B Jurklies

University of Duisburg-Essen, Essen, North Rhine-Westphalia, Germany

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Publications (57)183.35 Total impact

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    ABSTRACT: Bietti's crystalline dystrophy (BCD) is a rare, autosomal recessive retinal degenerative disease associated with mutations in CYP4V2. In this study, we describe the genetic and clinical findings in 19 unrelated BCD patients recruited from five international retinal dystrophy clinics. Patients underwent ophthalmic examinations and were screened for CYP4V2 mutations by Sanger sequencing and quantitative polymerase chain reaction (qPCR) copy number variation screening. Eight CYP4V2 mutations were found in 10/19 patients, including three patients in whom only monoallelic mutations were detected. Four novel mutations were identified: c.604G>A; p.(Glu202Lys), c.242C>G; p.(Thr81Arg), c.604+4A>G; p.(?), and c.1249dup; p.(Thr417Asnfs*2). In addition, we identified a heterozygous paternally inherited genomic deletion of at least 3.8 Mb, encompassing the complete CYP4V2 gene and several other genes, which is novel. Clinically, patients demonstrated phenotypic variability, predominantly showing choroidal sclerosis, attenuated vessels, and crystalline deposits of varying degrees of severity. To our knowledge, our study reports the first heterozygous CYP4V2 deletion and hence a novel mutational mechanism underlying BCD. Our results emphasize the importance of copy number screening in BCD. Finally, the identification of CYP4V2-negative patients with indistinguishable phenotypes from CYP4V2-positive patients might suggest the presence of mutations outside the coding regions of CYP4V2, or locus heterogeneity, which is unreported so far.
    Molecular Genetics & Genomic Medicine. 09/2014;
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    ABSTRACT: Mutations in the gene encoding the catalytic subunit of the cone photoreceptor phosphodiesterase (PDE6C) have been recently reported in patients with autosomal recessive inherited achromatopsia (ACHM) and early-onset cone photoreceptor dysfunction. Here we present the results of a comprehensive study on PDE6C mutations including the mutation spectrum, its prevalence in a large cohort of ACHM/cone dysfunction patients, the clinical phenotype and the functional characterization of mutant PDE6C proteins. Twelve affected patients from seven independent families segregating PDE6C mutations were identified in our total patient cohort of 492 independent families. Eleven different PDE6C mutations were found including two nonsense mutations, three mutations affecting transcript splicing as shown by minigene assays, one 1 bp-insertion and five missense mutations. We also performed a detailed functional characterization of six missense mutations applying the baculovirus system to express recombinant mutant and wildtype chimeric PDE6C/PDE5 proteins in Sf9 insect cells. Purified proteins were analyzed using Western blotting, phosphodiesterase (PDE) activity measurements as well as inhibition assays by zaprinast and Pγ. Four of the six PDE6C missense mutations led to baseline PDE activities and most likely represent functional null alleles. For two mutations, p.E790K and p.Y323N, we observed reduction in PDE activity of approximately 60% and 80%, respectively. We also observed differences for Pγ inhibition. The p.E790K mutant, with an IC₅₀ value of 2.7 nm is 20.7-fold more sensitive for Pγ inhibition, whereas the p.Y323N mutant with an IC₅₀ of 158 nm is 3-fold less sensitive when compared with the wildtype control.
    Human Molecular Genetics 02/2011; 20(4):719-30. · 7.69 Impact Factor
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    ABSTRACT: To investigate optic nerve function using the pattern-reversed visual evoked cortical potentials (VECP) before and after bony orbital decompression in dysthyroid optic neuropathy (DON) due to Graves' disease. A total of 30 eyes of 15 patients (n=14 female) were observed over 30 ± 13 months after bony three-wall orbital decompression. We examined visual acuity (VA), VECP P100 amplitudes and latencies, as well as proptosis using Hertel's exophthalmometry. Mean logarithm of the minimum angle of resolution (logMAR) VA increased, statistically significantly, by 2.4 lines during 30 ± 13 months (from 0.38 ± 0.25 before surgery to 0.14 ± 0.1 at the end of observation, p=0.0001). All eyes maintained or improved vision by at least one line. Mean postoperative reduction of proptosis was 6.4 ± 3 mm. While VECP P100 amplitudes improved significantly, P100 latencies remained abnormal in 18 eyes (60%) during follow-up of 10 ± 7 months. Nine eyes (30%) with previous latency defects improved in at least one check test, five of which normalised completely. Worsening was evident in seven eyes (23%), and three previously normal eyes developed new pathological latencies. P100 latencies in 14 eyes (47%) remained unchanged. After decompression surgery, DON remission was observed in all patients regarding vision and VECP amplitudes. New or persistent P100 latency defects were seen in 60% of eyes after surgery. DON is considered to be caused by compressive ischaemic damage, which further underlines the importance of early decompression surgery.
