Subepidermal calcified nodule.
Explore the source record for details and available documents.
Calcinosis↗
Biomedical subjects
A Jünemann
Publications and source records attributed to A Jünemann.
[Cataract surgery in nanophthalmic eyes with an axial length of less than 20.5 mm].
BACKGROUND: Aim of this study was to analyze the results of cataract surgery in nanophthalmic eyes with axial length of less than 20.5 mm. PATIENTS AND METHODS: From 1991 to 1996 extracapsular cataract extraction with posterior chamber lens implantation was performed in 20 eyes of 19 patients (mean age 70.2 +/- 12.7 years, 4 male, 16 female) with axial length of less than 20.5 mm. Mean preoperative visual acuity was 0.16 +/- 0.15, refractive error +5.1 +/- 3.8 dpt and intraocular pressure 18.7 +/- 10.3 mm Hg. The mean follow-up was 24.4 months. Patient data were collected prospectively with standardized "Erlanger Augenblätter" and the computer-aided automatized operation record system "OPERA". These data together with the biometrical data were analized in a retrolective manner. RESULTS: Preoperatively 6 of 20 eyes had angle closure situation, 7 of 20 eyes had undergone intraocular surgery previously (5 x iridotomy, 1 x surgical iridectomy, 1 x filtration procedure). Pseudoexfoliation syndrome was present in 3 eyes. The posterior chamber lens (mean refractive power 31.7 +/- 3.0 dpt, optic diameter 6.5 and 7.0 mm) was positioned 18 x intracapsular, 2 x into the sulcus and 1 x by scleral fixation due to capsular rupture without vitreous loss. In 16 of 20 eyes iris surgery was performed additionally, in one eye an anterior sclerotomy was necessary. Intraoperatively "vis a tergo" occurred in 10 eyes and anterior chamber hemorrhage in one eye. Visual acuity improved in 16 of 20 eyes. The mean visual acuity was 0.3 +/- 0.2. At the end of follow-up 13 eyes had an improvement of visual acuity. Mean intraocular pressure was 16.5 +/- 3.3 mm Hg, refractive error was +0.47 +/- 2.9 dpt and differed by -0.49 +/- 1.8 dpt from the preoperatively calculated refraction. Postoperatively angle closure glaucoma developed in one eye, a ciliopseudophakic angle closure glaucoma and recurrent iris bombata in one eye. Reoperations included cyclokryokoagulation in two eyes, pars plana vitrectomy in one eye and repeated Nd-YAG iridotomies in one eye. CONCLUSION: Regarding the special anatomic situation, the surgical procedure has to be planned individually, including the determination of sclera thickness, corneal diameter and lens volume/eye volume ratio.
Aged↗
[Epithelial giant inclusion cyst 50 years after enucleation without orbital implant].
BACKGROUND: Conjunctival cyst formation following enucleation may occur in 3% to 7% of patients receiving orbital implants, especially secondary implants. We present a patient with a giant epithelial inclusion cyst of the anophthalmic orbit 50 years after enucleation without orbital implant. PATIENT: A 54-year-old male presented with increasing proptosis of the ocular prosthesis, shallowing of the inferior fornix, a palpable orbital mass, and difficulty in retaining the ocular prosthesis. At the age of 1 year enucleation of the right eye without orbital implant was performed following perforating ocular trauma. Results of examination of the other eye were unremarkable. Transillumination of the orbital mass was possible. The clinical diagnosis of an epithelial inclusion cyst was confirmed using ultrasonography and CT scan. An incision of conjunctiva and cyst wall and subsequent marsupialization were performed. Nine months postoperatively there was no evidence of recurrence of the cyst. The ocular prosthesis was well in place. CONCLUSION: Conjunctival cyst formation following enucleation may rarely occur in patients receiving orbital implants, especially secondary implants. The presentation of a conjunctival cyst formation following enucleation without orbital implant 50 years after surgery is noteworthy in comparison to implantation cysts which are known to occur more commonly within the first two years following secondary orbital implants.
Blast Injuries↗
[Chalcosis oculi].
PURPOSE: To report on a patient including measurements of retinal changes in ocular chalcosis. PATIENT AND METHODS: After having suffered an open-globe injury presumably due to a small foreign body after a grenade explosion, a 30-year-old man presented six years later with ocular chalcosis including sunflower cataract, a multitude of tiny brownish particles in the anterior vitreous, a fibrillar degeneration of the posterior vitreous and brilliant patches overriding the foveal region. The patches were measured by confocal scanning laser tomography (HRT) and optical coherence tomography (OCT). RESULTS: Besides an acquired cyandyschromatopsia, psychophysical and electrophysiologic tests were unremarkable. Vision was 20/20. The central patches measured 200 to 700 microns in diameter (HRT) and 150 to 200 microns in height above the inner retinal surface (HRT and OCT). DISCUSSION: With exception of a Kayser-Fleischer ring of the cornea the patient presents all morphologic signs of ocular chalcosis. Although the observed patches on the central retina in ocular chalcosis are described in the literature, their nature is not known.
