Rupert W Strauss

Allgemeines Krankenhaus Linz, Linz, Upper Austria, Austria

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Publications (29)56.71 Total impact

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    ABSTRACT: PURPOSE:: To evaluate the selectivity and strength of intraoperative trypan blue staining during removal of epiretinal membranes (ERMs) and the internal limiting membrane. METHODS:: Based on intraoperative videos, 51 consecutive chromovitrectomies in 51 patients with macular holes, macular pucker, vitreomacular traction syndromes, or persistent macular edema were retrospectively studied. Fifteen subjects underwent trypan blue, 14 indocyanine green, and 22 brilliant blue G chromovitrectomy. The main outcome measure was the color contrast between stained internal limiting membrane or ERM and the underlying unstained tissue by means of objective, quantitative, semiautomated chromaticity difference measurements. RESULTS:: Trypan blue stains both ERM and the internal limiting membrane (average chromaticity scores 8.51 and 7.09, respectively; P = 0.48). Internal limiting membrane chromaticity scores were similar for trypan blue (7.09) and brilliant blue G (6.81; P = 0.71) but clearly higher for indocyanine green (15.81; P = 2.45 × 10). CONCLUSION:: Under the premises of our study, trypan blue stains both ERM and the internal limiting membrane. Trypan blue's staining capacity of the internal limiting membrane is similar to that of brilliant blue G but significantly inferior compared with indocyanine green. Trypan blue, thus, represents a useful vital dye for chromovitrectomy, particularly in the presence of ERM, where it allows a sequential approach.
    Retina (Philadelphia, Pa.) 02/2013; · 2.93 Impact Factor
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    ABSTRACT: Purpose:  To evaluate the potential of heavier-than-water brilliant blue G (BBG-D(2) 0) to stain the internal limiting membrane (ILM) during chromovitrectomy. Methods:  In a nonrandomized, prospective, clinical multicentre study, 71 consecutive chromovitrectomy interventions in 71 patients were analysed. During routine 23-gauge vitrectomy, conventional 0.25 mg/ml BBG was employed in 21 and 0.25 mg/ml BBG-D(2) 0 in 50 patients. All interventions were videotaped. Post-operatively, video frames were viewed and dye performance assessed subjectively and objectively. Main outcome measure was the chromaticity difference between the stained ILM and the unstained underlying retina, measured by means of an objective and quantitative analysis method to describe colour contrast strengths as they are perceived by the human eye. Results:  Removal of the ILM was possible in all interventions without additional vital dyes. BBG-D(2) 0 readily sank to the retinal surface, while conventional BBG tended to swirl up throughout the vitreous cavity. Conventional BBG was removed either with active suction or with a flute needle. Brilliant blue G-D(2) 0 needed to be whirled up from the retinal surface with a flute needle before aspiration. Objective chromaticity measurements yielded a mean chromaticity score of 7.98 for BBG-D(2) 0 and 6.51 for BBG (p = 0.09). Conclusions:  Brilliant blue G-D(2) 0 readily sinks to the retinal surface after injection and can be conveniently removed with a flute needle or active suction during chromovitrectomy. Based on the premises of the chromaticity measurements in this study, BBG's ILM staining capacity was not significantly improved through the recent revision its preparation, although a tendency towards slightly improved contrasts between the ILM and the underlying retina was observed.
    Acta ophthalmologica 11/2012; · 2.44 Impact Factor
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    ABSTRACT: The purpose of this article was to create a nanometer scale topographic and biomechanical profile of the human internal limiting membrane (ILM) under native conditions. ILMs from the posterior pole of postmortem human eyes were prepared as flat mounts and investigated by atomic force microscopy (AFM) under physiological conditions. Structural analysis was complemented by transmission electron microscopy. Average thickness of the fully hydrated, native ILMs was 3488 ± 460 nm. Thickness variations from 100 nm to 4326 nm characterized the fovea, which displayed a craterlike morphology. Outside the fovea, thickness distribution was uniform. Although mean ILM thicknesses were similar, standard deviation was higher on the retinal than on the vitreal side, indicating greater roughness. Average ILM stiffness was more than fivefold higher on the retinal than on the vitreal side (227 vs. 44 kPa). A detailed topographical and nanomechanical profile of native human ILM was generated using AFM. Thickness values were significantly higher than in previous studies because of the preservation of native conditions. Both thickness and stiffness showed marked variations around the fovea but were relatively uniform outside the foveal area. Interestingly, the foveal ILM displayed a craterlike morphological appearance with four distinct layers separated by comparatively steep thickness increments. ILM stiffness was considerably higher on the retinal than on the vitreal side. AFM opens new possibilities for investigating native basement membranes under physiological and pathological conditions. Transmission electron microscopy revealed higher extracellular matrix protein density on the retinal than on the vitreal side.