    The British journal of ophthalmology 02/2011; 95(2):222-6. · 2.92 Impact Factor
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    ABSTRACT: The aim was to investigate the Essen biopsy forceps as a new instrument and surgical approach for biopsy of intraocular tumours. Biopsy is indicated for assessment of any uncertain intraocular process or confirmation for presumed diagnosis before treatment. There is increasing interest for further genetic and immunocytological information in order to characterise the neoplasm, especially grading and prognosis of micrometastasis in uveal melanoma. The authors have developed a new surgical technique using special intraocular biopsy forceps. Twenty patients with uncertain intraocular subretinal tumour underwent biopsies carried out using the special Essen biopsy forceps. Biopsies were obtained through sutureless 23-gauge three-port vitrectomy. A small retinotomy tumour specimen was taken by the forceps branches. For further processing, the specimens were flushed out into a sterile tube and then sent to pathologists. The prebioptical tumour had a mean thickness of 3.48 mm (1.1 to 9.8 mm). In all cases (n=20) biopsies (0.3-2.1 mm in size) were obtained, in 19 cases (95%) allowing precise histological and immunohistochemical typing of the lesions following cytoblock embedding. Uveal melanoma was diagnosed in 50% (n=10), choroidal metastasis in 15% (n=3) and choroidal naevus in 15% (n=3); other diagnoses (n=3) included choroidal haemangioma, B cell lymphoma and old subretinal haemorrhage. Apart from three patients with temporary punctual bleeding on the surface, there were no intra- and postoperative complications. Biopsy using special forceps is a promising new approach and precise surgical procedure. Especially for small intraocular tumours, this technique has the advantage in providing enough tissue for improved histological examination and presenting a low risk for complications.
    The British journal of ophthalmology 01/2011; 95(1):79-82. · 2.92 Impact Factor
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    ABSTRACT: The results of conservative treatment for central retinal artery occlusion (CRAO) vary considerably and although local intraarterial fibrinolysis (LIF) is a promising treatment, outcomes have not been compared in randomized trials. The prospective randomized multicenter study by the European Assessment Group for Lysis in the Eye (EAGLE) is the first clinical trial to compare treatment outcomes of conservative standard treatment (CST) and LIF for acute non-arteritic CRAO. Patients (age 18-75 years) with CRAO present for less than 20 h and best-corrected visual acuity (BCVA) <0.5 logMAR were randomized to either CST or LIF group. Primary endpoint was BCVA after 1 month and secondary endpoint was safety. Mean BCVA (logMAR) improved significantly in both groups and did not differ between the groups. Because of similar efficacy and the higher rate of adverse events in the LIF group the study was halted after the first interim analysis. Due to the similar outcomes of the two therapies and the higher rate of adverse reactions associated with LIF superselective lysis cannot be recommended for the management of acute CRAO.
