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Publications (11)7.71 Total impact

  • [Show abstract] [Hide abstract] ABSTRACT: Study Objectives: To study the effect of tracheal intubation or laryngeal mask airway (LMA) insertion on intraocular pressure (IOP) in strabismus patients undergoing balanced anesthesia with sevoflurane and remifentanil.Design: Open, prospective, randomized study.Setting: Tertiary care academic medical institution.Patients: 40 adult ASA physical status I and II patients scheduled for elective strabismus surgery.Intervention: Patients were randomized to receive either tracheal intubation or LMA insertion following mask induction with sevoflurane in combination with IV remifentanil.Measurements: Intraocular pressure, mean arterial pressure (MAP), and heart rate (HR) were measured before induction, immediately following induction, and after airway insertion.Main Results: Intraocular pressure after tracheal intubation or LMA insertion did not differ significantly from preoperative baseline values. Mean arterial pressure and HR did not significantly differ between groups at any time point.Conclusions: Remifentanil and sevoflurane are not associated with an increase in IOP response during tracheal intubation or LMA insertion above baseline in healthy patients undergoing ophthalmic surgery.
    No preview · Article · Jun 2001 · Journal of Clinical Anesthesia
  • Carl Erb · Hans Hettesheimer · Nicole Stübiger · Wolfram Voelker
    [Show abstract] [Hide abstract] ABSTRACT: In earlier studies it was shown that patients with vascular disturbances (e.g. sudden hearing loss) had white-noise field campimetry abnormalities despite normal visual fields. The aim of this study was to clarify whether patients with coronary heart disease (CHD) have such disturbances in the white-noise field campimetry, too. Twenty-four patients (m:f = 23:1; mean age 58 +/- 9 years) with an angiographically documented CHD and 30 healthy controls (m:f = 29:1; mean age 54 +/- 7 years) were examined. In order to evaluate the morphological and functional ocular status, we examined the following parameters: morphological status, visual acuity, intraocular pressure, perimetry (Tübinger Automatic Perimeter 2000 ct, Oculus) and white-noise field campimetry (Tübinger Electronic Campimeter, Oculus). Fifteen patients had had a cardiac infarction. Twenty-one patients, but only 6 controls had alterations in perilimbal vessels of the conjunctiva and sixteen patients had a tortuousity of retinal vessels. The visual acuity, the intraocular pressure, the cup/disc ratio and the visual fields were within normal ranges. However, twenty patients and 5 controls were abnormal in the white-noise field campimetry. Although patients with CHD appeared unaffected in the standard eye examinations, the disturbances in the white-noise field campimetry indicated a functional visual impairment. Together with the changes in the perilimbal vessels of the conjunctiva and the retinal vessels, a disturbed ocular microcirculation as the underlaying cause could be discussed.
    No preview · Article · Dec 2000 · Klinische Monatsblätter für Augenheilkunde
  • H Hettesheimer · C Erb · U Schiefer · E Zrenner
    [Show abstract] [Hide abstract] ABSTRACT: The first morphological changes in eyes with HIV infection are microvascular disease of the retina with cotton-wool spots and microaneurysms. The study was performed to find out if evidence of disturbances of ocular microcirculation can be established by non-invasive methods. Twenty-seven patients with HIV infection and without opportunistic infections underwent thorough ophthalmologic examination with threshold-oriented, suprathreshold perimetry (TAP 2000 ct, Oculus) and white-noise field campimetry (TEC, Oculus). Visual field examination was normal in 23 out of 27 patients (85%), whereas 4 patients showed relative field defects in at least one eye. In white-noise field campimetry 13 out of 23 perimetrically unaffected patients (56%) perceived scotomas in one or both eyes. These scotomas were not stable. Three of 4 patients with relative scotomas in the visual field had cotton-wool spots in the retina and showed a stable scotoma in campimetry. Visual acuity, IOP, and cup/disc ratio were within normal ranges. White-noise field campimetry complements the standard examination of patients with HIV and might be capable of indicating disturbances of ocular microcirculation by a non-invasive method before morphological changes in the retina can be seen.
    No preview · Article · Aug 1999 · Der Ophthalmologe
  • Hans Hettesheimer · Carl Erb · Ulrich Schiefer · Eberhart Zrenner
    [Show abstract] [Hide abstract] ABSTRACT: Purpose: The first morphological changes in eyes with HIV infection are microvascular disease of the retina with cotton-wool spots and microaneurysms. The study was performed to find out if evidence of disturbances of ocular microcirculation can be established by non-invasive methods. Patients and methods: Twenty-seven patients with HIV infection and without opportunistic infections underwent thorough ophthalmologic examination with threshold-oriented, suprathreshold perimetry (TAP 2000 ct, Oculus) and white-noise field campimetry (TEC, Oculus). Results: Visual field examination was normal in 23 out of 27 patients (85 %), whereas 4 patients showed relative field defects in at least one eye. In white-noise field campimetry 13 out of 23 perimetrically unaffected patients (56 %) perceived scotomas in one or both eyes. These scotomas were not stable. Three of 4 patients with relative scotomas in the visual field had cotton-wool spots in the retina and showed a stable scotoma in campimetry. Visual acuity, IOP, and cup/disc ratio were within normal ranges. Conclusion: White-noise field campimetry complements the standard examination of patients with HIV and might be capable of indicating disturbances of ocular microcirculation by a non-invasive method before morphological changes in the retina can be seen.