    Investigative ophthalmology & visual science 03/2012; 53(6):2561-70. · 3.43 Impact Factor
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    ABSTRACT: To analyze the changes in optic surface roughness before and after injection of various intraocular lens (IOL) models using atomic force microscopy (AFM). Departments of Ophthalmology, Medical University of Graz, General Hospital Linz and University Hospital Basel; Upper Austria University, School of Applied Health and Social Sciences, Linz, Austria. Experimental study. The morphology and surface roughness of 3 hydrophobic acrylic IOLs from different manufacturers were analyzed by AFM in liquid using the tapping mode. First, AFM was performed on IOLs taken from the original package without further manipulation. In a second step, under sterile conditions, an experienced cataract surgeon loaded the IOLs into the appropriate injection system and pushed them through a system resembling an IOL implantation in cataract surgery; this was followed by AFM evaluation. Finally, 3 samples of a preloaded hydrophilic acrylic IOL taken from the original cartridge were compared with 3 samples that were pushed through the implantation system. Comparison of the arithmetic mean, standard deviation, root mean square, and surface skewness of the IOLs before and after injection showed a significant increase in surface roughness (P<.05). Standard application procedures of IOLs may alter the IOL surface. Increases in the surface roughness of IOLs may influence postoperative posterior capsule opacification. Further studies are necessary to evaluate the interfacial properties of IOLs.
    Journal of Cataract and Refractive Surgery 11/2011; 38(1):146-54. · 2.75 Impact Factor
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    ABSTRACT: The aim of this study was to examine the changes in static analysis of the retinal vasculature during an acute rise of blood pressure in young normal subjects. An increase of blood pressure was induced in 30 young normal subjects (age 18 - 30 years) by physiological stress. Retinal fundus photographs were taken before and immediately after the stress. The central retinal artery equivalent (CRAE), the central retinal vein equivalent (CRVE) and the arterio-venous ratio (AVR) were calculated by automated vessel analysis software (Talia Technology, Lod, Israel). The same vessel segments were measured before and after the rise of blood pressure. At rest, mean CRAE was 97.3 ± 9.6 micrometer, CRVE 114.5 ± 12.5 micrometer and AVR 0.85 ± 0.08. The mean systemic perfusion pressure was elevated by physiological stress from a mean of 90.7 ± 7 mmHg by 18.0 ± 7.8 mmHg. The static retinal vessel analysis showed a constriction of the arteries by a mean of -1.3 ± 3.9 microns and a venous dilatation of 0.6 ± 7.2 microns. The retinal AVR was diminished significantly (p = 0.02) by -0.015 ± 0.032. The degree of arterial constriction - but not the change of AVR - correlated significantly (r = -0.39; p = 0.048) with the degree of rise of blood pressure. Retinal autoregulation during acute increase of blood pressure in young normal subjects can be measured by static retinal vessel analysis.
