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Biomedical subjects

J B Jonas

Publications and source records attributed to J B Jonas.

At least 37 records · Page 2Linked to original sources

Visual acuity in northern China in an urban and rural population: the Beijing Eye Study.

AIM: To evaluate prevalence and demographic associations of visual impairment in an urban and rural population in northern China. METHODS: In the Beijing Eye Study, a population based cohort study in northern China, visual acuity was assessed for 8876 eyes (4438 subjects) according to a response rate of 83.4%. The study was divided into a rural part (1972 subjects) and an urban part (n=2466). Mean age was 56.20 (SD 10.59) years (median 56 years; range 40-101 years). RESULTS: Mean uncorrected visual acuity measured 0.72 (0.32) (median, 0.80), and mean best corrected visual acuity measured 0.91 (0.21) (median, 1.0). In a multiple regression analysis, best corrected visual acuity was significantly correlated with age (p<0.001), degree of nuclear cataract (p<0.001), amount of cortical cataract (p=0.014), amount of subcapsular cataract (p<0.001), educational background (p<0.001), and refractive error (p<0.001). Rural region versus urban region (p=0.34) and sex (p=0.053) were not statistically significantly associated with best corrected visual acuity. CONCLUSIONS: In northern China, determinants of a low degree of best corrected visual acuity are age, cataract, low educational background, and myopia. Despite marked differences in educational background and family income, sex, and rural area versus urban area are not markedly associated with best corrected visual acuity.

Adult↗

[Intraocular triamcinolone for diffuse diabetic macular edema].

BACKGROUND: The aim of the study was to evaluate the effect of an intravitreal injection of triamcinolone acetonide on the visual acuity of patients suffering from diffuse diabetic macular edema. PATIENTS AND METHODS: The prospective, clinically interventional, uncontrolled study included 32 eyes (26 patients) with diffuse diabetic macular edema and received an intravitreal injection of 25 mg triamcinolone acetonide. Visual acuity was 0.12+/-0.08 (min.-max. 0.03-0.3; median 0.1) at baseline. Mean follow-up was 6.8+/-4.3 months. RESULTS: Visual acuity increased to 0.17+/-0.11 (min.-max.: 0.03-0.4; median 0.125) after 4 weeks (p=0.009) and reached a mean maximum of 0.20+/-0.14 (min.-max.: 0.03-0.5; median 0.16) after 8 weeks (p=0.006). Later, visual acuity showed a slow decrease, but was significantly higher than at baseline up to 6 months postoperatively and 26 eyes (81.3%) gained in visual acuity. Ten eyes (31.2%) developed steroid-induced secondary ocular hypertension. CONCLUSION: An intravitreal injection of 25 mg of triamcinolone acetonide may be an option in the treatment of diffuse diabetic macular edema.

Aged↗

[Follow-up examination of eyes with chronic open-angle glaucoma and optic disc hemorrhages].

PURPOSE: To evaluate the frequency of neuroretinal rim loss in glaucomatous eyes with ophthalmoscopically detected optic disc hemorrhages. METHODS: The prospective comparative clinical observational study included 78 eyes from 69 Caucasian patients with chronic open-angle glaucoma and a flame-shaped optic disc hemorrhage at the time of presentation, and 386 eyes from 252 patients with chronic open-angle glaucoma without disc hemorrhages. All patients underwent repeated qualitative and morphometric evaluation of color stereo optic disc photographs. RESULTS: Patients with disc hemorrhages were older than patients without hemorrhages and showed an initially smaller neuroretinal rim area. Of the 78 eyes with disc hemorrhages 39 showed loss of neuroretinal rim during the follow-up period. For the remaining 39 eyes, no changes of the neuroretinal rim could be detected on optic disc photographs. Of the 386 eyes without disc hemorrhages 71 showed loss of neuroretinal rim during the follow-up period. A survival analysis confirmed a hazard ratio of three between eyes with and without disc hemorrhages and a hazard ratio of 1.85 per decade of patient's age (multivariate analysis). CONCLUSIONS: Disc hemorrhages lead to a 3-fold increase of risk for further retinal rim loss in eyes with chronic open-angle glaucoma.