Adult↗
[Confrontation test using Bagolini striated glasses--a new screening method for detection of quandrantanopia and hemianopia].
BACKGROUND: To propose a quick test using striated lens according to Bagolini for detecting quadrantanopic and hemianopic visual field defects. PATIENTS AND METHODS: The results of this test are presented and compared with Goldmann perimetry in five patients suffering from quadrantanopic and hemianopic visual field defects in hypophyseal adenoma (2 x quadrantanopia, 1 x bitemporal hemianopia) and occipital process (2 x homonymous hemianopia). To examine the visual field the patient has to fixate a light at 50 cm distance. Due to the striated glasses two light stripes are generated along the 45 degrees diagonal, crossing in the fixated light in normal binocular vision. The temporal lower and nasal upper quadrants of both eyes and after switch the striated glasses around the horizontal axis, the nasal lower and temporal upper quadrant of both eyes can be tested along the 45 degrees axis. While fixating the lamp the patient is asked (in normal binocularity identical with the crossing point), if one or more of the four light stripes, beginning at the crossing point is shorter or weaker than the others, or interrupted or missing totally. RESULTS: Shortened or absent light stripe indicating quadrantanopic visual field defect agrees with the location of visual field defect in kinetic Goldmann Perimetry. An absent light stripe indicates a complete quadrantanopia, a shortened light stripe an incomplete quadrantanopia. Fixation is warranted easily by the crossing light stripes. CONCLUSION: The dissociation with the aid of striated glasses allows a simultaneous test of both eyes in the 45 degrees-axis of all four quadrants in combination with the location of the visual field defect in this axis. The proposed confrontation test is a simple and quick test without extensive equipment. This test seems to be a useful tool in detecting homonymous or heteronymous quadrantanopic and hemianopic visual field defects for quick screening purposes, especially in immobile patients.
Adult↗
[Ophthalmomyiasis externa caused by Oestrus ovis in Franconia].
BACKGROUND: Ophthalmological diseases caused by parasites are a very rare entity in middle europe. Ophthalmomyiasis caused by parasites living in our country are only reported as case history in literature. PATIENT: We report on a 28-year old patient, seen in our department in august 1997 suffering from ophthalmomyiasis externa. CASE HISTORY: The male patient was riding on a motorbike when a fly gets into his right eye. 12 hours later he had a feeling of pain in the eye. When having a closer look to his right eye, he found some fly larva (2.0! 0.8 mm) in the conjunctival sack. The patient could extract the fly larva from the conjunctival sack by himself. On examination at our department we found a unspecific irritation of the conjunctiva. The fly larva was identified as larva of oestrus ovis ("Schafsbremse"). CONCLUSION: Although ophthalmomyiasis is a very rare entity in middle europe single appearance is possible even in our country. No specific therapy was necessary in this case.
Adult↗
A multivariate sensory model in glaucoma diagnosis.
PURPOSE: To evaluate whether the combination of two psychophysical and two electrophysiological procedures improves diagnostic validity compared with single procedures. METHODS: In a clinical study, 73 patients with glaucoma from the University Eye Hospital in Erlangen and 122 healthy control subjects from the university staff, ranging in age from 19 to 62 years, underwent measurement of temporal contrast sensitivity using a full-field flicker test, spatiotemporal contrast sensitivity, blue-on-yellow visual evoked potential (VEP), and a black-and-white, pattern-reversal electroretinogram. Diagnostic reference criteria included applanation tonometry, optic disc morphometry, and automated perimetry. Sensitivity was determined univariately with a fixed specificity of 80% and in a multivariate approach using logistic regression analysis. The classification rate was estimated using the leaving-one-out method. The correlation with intraocular pressure, visual field defects, and optic nerve defects was determined. RESULTS: Contrast sensitivity measurements and the blue-on-yellow pattern-onset VEP showed comparable sensitivity (85%, 84%, and 85%) with 80% specificity, and a pattern-reversal electroretinogram showed lower sensitivity (64%). The first three methods contributed independent information to a diagnostic score. This score improved sensitivity to 94%, with a specificity of 89%. All procedures moderately correlated with the neuroretinal rim area of the optic disc (r=0.32-0.46). The psychophysical tests showed a higher correlation with visual field defects (r > 0.5) than the electrophysiological tests (r < 0.3). CONCLUSIONS: The multivariate approach substantially increased the diagnostic validity compared with single procedures. This was probably because the diagnostic procedures under investigation tested different aspects of visual function.