    Klinische Monatsblätter für Augenheilkunde 03/2011; 228(6):544-9. · 0.70 Impact Factor
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    ABSTRACT: Adhesion and spreading of retinal pigment epithelial (RPE) cells on fibronectin-rich extracellular matrices is a crucial event in the pathogenesis of proliferative vitreoretinopathy (PVR). In the present study we explored the capacity of galectin-3, a β-galactoside-binding endogenous lectin, to inhibit early PVR-associated cellular events from a therapeutic perspective. We assessed the relative expression levels of galectin-3 in native RPE and dedifferentiated, cultured RPE. Galectin-3 was constitutively expressed under in vivo and in vitro conditions and was abundant in cultured cells. Treatment of human RPE cells with soluble galectin-3 disclosed no toxicity within control limits up to 250 μg/ml. When added to the medium, galectin-3 dose-dependently inhibited attachment and spreading of the cells on fibronectin by more than 75%. When coated on the plastic surface, galectin-3 alone impaired attachment and spreading of RPE cells, and reduced attachment but not spreading on fibronectin. Galectin-3 bound to the cell surface, and, as determined by the use of the competing sugar β-lactose, galectin-3-mediated effects were dependent on carbohydrate binding. To ascertain the role of the ability of galectin-3 to form pentamers, we proteolytically removed the N-terminal, cross-linking section. The remaining C-terminal carbohydrate-binding domain alone failed to bind to cells and was functionally inactive. These results emphasize the relevance of both properties, i.e., glycan-binding and cross-linking of glycan moieties, for the inhibitory activity of galectin-3. Incubation of mobilized RPE cells with galectin-3 significantly disturbed microfilament assembly and, in correlation with decreased attachment, inhibited ERK phosphorylation. Therefore, galectin-3, acting as a cross-linking lectin on the cell surface, negatively regulates attachment and spreading of RPE cells in vitro. This effect, at least in part, is attributed to an inhibition of the ERK-MAPK pathway, which prevents cytoskeletal rearrangements needed for RPE cell attachment and spreading. Further investigation at this pathway may disclose a promising nouveau perspective for treatment and prophylaxis of early PVR.
    Biochimie 03/2011; 93(3):477-88. · 3.14 Impact Factor
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    ABSTRACT: To evaluate the potential of brilliant blue G (BBG) and indocyanine green (ICG) for intraoperative staining of the internal limiting membrane (ILM) with respect to perceivable contrast. In a retrospective clinical case series the authors analyzed 26 consecutive chromovitrectomy interventions in 26 patients with macular holes, epiretinal fibrosis, vitreoretinal traction syndromes, or persistent macular edema. Fourteen subjects underwent ICG and 12 subjects, BBG chromovitrectomy. The main outcome measure was the difference in chromaticity between the stained ILM and the unstained underlying retina, measured by means of a novel objective and quantitative video-based analysis method to describe color contrast strengths as they are perceived by the human eye. Objective chromaticity measurements of the intraoperative videos of all 26 interventions showed a significantly inferior contrast for BBG compared with that of ICG (BBG = 6.1, ICG = 14.9; P = 3.885 × 10⁻¹⁵). As an adjunct to chromovitrectomy to stain the ILM, BBG yields a significantly less well discernible contrast to the human eye than that of ICG under the premises of this study.
    Investigative ophthalmology & visual science 03/2011; 52(7):4345-9. · 3.43 Impact Factor
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    ABSTRACT: Early age-related macular degeneration (AMD) is characterized by thickening of Bruch's membrane due to the accumulation of extracellular matrix (ECM). This finding could be related to hypoxia of the retinal pigment epithelium (RPE). In the present study, we investigated the effects of hypoxia and reoxygenation on the expression of connective tissue growth factor (CTGF), plasminogen activator inhibitor-1 (PAI-1), collagen type IV (Col IV) and fibronectin (Fn) in cultured human RPE cells. Cultured human RPE cells were kept for 12-36h under hypoxic conditions (1% O(2)). Reoxygenation was conducted for 24h. Hypoxia-mediated CTGF and PAI-1 expression were analyzed by using immunohistochemistry, Northern and Western blot analysis. Actinomycin D was added to examine whether hypoxia induces the transcription of CTGF and PAI-1 mRNA. Furthermore, cells were transfected with siRNA against hypoxia-inducible factor-1alpha (HIF-1alpha) and kept under hypoxic conditions. The effects of antioxidants on hypoxia/reoxygenation-mediated CTGF and PAI-1 expression were tested by real-time PCR analysis. Production of Col IV and Fn were investigated by real-time PCR and Western blot analysis. Both hypoxia and hypoxia/reoxygenation increased the expression of CTGF, PAI-1, Col IV and Fn. Actinomycin D prevented the new transcription of CTGF and PAI-1 mRNA by hypoxia. Using siRNA against HIF-1alpha, the hypoxia-mediated increase of CTGF and PAI-1 was inhibited. Antioxidants attenuated the reoxygenation-mediated increase of CTGF and PAI-1. The process of hypoxia/reoxygenation in the RPE may lead to an increase of ECM in the RPE and thus may contribute to the accumulation of ECM in Bruch's membrane.
