M Derse

Universitätsklinikum Tübingen, Tübingen, Baden-Württemberg, Germany

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Publications (14)18.3 Total impact

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    ABSTRACT: A familial accumulation in some forms of uveitis has rarely been described. The objective of this study was to identify such cases and to examine both clinical course and similarities in the HLA-pattern. From 1993 to 2000 all new uveitis patients, who were examined in the uveitis clinic of the University Eye Hospital Tuebingen, were asked about a positive family history. If possible, all affected family members underwent an ophthalmological examination and HLA-typing was performed. In 7 families we found a familial accumulation of uveitis. The underlying etiologies were anterior uveitis in ankylosing spondylitis with HLA-B27 association, anterior uveitis in Blau syndrome with no HLA association, anterior and intermediate uveitis in sarcoidosis with no HLA association, and panuveitis in Behçet's disease with HLA-B51 association. For familial uveitis we calculated an incidence of 0.03 cases per 100,000 persons and year. Our data confirm that familial forms of uveitis are very rare. We suggest that these may be subgroups of known uveitis syndromes (e.g. sarcoidosis, ankylosing spondylitis). The factors causing the inheritance are still unknown. By genetic examination of families with uveitis it may be possible to identify single uveitis genes or possible antigens.
    Der Ophthalmologe 10/2003; 100(9):713-9. DOI:10.1007/s00347-002-0767-x · 0.72 Impact Factor
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    ABSTRACT: In clinical practice ophthalmologists often need a tonometer which is independent of a slit lamp. Such a hand-held device is the Tono-Pen. We compared the precision of two equal Tono-Pens with Goldmann applanation tonometry. Measurement of intraocular pressure (IOP) was done in 100 eyes of 51 patients (mean age 63 +/- 15 years) suffering from ocular hypertension or glaucoma. According to a random table either the right or left eye was measured using Goldmann tonometer first and the Tono-Pen second. For the other eye the measurement was reversed. One of the two equal Tono-Pens (Solan/USA) was used according to a second random table. Three measurements were obtained with each instrument on both eyes within 15 minutes subsequently. Patients were placed in an upright position for all measurements. Even for well-trained ophthalmologists a learning curve of approximately 10 measurements was observed using the Tono-Pen. The Tono-Pen measured an average IOP of 16.9 mm Hg in all 100 eyes. The Goldmann tonometer measured an average IOP of 17.7 mm Hg. The difference was not statistically significant. The standard deviation for all measurements was better for the Tono-Pen (4.7 mm Hg vs 5.8 mm Hg for Goldmann tonometer). No reduction of the IOP after Tono-Pen measurement was observed (in contrast to the Goldmann tonometer). The reproducibility of the Tono-Pen on the same eye was inferior to the Goldmann tonometer by a factor of 2. There was an almost significant difference in reproducibility between two equal Tono-Pens. Measurement of IOP with the Tono-Pen is comparable to Goldmann applanation tonometry if an average of 3 measurements is used. The difference between two equal Tono-Pens indicates the need for improvement of the quality check during production.
    Klinische Monatsblätter für Augenheilkunde 04/2002; 219(3):138-42. DOI:10.1055/s-2002-26718 · 0.67 Impact Factor
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    ABSTRACT: This prospective study was conducted to evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation in refractory, advanced glaucoma. One hundred eyes of 100 patients with advanced glaucoma refractory to medical treatment were consecutively treated by transscleral diode laser cyclophotocoagulation. Success was defined as a final intraocular pressure between 5 and 21 mm Hg in eyes with a visual acuity of more than hard movements, relief of pain in eyes with a visual acuity of hand movements or less including blind eyes, and reduction of carbonic anhydrase inhibitor use in all eyes. Ninety-three patients were followed up for 1 year after initial treatment. The overall success rate was 74.2%. Of 60 eyes with a visual acuity of more than hand movements, intraocular pressure between 5 and 21 mm Hg was achieved in 41 (68.3%) eyes. Relief of pain was achieved