    Der Ophthalmologe 09/2010; 107(9):799-805. · 0.53 Impact Factor
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    ABSTRACT: The reported outcomes of central retinal artery occlusion (CRAO) with or without treatment vary considerably. Although local intra-arterial fibrinolysis (LIF) using recombinant tissue plasminogen activator (rtPA) is a promising treatment, outcomes have not been compared in randomized trials. Prospective randomized multicenter clinical trial (the European Assessment Group for Lysis in the Eye Study) to compare treatment outcome after conservative standard treatment (CST) and LIF for acute nonarteritic CRAO. Between 2002 and 2007, 9 centers in Austria and Germany recruited 84 patients (40 received CST, 44 received LIF), and data for 82 patients were analyzed. Patients (age 18-75 years) with CRAO, symptoms for 20 hours or less, and best-corrected visual acuity (BCVA) <0.5 logarithm of the minimum angle of resolution (logMAR) were randomized to the CST or LIF group. The primary end point was BCVA after 1 month; the secondary end point was safety. The mean interval between first symptoms and therapy was 10.99+/-5.49 hours (CST) and 12.78+/-5.77 hours (LIF). The mean BCVA (logMAR) improved significantly in both groups (CST: -0.44 [standard deviation 0.55]; LIF: -0.45 [standard deviation 0.55]; both P < 0.0001) and did not differ between groups (P=0.69). Clinically significant visual improvement (> or = 0.3 logMAR) was noted in 60.0% (CST) and 57.1% (LIF) of patients. Two patients in the CST group (4.3%) and 13 patients in the LIF group (37.1%) had adverse reactions. Because of apparently similar efficacy and the higher rate of adverse reactions in the LIF group, the study was stopped after the first interim analysis at the recommendation of the data and safety monitoring committee. In light of these 2 therapies' similar outcomes and the higher rate of adverse reactions associated with LIF, we cannot recommend LIF for the management of acute CRAO. The author(s) have no proprietary or commercial interest in any materials discussed in this article.
    Ophthalmology 07/2010; 117(7):1367-75.e1. · 5.56 Impact Factor
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    ABSTRACT: Der nichtarteriitische Zentralarterienverschluss (ZAV) ist noch immer eine Erkrankung mit schlechter Visusprognose. Als Hoffnungsträger Der nichtarteriitische Zentralarterienverschluss (ZAV) ist noch immer eine Erkrankung mit schlechter Visusprognose. Als Hoffnungsträger bei der Behandlung galt die superselektive Lysetherapie, bei der ein Fibrinolytikum über einen Katheter in der A.ophthalmica bei der Behandlung galt die superselektive Lysetherapie, bei der ein Fibrinolytikum über einen Katheter in der A.ophthalmica injiziert wird. Die „European Study Group for lysis in the Eye“ (EAGLE) hatte sich zum Ziel gesetzt, die Wirksamkeit dieser injiziert wird. Die „European Study Group for lysis in the Eye“ (EAGLE) hatte sich zum Ziel gesetzt, die Wirksamkeit dieser Lysetherapie in einer prospektiven und randomisierten Studie zu untersuchen. Dabei wurden die Ergebisse eines konservativen Lysetherapie in einer prospektiven und randomisierten Studie zu untersuchen. Dabei wurden die Ergebisse eines konservativen Therapieschemas (KoTh) mit denen der intraarteriellen superselektiven Lysetherapie (LyTh) verglichen. Eingeschlossen wurden Therapieschemas (KoTh) mit denen der intraarteriellen superselektiven Lysetherapie (LyTh) verglichen. Eingeschlossen wurden Patienten (Alter: 18–75Jahre) mit einem nichtarteriitischen ZAV mit einer Dauer von maximal 20h und einer bestkorrigierten Patienten (Alter: 18–75Jahre) mit einem nichtarteriitischen ZAV mit einer Dauer von maximal 20h und einer bestkorrigierten Sehschärfe (BCVA) von mehr als 0,5logMAR („logarithm of the minimum angle of resolution“; entspricht <0,32 dezimal). Die Sehschärfe (BCVA) von mehr als 0,5logMAR („logarithm of the minimum angle of resolution“; entspricht <0,32 dezimal). Die Patienten wurden in eine der beiden Gruppen (KoTh oder LyTh) randomisiert. Hauptzielkriterium war die bestkorrigierte Sehschärfe Patienten wurden in eine der beiden Gruppen (KoTh oder LyTh) randomisiert. Hauptzielkriterium war die bestkorrigierte Sehschärfe 1Monat nach Behandlung, Nebenzielkriterium war die Sicherheit der Therapie. Die durchschnittliche BCVA stieg in beiden Gruppen 1Monat nach Behandlung, Nebenzielkriterium war die Sicherheit der Therapie. Die durchschnittliche BCVA stieg in beiden Gruppen signifikant an, es