
Albert J AugustinKlinikum Karlsruhe · Department of Ophthalmology
Albert J Augustin
MD, Professor of Ophthalmology
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393
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Publications (393)
To improve the understanding of potential pathological mechanisms of macular edema (ME), we try to discover biomarker candidates related to ME caused by diabetic retinopathy (DR) and retinal vein occlusion (RVO) in spectral-domain optical coherence tomography images by means of deep learning (DL). 32 eyes of 26 subjects with non-proliferative DR (N...
Dry eye disease is an umbrella term that includes a variety of symptoms and signs. A link between diabetes mellitus and dry eye disease exists, but the associated phenotype needs further examination. Thus, our aim was to determine how diabetes mellitus relates to the dry eye disease phenotype. A prospective, cross-sectional study was conducted at t...
Diabetic retinopathy (DR) is a leading cause of blindness worldwide and a costly complication of diabetes mellitus (DM). DR severity is associated with DM duration; thus, DR has become more devastating to individuals and healthcare systems owing to the aging population and the significantly increased human lifespan. Aging is an irreversible cellula...
Metformin is the most commonly prescribed antihyperglycemic drug as first-line therapy in type II diabetic patients. In recent years, evidence is increasing that metformin has beneficial effects beyond its classical antihyperglycemic way of action. Those effects include anti-inflammation, anti-oxidation, anti-aging, anti-angiogenesis, anti-neoplasi...
Age-related macular degeneration (AMD) results in progressive vision loss that significantly impacts patients’ quality of life and ability to perform routine daily activities. Although pharmaceutical treatments for AMD are available and in clinical development, patients with late-stage AMD are relatively underserved. Specialized rehabilitation prog...
Purpose
To investigate the efficacy and safety of dexamethasone (DEX) implant in eyes with diabetic macular edema (DME) over 12-months.
Methods
In this retrospective study charts from a single center were analysed, including naïve and pre-treated patients. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at ba...
Optical coherence tomography angiography (OCT-A) was commercially introduced in 2014. OCT-A allows a fast, non-invasive, three-dimensional analysis of the retinal vasculature from the vitreoretinal interface to the choriocapillaris. The results can be evaluated separately in automated or custom-defined retinal layers. Since its introduction, OCT-A...
b>Background: The prospective DIabetes and CATaract Study II (DICAT II) was performed to characterise the risks of cataract surgery to the retinae of patients with early diabetic macular oedema (E-DMO). Methods: DICAT II was a prospective, comparative, multicentre, observational study involving six Italian clinics. Patients were aged ≥55 years, had...
Purpose
The purpose was to assess the number and intervals of dexamethasone intravitreal implant (DEX) reinjections in a real-world setting for the treatment of diabetic macular edema (DME) and to determine the relationship with effectiveness and safety.
Patients and Methods
Data were abstracted from medical records of DME patients in Germany and...
Age-related macular degeneration (AMD) represents the leading cause of irreversible blindness in elderly people, mostly after the age of 65. The progressive deterioration of visual function in patients affected by AMD has a significant impact on quality of life and has also high social costs. The current therapeutic options are only partially able...
b>Background: Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients. Methods: This is a retrospective case series s...
Background:
There is a lack of consensus on the use of intravitreal corticosteroid therapies in patients with diabetic macular edema (DME) and prior vitrectomized eyes in clinical practice.
Methods:
Retro-IDEAL was a 3-year retrospective, multicenter study in patients with chronic DME (i.e. DME that persists or recurs despite treatment) treated...
In the last decades, significant changes have been taking place regarding the pathogenesis of diabetic retinopathy (DR) and the complex mechanisms that eventually lead to the various manifestations of the disease, including diabetic macular edema (DME). DR was first considered a pure microvascular disease, due to the evident capillary structural ch...
Purpose:
To evaluate the safety and efficacy of Brimonidine Drug Delivery System (Brimo DDS), a biodegradable intravitreal implant, in the treatment of geographic atrophy (GA) secondary to age-related macular degeneration.
Methods:
Phase 2, randomized, multicenter, double-masked, 24-month study. Study eyes were treated (Day 1; Month 6 retreatmen...
Introduction: Diabetic macular edema (DME) is a sight threatening disease and a major cause for blindness for people in working age. The pathogenesis is multifactorial and complex. The pharmacotherapy of DME addresses both the inhibition of vascular endothelial growth factor (VEGF) by the intravitreal injection of VEGF inhibitors and inflammatory p...