    Experimental Eye Research 01/2009; 88(5):889-99. · 3.03 Impact Factor
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    ABSTRACT: PROBLEMSTELLUNG: Evaluierung von Brilliant Blau als Vital-Farbstoff in der Chirurgie von Erkrankungen der vitreo-makulären Grenzfläche und Makulopathien. METHODE UND/ODER PATIENTEN: Bei 20 (je zehn männliche und weibliche) Patienten mit einem Durchschnittsalter von 68 ± 11,1 Jahren wurde aufgrund folgender Pathologien unter Verwendung von Brilliant Blau als Vitalfarbstoff eine Vitrektomie mit peeling durchgeführt: Makulaforamina, Makular pucker, vitreo-makuläres Traktionssyndrom, klinisch signifikantes Makulaödem bei diabetischer Retinopathie. Prä- und postoperativ erfolgte eine komplette augenärztliche Untersuchung inklusive bestkorrigierter Sehschärfe, Spaltlampenbiomikroskopie, Funduskopie, Fluoreszenzangiographie, Messung der makulären Dicke mittels optischer Kohärenztomographie und einer Gesichtsfelduntersuchung. ERGEBNISSE: Die Verwendung von Brilliant Blau zeigte eine sehr gute Demarkation der "inner limiting membrane" (ILM) bei allen 20 operierten Patienten. Im Gegensatz dazu war die Anfärbung von epiretinalen Membranen schwächer ausgeprägt. Glaskörper und hintere Glaskörpergrenzfläche zeigten keine Anfärbung mit Brilliant Blau. In der bisherigen Nachbeobachtungszeit konnten keine Farbstoff-assoziierten unerwünschten Nebenwirkungen in den funktionalen Untersuchungen (Sehschärfe, Gesichtsfeld) oder objektiven Befunden (FLA/OCT) beobachtet werden. Die fünf operierten Makulaforamina zeigten sich in der Folgezeit alle verschlossen. In der Gruppe der epiretinalen Gliosen, vitreo-makulärer Traktionssyndrome und klinisch signifikanten Makulaödeme konnte eine kontinuierliche Abnahme der Netzhautdicke beobachtet werden. SCHLUSSFOLGERUNGEN: Brilliant Blau scheint ein hilfreicher und sicherer Farbstoff für die Chirurgie des Augenhinterabschnittes zu sein. Prospektive Studien mit größeren Patientenzahlen sind für die weitere Evaluierung von Nöten. INTRODUCTION: Evaluation of brilliant blue G as a vital dye for surgery of eyes with vitreo-macular interface pathologies and other maculopathies. MATERIAL AND METHODS: 20 patients (ten male and ten female) with an average age of 68 ± 11,1 years underwent vitrectomy and peeling of the internal limiting membrane with brilliant blue G as a vital dye. Pathologies included: macular holes, macular pucker, vitreo-macular traction syndrome, and clinical significant macular edema (CSME) due to diabetic retinopathy. Pre- and postoperatively a complete ophthalmological examination including best corrected visual acuity, slit-lamp biomicroscopy, funduscopy, fluorescein angiography, measurement of macular thickness by optical coherence tomography (OCT) and visual field testing was performed. RESULTS: Brillinat blue G showed a very good staining of the "inner limiting membrane" (ILM) in all 20 operated patients. In contrast, staining of epiretinal membranes with brilliant blue G was less pronounced. Brillinat blue G did not stain vitreous remnants. During follow-up, no dye-related adverse events could be observed both in functional tests (visual acuity, visual field) and in objective measurements (FA, OCT). All five macular holes were successfully closed. In the group of eyes with epiretinal membranes, vitreomacular tractions syndrome and CSME, a continuous decrease of macular thickness could be observed during follow-up. CONCLUSION: Brilliant blue G seems to be an effective and safe dye for vitreo-retinal surgery. Prospective studies with higher numbers of patients are necessary for further evaluation.