Adult↗
The full-field flicker test in early diagnosis of chronic open-angle glaucoma.
PURPOSE: To evaluate whether the full-field flicker test, a psychophysical test employing full-field flickering stimuli to measure temporal contrast sensitivity, can detect glaucomatous optic nerve damage in patients with increased intraocular pressure and glaucomatous optic disk abnormalities but normal visual fields. METHODS: Temporal contrast sensitivity was determined with a sinusoidally flickering light (frequency, 37.1 Hz) of constant mean photopic luminance (10 cd/m2) presented in a full-field bowl of 58-cm diameter. The prospective study included three groups of individuals: the "preperimetric" glaucoma group of 80 patients with increased intraocular pressure, glaucomatous optic disk abnormalities, and normal visual fields; the "perimetric" glaucoma group of 56 glaucomatous patients with increased intraocular pressure and glaucomatous changes of the optic disk and visual field; and the control group of 96 normal subjects. RESULTS: Temporal contrast sensitivity was significantly (P < .001) lower in the two glaucoma groups than in the control group. In the preperimetric glaucoma group, 34% of the patients (27/ 80) were recognized by the full-field flicker test at a specificity of 99%. For all study subjects, temporal contrast sensitivity decreased significantly (P < .001) with decreasing neuroretinal rim area, enlarging peripapillary atrophy, and diminishing retinal nerve fiber layer visibility. CONCLUSIONS: The full-field flicker test can detect glaucomatous optic nerve damage in patients with increased intraocular pressure, glaucomatous optic disk abnormalities, and normal visual fields. Considering its feasibility, simplicity, quick performance, and low costs, the full-field flicker test may be helpful in clinics and in screening examinations as a supplement to glaucoma diagnosis.
Adult↗
[Chloroquine-induced bull's eye maculopathy without electrophysiologic changes].
BACKGROUND: Electrophysiologic findings are usually pathologic in patients with chloroquine-induced bull's-eye maculopathy. To avoid maculopathy the daily dosage of chloroquine is estimated not from the actual but from the ideal body weight and should not exceed 3.5 mg/kg/day. PATIENT AND METHODS: A 59-year-old housewife took a daily dosage of 250 mg chloroquine for her rheumatoid arthritis over a period of 5 years up to a total dose of 450 g. With the height of 160 cm she weighed 68 kg. In 1990, two years after cessation of treatment she complained about blurred vision. Her visual acuity then was 0.8 and fell to 0.3 (right eye) and 0.4 (left eye) in 1996. No vortex keratopathy was observed. A central scotoma was present and fundus-examination showed a typical bull's-eye maculopathy. The mid hypopigmented ring correlated with an increased background fluorescence in the fluorescence-angiogram. Color vision and the retinal nerve fiber photo were normal. In spite of the prominent fundoscopic changes the electrophysiologic examination of this patient (ERG, EOG and pattern-ERG) was normal. The relative smallness of affected retina might explain the normal electrophysiology. CONCLUSION: This case of a patient with typical chloroquine-induced bull's-eye maculopathy with normal electrophysiology points to the importance of ophthalmoscopic and visual fields examination in patients under long-term chloroquine treatment. The correct daily dosage of chloroquine below 3.5 mg/kg/day should be given to avoid maculopathy.
Antirheumatic Agents↗
[Are there genuine and pseudo-normal pressure glaucomas? Body position-dependent intraocular pressure values in normal pressure glaucoma].