zeigte sich kein Gruppenunterschied. In der Lysegruppe gab es eine höhere Rate an unerwünschten Ereignissen. signifikant an, es zeigte sich kein Gruppenunterschied. In der Lysegruppe gab es eine höhere Rate an unerwünschten Ereignissen. Die EAGLE-Studie wurde nach der ersten Interimsanalyse vorzeitig beendet. Zusammenfassend ist die intraarterielle Fibrinolyse Die EAGLE-Studie wurde nach der ersten Interimsanalyse vorzeitig beendet. Zusammenfassend ist die intraarterielle Fibrinolyse bei nahezu identischer funktioneller Verbesserung in beiden Gruppen und einer höheren Komplikationenrate nicht mehr für die bei nahezu identischer funktioneller Verbesserung in beiden Gruppen und einer höheren Komplikationenrate nicht mehr für die Therapie von Patienten mit akutem nichtarteriitischem ZAV zu empfehlen. Therapie von Patienten mit akutem nichtarteriitischem ZAV zu empfehlen. The results of conservative treatment for central retinal artery occlusion (CRAO) vary considerably and although local intraarterial The results of conservative treatment for central retinal artery occlusion (CRAO) vary considerably and although local intraarterial fibrinolysis (LIF) is a promising treatment, outcomes have not been compared in randomized trials. The prospective randomized fibrinolysis (LIF) is a promising treatment, outcomes have not been compared in randomized trials. The prospective randomized multicenter study by the European Assessment Group for Lysis in the Eye (EAGLE) is the first clinical trial to compare treatment multicenter study by the European Assessment Group for Lysis in the Eye (EAGLE) is the first clinical trial to compare treatment outcomes of conservative standard treatment (CST) and LIF for acute non-arteritic CRAO. Patients (age 18–75 years) with CRAO outcomes of conservative standard treatment (CST) and LIF for acute non-arteritic CRAO. Patients (age 18–75 years) with CRAO present for less than 20h and best-corrected visual acuity (BCVA) <0.5 logMAR were randomized to either CST or LIF group. present for less than 20h and best-corrected visual acuity (BCVA) <0.5 logMAR were randomized to either CST or LIF group. Primary endpoint was BCVA after 1 month and secondary endpoint was safety. Mean BCVA (logMAR) improved significantly in both Primary endpoint was BCVA after 1 month and secondary endpoint was safety. Mean BCVA (logMAR) improved significantly in both groups and did not differ between the groups. Because of similar efficacy and the higher rate of adverse events in the LIF groups and did not differ between the groups. Because of similar efficacy and the higher rate of adverse events in the LIF group the study was halted after the first interim analysis. Due to the similar outcomes of the two therapies and the higher group the study was halted after the first interim analysis. Due to the similar outcomes of the two therapies and the higher rate of adverse reactions associated with LIF superselective lysis cannot be recommended for the management of acute CRAO. rate of adverse reactions associated with LIF superselective lysis cannot be recommended for the management of acute CRAO. SchlüsselwörterZentralarterienverschluss-EAGLE-Studie-Fibrinolyse-Rekombinanter Gewebeplasminogenaktivator (rt-PA)-Konservative Therapie SchlüsselwörterZentralarterienverschluss-EAGLE-Studie-Fibrinolyse-Rekombinanter Gewebeplasminogenaktivator (rt-PA)-Konservative Therapie KeywordsCentral retinal artery occlusion-EAGLE study-Fibrinolysis-Recombinant tissue plasminogen activator-Conservative treatment KeywordsCentral retinal artery occlusion-EAGLE study-Fibrinolysis-Recombinant tissue plasminogen activator-Conservative treatment
    Der Ophthalmologe 01/2010; 107(9):799-805. · 0.53 Impact Factor
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    ABSTRACT: Retinal cone photoreceptors mediate fine visual acuity, daylight vision, and color vision. Congenital hereditary conditions in which there is a lack of cone function in humans cause achromatopsia, an autosomal recessive trait, characterized by low vision, photophobia, and lack of color discrimination. Herein we report the identification of mutations in the PDE6C gene encoding the catalytic subunit of the cone photoreceptor phosphodiesterase as a cause of autosomal recessive achromatopsia. Moreover, we show that the spontaneous mouse mutant cpfl1 that features a lack of cone function and rapid degeneration of the cone photoreceptors represents a homologous mouse model for PDE6C associated achromatopsia.