    Spektrum der Augenheilkunde 11/2008; 22(6):365-369. · 0.18 Impact Factor
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    The British journal of ophthalmology 10/2008; 92(9):1298-9. · 2.92 Impact Factor
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    ABSTRACT: To evaluate the long-term efficacy of bevacizumab for the treatment of chronic diffuse diabetic macular edema after various previous treatments. A total of 126 patients (mean age: 66 years) with chronic diffuse diabetic macular edema were consecutively incorporated in this prospective, noncomparative case series. Inclusion was performed independently from the size of edema, retinal thickness, visual acuity (VA), age, metabolic control, type of diabetes, or type of previous treatments. The patients underwent a complete eye examination including best-corrected VA with ETDRS charts, slit lamp examination, intraocular pressure measurement, stereoscopic biomicroscopy of the macula, retinal thickness measurement using optical coherence tomography (OCT), fluorescein angiography, and fundus photography. All patients were treated with repeated intravitreal injections of bevacizumab (1.25 mg). Patients were observed in intervals of 4-12 weeks for a period of up to 6-12 months. All patients had received various previous treatments such as laser treatment (62% focal laser treatment, 38% panretinal laser treatment), vitrectomy (11%), or intravitreal injection of triamcinolone (41%). All patients completed 6 months and 59 patients (47%) completed 12 months of follow-up; within this period 48% had received at least three intravitreal injections of bevacizumab. Mean diameter of foveal avascular zone was 858 +/- 341 microm. At baseline mean VA was 40.3 ETDRS letters (0.82 logMAR Snellen VA) and mean central retinal thickness on OCT was 463 microm. Throughout follow-up VA changes were not significant with a mean change of -1.6 ETDRS letters after 6 months, but significant with +5.1 ETDRS letters after 12 months. Mean central retinal thickness (OCT) decreased to 374 microm after 6 months (P < 0.001) and to 357 microm after 12 months (P < 0.001). Changes of retinal thickness and visual acuity did not correlate. No other factors investigated, such as age, central retinal thickness, or previous treatments, were predictive for a change of VA. Macular ischemia was not exacerbated as a result of the treatment. Even in cases with chronic diffuse ischemic diabetic macular edema, a long-term decrease of central retinal thickness can be observed following repeated intravitreal injections of bevacizumab. In these patients, mean decrease in retinal thickness is aligned with a gain in mean VA. Treatment with bevacizumab at an earlier stage of diabetic macular edema without ischemia may be associated with an even better functional outcome.
    Retina (Philadelphia, Pa.) 10/2008; 28(8):1053-60. · 2.93 Impact Factor
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    ABSTRACT: To evaluate a capsular tension ring (CTR)-supported anterior and posterior capsule opacification (PCO) model in cadaver eyes. The effect of CTR designs on lens capsule shape and lens epithelial cell (LEC) growth were investigated in vitro. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Following open-sky extracapsular cataract extraction, CTR models were implanted in 32 eyes of 16 human donors. The lens capsule expansion by the CTRs was evaluated. The capsular bags supported by the CTRs were excised and maintained at physiological conditions for up to 3 months. The area of LEC coverage over the posterior capsule surface was objectively determined twice a day using a graticule. After CTR implantation, all lens capsules could be safely excised and transferred into organ culture. The CTR designs resulted in different shapes of lens capsule expansion. Complete LEC confluence occurred after a mean of 8.25 days+/-2.87 (SD) with the AcriRing KR10 (AcriTec), 6.50+/-1.0 days with the Acrimed, 8.62+/-3.34 days with the InjectoRing (Corneal), 9.00+/-1.87 days with the Morcher 14C, 9.33+/-0.75 days with the Morcher 2A, and 6.25+/-0.5 days with the Ophthalmic Innovation CTR. The CTR-supported in vitro PCO model offers a physiological method to support the lens capsule and is a reproducible system for the study of LEC proliferation.
    Journal of Cataract and Refractive Surgery 08/2008; 34(7):1167-72. · 2.53 Impact Factor
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    ABSTRACT: To evaluate the effect of intravitreal bevacizumab (Avastin) injections on visual acuity (VA) and foveal retinal thickness in patients with macular oedema secondary to branch retinal vein occlusion. A prospective, non-comparative, consecutive, interventional case series of 34 patients. Patients received repeated intravitreal injections of 1.25 mg bevacizumab. Main outcome measures were VA (Snellen charts and ETDRS) and retinal thickness (optical coherence tomography measurements) in a follow-up period of 6 months. Patients presented at a mean age of 69 years (range 44-86). Mean duration of symptoms was 40 weeks (range 1-300). Mean (SD) VA at baseline was 0.79 (0.39) logMAR, improving to 0.51 (0.34) logMAR at 6 months (p = 0.009). Mean number of letters on the ETDRS chart at baseline was 45.3 (19.0), improving to 60.6 (19.9) at 6 months (p = 0.003). Mean (SD) retinal thickness at baseline was 474 (120) microm, declining to 316 (41) microm at 6 months. Intravitreal injection of 1.25 mg bevacizumb appears to be an effective treatment option for branch retinal vein occlusion.