Purpose
To describe the natural history of diabetic macular edema (DME) with respect to best-corrected visual acuity (BCVA) and central retinal thickness (CRT) outcomes and to identify baseline patient characteristics and systemic factors associated with improvement or worsening of outcomes in sham-treated patients.
Methods
The study population wa...
Zusammenfassung
Hintergrund In Deutschland sind 2 intravitreal anzuwendende Kortikosteroide (Dexamethason und Fluocinolon) für die Behandlung des diabetischen Makulaödems (DMÖ) zugelassen. Der Einsatz von DEX-Implantat bei DMÖ ist in der täglichen Praxis bisher nicht im Detail definiert. Mithilfe eines Delphi-Panels und einer Runde von Retinaspezia...
Aims
To present an authoritative, universal, easy-to-use morphologic classification of diabetic maculopathy based on spectral domain optical coherence tomography.
Methods
The first draft of the project was developed based on previously published classifications and a literature search regarding the spectral domain optical coherence tomography quan...
Background/objectives:
This post hoc analysis explores the relationship between residual oedema exposure after ranibizumab treatment initiation and long-term visual acuity outcome in eyes with centre-involved diabetic macular oedema (DMO).
Subjects/methods:
Eyes randomised to the ranibizumab + prompt or deferred laser treatment arms in the Proto...
Management of center-involving diabetic macular edema represents a real therapeutic challenge. Diabetic macular edema is the leading cause of visual acuity impairment in diabetic patients. Since the advent of intravitreal drugs, management of diabetic macular edema has significantly evolved. The historical grid laser photocoagulation is no longer r...
Importance
The Argus II Retinal Prosthesis System is indicated for patients with vision loss due to severe to profound outer retinal degeneration, a group with few treatment options.
Objectives
To collect postapproval safety and visual function data for the Argus II.
Design, Setting, and Participants
Multicenter, postapproval clinical trial condu...
Background/aims:
To report a case of Rosai-Dorfman disease (RDD) presenting as a solitary, choroidal mass, initially suspicious for uveal melanoma, in a 72-year-old woman.
Methods:
Retrospective case report of a single patient.
Results:
A 72-year-old woman presented with sudden vision loss in the right eye. A month prior, visual acuity was 20/...
Introduction:
The Retro-IDEAL (ILUVIEN Implant for chronic DiabEtic MAcuLar edema) study is a retrospective study designed to assess real-world outcomes achieved with the ILUVIEN® (0.19 mg fluocinolone acetonide (FAc)) in patients with chronic diabetic macular edema (DME) in clinical practices in Germany.
Methods:
This study was conducted across...
Purpose:
To analyze and provide an overview of the incidence, management, and prevention of conjunctival erosion in Argus II clinical trial subjects and postapproval patients.
Methods:
This retrospective analysis followed the results of 274 patients treated with the Argus II Retinal Prosthesis System between June 2007 and November 2017, includin...
COMO_Supplementary_Table – Supplemental material for A 12-month, multicenter, parallel group comparison of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion
COMO_Supplementary_Fig – Supplemental material for A 12-month, multicenter, parallel group comparison of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion
Introduction: Diabetic macular edema is a sight threatening disease and a major cause for blindness for people in working age. The pathogenesis or pathophysiology of this condition is multifactorial and different pathways have been identified, such as inflammation, the modulation of vascular integrity and tractional forces at the vitreomacular inte...
Purpose:
To assess the retinal anatomy and array position in the Argus II Retinal Prosthesis recipients.
Design:
Prospective, non-comparative cohort study METHODS: Setting: international multicenter study PATIENTS: Argus II recipients enrolled in the Post-Market Surveillance Studies.
Procedures:
Spectral-domain Optical Coherence Tomography ima...
Purpose:
Dexamethasone intravitreal implant and intravitreal ranibizumab are indicated for the treatment of macular edema secondary to retinal vein occlusion. This non-inferiority study compared dexamethasone with ranibizumab in patients with branch retinal vein occlusion.
Methods:
In this randomized, 12-month head-to-head comparison, subjects w...
Purpose:
This post hoc analysis explores the relationship between early retinal anatomical response and long-term anatomical and visual outcomes with ranibizumab in center-involved diabetic macular edema.
Methods:
Eyes randomized to the ranibizumab plus prompt laser and ranibizumab plus deferred laser treatment arms in the Protocol I study were...
Purpose:
Meibomian gland disease is generally accepted as the leading cause for evaporative dry eye disease (DED). In a previous study, perfluorohexyloctane, a semifluorinated alkane, has been demonstrated to significantly increase tear film breakup time and to reduce corneal fluorescein staining in patients with evaporative DED, thereby vastly re...