in 28 (84.8%) of 33 eyes. Reduction of systemic carbonic anhydrase inhibitor use was highly significant (P < 0.0001). Within 1 year, 173 laser procedures (mean, 1.9 per patient) were performed. The probability of success increased significantly (P = 0.004) with the age of the patients, from 55% for patients younger than the age of 50 years to 83% for patients older than the age of 50 years. Previous ocular surgery decreased the success probability from 95% to 68% (P = 0.02). A high success rate was achieved in inflammatory glaucoma (75%), primary open-angle glaucoma (89.5%), and neovascular glaucoma (86.7%). The results were relatively poor in traumatic glaucoma (57.1%), aphakic glaucoma (57.1%), and congenital or juvenile glaucoma (62.5%). No significant relationship between loss of visual acuity and failure of treatment (P = 0.3) could be detected. No phthisis bulbi or persistent hypotonia developed. Transscleral diode laser cyclophotocoagulation is an effective and safe method for the treatment of advanced, refractory glaucoma. However, repeated treatments are often necessary. Success of treatment depends on the age of patients, previous surgery, and the type of glaucoma.
    Journal of Glaucoma 08/2001; 10(4):294-301. DOI:10.1097/00061198-200108000-00009 · 2.43 Impact Factor
  • T Schlote · M Derse
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    ABSTRACT: Retro- or peribulbar anesthesia are the standard procedures for cyclodestructive surgery. Because these methods of anesthesia may further compromise optic nerve function, especially in advanced glaucoma, subconjunctival anesthesia was evaluated as an alternative procedure in contact diode laser cyclophotocoagulation (CPC). A prospective study concerning diode laser CPC in advanced glaucoma was started using subconjunctival anesthesia with 2% mepivacaine. Complications and pain during CPC (5 point rating scale) and on the first postoperative day were recorded. Only the first CPC in every patient was included for evaluation. Included in the study were 120 eyes of 120 patients. During CPC, 82.5% of patients experienced no pain, 11.7% mild pain, and 5.8% moderate pain. No instances of pain or excess motion occurred that required peribulbar anesthesia or discontinuation of the procedure. Most of the patients experienced no pain during diode laser CPC using subconjunctival anesthesia. Therefore, risks and side effects of retro- or peribulbar anesthesia can be successfully avoided by this simple modification.
    Ophthalmic surgery and lasers 01/2001; 32(4):289-93.
  • Source
    T Schlote · M Derse · M Zierhut
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    ABSTRACT: Inflammatory glaucoma is still a diagnostic and therapeutic dilemma and surgical intervention is always associated with a high risk of failure or reactivation of the inflammatory disease. In this study we prospectively examined the value of transscleral diode laser cyclophotocoagulation (TDLC) for the treatment of refractory inflammatory glaucoma. 22 eyes of 20 consecutive patients with inflammatory, medically uncontrollable, glaucoma secondary to chronic uveitis/trabeculitis (n = 18), chemical injury (n = 2), episcleritis (n = 1), and necrotising scleritis with inflammation (n = 1) were treated by TDLC. Nine eyes (41%) had had previous failed glaucoma surgery (trabeculectomy, cyclocryocoagulation) and 15 eyes (68.2%) had had previous anterior segment surgery. All patients were followed for 1 year after the initial treatment. Within 12 months of the first treatment the intraocular pressure was controlled in 77.3% of all eyes (72.2% of those with uveitic glaucoma). No serious side effects such as activation of the inflammatory process, phthisis bulbi or persistent hypotonia were observed, except one patient with a temporary fibrin reaction. More than one treatment was necessary in 63.6% of the patients. The use of systemic carbonic anhydrase inhibitors was reduced from 68.2% before treatment to 27.3% after 1 year. TDLC seems to be a safe and effective procedure for the treatment of inflammatory glaucoma and may become an alternative to trabeculectomy with antimetabolites in uveitic glaucoma. TDLC may become the surgical procedure of choice in treating secondary glaucoma caused by chemical injury and also in scleritis associated glaucoma, using reduced parameters for application.
    British Journal of Ophthalmology 10/2000; 84(9):999-1003. · 2.81 Impact Factor