    The British journal of ophthalmology 04/2008; 92(3):351-5. · 2.92 Impact Factor
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    ABSTRACT: To describe visualization of the vitreous and the posterior hyaloid membrane using bromophenol blue during vitrectomy for macular hole and retinal detachment. Six patients with macular holes and four with retinal detachments were included in the study. Before and after surgery, complete clinical examination, including funduscopy and measurements of best-corrected visual acuity and intraocular pressure, was performed. Additional functional tests, such as fluorescein angiography, optical coherence tomography (Stratus OCT; Carl Zeiss Meditec, Jena, Germany, Germany), Goldmann perimetry, and multifocal electroretinography as well as photography of the posterior pole, were performed for macular hole patients. Bromophenol blue was used in concentrations of 0.2%. During macular hole surgery, the dye was injected into the air-filled globe, while during surgery for retinal detachment, the globe was partially filled with perfluorocarbon before dye injection after induction of a posterior vitreous detachment to stain the vitreous peripherally. Bromophenol blue provided sufficient staining of the attached posterior hyaloid membrane and vitreous remnants in the periphery. This was especially helpful for patients in whom a posterior vitreous detachment could not be induced mechanically by suction using the vitrectomy probe alone, as seen in three of six interventions for a macular hole in this series. In addition, staining of the vitreous or vitreous remnants in the periphery and at the vitreous base was seen in all patients and helped to completely remove the vitreous in a controlled fashion. After macular hole surgery, increase of visual acuity from 20/100 (mean) to 20/40 was seen during follow-up up to 6 months. In one case, the hole persisted and required a second operation. Finally, closure of the hole was achieved in all patients. After retinal detachment surgery, reattachment was achieved in all cases. No dye-related adverse events were seen during follow-up as shown by the functional tests (visual acuity measurement, electroretinography, and perimetry) applied. Delineation of the vitreous and the posterior hyaloid using bromophenol blue staining greatly facilitates vitreoretinal procedures. Bromophenol blue appeared to be a very helpful and safe tool to visualize the posterior hyaloid membrane in macular hole surgery and assured its complete separation from the retinal surface. The dye also helped to remove vitreous at the vitreous base during retinal detachment surgery. Therefore, bromophenol blue appears as a very good alternative to triamcinolone, which has been used for this purpose, because the dye has no pharmacological properties and no side effects are likely to occur such as cataract formation and increase in intraocular pressure. Further studies including larger numbers of patients are mandatory.
    Retina 03/2008; 28(2):333-9. · 2.83 Impact Factor
  • R W Strauss, A Kampik, A S Neubauer
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    ABSTRACT: Autofluorescence of the retina allows one to quantify and follow the extent and progression of dry, age-related macular degeneration (ARMD) changes. The objective of this study was to compare different analysis methods for displaying autofluorescence images. In a consecutive series of 15 patients with mild dry AMD and 15 patients without retinal pathologies, one 30 degrees autofluorescence image was obtained with the Heidelberg retina angiograph (HRA). Evaluation was performed by observers masked to the clinical group for each of the three analysis displays: topographic map in false colours (similar to height lines in maps), 3D display of optical density and quantitative, standardised evaluation of optical density values. For the 30 eyes included, grading of ARMD versus normal yielded a sensitivity of 83 -92 % for the topographic map, 58 - 83 % for the 3D and 75 - 83 % for quantitative optical density display. The corresponding specificity was 87 - 93 % for the topographic map, 53 - 60 % for the 3D and 67 - 80 % for the quantitative optical density display. Analysis by topographic mapping is suitable to supply quantitative information of optical density for evaluating autofluorescence images. In spite of being illustrative, a 3D display of optical density does not offer sufficient properties for analysis.
    Klinische Monatsblätter für Augenheilkunde 01/2008; 224(12):927-31. · 0.70 Impact Factor
  • Spektrum Der Augenheilkunde - SPEKTRUM AUGENHEILKD. 01/2008; 22(6):365-369.
