Claus Cursiefen

University of Cologne, Köln, North Rhine-Westphalia, Germany

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Publications (294)710.15 Total impact

  • C Cursiefen
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 01/2015;
  • G Avgitidou, C Cursiefen, L M Heindl
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    ABSTRACT: A 2-year-old boy suffering from Cornelia de Lange syndrome, presented with mucopurulent ocular discharge and epiphora since birth. Irrigation and probing of the nasolacrimal system revealed and successfully treated bilateral nasolacrimal duct obstructions. Cornelia de Lange syndrome is characterized not only by typical facial features, visceral and urogenital anomalies but also by ophthalmological manifestations in 99 % of cases. The most common ophthalmological disorders are synophrys, blepharitis, epiphora, hypertrichosis of the eyebrows and eyelashes, myopia, ptosis and nasolacrimal duct obstruction.
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 01/2015;
  • K R Koch, H Kühner, C Cursiefen, L M Heindl
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    ABSTRACT: For the treatment of postsaccal lacrimal drainage obstructions transcanalicular laser dacryocystorhinostomy (TCL-DCR) represents a less invasive alternative to external Toti procedures. Herein, a diode laser optical fiber is inserted into the lacrimal sac via the canaliculi. Under visual control with a nasal endoscope laser energy is applied until a patent osteotomy between the sac and nasal mucosa has been created. Published success rates of 70-90 % get close to the excellent results of Toti procedures. Besides describing therapy planning and surgical technique, pros and cons of TCL-DCR are discussed.
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 12/2014;
  • Robert Siggel, Ludwig M Heindl, Claus Cursiefen
    Albrecht von Graæes Archiv für Ophthalmologie 11/2014; · 2.33 Impact Factor
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    ABSTRACT: The worldwide need for donor corneal tissue clearly exceeds the availability of transplantable human tissue; therefore, recent efforts aim to identify and characterize alternative tissues, such as decellularized collagen scaffolds.
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 10/2014;
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    ABSTRACT: Fuchs endothelial corneal dystrophy (FECD) is a genetically heterogeneous disease. Hypothesizing that cellular senescence may be relevant in FECD pathogenesis, genetically undifferentiated late-onset FECD endothelial samples were analyzed to identify common changes of specific senescence-related transcripts. Total RNA was extracted from 21 FECD endothelial samples retrieved from patients undergoing lamellar keratoplasty due to clinically diagnosed end-stage FECD and from 12 endothelial samples retrieved from normal autopsy eyes. Taqman low density array (TLDA) cards were used to analyze differential expression of 89 cellular senescence-related transcripts. Result validation was performed using individual real-time PCR assays. TLDA-analysis demonstrated differential expression of 31 transcripts (fold-change >1.5; p<0.05). Thereof, 27 showed significant up-regulation and 4 significant down-regulation. Markedly elevated mRNA-levels of the constitutively active and reactive oxygen species-generating enzyme NOX4 were found in all evaluable FECD samples. In addition, increased expression of CDKN2A and its transcriptional activators ETS1 and ARHGAP18 (SENEX) along with decreased expression of CDKN2A inhibitor ID1 were detected in FECD samples. Consistent over-expression of NOX4 in FECD endothelial samples suggests a role as pathogenic factor and as a potential new treatment target in FECD. Transcriptional up-regulation of the CDKN2A-pathway provides further evidence for increased cellular senescence in FECD endothelium.
    Experimental Eye Research 10/2014; · 3.02 Impact Factor
  • C Cursiefen
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 10/2014;
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    ABSTRACT: There is currently considerable controversy about existence and classification of "lymphatic vessels" in the eye. Some of the confusion is certainly caused by inappropriate use (or nonuse) of the correct immunohistochemical markers. Many experts in the field expressed the need for a consensus statement, and, in this perspective, authors offer arguments and solutions to reliably continue with immunohistochemical ocular lymphatic research.
    Investigative Ophthalmology &amp Visual Science 10/2014; 55(10):6440-2. · 3.66 Impact Factor
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    ABSTRACT: The aim of this study was to describe novel, flap-based tattooing techniques for the treatment of disfiguring corneal scars in blind eyes.
    Cornea 09/2014; · 1.75 Impact Factor
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    ABSTRACT: To evaluate the potential of lowering intraocular pressure in pseudoexfoliation glaucoma with combined phacoemulsification, Trabectome, and trabecular aspiration (triple procedure) compared to phacoemulsification and trabecular aspiration alone.
    Albrecht von Graæes Archiv für Ophthalmologie 09/2014; · 2.33 Impact Factor