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    T Schlote · M Derse · H J Thiel · B Jean
    British Journal of Ophthalmology 04/2000; 84(3):337-8. DOI:10.1136/bjo.84.3.337a · 2.81 Impact Factor
  • T Schlote · M Derse · B Wannke · T Bende · B Jean
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    ABSTRACT: Halos, glare disability and problems during night driving are significant side effects of photorefractive keratectomy, caused by increasing optical aberrations under reduced conditions of luminiscence. In a previously performed retrospective study an impairment of mesopic vision in most of the investigated eyes was found. To prove these results, a prospective study was conducted. In a prospective, consecutive study mesopic function was investigated in 41 myopic patients, who were interested in PRK. 26 patients underwent surgery (Summit ExciMed UV200LA, optical zone 5 mm), which was performed in 30 eyes. Mesopic function (contrast vision, glare sensitivity) was measured by using the Mesoptometer II test in all 30 eyes preoperatively and 6 to 9 months postoperatively. Additionally, 21 eyes were examined after 12 to 15 months of follow up. There was a statistically significant reduction of contrast vision and increase of glare sensitivity after 6 to 9 and 12 to 15 months. The Mesoptometer II contrast level of 1:5 (with and without glare) can be used as a critical parameter for the decision, whether mesopic function is markedly reduced or not. Before surgery, contrast level of 1:5 without glare was not recognized in 30%, with glare in 40%. After 6 to 9 months, this contrast level was not recognized in 73% of the 30 eyes without glare, with glare in 80%. Out of these 30 eyes, 21 eyes were followed over 12 to 15 months. Whereas 38% of these eyes (with glare 48%) did not recognized the critical contrast level before surgery, this rate increased to 67% (with glare 81%) 12 to 15 months after surgery. Impairment of mesopic function has to be considered as a possible side effect of PRK (optical zone 5 mm). Although further investigations are needed, the indication for PRK in special professions (pilots, professional drivers) should be very critical discussed.
    Klinische Monatsblätter für Augenheilkunde 04/1999; 214(3):136-41. · 0.67 Impact Factor
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    ABSTRACT: For several years it has been discussed whether cyclocryotherapy is still an up-to-date treatment of resistant inadequately controlled glaucoma. This retrospective study investigates the clinical aspects of 185 cyclocryotherapies between 1988 and 1997. At the University Eye Clinic of Tübingen, 114 patients received in 119 eyes (64.3%) one cyclocryotherapy, and in 66 eyes (35.7%) multiple cyclocryotherapies. The standard surgical techniques for cyclocryotherapy can be summarized as followed: probe placements per eye, 4 to 6; location of probe placement, inferior circumference (63.9%); distance of the applicator from limbus, 3 mm (50.7%); temperature of the probe tip, -70 degrees C (34.2%); and time of the treatment, 60 seconds (89.9%). Intraocular pressure was on average 33.8 mm Hg before treatment. In all analysed glaucoma types intraocular pressure was lowered to 10.2 mm Hg (30%). The most frequent type of glaucoma was the neovascular glaucoma (55%). One year after treatment, this type showed on average, relative to all other types of glaucoma, the highest intraocular pressure (28.1 mm Hg) and a lowering of intraocular pressure by 8.3 mm Hg (22.7%). Half a year after cyclocryotherapy, a highly significant (p < 0.002) reduction of antiglaucomatous medication was achieved in comparison to the preoperative medication. Despite the fact that cyclocryotherapy is not always effective, it is an ambulant surgical technique easy to apply, non-invasive, cost-effective and can be repeated to lower intraocular pressure in resistant chronic glaucoma. We conclude that cyclocryotherapy will remain useful until new techniques, like the diode laser cyclophototherapy (especially ultrasonic controlled), are developed as alternative therapies.
    Klinische Monatsblätter für Augenheilkunde 04/1999; 214(4):224-30. · 0.67 Impact Factor
  • Klinische Monatsblätter für Augenheilkunde 01/1999; 214(04):224-230. DOI:10.1055/s-2008-1034780 · 0.67 Impact Factor
  • Klinische Monatsblätter für Augenheilkunde 01/1999; 214(03):136-141. DOI:10.1055/s-2008-1034765 · 0.67 Impact Factor
  • T Bende · Benedikt Jean · Matthias Derse · Katja Rassmann · H J Thiel