    Proceedings of the National Academy of Sciences 11/2009; 106(46):19581-6. · 9.81 Impact Factor
  • B. Jurklies, N. Bornfeld
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    ABSTRACT: Die Therapieoptionen verschiedener vaskulärer Läsionen der Choriokapillaris, der Aderhaut und der Netzhaut wurden durch die photodynamische Therapie (PDT) erheblich erweitert. Dies gilt auch für die beobachteten Effekte bei der Behandlung choroidaler Hämangiome mit einer PDT. Verglichen mit den bisherigen Therapieansätzen, stand erstmals ein relativ selektives Verfahren mit überwiegender Wirksamkeit im Bereich der zu behandelnden Läsion und der Choroidea unter relativer Schonung unmittelbar benachbarter retinaler Strukturen zur Verfügung. Diese relative Selektivität ist besonders bei der Behandlung subfoveal gelegener Läsionen von Bedeutung. Während seit der Erstbeschreibung der Behandlung eines choroidalen Hämangioms mit einer PDT [2] die Wirksamkeit in mehreren klinischen Studien und Fallserien beobachtet wurde, gab es bezüglich des Zeitpunktes und der Parameter zum Teil unterschiedliche Behandlungsmodalitäten. Im Folgenden soll auf die Effekte der PDT mit Verteporfin bei der Behandlung des umschriebenen, solitären choroidalen Hämangiomes unter Berücksichtigung der klinischen Merkmale eingegangen werden.
    10/2008: pages 29-45;
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    A Lipski, N Bornfeld, B Jurklies
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    ABSTRACT: Vision impairment in children and young adults may derive from choroidal neovascularisation (CNV) related to numerous conditions. The aim of this study is to highlight the applicability of photodynamic therapy using verteporfin (PDT) in these patients. In 16 eyes of 16 consecutive patients aged 30 years or younger, prospective open-label PDT was performed. Outcomes of visual acuity as well as changes in CNV lesion parameters were evaluated. The mean patient age at first PDT was 19.7 (SD 8.7) years (range 6-30). 81% of the patients retained stable vision within two lines or exceedingly improved vision during follow-up of 34 (24) months. Significant vision gain was denoted in seven paediatric patients (2.7 (1.4) lines, mean (SD); p = 0.019) as well as in a subgroup of 12 patients not affected by active uveitis (2.6 (2.0) lines, p = 0.0005). Two patients with multifocal choroiditis and panuveitis (MCP) experienced vision losses of five and 11 lines after four PDT sessions despite receiving additional steroidal treatment. Except for one patient with MCP and two patients who dismissed follow-up, a mean of 2.2 (1.3) PDTs per patient sufficiently inactivated CNV lesions during follow-up. In the area of the former PDT spot, alterations of the pigment epithelium increased by 40% without correlation to changes in vision. The results indicate good PDT efficacy and tolerability most promising in a subgroup of patients with vision-impairing CNV not associated with active uveitis. PDT in young patients with CNV remains a valuable treatment with good risk-benefit profile over the long term.
    The British journal of ophthalmology 06/2008; 92(5):655-60. · 2.92 Impact Factor
  • Andreas Lipski, Norbert Bornfeld, Bernhard Jurklies
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    ABSTRACT: To objectively investigate central retinal function in patients with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) before and after treatment with pegaptanib sodium (PS). Patients with CNV due to exudative AMD received intravitreal injections of 0.3 mg PS every sixth week if angiographic activity was evident. Longitudinal observation included recordings with multifocal electroretinography (mfERG) before the first treatment and before each injection at follow-up intervals. During the observation period of 30.5 +/- 8 weeks (mean +/- SD) a mean number of 5.3 +/- 1.3 injections were applied. Final mean log(MAR) visual acuity decreased, statistically nonsignificant, from 0.67 +/- 0.3 at baseline to 0.74 +/- 0.16. mfERG recordings in 12 patients after 25 +/- 9 weeks evinced a decrease in response density which was statistically significant in the central 5 degrees . Mean P1-amplitudes of ring 1, 2, and 3 were reduced by 66%, 39% and 30%, respectively. During follow-up, implicit times of the P1 components remained stable within 4% of baseline. In three of four patients with vision loss of 2 lines or more, P1-response amplitudes decreased substantially at least 6 weeks prior vision loss. Treatment with PS resulted in a decrease of central retinal function more obvious in mfERG than in VA longitudinal testing. Good correlations were seen between changes in mean vision and changes in mfERG response density components. As a decline in P1-response amplitudes anteceded vision loss in this study, our results indicate a possible role of mfERG to predict vision loss during intravitreal pharmacotherapy.