Die intraoperative optische Kohärenztomografie (iOCT) stellt einen weiteren, erheblichen Entwicklungsschritt in der ophthalmologischen Bildgebung dar – erstmals sind nun hochaufgelöste OCT-Darstellungen nicht nur prä- und postoperativ, sondern auch intraoperativ verfügbar. In den letzten Jahren wurden intraoperative OCT-Technologien intensiv erfors...
PurposeLimited data are available on the efficacy of the 0.2 μg/day fluocinolone acetonide (FAc) implant in eyes with prior vitrectomy. Here, we present a collection of 26 vitrectomized eyes treated with the 0.2 μg/day FAc implant.Methods
Retrospective study involving six centers from four European countries analyzing the safety and efficacy data f...
In der ophthalmologischen Praxis bzw. Klinik werden unterschiedlichste diagnostische Verfahren eingesetzt, um Erkrankungen des Auges und seiner Strukturen zu erkennen und Therapien einzuleiten und diese zu überwachen. In diesem Kapitel werden in standardisiert gegliederten Abschnitten (Messobjekt, Messung, Indikation, Auswertung, Relevanz, ggf. Fal...
Purpose:
Dry-eye disease (DED) is one of the most common pathological conditions of the eye, affecting millions of patients. Meibomian gland dysfunction (MGD) is thought to be one of the core reasons for DED. Re-
cently the novel eye lubricant perfluorohexyloctane (F6H8) has been certified as a medical device under the names NovaTears® and EvoTears...
Purpose:
To determine whether early visual acuity response to ranibizumab in diabetic macular edema is associated with long-term outcome.
Design:
Post hoc analysis of randomized controlled trial data.
Methods:
Pooled data from the ranibizumab plus prompt and deferred laser treatment arms of the Diabetic Retinopathy Clinical Research Network's...
Pathological angiogenesis is a major characteristic of many diseases, such as cancer and retinal vascular disorders. Vascular diseases of the eye, such as diabetic retinopathy (DR) and neo-vascular age-related macular degeneration (nAMD), are the main cause of severe vision loss. The specific role of the cytokine VEGF-A in these pathologies has bee...
In recent years, several intravitreal drug applications have become available for the treatment of diabetic macular oedema (DME). This review aims to summarise and compare available results. Based on a PubMed search, appropriate studies or reviews were evaluated. Clinical trial data suggest that the intravitreal administration of both vascular endo...
Dexamethasone intravitreal implant 0.7 mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME.
Three-ye...
The leading symptom ,,red eye“ is a common appearance in ophthalmology. Conjunctivitis ranks among the leading causes. However many differential diagnoses like uveitis have to be considered. Therefore a targeted diagnostic approach and treatment is of high clinical and pharmacoeconomic relevance. German Das Leitsymptom ,,rotes Auge“ ist ein häufige...
In der ophthalmologischen Praxis bzw. Klinik werden unterschiedlichste diagnostische Verfahren eingesetzt, um Erkrankungen des Auges und seiner Strukturen zu erkennen und Therapien einzuleiten und diese zu überwachen. In diesem Kapitel werden in standardisiert gegliederten Abschnitten (Messobjekt, Messung, Indikation, Auswertung, Relevanz, ggf. Fal...
This book explains how to use intravitreal steroids optimally in the management of patients with intraocular inflammation (uveitis) and macular edema. The rationale for this treatment approach is first explained by examining the pathophysiology of these disease entities, with particular attention to the major role of inflammatory processes. Devices...
Purpose:
To retrospectively evaluate the re-injection interval, efficacy and safety of dexamethasone (DEX) intravitreal implant 0.7 mg in the treatment of macular oedema (ME) due to retinal vein occlusion (RVO) in Germany in 2009-2012.
Methods:
Retrospective, multicentre, anonymised observational study of data collected from the first DEX implan...
Purpose
To evaluate the safety and efficacy of dexamethasone intravitreal implant (Ozurdex, DEX implant) 0.7 and 0.35 mg in the treatment of patients with diabetic macular edema (DME).
Design
Two randomized, multicenter, masked, sham-controlled, phase III clinical trials with identical protocols were conducted. Data were pooled for analysis.
Part...
Purpose:
To clinically evaluate the effect of blue light-filtering intraocular lenses (IOLs) on disease progression in patients with geographic atrophy (GA).
Methods:
Clinical data from 66 eyes of 40 patients were investigated, 27 with a blue filter and 39 with a non-blue filter IOL. Spectral-domain optical coherence tomography technology and th...
