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Biomedical subjects

A Kampik

Publications and source records attributed to A Kampik.

At least 37 records · Page 2Linked to original sources
PubMed2004

[Homogeneity of G-DRGs in ophthalmology].

BACKGROUND: Since the year 2004 hospitals in Germany are obliged to participate in a payment system based on diagnosis-related groups (DRG), which bases hospital reimbursement on the diagnosis and treatment of patients. The aim of this study was to analyze the data of the first German national hospital cost data calculation for their homogeneity. METHODS: The cases at the LMU hospital in Munich were calculated analogous to the national hospital cost data calculation for a period of 7 months. These exemplary data were then analyzed in detail for homogeneity. RESULTS: For many DRGs, the numbers of cases in the analysis were within a range similar to those in the official nationwide calculation. The costs and lengths of stay were similar to those of the official national calculation. CONCLUSIONS: Many ophthalmologic DRGs are quite inhomogeneous necessitating regrouping to avoid false incentives. For cases with high complexity the current system may lead to cost deficits especially for hospitals providing maximum care.

Analysis of Variance↗
PubMed2004

Retinal vascular abnormalities in CADASIL.

To assess retinal vascular alterations in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, the authors examined 10 affected individuals with ophthalmologic evaluation including fluorescence angiography. Findings included bilateral peripapillary arteriolar sheathing (30%), arteriolar narrowing (80%), and arteriovenous nicking (90%). No retinal infarcts, vascular occlusions, exudation, or hypoperfusion of affected vessels were found.

Adult↗
PubMed2004

[Clinical and genetic results with reference to corneal alterations in Lowe-syndrome].

BACKGROUND: The Lowe oculo-cerebro-renal syndrome (OCRL1) is a rare X-linked disease which causes impairment of visual acuity. The situation may be further complicated by corneal alterations. PATIENTS AND METHODS: In total seven patients from different families were clinically examined by slit-lamp examination, funduscopy, measurement of the intraocular pressure and ultrasound sonography. Molecular genetic analysis was performed in six patients by sequencing large PCR amplicons with a DNA sequencer and the ABI PRISM Sequence navigator software. RESULT: All affected boys were aphakic. Due to high intraocular pressure, iridectomy, goniotomy, cyclo-cryo treatment or trabeculectomy were performed. All patients showed opacity or pannus-like alterations of the cornea. Molecular genetic analysis revealed four novel and two known mutations. CONCLUSION: Reduced visual acuity was partly explained by morphological changes due to the underlying genetic defect and the development of cataract and glaucoma. Opacity of the cornea as well as alterations of the cornea seem to be a major problem in the course of the disease.

Adult↗
PubMed2004

[Surgery for macular edema].

At the end of the nineteenth century, "macular edema" had already been recognized as a pathological condition. The main causes for macular edema are vascular, inflammatory, degenerative, and congenital diseases or trauma. The therapeutic approaches have changed along with the increasing knowledge on the underlying causes of action during the last few years and include laser treatment as well as surgical interventions. Pars plana vitrectomy (including ILM peeling) seems beneficial in cases of macular edema that are associated with alterations of the vitreous or the vitreoretinal interface. For the treatment of chronic macular edema, intravitreal application of agents such as triamcinolone has become an option.

Anti-Inflammatory Agents↗
PubMed2004

[Triple surgery. Keratoplasty combined with cataract extraction and intraocular lens implantation].

Since the 1980s, combined perforating keratoplasty and extracapsular cataract surgery with intraocular lens implantation (triple procedure) has been performed with increasing success for patients with corneal disease and cataract. Advantages include prompt visual rehabilitation, protection of the transplanted endothelium from sequential cataract surgery, and similar up to superior functional results following triple procedures. In the following review article, the authors discuss advantages and disadvantages of triple procedures, alternative surgical techniques, problems in intraocular lens power calculation, intraoperative pitfalls, and postoperative results of combined keratoplasty, cataract removal, and intraocular lens implantation.

Cataract Extraction↗
PubMed2004

[Combined anterior and posterior segment surgery].

AIM: The aim of this study was to review the postoperative findings in the anterior segment after primary vitrectomy performed in combination with cataract surgery. PATIENTS AND METHOD: In a retrospective analysis covering the period from August 2000 to March 2002, we identified 513 consecutive operations on the retina and vitreous body performed primarily to correct various retinal diseases in the ophthalmology department of the Ludwig Maximilian University in Munich. Concomitant cataracts present in all cases were also treated in the one session. Measurement parameters of postoperative irritation of the anterior chamber included anterior chamber cells, Tyndall effect, fibrin, intraocular pressure, and synechiae formation. Various influencing factors were compared to the measurement parameters in univariate analysis. RESULTS: Correlations between some influencing factors and various measurement parameters were statistically significant in univariate analysis. This was not, however, the case for any of the factors in multivariate analysis. CONCLUSION: Performance of the combined operation according to our protocol does not entail any single parameter that indicates a risk for increased postoperative irritation of the anterior chamber.