Comorbidity↗

[Intravitreal triamcinolone acetonide for the treatment of intraocular edematous and neovascular diseases].

BACKGROUND: Within the last 2 years, intravitreal application of triamcinolone acetonide has exponentially increased as a treatment option for various intraocular neovascular and edematous proliferative disorders. METHODS AND RESULTS: The best response to intravitreal triamcinolone acetonide injection in terms of gain in visual acuity was obtained for eyes with intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. Visual acuity increased and degree of intraocular inflammation decreased in eyes with various types of noninfectious uveitis including sympathetic ophthalmia. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal triamcinolone may be helpful for exudative age-related macular degeneration, alone or in combination with photodynamic therapy. In eyes with chronic, therapy-resistant, ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy, such as secondary ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and noninfectious endophthalmitis, and pseudo-endophthalmitis will be covered in another article. Intravitreal triamcinolone injection can be combined with other intraocular surgeries including cataract surgery. Cataract surgery performed some months after the injection did not show a markedly elevated rate of complications. If vision increases after the intravitreal triamcinolone injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone ranges between 2 and 9 months, probably depending on the dosage used. CONCLUSIONS: Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular oedematous and neovascular disorders. One has to take into account the side effects and the lack of long-term follow-up observations.

Aged↗

Cataract surgery after intravitreal injection of triamcinolone acetonide.

PURPOSE: To report the clinical outcome of patients undergoing cataract surgery after one or repeated intravitreal injections of triamcinolone acetonide as treatment of intraocular neovascular or oedematous diseases. METHODS: The interventional clinical case series study included all patients (n=22) who presented with cataract which had progressed after a single or repeated intravitreal injection of 25 mg of triamcinolone acetonide as treatment of exudative age-related macular degeneration (n=18) or diffuse diabetic macular oedema (n=4). Duration of the follow-up period was 3.76+/-4.99 months. With topical anaesthesia, the patients underwent standard cataract surgery including clear cornea incision, phakoemulsification and aspiration of the lens nucleus and cortex, and implantation of a foldable posterior chamber lens. The main outcome measures were frequencies of capsular rupture, vitreous loss, postoperative infectious endophthalmitis, secondary cataract, and decentration of the intraocular lens, visual acuity and intraocular pressure. RESULTS: Intraoperative dialysis of the lens zonules occurred in one (4.5%) eye and resulted in a loss of vitreous. Secondary cataract leading to Nd : YAG laser capsulotomy was observed in one (4.5%) eye. An optically significant decentration of the IOL or infectious endophthalmitis was not encountered in any patient. Visual acuity increased from 0.11+/-0.10 to 0.13+/-0.94 during the follow-up. Within 1 week after surgery, intraocular pressure was in the normal range in all the eyes. CONCLUSIONS: Cataract surgery after single or repeated intravitreal injection of 25 mg of triamcinolone acetonide does not harbour a markedly elevated frequency or a markedly changed profile of surgical complications.

Aged↗

Ophthalmodynamometric determination of the central retinal vessel collapse pressure correlated with systemic blood pressure.