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    ABSTRACT: Recent studies have identified diminishment of corneal nerves as another hallmark of Fuchs endothelial corneal dystrophy. This study aimed to analyze changes in corneal nerves after Descemet membrane endothelial keratoplasty (DMEK).
    Cornea 09/2014; · 1.75 Impact Factor
  • Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 09/2014;
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    ABSTRACT: Purpose To test whether subconjunctival cyclosporine A (CsA) implants affect the incidence and the degree of corneal neovascularization occurring after penetrating keratoplasty. Design Prospective, randomized, multicenter, controlled phase 2/3 clinical trial. The study comprised 43 trial sites in Germany, India, and the United States. Participants Enrolled patients (n = 97) were randomized to 1 of 3 groups: treatment group A (n = 36), treatment group B (n = 40), and the control group (n = 21). Methods Patients from each group received either of 2 doses of subconjunctival CsA (group A, low-dose CsA; group B, high-dose CsA) or placebo (carrier only) implants at the time of high-risk penetrating keratoplasty. Main Outcome Measures The incidence and degree of corneal neovascularization occurring after penetrating keratoplasty were evaluated in a substudy (LX201-01 study: NCT00447187). A web-based image upload system was developed. Standardized digital slit-lamp pictures were quantitatively and objectively evaluated using CellˆF morphometry software. Results No statistically significant difference in incidence and degree of corneal neovascularization developing after penetrating keratoplasty was found between treatment groups and placebo group. Mean corneal neovascularization area at week 52 (visit 12) was 2.32±1.79% in treatment group A versus placebo (2.79±2.11%; P = 0.45) and 2.74±2.22% in treatment group B versus placebo (2.79±2.11%; P = 0.94). Conclusions High-dose subconjunctival CsA implants do not significantly affect corneal neovascularization after high-risk penetrating keratoplasty. This suggests that local CsA has negligible antiangiogenic effects in the human cornea, at least in the transplant setting.
    Ophthalmology 09/2014; · 5.56 Impact Factor
  • Cornea 07/2014; · 2.36 Impact Factor
  • Deniz Hos, Claus Cursiefen
    The Journal of pediatrics. 07/2014;
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    ABSTRACT: The adult sclera is free of lymphatic vessels, but contains a net of blood vessels. Whether and when this selectively lymphangiogenic privilege is achieved during embryologic development is not known yet. Therefore, we investigated the developing human sclera for blood- and lymphatic vessels in 34 abortions/stillborns (12-38 weeks of gestation). The probes were subdivided into three groups (group 1: 12-18 weeks of gestation, n=10; group 2: 19-23 weeks of gestation, n=13; group 3: 24-38 weeks of gestation, n=11), and prepared for paraffin sections followed by immunohistochemistry against CD31 to detect blood vessels, and against lymphatic vessel endothelial hyaluronan receptor-1 (LYVE1)/podoplanin to detect lymphatic vessels. We could show, that in the human episclera distinct CD31+ blood vessels are present as early as week of gestation 13. Their amount increased during pregnancy, whereas stromal CD31+ blood vessels were elevated in early pregnancy and regressed with ongoing pregnancy. In the lamina fusca CD31+ blood vessels were absent at any time point investigated. Single LYVE1+ cells were identified primarily in the episclera; their amount decreased significantly with increasing gestational ages (group 1 compared to group 3: p<0.01). However, LYVE1+/podoplanin+ lymphatic vessels were not detectable in the sclera at any gestational ages analyzed. In contrast to the conjunctiva where LYVE1+ /podoplanin+ lymphatic vessels were detectable as early as week 17, the amount of LYVE1+ cells in the sclera was highest in early pregnancy (group 1), with a significant decrease during continuing pregnancy (p<0.001). These findings are the first evidence for a fetal lymphangiogenic privilege of the sclera and show, that the fetal human sclera contains CD31+ blood vessels, but is primarily alymphatic. Our findings suggest a strong expression of selectively antilymphangiogenic factors, making the developing sclera a potential model to discern antilymphangiogenic mechanisms.
    Experimental Eye Research 06/2014; · 3.02 Impact Factor
  • C Ammermann, C Cursiefen, M Hermann
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    ABSTRACT: Background: Corneal cross-linking (CXL) with riboflavin is being used more frequently for the treatment of therapy-resistant microbial keratitis, since increasing drug resistance and specific pathogens, e.g. contact lens-associated Acanthamoeba, make this therapy appear as an attractive option to avoid a keratoplasty à chaud. Patients and Methods: This retrospective case series of 11 consecutive patients (4 women, 7 men, aged 24-82 years) who received standardised antimicrobial CXL for therapy-resistant keratitis to avoid a keratoplasty à chaud, included 4 cases with detection of bacterial pathogens, one case with proven fungal infection and 6 cases without pathogen detection. Analysed data comprised ophthalmic medical history, general risk factors for microbial keratitis, treatment before