.7 photons/ms before laser treatment. After grid photocoagulation, the flare value was 7.1 +/- 3.6 photons/ms. Flare values were significantly decreased after laser treatment. Our results suggest a correlation between the effect of grid photocoagulation on the blood-retina barrier and the permeability of the blood-aqueous barrier. The laser flare intensity seems to be a quantitative indicator for the diabetic dysfunction of the blood-retina barrier.
    Ophthalmologica 01/2003; 217(1):49-52. · 1.41 Impact Factor
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    ABSTRACT: Compared to non-diabetic patients, outcome after cataract surgery was reported to be worse in diabetic patients--especially in those with diabetic retinopathy. This prospective study was planned to evaluate visual outcome, progression of diabetic retinopathy, and incidence of clinically significant macular oedema (CSME) in a homogenous group of patients with non-proliferative diabetic retinopathy (NPDR) without CSME at baseline 1 year after cataract surgery. Over a period of 18 months, all consecutive patients with mild-to-moderate diabetic retinopathy who had cataract surgery with phacoemulsification and posterior chamber lens implantation were prospectively followed up. Outcomes were assessed 1 year postoperatively and included visual acuity (VA), progression of retinopathy, and incidence of CSME. Progression of retinopathy and incidence of CSME were compared to the non-operated fellow eyes. Of 50 patients included, 42 completed the 1-year follow-up. VA improved in 85% of patients, and was better than 0,5 in 71%. Progression of retinopathy occurred in 12% of eyes after cataract surgery and in 10.8% of non-operated fellow eyes. No patient developed proliferative diabetic retinopathy in the operated eye. CSME occurred in 13 operated eyes (31%), five of them with retinal ischemia, and in five non-operated eyes (13.5%). Patients with ischemic macular oedema had the worst prognosis regarding VA. Modern cataract surgery seems to have no influence on the progression of diabetic retinopathy. A visual improvement is achieved in the majority of patients with NPDR, but poorer visual outcome is observed in patients developing macular oedema.
    Albrecht von Graæes Archiv für Ophthalmologie 10/2002; 240(9):735-8. · 1.93 Impact Factor
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    ABSTRACT: To gain insight into the role of circulating catecholamines on retinal blood flow in vivo. Nonrandomized, open, crossover design. In 10 healthy male subjects, tyramine and noradrenaline were administered in stepwise increasing doses. These doses were selected to induce comparable changes in systemic blood pressure. During each infusion step, retinal vessel diameter and retinal venous blood speed were measured with the Zeiss retinal vessel analyzer (Zeiss, Jena, Germany) and laser Doppler velocimetry, respectively. Retinal blood flow through a major temporal vein was calculated. As expected, tyramine and noradrenaline induced a systemic hypertensive response. Tyramine caused a moderate increase in noradrenaline plasma levels, whereas exogenous noradrenaline increased noradrenaline plasma levels more than 10-fold. Nevertheless, neither tyramine nor noradrenaline induced any effect on retinal hemodynamic parameters. These data indicate that even high levels of circulating noradrenaline have little impact on retinal vascular tone and retinal blood flow. Hence, the adrenergic system appears not to play a major role in retinal blood flow regulation.
    Ophthalmology 03/2002; 109(2):291-5. · 5.56 Impact Factor
  • Advances in experimental medicine and biology 02/2002; 506(Pt A):723-6. · 1.83 Impact Factor
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    ABSTRACT: This study was performed to test viscoelastic artificial tears (VAT) based on both subjective and clinical parameters in patients with keratoconjunctivitis sicca (KCS). Twenty-eight patients were evaluated in a randomized double-blind study. Sodium hyaluronate was used in two different concentrations (0.4%, 0.25%) and in combination with chondroitin sulfate. Each preparation was used for one week preceded by another weekly cycle using a sodium chloride solution. Before and after each cycle, clinical examinations were performed: tear film break-up time, Schirmer's test, lipid-layer thickness and fluorescein staining. Patients kept a record of the drop-frequency, subjective response and side effects. After the study, they were asked to give a rating of the various preparations. The severity of KCS was expressed based on a sicca score and correlated with response to viscoelastic treatment. Both the subjective and the clinical parameters revealed no statistically significant differences between the various viscoelastic agents or between the viscoelastics and the sodium chloride solutions. Severe side effects did not occur. There was a positive correlation of response to viscoelastic treatment with severe KCS (+ 0.36) but not with mild KCS (-0.07). The VAT seems to be indicated in severe cases of dry-eye syndrome. Sodium chloride solutions may be a useful short-term alternative to other tear formulations.