    Retina 10/2007; 27(7):864-72. · 2.83 Impact Factor
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    ABSTRACT: In the prospective, randomised and multicenter EAGLE study, the therapeutic efficiency of local intra-arterial fibrinolysis (LIF) versus conservative treatment is being tested in patients with an acute central retinal artery occlusion (CRAO). The most important inclusion criteria are: (1) age between 18-75 years, (2) CRAO not older than 20 h, and (3) visual acuity <0.32. The primary study endpoint is the visual acuity before and 1 month after therapy. The study was started in 2002. To August 2006, 63 of the 200 required patients have been included in the study at 17 medical centers in Germany, Switzerland and Austria.
    Der Ophthalmologe 11/2006; 103(10):898-900. · 0.53 Impact Factor
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    ABSTRACT: In der prospektiven, randomisierten und multizentrischen EAGLE-Studie wird die Wirksamkeit der lokalen intraarteriellen Fibrinolyse (LIF) mit einer definierten konservativen Therapie in Patienten mit akutem Zentralarterienverschluss (ZAV) verglichen. Eingeschlossen werden Patienten zwischen 18 und 75Jahren mit einem Zentralarterienverschluss nicht lter als 20h und einem Visus von <0,32. Primres Zielkriterium ist die Sehschrfe vor und 1Monat nach Behandlung. Die Studie wurde im Jahr 2002 begonnen. Bis August 2006 wurden 63 der erforderlichen 200Patienten von den 17 teilnehmenden Zentren in Deutschland, sterreich und der Schweiz eingeschlossen.In the prospective, randomised and multicenter EAGLE study, the therapeutic efficiency of local intra-arterial fibrinolysis (LIF) versus conservative treatment is being tested in patients with an acute central retinal artery occlusion (CRAO). The most important inclusion criteria are: (1) age between 18–75years, (2) CRAO not older than 20h, and (3) visual acuity <0.32. The primary study endpoint is the visual acuity before and 1month after therapy. The study was started in 2002. To August 2006, 63 of the 200 required patients have been included in the study at 17 medical centers in Germany, Switzerland and Austria.
    Der Ophthalmologe 09/2006; 103(10):898-900. · 0.53 Impact Factor
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    ABSTRACT: The natural course of central retinal artery occlusion (CRAO) often leads to legal blindness in the affected eye. To date, none of the conservative therapies had proven effective in retrospective studies. In 1991, a new minimally invasive therapy was started in patients with an acute CRAO. This therapy, namely, local intra-arterial fibrinolysis, is comparable to the minimally invasive therapy in patients with an acute ischemic stroke. In pilot studies, it showed promising results in comparison with conservative treatments. The efficacy of this method is now being investigated in a randomized multicenter study. The European Assessment Group for Lysis in the Eye (EAGLE) started a prospective and randomized multicenter study in 2002 to evaluate therapeutic efficacy. Inclusion criteria are age between 18 and 75 years and a CRAO not older than 20 h with a visual acuity less than 0.32. The most important exclusion criteria are branch retinal artery occlusion (BRAO), cilioretinal arteries supplying the macula, and serious general disease. After randomization the patient is treated by conservative or local intra-arterial lysis therapy. The conservative regime included bulbus massage, lowering intraocular pressure with topical beta-blocker and acetazolamide, acetylsalicylic acid, heparin, and-depending on the hematocrit-isovolemic hemodilution. In case of local intra-arterial fibrinolysis, a maximum of 50 mg rtPA is injected into the ophthalmic artery by the neuroradiologist. During the following 5 days, all patients are treated with heparin. Primary study end point is visual acuity 1 month after therapy in comparison with visual acuity before therapy. The calculated sample size is 100 patients per subtrial (a total of 200 patients). The study was started in June 2002. To April 2005, 47 patients were included. The EAGLE Study is the first randomized prospective clinical trial to compare conservative medical treatment and local intra-arterial fibrinolysis in patients with CRAO. The results of this study should enable ophthalmologists and neuroradiologists to improve the therapy of patients with acute CRAO. To April 2005, treatment is only justified in randomized multicenter studies because of the limited therapeutical visual outcome. We welcome new study centers to join.