Since the late 1980s implantation of UV-blocker intraocular lenses during cataract surgery has become an internationally accepted standard. Last year the Kassenärztliche Vereinigung Bayern (KVB) and statutory health insurance organisations proposed for the first time quality criteria for intraocular lenses (IOL), thereby including exact parameters...
Until now, the only treatment available for severe symptomatic vitreomacular traction, has been pars-plana-vitrectomy. Now, there is evidence for a new minimally invasive surgical therapy: the results of two Phase III studies show that an intravitreal injection of ocriplasmin allows an enzymatic vitreolysis.
The satellite symposium moderated by Usha Chakravarthy entitled ‘Changing Perspectives in Diabetic Macular Oedema: Recognising and Understanding Chronic Diabetic Macular Oedema’ was convened at the 2014 EURETINA Congress. The symposium discussed the multiple processes involved in chronic diabetic macular oedema (DMO) and the use of medications, in...
Purpose: To review the current practice of retreatment with Ozurdex injections in patients with macular edema (ME) secondary to retinal vein occlusion (RVO), and to recommend simple guidelines for Ozurdex reinjection in management of RVO.
Methods: This was a multicenter retrospective study of patients who received more than 2 Ozurdex injections fo...
The purpose of this study is to measure the macular pigment optical density and study its spatial profile as well as identify its determinant factors in a Central European population.
The macular pigment optical density (MPOD) and its distribution were assessed in 228 eyes of 129 subjects using fundus reflectometry with the Visucam 500 (Carl Zeiss...
Background:
Age-related macular degeneration is the leading cause of blindness among elderly individuals in industrialized countries. New drugs and advanced concepts for the treatment of dry AMD (dAMD) are needed. A new approach is the application of intravenous infusions of prostaglandin E1.
Objective:
The aim of this study was to assess effica...
A symposium hosted by the European Society of Ophthalmology discussed challenges in the management of diabetic macular oedema (DMO). Clinical evidence suggests that the longer the duration of DMO, the worse the response to anti-vascular endothelial growth factor (anti-VEGF) agents and better the response to corticosteroids. This is explained by the...
Purpose This retrospective study was designed to investigate the re‐injection interval, efficacy and safety of OZURDEX® in routine clinical practice.
Methods This analysis contains data from 87 patients from 10 sites in Germany who had received at least 2 OZURDEX® injections. Data was collected from the time of the patients’ first injection until 3...
Purpose:
To describe treatment patterns among patients with central or branch retinal vein occlusion (CRVO or BRVO) in France, Germany, and Italy, and to estimate retinal vein occlusion (RVO)-related direct medical costs.
Methods:
We used a retrospective chart review to determine 18-month RVO-related resource utilization and calculate 12-month h...
This article provides a short overview of developments in optical coherence tomography (OCT) technology and highlights the advantages of spectral domain OCT, which allows for high-speed, high-resolution imaging of retinal structures. Established clinical applications to diagnose and monitor macular diseases are summarized and the rapidly evolving r...
To investigate the safety and feasibility of using a microcatheter for drug delivery in the suprachoroidal space in eyes with advanced, exudative, age-related macular degeneration (AMD) unresponsive to conventional therapy.
A unique microcatheter was used to deliver a drug combination consisting of bevacizumab and triamcinolone to the submacular su...
The current therapeutic standard for choroidal neovascularization secondary to age-related macular degeneration (AMD) is consecutive monthly injections of ranibizumab (Lucentis). In most cases, however, a monotherapy cannot fully address the multifactorial pathogenesis of wet AMD. Thus, dual- and triple-combination therapies with photodynamic ther...
The purpose of this article is to show the feasibility of the ‘Advanced [retinal pigment epithelium] RPE analysis’ software tool to measure drusen area and volume as well as the area of geographic atrophy (GA) in patients with dry age-related macular degeneration (AMD). The source data from spectral domain optical coherence tomography (SD-OCT) imag...
In this article, we review recent research in suprachoroidal drug administration for the treatment of advanced, refractory, retinal disease. A microcatheter (iTRACK 400) has been used to access and deliver drugs to the suprachoroidal space. This technology has been investigated in several animal models as well as in patients with advanced disease...
Introduction:
Diabetes mellitus with its ophthalmic complications is the major cause for legal blindness in industrialized countries. Diabetic macular edema and its complex pathophysiology as part of diabetic retinopathy are the leading cause of vision loss among diabetic patients. In recent years, treatment options have developed involving the in...