    Biomaterials 01/2002; 22(24):3305-10. · 8.31 Impact Factor
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    ABSTRACT: Pain that does not respond to conventional treatment procedures makes it necessary to look for alternative methods. Acupuncture is an ancient procedure with empirical effects on pain. Previous studies established the increased output of messengers at neuronal junctions in spinal cord and hypothalamic locations, especially of endorphins which inhibit the perception of pain. We treated several painful symptoms with acupuncture and evaluated the outcome of the treatment. Patients with various kinds of therapy-refractory pain and patients in whom conventional treatment methods could not be applied were included in the study. The diagnoses included glaucoma. Tolosa-Hunt-Syndrome, ophthalmic migraine, blepharospasm, and dry eyes. In one case acupuncture was used for analgesia during surgery. Acupuncture was performed with sterile disposable needles, at points known to have an empirical analgesic effect. The stimulation was adapted to the patient's individual needs. VAS assessments before and after acupuncture were compared. The t-test was used for statistical evaluation. Acupuncture had no side effects, but reduced pain to a variable extent. Especially in cases of severe pain and in surgery, very effective pain reduction was achieved. In general, pain was significantly reduced in all patients by the use of acupuncture. A statistically significant effect was noted (p < 0.05). Further studies should be conducted to demonstrate the specific effect in larger patient populations. Monitoring neurotransmitter activity will possibly help to illustrate the effect.
    Acupuncture & electro-therapeutics research 01/2002; 27(3-4):171-82. · 0.74 Impact Factor
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    ABSTRACT: The treatment of pterygia often results in irregular astigmatism. Corneal smoothing at the end of surgery plays a major role in the development of astigmatism. The aim of our study was to compare the efficiency of corneal smoothing performed by phototherapeutic keratectomy compared with the conventional method performed by a diamond fraise. The effect of postoperative excimer laser smoothing on refraction, visual acuity and irregular astigmatism was investigated. 32 eyes underwent pterygium excision using a standardized surgical procedure. In addition 9 eyes underwent postoperative phototherapeutic keratectomy of the wound region with an excimer laser, 23 eyes were treated with a diamond fraise for corneal smoothing. The postoperative examination was performed 7, 14 and 30 days after surgery. Corneal topography was performed by a computer-assisted videokeratoscope (TMS-1). The results were evaluated by the Fourier transform analysis. Both methods showed similar results concerning refraction and visual acuity postoperatively. Preoperatively all patients had an irregular flattening of the corneal topography in the area of the pterygium. Postoperatively a small irregular flattening was left in eyes treated with a diamond fraise. In the excimer laser treated group a steepening in the corneal topography could be observed. The phototherapeutic keratectomy with excimer laser in the treatment of pterygia suggests to be a gentle alternative creating a smooth wound surface. Despite of this advantage the treatment with the excimer laser effects a remarkable increase in administration and expense.
    Klinische Monatsblätter für Augenheilkunde 07/2001; 218(6):418-23. · 0.70 Impact Factor
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    ABSTRACT: There is controversy regarding the nervous control of retinal blood vessels in humans. Most in vitro studies indicate that the intraocular part of the central retinal artery lacks autonomic innervation. We investigated the response of retinal vessels to isometric exercise during blockade of beta-receptors (propranolol) or muscarinic receptors (atropine). Twelve healthy subjects performed squatting for 6 min during infusion of either propranolol atropine or placebo. Blood pressure and pulse rate were measured non-invasively. Retinal vessel diameters were measured continuously using the Zeiss Retinal Vessel Analyser. Squatting induced a significant increase in blood pressure and pulse rate, which was paralleled by a decrease in retinal vein and artery diameters. Atropine did not change the retinal vessel response to isometric exercise. Propranolol significantly blunted the exercise-induced vasoconstriction in retinal arteries. This result likely indicates propranolol-evoked vasoconstriction in the extraocular parts of the central retinal artery during isometric exercise.
    Ophthalmic Research 01/2001; 33(4):185-90. · 1.56 Impact Factor
  • Cornea 01/2000; 19. · 1.75 Impact Factor
  • Cornea 01/2000; 19. · 1.75 Impact Factor
  • Cornea 01/2000; 19. · 1.75 Impact Factor