    Albrecht von Graæes Archiv für Ophthalmologie 09/2006; 244(8):950-6. · 1.93 Impact Factor
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    ABSTRACT: The aim of this non-comparative, consecutive case series is to evaluate the short-term results after endoresection of large uveal melanomas in combination with pretreatment with stereotactic gamma knife radiosurgery. Between March 2000 and November 2002, forty-six patients with large uveal melanomas underwent stereotactic radiosurgery followed by endoresection of the tumour via a standard three-port vitrectomy including laser photocoagulation and silicone oil tamponade. The average tumour height was 9.5 mm. The minimum dose delivered to the tumour volume was 25 Gy. The median follow-up time was 410 days. In 40 cases (87 %), the eye was retained with a VA of 20/200 or better in 30 cases (65.2 %) and 20/63 or better in ten cases (21.7 %). In 12 eyes with a follow-up of >/= 0.5 years, the median VA was 20/80 after silicone oil removal and cataract surgery had been performed. Six eyes (13 %) were enucleated due to serious complications caused by the radiosurgery (3 cases) or endoresection (3 cases). In 13 patients (28.2 %), additional major surgery was required. Seven patients developed liver metastases during follow-up and six patients died. No local tumour recurrences were observed. Eyes with large uveal melanomas can be salvaged by stereotactic radiotherapy followed by endoresection.
    Klinische Monatsblätter für Augenheilkunde 07/2006; 223(6):513-20. · 0.70 Impact Factor
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    ABSTRACT: To investigate the safety and efficacy of beta ray brachytherapy in treatment of vasoproliferative tumours of the retina (VTR). 35 consecutive patients with symptomatic VTR were treated with a ruthenium-106 ((106)Ru) plaque. Three tumours had been treated previously (two with cryotherapy; one with transpupillary thermotherapy). 32 VTR (91.4%) were located in the lower half of the retina and all of them were found between the mid-periphery and the ora serrata. The mean tumour thickness was 2.8 mm. An exudative retinal detachment was present in 25 eyes (71.4%) and in 15 cases (42.9%) hard exudates were found in the macula. The major symptom was loss of vision (77.1%). Brachytherapy was well tolerated by every patient. The mean applied dose was 416 Gy at the sclera and 108 Gy at the tumour apex. In all but four eyes (88.6%), it was possible to control the VTR activity. The median follow up time was 24 months. Three of the above mentioned four eyes with treatment failure had had secondary glaucoma before therapy. There was no case of radiation induced neuropathy or retinopathy. Cataract surgery was necessary for five patients. The development of epiretinal gliosis was the most common event during follow up (n = 10, 28.6%). The mean visual acuity decreased slightly (0.33 before and 0.29 after brachytherapy). Multivariate analysis showed that the presence of macular pathology before treatment was associated with a 6.1-fold risk of vision of 0.25 or better (p = 0.03). beta ray brachytherapy with (1106)Ru plaques was able to control the activity of VTR and retain vision. Cases with secondary glaucoma before treatment had a very poor prognosis.
    British Journal of Ophthalmology 05/2006; 90(4):447-50. · 2.73 Impact Factor
  • Bernhard Jurklies, Norbert Bornfeld, Harald Schilling
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    ABSTRACT: To investigate the safety and efficacy of photodynamic therapy with verteporfin (PDT) in patients with choroidal neovascularization associated with angioid streaks (CNVAS). A nonrandomized, prospective clinical investigation of 12 patients with CNVAS was performed. PDT was based on the criteria concerning the treatment of age-related macular degeneration. The mean follow-up was 41.75 months (range 24-60). The mean number of (re)treatments was 3.3 (range 2-7). Visual acuity improved by at least 1 line in 42%, was stable within +/-2 lines in 33%, decreased by at least 1 line in 58% and by >3 lines in 25% of the patients. The mean visual acuity was 0.30 (range 0.2-0.5) prior to and 0.17 (range 0.03-0.6) after the final PDT. The mean visual acuity of the contralateral eye was 0.1. 75% of contralateral eyes and 25% of the treated eyes had a final visual acuity of < or =0.1 (20/200). At the final follow-up, a significant enlargement of the lesion size was noted in 92% of the cases. Using the current (re)treatment criteria, PDT does not appear to limit the growth of CNVAS. Compared to the aggressive natural course and to the limited treatment options, PDT may at least in part help to stabilize macular function over a limited period of time.