and after CXL. The characterisation of the corneal ulcer included photometric measurements of the infiltrates with a median of 16.2 mm² and four unmeasurable cases due to extended, not circumscribed lesions. Results: Within the follow-up period (mean 134 ± standard deviation 82 days), a penetrating keratoplasty was successfully avoided in 6 patients (55 %). After CXL 9 patients (82 %) received additionally amniotic membrane transplantation. After CXL treatment, topical antibiotic therapy was continued for a mean 27 ± 13 days postoperatively. Steroids were applied in 91 % of the patients. The cornea cleared at least to some extent in 9 patients (82 %). Patients with neurotrophic keratopathy or potentially compromised immune system showed no increased failure rate. Conclusion: These results suggest that antimicrobial CXL might be a useful option in patients with therapy-resistant corneal ulcer in order to avoid a perforating keratoplasty à chaud. For a comprehensive scientific assessment of this therapy, however, further, ideally prospective randomised interventional studies with large sample sizes are needed.
    Klinische Monatsblatter fur Augenheilkunde. 06/2014; 231(6):619-625.
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    ABSTRACT: To analyze potential alterations in corneal nerve morphology and function in different stages of Fuchs' endothelial corneal dystrophy (FECD).
    05/2014;
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    ABSTRACT: Eye drops of aganirsen, an antisense oligonucleotide preventing insulin receptor substrate-1 expression, inhibited corneal neovascularization in a previous dose-finding phase II study. We aimed to confirm these results in a phase III study and investigated a potential clinical benefit on visual acuity (VA), quality of life (QoL), and need for transplantation. Multicenter, double-masked, randomized, placebo-controlled phase III study. Analysis of 69 patients with keratitis-related progressive corneal neovascularization randomized to aganirsen (34 patients) or placebo (35 patients). Patients applied aganirsen eye drops (86 μg/day/eye) or placebo twice daily for 90 days and were followed up to day 180. The primary end point was VA. Secondary end points included area of pathologic corneal neovascularization, need for transplantation, risk of graft rejection, and QoL. Although no significant differences in VA scores between groups were observed, aganirsen significantly reduced the relative corneal neovascularization area after 90 days by 26.20% (P = 0.014). This improvement persisted after 180 days (26.67%, P = 0.012). Aganirsen tended to lower the transplantation need in the intent-to-treat (ITT) population at day 180 (P = 0.087). In patients with viral keratitis and central neovascularization, a significant reduction in transplantation need was achieved (P = 0.048). No significant differences between groups were observed in the risk of graft rejection. However, aganirsen tended to decrease this risk in patients with traumatic/viral keratitis (P = 0.162) at day 90. The QoL analyses revealed a significant improvement with aganirsen in composite and near activity subscores (P = 0.039 and 0.026, respectively) at day 90 in the per protocol population. Ocular and treatment-related treatment-emergent adverse events (TEAEs) were reported in a lower percentage with aganirsen compared with placebo. Only 3 serious TEAEs (2 with aganirsen and 1 with placebo) were considered treatment-related. This first phase III study on a topical inhibitor of corneal angiogenesis showed that aganirsen eye drops significantly inhibited corneal neovascularization in patients with keratitis. The need for transplantation was significantly reduced in patients with viral keratitis and central neovascularization. Topical application of aganirsen was safe and well tolerated.
    Ophthalmology 05/2014; · 5.56 Impact Factor
  • U Gehlsen, C Cursiefen, P Steven
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    ABSTRACT: Background: Ocular allergy belongs to the most common ocular diseases globally. Following clinical phenotype and immunopathogenesis different forms of allergy are distinguished, which require different forms of therapeutic approach. This manuscript reviews the basic immunological processes involved in the development of ocular allergies and current and future therapeutic approaches. Methods: Results of a literature search in PubMed and our own clinical and experimental experience are presented. Results: In the immunopathogenesis of ocular allergy different immune cells such as dendritic cells, B-cells, T-cells, mast cells, eosinophils and regulatory T-cells are involved. Therapeutic approaches focus on either relief of symptoms using antihistamins or mast cell stabilisers or combinations of both. In severe cases steroids or calcineurin inhibitors are used. Discussion: Despite great progress in the investigation of ocular allergy in the past decade several open questions remain, such as the relation of ocular allergy with dry eye disease. Future therapeutic approaches will likely be based on recently identified new aspects such as lymphangiogenesis and will allow better and potentially causal treatment of ocular allergy.
    Klinische Monatsblätter für Augenheilkunde 05/2014; 231(5):490-5. · 0.70 Impact Factor