Anterior Chamber↗
PubMed2003

[Stereotactic radiosurgery using the Gamma Knife for large uveal melanomas].

BACKGROUND: We report the results over 3 years with stereotactic radiosurgery using the Gamma Knife for large and unsuitably located uveal melanomas. PATIENTS AND METHODS: A total of 100 patients (51 male, 49 female) have been treated since 1997 following a standardised treatment protocol (outpatient single-shot treatment, maximum dose 50 Gy, tumour margin dose min.25 Gy, retrobulbar anaesthesia alone for globe fixation). The localisation and/or dimension of the tumours did not allow radiation brachytherapy with Ru106 plaques. Of the tumours 18 were located in the ciliary body, 61 were located at the posterior pole, and 21 were located in the mid-periphery. All patients were followed and tested ophthalmologically and neuroradiologically at regular intervals. The 1-year follow-up data were available for 73 patients, 2-year follow-up data for 33 patients and 3-year follow-up-data for 17 patients. RESULTS: Before therapy the maximum apical tumour height (MAH) was median 7.8 mm (95% CI 2.9-12.5 mm): 1 year after treatment (73 patients) the MAH was median 5.7 mm (95% KI 2.4-10.2 mm),2 years after treatment (33 patients) the MAH was median 4.3 mm (95% KI 2.2-8.8 mm),and 3 years after treatment (17 patients) the MAH was median 4.6 mm (95% KI 2.4-8.5 mm). All differences to the MAH of the corresponding patients before treatment were statistically significant (paired t-test). Within the first year after treatment seven patients were enucleated due to a painful secondary glaucoma,within the second year after radiation two patients (one tumour recurrence, and one secondary glaucoma) and within the third year one more patient (tumour recurrence) was enucleated. CONCLUSIONS: Our 3-year results demonstrate that radiosurgery using the Gamma Knife is beneficial in achieving a local tumour control in 98% of eyes with large and unsuitably located uveal melanomas. The risk for a secondary enucleation is highest in the first year after treatment with a favourable overall rate of 10%. Due to the excellent local tumour control rate we decreased the maximum dose to 40 Gy (min.tumour margin dose 20 Gy) in the subsequently treated patients.

Ciliary Body↗
PubMed2003

[Anthrax--an old disease becomes topical: cutaneous anthrax and the eye].

BACKGROUND: Anthrax disease and its eye manifestations were rare in the last 100 years, but the threat of terrorist actions has revived its topicality. MATERIALS AND METHODS: After an introductory historical review, the pathogenesis of this disease with regard to the virulence of Bacillus anthracis is reported. On the basis of photos displaying the course of the disease, the symptoms particularly of the cutaneous form of this disease as well as the diagnostic possibilities are described. RESULTS AND CONCLUSIONS: The current status of therapy and research for more effective treatment is discussed, with particular emphasis on the development of new substances with antitoxin properties and better vaccines. Bacillus anthracis is once again an actual threat, and therefore it is necessary for doctors to familiarize themselves with the current knowledge of this infection.

Anthrax↗
PubMed2003

[Scanning laser ophthalmoscope multifocal electroretinography and microperimetry in patients with Stargardt's disease].

PURPOSE: We used a scanning laser ophthalmoscope (SLO) evoked multifocal electroretinography (mf-ERG) to evaluate retinal function in patients with Stargardt's disease. SLO microperimetry could demonstrate the size of central retinal scotoma very well in these patients. The aim of the examination was to correlate the results of SLO mf-ERG and SLO microperimetry. METHODS: In four patients with Stargardt's disease SLO mf-ERG and SLO microperimetry were performed. The area of measurement in the SLO mfERG had a 24 degrees diameter (12 degrees visual angle) at the posterior pole of the eye. Stimulation was done using a helium-neon laser (632.8 nm). Simultaneous control of fixation was made using a infrared laser (730 nm). SLO microperimetry was performed with stimuli having the size of Goldmann III stimuli and the intensities 0 dB, 12 dB and 20 dB. In this study the reduction of SLO mfERG amplitudes was correlated to graded stimulus intensities in the SLO microperimetry. RESULTS: The area of reduced retinal function in the SLO mf-ERG measurement could be well correlated to the size of the scotoma in the SLO microperimetry, using the stimulus Goldmann III with the intensity 20 dB. CONCLUSION: SLO mfERG and SLO microperimetry are sensitive methods for quantifying functional deficits and are therefore useful for performing a detailed examination of the retina.