    No preview · Article · Jun 1999 · Der Ophthalmologe
  • No preview · Article · Jan 1998 · Klinische Monatsblätter für Augenheilkunde
  • U Kretschmann · K Gendo · H Wilhelm · U Schiefer · H Hettesheimer · E Zrenner
    [Show abstract] [Hide abstract] ABSTRACT: Multifocal electroretinography allows simultaneous recording of 61 focal electroretinographic signals from the retina of the posterior pole. The function of the outer retinal layers can be mapped for a visual field of 30.5 degrees radius. We herein describe the topography of such potentials in patients with hemianopic and concentric visual field defects. Six patients with visual field defects caused by chorioretinal and central visual pathways diseases were examined using multifocal ERG. In 30 normal volunteers in the entire 30 degrees visual field clear signals were obtained. In the patients with visual field defects caused by retinal diseases in areas with reduced light sensitivity diminished electroretinographical activity was found. In contrast, in patients with bitemporal hemianopsia due to a chiasmal lesion no correlation between visual field and magnitude of focal ERGs was seen. In retinal disorders defects in multifocal ERG presented the similar pattern as scotomata in perimetry. The patient with visual field defects due to disturbances in the chiasma exhibited a normal ERG-topography. In patients with visual field defects multifocal ERG supported differentiation of the location of the lesion.
    No preview · Article · Jan 1998 · Klinische Monatsblätter für Augenheilkunde
  • [Show abstract] [Hide abstract] ABSTRACT: Purpose. Hyaluronic acid (HA) and Methylhydroxypropylcellulose (MHPC) are widely used in intraocular ophthalmic surgery because of their viscoelastic properties. Components of the extracellular matrix, such as HA play a pivotal role in the regulation of cellular behaviour (e.g., proliferation). HA has been shown to be an important extracellular signal for various cell types. Aim of the present study was to evaluate the proliferative effect of HA and MHPC on cultured bovine lens epithelium cells (BLEC). Methods. The effects of HA and MHPC in concentrations ranging from 100 to 1000 μg/ml were evaluated under serum-free culture conditions. Cell numbers were determined after 3, 5 and 7 days using a cell counter. Results. Stimulation of BLEC with HA led to a dose-dependent increase in cell proliferation with an EC50 of 260μg/ml. Maximal stimulation occured after 5 days with 500μg/l of HA. Higher concentrations of HA revealed no further stimulation. MHPC, when used in similar concentrations, was not effective. Conclusion. Our data indicate that HA, in contrast to MHPC, act as a proliterative stimulus for BLEC and may influence ocurrence and extent of posterior capsule opacification after extracapsular cataract surgery. Further investigations are necessary to illucidate the mode of action of HA at the cellular level.
    No preview · Article · Feb 1996
  • E. Hipp · C. Erb · H. Hettesheimer · I. Kreissig · H.-J. Thiel
    [Show abstract] [Hide abstract] ABSTRACT: Purpose: At present, central serous chorioretinopathy (CSCR) is an etiologically unclear disease. Among theories like a virale infection, the vascular hypothesis is the most common one. This study was performed to find out, if there is evidence of disturbances of ocular microcirculation with non-invasive methods. Patients and Methods: 18 patients (m:f=14:4; mean age 40±11 years) with an angiographically documented CSCR were examined between 1994 and 1995. In order to evaluate the functional changes in ocular physiology, we examined the following parameters: morphological status, visual acuity, intraocular pressure, perimetry (TAP 2000 ct, Oculus), white-noise field campimetry (TEC, Oculus) and color vision (Roth 28 HUE desaturated). Results: Morphologically, 11 patients had intensive perilimbal ectasia of the conjunctival vessels on both eyes and a similar cup/disc-ratio between the CSCR eye and the other eye (0.26±0,1 vs 0.24±0.1). Refraction and intraocular pressure showed no differences between the affected and the control eye. The visual acuity was reduced in the CSCR eye. In the perimetry, only 8 patients had relative and/or absolute scotomas in the affected eye, but none in the control eye. In the white-noise field campimetry 17 patients (94%) had scotomas in the affected eye, only 2 patients had scotomas in the control eye. In the color test, the CSCR eye had a blue-yellow-axis disturbance and a high sum of errors. As rise factors 3 patients had a hyperlipidemia and 7 patients were smokers. In addition, general vascular diseases were: migraine (7x), peipheral vasospasmus (5x), hypertension (3x), hypotension (2x) and tinnitus (2x). Conclusion: As a result, our findings suggest a vascular genesis of CSCR in the course of additional general vascular diseases. Visual disturbances experienced by these patients despite generally good visual acuity could be confirmed by the white-noise field campimetry and the color test. Therefore, both non-invasive methods complement the standard examination of patients with CSCR and indicate disturbances in the ocular microcirculation.
    No preview · Article · Feb 1996
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    H. Hettesheimer · F. Gelisken · C. Erb · I. Kreissig
    Preview · Article · Oct 1995 · Vision Research
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    Erb C · Hipp E · Hettesheimer H · Thiel H.-J
    Preview · Article · Sep 1995 · Vision Research
  • K H Türmer · A Guhl · H Hettesheimer · I Kreissig
    [Show abstract] [Hide abstract] ABSTRACT: By microcatheterization of the ophthalmic artery it was possible to test a controlled retinal fibrinolysis in the rabbit. Heparin, tolazoline and urokinase were applied through the microcatheter. By continuous administration of highly diluted fluorescein (0.1%), on-line control of the therapeutic effects was available. Treatment was carried out in cycles of enforced perfusion. In 12 main vessel occlusions the rates of flow could nearly be normalized after mobilization of thrombi by combined emergency therapy. An average of 14 cycles of treatment was necessary. The time needed was 40-60 min. With this technique drug therapies of ocular circulation disturbances are testable and controlled emergency treatment of the eye begins to become feasible.
    No preview · Article · Nov 1993 · Der Ophthalmologe