    Ophthalmic Research 02/2006; 38(4):209-17. · 1.56 Impact Factor
  • Klinische Monatsblatter Fur Augenheilkunde - KLIN MONATSBL AUGENHEILK. 01/2006; 223(6):513-520.
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    ABSTRACT: In der prospektiven, randomisierten und multizentrischen EAGLE-Studie wird die Wirksamkeit der lokalen intraarteriellen Fibrinolyse (LIF) mit einer definierten konservativen Therapie in Patienten mit akutem Zentralarterienverschluss (ZAV) verglichen. Eingeschlossen werden Patienten zwischen 18 und 75 Jahren mit einem Zentralarterienverschluss nicht älter als 20 h und einem Visus von Keywords: Acute central retinal artery occlusion; Akuter Zentralarterienverschluss; Conservative treatment; Intra-arterial fibrinolysis; Konservative Therapie; Lokale intraarterielle Fibrinolyse Document Type: Research Article DOI: http://dx.doi.org/10.1007/s00347-006-1429-1 Affiliations: Email: nicolas.feltgen@uniklinik-freiburg.de Publication date: October 1, 2006 $(document).ready(function() { var shortdescription = $(".originaldescription").text().replace(/\\&/g, '&').replace(/\\, '<').replace(/\\>/g, '>').replace(/\\t/g, ' ').replace(/\\n/g, ''); if (shortdescription.length > 350){ shortdescription = "" + shortdescription.substring(0,250) + "... more"; } $(".descriptionitem").prepend(shortdescription); $(".shortdescription a").click(function() { $(".shortdescription").hide(); $(".originaldescription").slideDown(); return false; }); }); Related content In this: publication By this: publisher In this Subject: Ophthalmology By this author: Feltgen, N. ; Reinhard, T. ; Kampik, A. ; Jurklies, B. ; Brückmann, H. ; Schumacher, M. GA_googleFillSlot("Horizontal_banner_bottom");
    Der Ophthalmologe 01/2006; 103(10). · 0.53 Impact Factor
  • Bernhard Jurklies, Norbert Bornfeld
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    ABSTRACT: Photodynamic therapy (PDT) with verteporfin has significantly improved the functional outcome in the treatment of choroidal neovascularization (CNV) in various clinical disorders [16]. While CNV due to age-related macular degeneration and pathologic myopia was the primary focus, several studies showed that the treatment effects of PDTwere not only restricted to these two underlying disorders. Recently, several clinical studies observed PDTas a treatment modality of symptomatic choroidal hemangioma [4, 12, 17].
    Albrecht von Graæes Archiv für Ophthalmologie 06/2005; 243(5):393-6. · 1.93 Impact Factor

Publication Stats

1k Citations
183.35 Total Impact Points

Institutions

  • 2006–2014
    • University of Duisburg-Essen
      Essen, North Rhine-Westphalia, Germany
    • Universitätsklinikum Freiburg
      Freiburg an der Elbe, Lower Saxony, Germany
    • University of Freiburg
      Freiburg, Baden-Württemberg, Germany
  • 1995–2011
    • University Hospital Essen
      Essen, North Rhine-Westphalia, Germany
  • 1997–2001
    • University of Wuerzburg
      • Institute for Human Genetics
      Würzburg, Bavaria, Germany
  • 1994–1997
    • Universitätsklinikum Tübingen
      Tübingen, Baden-Württemberg, Germany
    • University of Cologne
      Köln, North Rhine-Westphalia, Germany
  • 1996
    • University of Zurich
      • Ophthalmology Unit
      Zürich, ZH, Switzerland