BACKGROUND: Elevation of intraocular pressure in the supine position has been previously described in literature. Aim of this study is to investigate the elevation of intraocular pressure in normal tension glaucoma and its effect on the morphology of the optic disc, visual field function and capillary blood flow of the retina and optic disc. PATIENTS AND METHODS: 56 eyes of 28 preperimetric and advanced normal tension glaucoma patients were prospectively evaluated. Ten eyes of ten normal patients served as a control group for the measurements of the intraocular pressure. In the course of a 24-h pressure profile applanation tonometry was performed in the morning in a supine and three and ten minutes later in a sitting position with Draeger's and Goldmann's tonometers. Arterial blood pressure was measured at the same time. The optic disc's morphology was evaluated by stereo photographs and Laser Scanning Tomography. As a sensory test computer perimetry was used. Capillary blood flow was measured at defined areas of the retina and optic disc. An intraocular pressure above 21 mm Hg in the supine position was used as a criterium to define two groups of normal tension glaucoma patients. RESULTS: In the supine position a statistically significant elevation of intraocular pressure was observed in 24 normal tension glaucoma patients by 6.2 +/- 2.8 mm Hg up to 21.8 +/- 3 mm Hg. Diastolic blood pressure in the supine position (80 +/- 10.5 mm Hg) was significantly lower than in the sitting position (94 +/- 11 mm Hg, p = 0.021). 12 of 28 normal tension glaucoma patients showed an intraocular pressure lower than 22 mm Hg in the supine position. In these patients a tendency towards a higher incidence for the occurrence of optic disc haemorrhages and significantly higher values for blood flow (p < 0.0005) and volume (p < 0.005) in the retina and optic nerve head could be shown. In this group of normal pressure glaucoma patients a higher incidence of migraine and vasospastic complaints was reported in the patients' history. CONCLUSION: In this study some normal tension glaucoma patients showed intraocular pressures in the supine position higher than 21 mm Hg and a lower diastolic arterial pressure. The higher incidence of haemorrhages and higher values for flow and volume parameters of the optic disc in normal tension glaucoma patients with an intraocular pressure lower than 22 mm Hg implicate the existence of two entities: real and pseudo normal tension glaucomas.
Adult↗
Color axis evaluation of the Farnsworth Munsell 100-hue test in primary open-angle glaucoma and normal-pressure glaucoma.
BACKGROUND: It was the aim of the present study to analyze a separate color-axis evaluation of the Farnsworth Munsell 100-hue test (FM 100) in primary open-angle glaucoma (POAG) and normal pressure glaucoma (NPG). PATIENTS AND METHODS: One eye of each of 112 individuals (age 35-65 years, visual acuity > 20/28, myopia < -7.5 D) was included. The groups consisted of 62 normal subjects and 50 glaucoma patients (33 POAG and 17 NPG). We evaluated the FM 100 overall error score and the error scores of the protan, deutan and tritan axes. The results were compared with perimetric (Octopus G1 mean defect) and morphometric data of the optic disc. RESULTS: All error scores were significantly higher in the glaucoma group than in the normal group. In an age-related evaluation, differences were significant in age groups above 45 years. No significant differences were found between the POAG and NPG groups. The sensitivity of the overall score to identify glaucoma was 62% (specificity 80%). In the glaucoma group the overall score and the protan score increased significantly with the mean defect (r > 0.3, P < 0.01). Several scores increased slightly with decreasing neuroretinal rim area, but not on a significant level. Separate color-axis evaluations did not show any stronger correlations and did not reveal any differences between POAG eyes and NPG eyes. This was true even for the tritan axis error. CONCLUSIONS: Although FM 100 error scores are higher in glaucoma eyes and increase with glaucomatous damage, they do not separate well. In the sample of this study, separate color-axis evaluation did not improve the diagnostic value. With the FM100 a different pattern of color vision defects in POAG and NPG eyes could not be detected.
Adult↗
[Sensory physiology and biomorphology of the optic papilla: analysis of correlation in normal persons].
BACKGROUND: The aim of the present study was to investigate whether the morphological variability of the optic disc has an influence on sensory test procedures. PATIENTS AND METHODS: In 52 eyes of 52 normal persons psychophysical (perimetry, color vision, contrast sensitivity) and electrophysiological (pattern-ERG and pattern-VEP) tests and planimetric papillometry were performed. A correlation analysis was made between sensory tests and area of optic disc (1.79 to 5.2 mm2) and neuroretinal rim. RESULTS: There was no significant correlation between perimetry, color vision, pattern-ERG, pattern-VEP, spatio-temporal and temporal contrast sensitivity on the one hand and optic disc area or neuroretinal rim area on the other. CONCLUSION: Results of psychophysical and electrophysiological tests do not have to be corrected with respect to the neuroretinal rim area.
Adult↗
[Intraocular pressure after filtering operation or combined filter-cataract operation].