Macular edema represents a common final pathway of many intraocular and systemic diseases, which usually involve the retinal vessels. It typically occurs with painless impairment of visual acuity in one eye, but can also be bilateral, depending on the etiology. A macular edema is a nonspecific sign of many ocular disorders. Usually the symptoms pro...
To evaluate the safety, feasibility, and preliminary efficacy of suprachoroidal drug delivery with a microcatheter for the treatment of severe subfoveal hard exudates (SHE) in retinal vasculopathies. Definitive treatments for SHE have not yet been identified and prognosis is unfavorable.
In this prospective, interventional pilot study, six eyes of...
Retinal vein occlusion (RVO) can have severe consequences for the people affected by the disease, including visual loss with costly social repercussions. Currently, there is no European consensus with regard to the management of RVO. Following a careful review of the medical literature as well as the data from several clinical trials, a collaborati...
Introduction:
Diabetes mellitus, through its ophthalmic complications diabetic retinopathy and diabetic macular edema (DME), is a leading cause of vision loss in industrialized countries.
Areas covered:
This review covers laser treatment, which is a standard treatment strategy that has proven efficacy and safety through large clinical trials in...
Messobjekt: Die Tonometrie dient der Messung des intraokularen Druckes.
Modern ophthalmology uses numerous techniques to evaluate both function and pathophysiology of the organ. This chapter covers the major techniques used in ophthalmology. These include evaluation-techniques for the refractive part of the eye such as wavefront-analysis (Sect. 13.13), confocal laser microscopy (Sect. 13.5), as well as keratometry (Sec...
L’œdème maculaire constitue une modalité évolutive commune de nombreuses affections intra oculaires et systémiques et comporte en général une atteinte des vaisseaux rétiniens.
L’œdème maculaire est un signe non spécifique de nombreuses affections oculaires telles que rétinopathie diabétique, occlusions vasculaires, complications postopératoires et...
Abstract. Macular edema represents a common final pathway for many ocular diseases. Related ocular disorders include diabetic retinopathy, vascular occlusions, postsurgical situations, and uveitic diseases. The key pathophysiologic process is a breakdown of the blood-retinal barrier, normally preventing water movement in the retina, thus allowing f...
The development of therapy with anti-angiogenics or vascular endothelial growth factor inhibitors (anti-VEGF) has marked the beginning of a new era in neovascularization and macular edema treatment. Its main goals are the inhibition of growth and development of new vessels along with the reduction of vascular permeability. The advantages over conve...
Data from both experimental and epidemiological trials have suggested a potential correlation between extraction of the natural lens associated with exposure to photo-oxidative stress to the retina and a progression of diseases such as AMD. A fundamental factor could be the unchecked exposure to blue light. This is why in the past years so-called b...
Both diminution of angiostatic and increment of angiogenic factors seem to contribute to neovascularization in the eye under pathologic conditions. They are presented here separately. The involved proteins can change their role during the process of neovascularization from promoters to inhibitors and vice versa. Angiostatic factors can be divided i...
Angiogenesis is defined as the formation of new blood vessels from the existing vasculature. It is a highly coordinated process occurring during development of the retinal vasculature, ocular wound healing, and in pathological conditions. Complex interactions are involved between non-vascular and microvascular cells, such as endothelial cells and p...
Macular edema is an abnormal thickening of the macula associated with the accumulation of excess fluid in the extracellular space of the neurosensory retina. The following chapter looks at the basic pathomechanisms of macular edema as well as major pathologic conditions leading to it: special focus is on diabetic retinopathy, retinal venous occlusi...
Proangiogenic growth factors, mainly VEGF (vascular endothelial growth factor) play a significant role in anterior segment diseases, characterized by neovascularization. Newly grown vessels in the cornea can lead to an impairment of transparency and visual acuity. Neovascularization of the iris (rubeosis iridis) and the anterior chamber angle are c...
Macular edema represents a common final pathway for many disease processes. Related ocular disorders include diabetic retinopathy, vascular occlusions, post surgical situations and inherited disorders. The pathophysiology includes breakdown of the blood ocular barrier, release of various cytokines and significant inflammations. These mechanisms may...
Data from both experimental and epidemiological trials have suggested a potential correlation between extraction of the natural lens associated with exposure to photo-oxidative stress to the retina and a progression of diseases such as AMD. A fundamental factor could be the unchecked exposure to blue light. This is why in the past years so-called b...
Macular edema is defined as an accumulation of fluid in the outer plexiform layer and the inner nuclear layer as well as a swelling of Müller cells of the retina. It consists of a localized expansion of the retinal extracellular space (sometimes associated with the intracellular space) in the macular area. Macular edema is a common cause of a sudde...