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    ABSTRACT: The refractive outcome of thermokeratoplasty for astigmatism correction depends upon the optical zone diameter (OZD) and coagulation angle (CA; distance between two coagulation spots around the flat meridian). Astigmatism was induced in 36 spherical human eye-bank eyes (Ho:YAG laser, 15 Hz, 20 mJ/pulse, 25 pulses per coagulation spot) with different OZDs and CAs. Thirty eyes received free-hand laser application (marked positions). Six eyes were treated using a suction mask, providing a constant OZD of 8.1 mm and an angle of 22.5 degrees between the laser spots. To compare the results, silicone replicas of the eyes were made pre- and postoperatively and analyzed by video-topometery. With an average decrease of 4 D/mm the refractive change is inversely linear to the OZD. Changes of the CA showed significant variations between 22.5 degrees and 45 degrees, only. Mask guidance leads to the same amount of average refractive change. The deviation is +/- 3.4 D for the freehand application but only +/- 0.8 D for mask guidance. The data obtained in this in vitro study are transferred to a treatment nomogram describing the immediate postoperative refractive change, not identical with the final refraction. The results of the study are limited by the fact that astigmatism was induced in spherical corneas, rather than correcting preexisting ones.
    Albrecht von Graæes Archiv für Ophthalmologie 07/1998; 236(6):405-9. DOI:10.1007/s004170050097 · 2.33 Impact Factor
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    ABSTRACT: To evaluate contrast vision and glare sensitivity under mesopic conditions in eyes having uncomplicated excimer laser photorefractive keratectomy (PRK) for myopia and in eyes corrected by disposable soft contact lenses, soft contact lenses, and spectacles. Division of Experimental Ophthalmic Surgery, University of Tübingen, Germany. The Mesoptometer II test was used to evaluate mesopic vision (glare sensitivity and contrast vision) in 28 eyes of 14 patients wearing disposable soft contact lenses, 20 eyes of 10 patients wearing soft contact lenses, 39 eyes of 20 patients wearing spectacles, 30 eyes of 15 emmetropic patients, and 33 eyes of 22 patients after PRK with 5.0 mm optical zone. Follow-up was between 15 and 60 months after PRK (mean 34.5 months). The guidelines of the German Ophthalmologic Society state that patients must recognize Mesoptometer II contrast levels of 1:5 or better with and without glare to meet the minimum legal night-driving standards for private cars. All eyes with disposable soft contact lenses and soft contact lenses, all emmetropic eyes, and 38 eyes corrected by spectacles recognized contrast levels of 1:5 or better without glare. In contrast, 18 eyes in the PRK group were unable to recognize contrast level 1:5 without glare. With glare, 1 eye in the disposable soft contact lens group, 1 in the soft contact lens group, and 7 with spectacles were unable to recognize the 1:5 contrast level. All emmetropic eyes recognized contrast levels of 1:5 or better; 22 PRK eyes were unable to recognize contrast level 1:5 with glare. Myopic PRK may lead to long-term impairment of mesopic vision, while soft contact lens use does not seem to markedly influence mesopic vision in eyes with low to moderate myopia.
    Journal of Cataract and Refractive Surgery 07/1997; 23(5):718-25. DOI:10.1016/S0886-3350(97)80280-5 · 2.55 Impact Factor
  • J M Rohrbach · M Derse · T M Wohlrab
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    ABSTRACT: A 3.5-year-old girl suffered from a penetrating injury of the left eye. One and a half years later epithelial ingrowth was detected. Although block-excision was performed in the usual manner without technical problems the retina was excised accidentally. Histology revealed that the retina had been massively displaced in anterior direction prior to surgery because of fibrovascular proliferations.
    Klinische Monatsblätter für Augenheilkunde 05/1997; 210(4):225-6. · 0.67 Impact Factor
  • Jens Rohrbach · Matthias Derse · Thomas-Michael Wohlrab
    Klinische Monatsblätter für Augenheilkunde 01/1997; 210(04):225-226. DOI:10.1055/s-2008-1035046 · 0.67 Impact Factor

Publication Stats

149 Citations
18.30 Total Impact Points

Institutions

  • 1998–2001
    • Universitätsklinikum Tübingen
      Tübingen, Baden-Württemberg, Germany
  • 1999
    • University of Tuebingen
      Tübingen, Baden-Württemberg, Germany