Adult↗
PubMed2003

[Relative contraindication of latanoprost in iris tumors with secondary glaucoma].

INTRODUCTION: Melanocytic iris tumors are often benign and merely require regular follow-up. Evident growth, increasing pigmentation and secondary glaucoma, however, are possible signs of a malignant transformation. PATIENT: We present a 34-year-old male patient showing a localized, mildly prominent hyperpigmentation of the right iris expanding over 2 h. The lesion had been known since childhood and increasing intraocular pressure (IOP) was treated with timolole, dipivefrin and finally with latanoprost. PROGRESSION: The patient was seen for the first time at our hospital 4 years previously, presenting an IOP of 28-30 mmHg of the right eye. The tumor had developed marked heterochromia and a nodular prominent surface, the chamber angle was partly closed and completely hyperpigmented. The ciliary body was not affected by the tumor and standard ultrasound revealed a maximum thickness of 1.2 mm. Over the last 4 years, IOP and heterochromia had increased but without growth of the tumor. An excisional biopsy of the prominent portion was refused by the patient. DISCUSSION: The melanocytic iris tumor described shows malignant characteristics such as progressive heterochromia and secondary glaucoma. However, increasing iris pigmentation can also be caused by topical application of latanoprost. With the evidence of absent tumor growth, there is no reason to suggest malignant degeneration. Generally, in iris naevi or tumors requiring regular follow-up, application of latanoprost should be avoided in order not to conceal the alteration of pigmentation as possible malignant conversion.

Adult↗
PubMed2003

[Measuring patient's quality of life in ophthalmology].

BACKGROUND: The assessment of patient's quality of life is not only of vital importance for clinical trials of new therapies but also becomes more and more implemented into daily clinical therapeutical decisions. METHODS: Different methods for evaluating quality of life are available. A well-known questionnaire for measuring global quality of life is the Short Form 36 (SF 36). However, in ophthalmology more specific instruments for measuring visual quality of life are needed. We review the usefulness of specific questionnaires such as the Visual Function 14 (VF-14) or the National Eye Institute Visual Function Questionnaire (NEI-VFQ) in their application to common ophthalmologic diseases such as cataract, age-related macular degeneration and glaucoma. Studies applying these methods were identified by a search in the Medline database. RESULTS: Several instruments to measure visual life quality in ophthalmologic patients are available. Internal consistency and validity are shown. CONCLUSIONS: Evaluating visual quality of life is an important parameter for assessing ophthalmologic diseases and the value of different therapies. It is an important outcome variable in clinical studies. Furthermore, individual visual quality of life should be considered in individual therapeutic decisions and helps to assess the economic effect of current and new therapies.

Aged↗
PubMed2003

Scanning laser ophthalmoscope-evoked multifocal ERG (SLO-mfERG) in patients with macular holes and normal individuals.

AIMS: A scanning laser ophthalmoscope (SLO) has been used for multifocal electroretinography (mf ERG) measurements under simultaneous fundus monitoring. The aim of this study was to prove if the SLO-mfERG measurement reflects reliably the clinically registered underlying disease, and to demonstrate the importance of its main advantage, fixation monitoring. METHODS: In all, 10 patients with macular hole stage II/III were included in the study, and 19 normal individuals served as the control group. The mf ERG device was combined with an SLO, which was used both as a stimulus and trigger unit as well as a fundus-monitoring system. Monitoring of the fundus was guaranteed by an infrared laser (780 nm). The stimulus matrix consisted of 61 hexagonal elements, covering 24 degrees of the posterior pole. We examined both, patients with macular holes and healthy individuals. RESULTS: Compared to normal controls, patients with a macular hole (Gass stage III) showed a significant decrease in response density in the centre of the stimulus array, which correlated well with the morphological alteration observed by clinical examination. However, variation of response density of the central hexagonal area has been proved to be high. CONCLUSIONS: SLO-mfERG is a feasible and reliable new technique to investigate macular function under simultaneous fundus control. The main advantage is that control of fixation can be used in order to obtain more reliable results that correlate well with visible fundus abnormalities such as in patients with macular holes. However, further investigations have to be performed in order to overcome sufficiently the problem of fixation instability.

Adult↗