  • Journal of Cataract and Refractive Surgery 01/2008; 33(12):2155-7. · 2.53 Impact Factor
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    ABSTRACT: To establish a set of quality parameters for grading image quality and apply those to evaluate the fundus image quality obtained by a new scanning digital ophthalmoscope (SDO) compared with standard slide photography. On visual analogue scales a total of eight image characteristics were defined: overall quality, contrast, colour brilliance, focus (sharpness), resolution and details, noise, artefacts and validity of clinical assessment. Grading was repeated after 4 months to assess repeatability. Fundus images of 23 patients imaged digitally by SDO and by Zeiss 450FF fundus camera using Kodak film were graded side-by-side by three graders. Lens opacity was quantified with the Interzeag Lens Opacity Meter 701. For all of the eight scales of image quality, good repeatability within the graders (mean Kendall's W 0.69) was obtained after 4 months. Inter-grader agreement ranged between 0.31 and 0.66. Despite the SDO's limited nominal image resolution of 720 x 576 pixels, the Zeiss FF 450 camera performed better in only two of the subscales - noise (p = 0.001) and artefacts (p = 0.01). Lens opacities significantly influenced only the two subscales 'resolution' and 'details', which deteriorated with increasing media opacities for both imaging systems. Distinct scales to grade image characteristics of different origin were developed and validated. Overall SDO digital imaging was found to provide fundus pictures of a similarly high level of quality as expert photography on slides.
    Ophthalmic and Physiological Optics 12/2007; 27(6):611-8. · 1.74 Impact Factor
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    ABSTRACT: To evaluate the effect of intravitreal bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA) injections on visual acuity and foveal retinal thickness in patients with central retinal vein occlusion (CRVO). In this prospective, noncomparative, consecutive, interventional case series, 46 patients received repeated intravitreal injections (1.25 mg) of bevacizumab. Main outcome measures were visual acuity (Snellen and ETDRS charts) and optical coherence tomography measurements in a 6-month follow-up period. Mean visual acuity improved from 20/250 at baseline to 20/80 at the 6-month follow-up (P < 0.001). ETDRS chart findings revealed a mean letter gain +/-SD from baseline to 6 months of 13.9 +/- 14.4 letters. Mean central retinal thickness +/-SD decreased from 535 +/- 148 microm at baseline to 323 +/- 116 microm at the 6-month follow-up. Ischemic CRVO was associated with significantly lower visual acuity than nonischemic CRVO (P < 0.001). However, visual acuity gain was similar in both groups. Independent of duration of symptoms, CRVO was associated with a similar gain in visual acuity. Intravitreal injection of bevacizumab appears to be a new treatment option for patients with macular edema secondary to CRVO.
    Retina 11/2007; 27(8):1004-12. · 2.83 Impact Factor
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    ABSTRACT: To evaluate the staining characteristics of bromphenol blue used during vitreoretinal surgery in humans. Patients and methods: 13 patients with epiretinal membranes were included. Before and after surgery a complete clinical examination including best corrected visual acuity, funduscopy, fluorescein angiography, OCT (Stratus), Goldmann perimetry and multifocal ERG as well as photography of the macular area was performed. Bromphenol blue was used in concentrations of 0.2% in most patients. Removed epiretinal tissue was evaluated using electron microscopy. Using dye concentrations of 0.2% a good demarcation of epiretinal membranes was seen in 11/13 patients. Staining of vitreous remnants at the vitreous base was seen in all patients. No dye-related adverse events were seen during follow-up in the functional tests (VA, ERG, perimetry) performed. Histological evaluation of epiretinal membranes showed unremarkable aspects of epiretinal cellular layers and unremarkable retinal surface of the internal limiting membrane (ILM). Bromphenol blue appears to be a very helpful and safe tool in posterior segment surgery. The staining characteristics need to be further evaluated in prospective study settings and larger numbers of patients.
    British Journal of Ophthalmology 10/2007; 91(9):1125-8. · 2.73 Impact Factor

Publication Stats

486 Citations
56.71 Total Impact Points

Institutions

  • 2011–2013
    • Allgemeines Krankenhaus Linz
      Linz, Upper Austria, Austria
    • Universitätsspital Basel
      Bâle, Basel-City, Switzerland
    • Medical University of Graz
      Gratz, Styria, Austria
  • 2005–2009
    • Ludwig-Maximilian-University of Munich
      • Eye Clinic
      München, Bavaria, Germany