BACKGROUND: The prevalence of glaucoma is 2% and of cataract 25% in patients at the age of 65 to 75 years. To this moment the discussion is open about the optimal therapy when there is simultaneous cataract and glaucoma. We evaluated and compared the intraocular pressure and the visual acuity in patients with filtering-surgery and combined surgery (= filtering surgery plus simultaneous cataract surgery). METHOD: In a retrospective study 56 eyes of 45 patients operated by filtering surgery and 46 eyes of 40 patients operated by combined surgery were examined. RESULTS: Patients with combined surgery showed significant higher frequency of fibrin in the anterior chamber compared to patients with filtering-surgery. After 12 months there was no significant difference in intraocular pressure between both groups. The IOP of the last examination was 16 +/- 4 mm Hg in eyes with combined surgery and 14 +/- 4 mm Hg in eyes with filtering surgery. Eyes with combined surgery showed an increase of visual acuity from 0.2 +/- 0.2 to 0.4 +/- 0.3, eyes with filtering surgery a decrease of visual acuity from 0.7 +/- 0.3 to 0.6 +/- 0.3. CONCLUSION: Combined surgery is perioperatively associated with a higher frequency of complications, but showed 12 months postoperatively equal values of regulated intraocular pressure.
Aged↗
Aplasia of the optic nerve in two cases of partial trisomy 10q24-ter.
We report two cases with partial trisomy of 10q24.1-ter with concomitant deficiency of 7pter and 4qter, which share aplasia of the optic nerve and malformation of the anterior chamber. A review of published observations of partial trisomies of 10q showed that abnormalities of the eye, and particularly of the orbital region, are frequent, but ophthalmological studies are lacking. We conclude that our findings demonstrate a major effect of this chromosomal imbalance.
Abnormalities, Multiple↗
Epithelial iron line in juvenile corneal arcus lipoides.
Iron lines of the corneal epithelium are well-described phenomena in both normal and pathologic conditions. We found a bilateral corneal epithelial iron line at the inner edge of a juvenile corneal arcus lipoides in an otherwise normal eye of a 38-year-old white man. Possible mechanisms that may have led to the development of this new iron line are discussed.
Adult↗
[Use of a new anomaloscope test in diagnosis of glaucoma].
BACKGROUND: The Color Vision Meter 712 (CVM) is a new automatic computerized anomaloscope relying on both the Rayleigh and the Moreland equation. In the present study the diagnostic value of Color Vision Meter was examined in glaucoma for the first time and was compared with the Farnsworth 100 hue test. PATIENTS AND METHODS: 33 normals, 15 patients with ocular hypertension (OHT) and a heterogenic group of 31 glaucoma patients were tested with the Nagel anomaloscope, the Color Vision Meter 712 and the Farnsworth 100 hue test. The following determinations were made in all subjects: 1. Anomalous quotient of the Rayleigh equation of the Nagel anomaloscope and of the Color Vision Meter, 2. Mean tritan score of 100 hue test, 3. The matching range, mid matching point, and anomalous quotient of the Moreland equation with the Color Vision Meter. RESULTS: While in the OHT group only the matching range of the Moreland equation was enlarged, all three variables (matching range, mid matching point and anomalous quotient) of the Moreland equation were significantly changed in the glaucoma group. The mean tritan score of the 100 hue test showed in the OHT group only a slight difference compared to normals, and in the glaucoma group a low significance and a low sensitivity. The matching range of the Moreland equation seems to be most useful with a sensitivity of 87.1% and a specificity of 93.6%. CONCLUSION: Our results show that the new anomaloscope Color Vision Meter 712 should be considered as a quick screening test for the examination of blue-color vision disturbances in glaucoma because of its higher sensitivity, its easier use for examiner and patients, and its shortened examination time (5 min per equation).
Adult↗
VEP test of the blue-sensitive pathway in glaucoma.
PURPOSE: The blue-sensitive pathway in normal subjects and in patients with primary open-angle glaucoma (POAG) was tested with the pattern visual evoked potential (VEP) method under selective adaptation. METHODS: Recording of pattern-onset VEP in response to blue (460-nm) stripes (0.88 c/deg) presented either without or with a bright yellow (570-nm) adaptation light (Maxwellian view, 33 degree diameter). Amplitude and peak times were evaluated, and the mean tritan score of the Farnsworth 100-hue test was determined. Age-matched normal subjects (n = 34) and (n = 32) patients with POAG were examined. RESULTS: The amplitude and peak time of the VEP without selective adaptation did not discriminate normal subjects from the POAG group. With selective adaptation, the amplitude was reduced (P = 0.002) and its peak time delayed (P < 0.0001) in POAG, yielding a sensitivity of 75% and a specificity of 94%. The VEP measures only under selective adaptation correlated significantly in patients with POAG with the mean perimetric defect, with the optic disc damage, and with the 100-hue test. CONCLUSIONS: Recording the blue-on-yellow VEP is a useful test in glaucoma research.
Adult↗