Publication Stats

5k Citations
710.15 Total Impact Points

Institutions

  • 2011–2014
    • University of Cologne
      • Department of Ophthalmology
      Köln, North Rhine-Westphalia, Germany
  • 2013
    • University of Freiburg
      Freiburg, Baden-Württemberg, Germany
  • 2012–2013
    • Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
      Shanghai, Shanghai Shi, China
  • 1970–2013
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Department of Ophthalmology
      Erlangen, Bavaria, Germany
  • 2007–2012
    • Universitätsklinikum Erlangen
      • Department of Ophthalmology
      Erlangen, Bavaria, Germany
  • 2003–2011
    • Universität zu Lübeck
      • Department of Ophthalmology
      Lübeck, Schleswig-Holstein, Germany
    • University of Sydney
      Sydney, New South Wales, Australia
  • 2010
    • Philipps-Universität Marburg
      • Klinik für Augenheilkunde (Marburg)
      Marburg an der Lahn, Hesse, Germany
    • Netherlands Institute for Innovative Ocular Surgery
      Rotterdam, South Holland, Netherlands
    • Aristotle University of Thessaloniki
      • Faculty of Medicine
      Thessaloníki, Kentriki Makedonia, Greece
  • 2008
    • University of Tuebingen
      Tübingen, Baden-Württemberg, Germany
  • 2006
    • Semmelweis University
      • Department of Ophthalmology
      Budapest, Budapest fovaros, Hungary
  • 2004–2006
    • Schepens Eye Research Institute
      Boston, Massachusetts, United States
    • Harvard Medical School
      Boston, Massachusetts, United States
  • 2003–2006
    • Massachusetts Eye and Ear Infirmary
      • • Schepens Eye Research Institute
      • • Department of Ophthalmology
      Boston, MA, United States
  • 2001
    • Justus-Liebig-Universität Gießen
      Gieben, Hesse, Germany
  • 1999
    • Universitätsklinikum Tübingen
      Tübingen, Baden-Württemberg, Germany