Bernhard Jurklies

University Hospital Essen, Essen, North Rhine-Westphalia, Germany

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Publications (63)193.23 Total impact

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    ABSTRACT: To analyze the underlying risk factors in patients with nonarteritic central retinal artery occlusion (CRAO) in a well-defined and homogenous group of patients enrolled in the European Assessment Group for Lysis in the Eye (EAGLE) study. Analysis of the cardiovascular risk factors in a prospective, randomized clinical trial. Seventy-seven EAGLE patients with nonarteritic CRAO. Analysis of vascular risk factors and underlying diseases detected by questionnaire and standardized physical examination within 1 month after occlusion. The standardized physical examination included carotid Doppler ultrasonography, echocardiography, electrocardiography, blood pressure monitoring, pulse rate, urine analysis, body mass index analysis, and laboratory tests. Seventy-seven of 84 patients had complete datasets for analysis. Fifty-two (67%) patients had cardiovascular risk factors in their medical history, and comprehensive phenotyping identified at least 1 new risk factor in 60 patients (78%; 95% confidence interval, 67%-87%). Thirty-one (40%) had carotid artery stenosis of at least 70%. Eleven patients experienced a stroke, 5 of those within 4 weeks after the CRAO occurred. Arterial hypertension was found in 56 (73%) patients and was newly diagnosed in 12 (16%) study participants. Cardiac diseases were also highly prevalent (22% coronary artery disease, 20% atrial fibrillation, and 17% valvular heart disease). Previously undiagnosed vascular risk factors were found in 78% of all CRAO patients. The most meaningful risk factor was ipsilateral carotid artery stenosis. A comprehensive and prompt diagnostic work-up is mandatory for all CRAO patients. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
    Full-text · Article · Jul 2015 · Ophthalmology
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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.
    Full-text · Article · Sep 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.
    Full-text · Article · Feb 2011 · Human Molecular Genetics
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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.
    Full-text · Article · Feb 2011 · The British journal of ophthalmology
  • Harun Akgul · Friedrich Otterbach · Norbert Bornfeld · Bernhard Jurklies
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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.
    No preview · Article · Jan 2011 · The British journal of ophthalmology
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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.
    Full-text · Article · Sep 2010 · Der Ophthalmologe
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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
    Full-text · Article · Sep 2010 · Der Ophthalmologe
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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.
    Full-text · Article · Jul 2010 · Ophthalmology
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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.
    Full-text · Article · Nov 2009 · Proceedings of the National Academy of Sciences

  • No preview · Article · Sep 2009 · Klinische Monatsblätter für Augenheilkunde
  • G E Lang · S Mennel · G Spital · J Wachtlin · B Jurklies · H Heimann · B Damato · C H Meyer
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    ABSTRACT: Photodynamic therapy (PDT) in eye disease was approved 10 years ago for age-related macular degeneration (AMD). Thereafter it was approved for choroidal neovascularisation (CNV) in pathological myopia. The treatment regimen is based on two prospective, multicentre trials (TAP and VIP studies). In the meantime PDT has been successfully used also in several other ocular diseases. PDT is minimally invasive and has an excellent side effect profile. Different diseases and their treatment with PDT are discussed. The treatments of idiopathic CNV, secondary CNV in inflammatory diseases of the retina and choroid, choroidal haemangioma, vasoproliferative tumours, malignant melanoma of the choroid, and central serous chorioretinopathy with PDT are described. In most patients the disease progression can be stopped and in some the PDT treatment results in visual improvement. The prognosis is better in patients with early disease detection and small lesions. Several retinal and choroidal diseases can be treated successfully with PDT. Except for AMD and pathological myopia, PDT is an off label treatment.
    No preview · Article · Aug 2009 · Klinische Monatsblätter für Augenheilkunde
  • 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.
    No preview · Chapter · Oct 2008
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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.
    Full-text · Article · Jun 2008 · The British journal of ophthalmology
  • 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.
    No preview · Article · Oct 2007 · Retina
  • B. Jurklies · N. Bornfeld
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    ABSTRACT: Photodynamic therapy (PDT) with verteporfin has significantly improved functional outcome in the treatment of choroidal neovascularization (CNV) in various clinical disorders [86]. While CNV due to age-related macular degeneration [4, 53, 76-80, 84] and pathologic myopia [83, 85] was the primary focus, several studies showed that the treatment effects of PDT were not only restricted to these two underlying disorders. Recently, several clinical studies observed PDT as a treatment modality of CNV due to ocular histoplasmosis syndrome [52, 55, 68], choroiditis [71, 89], angioid streaks [31, 37, 68], Stargardt's disease [81], symptomatic choroidal hemangioma [30, 61, 82] and other causes [15, 72]. While PDT has become an established treatment modality for various choroidal disorders, its role in the treatment of retinal diseases remains to be determined.
    No preview · Article · Jan 2007
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    ABSTRACT: These congenital, non-progressive lesions are benign, and often solitary and unilateral. Patients are usually asymptomatic, although some may experience decreased vision and neurologic symptoms, such as seizures and cranial nerve palsies [15, 87]. Cutaneous or cerebral hemangiomas may also be found, especially in cases of inherited lesions [2, 4, 15, 22, 23, 58]. Pedigree analysis suggests that this neurooculocutaneous syndrome may be inherited in an autosomal dominant pattern, with incomplete penetrance or variable expressivity [23, 58].
    No preview · Article · Jan 2007
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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.
    Full-text · Article · Nov 2006 · Der Ophthalmologe
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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");
    No preview · Article · Oct 2006 · Der Ophthalmologe
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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.
    No preview · Article · Sep 2006 · Der Ophthalmologe
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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.
    Full-text · Article · Sep 2006 · Albrecht von Graæes Archiv für Ophthalmologie

Publication Stats

2k Citations
193.23 Total Impact Points

Institutions

  • 1999-2014
    • University Hospital Essen
      Essen, North Rhine-Westphalia, Germany
  • 2006-2011
    • University of Duisburg-Essen
      • Faculty of Medicine
      Essen, North Rhine-Westphalia, Germany
    • Universitätsklinikum Freiburg
      • Department of Neuroradiology
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2001
    • Radboud University Medical Centre (Radboudumc)
      • Department of Human Genetics
      Nymegen, Gelderland, Netherlands
  • 1997
    • Universitätsklinikum Tübingen
      Tübingen, Baden-Württemberg, Germany
  • 1994
    • University of Cologne
      Köln, North Rhine-Westphalia, Germany