AIMS: To evaluate whether determination of the central retinal artery and vein collapse pressure correlate with systemic blood pressure measurements, using a new Goldmann contact lens associated ophthalmodynamometric device METHODS: The prospective clinical study included 92 eyes of 92 patients presenting with cataract or refractive problems (n = 40; control study group) or with retinal and orbital pathologies (n = 52). With topical anaesthesia, a Goldmann contact lens fitted with a pressure sensor in its holding ring was placed onto the cornea. Pressure was asserted onto the globe by pressing the contact lens, and the pressure value at the time when the central retinal artery and vein started pulsating were noted as central retinal artery and vein collapse pressure. Additionally, the brachial arterial blood pressure was measured. RESULTS: In the control study group, central retinal artery collapse pressure was highly significantly correlated with diastolic blood pressure (correlation coefficient r = 0.77; p<0.001) and systolic blood pressure (r = 0.35; p = 0.03). Central retinal vein collapse pressure was statistically independent of diastolic blood pressure (p = 0.11). In eyes with retinal or orbital diseases, the correlation coefficients were lower than in the control study group. In eyes with retinal arterial occlusions, central retinal vessel collapse pressure measurements were not correlated with arterial blood pressure measurements. CONCLUSIONS: Depending on coexisting retinal or orbital diseases, ophthalmodynamometric estimation of the central retinal artery collapse pressure, performed during a routine Goldmann contact lens ophthalmoscopy, correlates with systemic blood pressure measurements.

Adult↗

Factors influencing visual acuity after intravitreal triamcinolone acetonide as treatment of exudative age related macular degeneration.

AIM: To evaluate factors influencing change in visual acuity (VA) after intravitreal injection of triamcinolone acetonide as treatment of exudative age related macular degeneration (AMD). METHODS: This prospective, interventional, comparative non-randomised clinical case series study included 94 patients (99 eyes) showing progressive exudative AMD with occult (n = 61 eyes), minimally classic (n = 18), predominantly classic (n = 1), or totally classic (n = 8) subfoveal neovascularisation. Mean follow up was 8.5 (SD 4.7) months (median, 7.3 months; range 3.1-24.5 months). All patients received an intravitreal injection of 20-25 mg of triamcinolone acetonide. RESULTS: An increase in best VA of at least one line on the Snellen charts was found in 63 (63.1%) eyes. Correspondingly, mean VA increased significantly (p<0.001) from 0.17 (SD 0.13) to 0.22 (SD 0.17) after the injection. Postoperative increase in VA was significantly (p<0.001) and negatively correlated with preoperative VA (correlation coefficient, -0.49). Gain in visual acuity was significantly (p = 0.009) higher if preoperative visual acuity was less than 0.08 (gain: 3.2 (SD 2.9) Snellen lines) than if preoperative VA ranged between 0.08 and 0.20 (gain: 1.2 (SD 2.2) Snellen lines). Change in VA was significantly (p = 0.016) less if preoperative VA was higher than 0.20 (change: -0.8 (SD 3.4) Snellen lines). Maximal gain in VA was significantly (p = 0.035) larger in eyes with retinal pigment epithelium detachment than in eyes with minimally classic subfoveal neovascularisation. This was statistically independent of age (p = 0.99), refractive error (p = 0.88), sex (p = 0.92), and duration of follow up (p = 0.46). CONCLUSIONS: Gain in VA after intravitreal injection of 20-25 mg of triamcinolone acetonide is significantly and negatively correlated with preoperative VA. It is significantly larger in eyes with retinal pigment epithelium detachment than in eyes with minimally classic subfoveal neovascularisation.

Aged↗

[Glaucoma diagnosis of the optic disc using photography and planimetry].

Ophthalmoscopically and on clinical optic disc photographs, the optic nerve head can be described by the following parameters: size and shape of the optic disc, size and shape of the neuroretinal rim, size and shape of the optic cup, size and shape of the alpha and beta zones of parapapillary chorioretinal atrophy, visibility of the retinal nerve fiber layer, diameter of the retinal arteries, presence and location of optic disc hemorrhages.

Disease Progression↗

[Influence of ciliary-retinal arteries on functional damage in open-angle glaucoma].

PURPOSE: The pattern of functional perimetric loss and morphologic neuroretinal rim loss in glaucoma depends on the localization of the central retinal vessel trunk in the lamina cribrosa. The purpose of the present study was to determine if the pattern of perimetric loss and rim loss are influenced by the presence and position of cilioretinal arteries. PATIENTS AND METHODS: Using automated perimetry and 15 degrees color stereo optic disc photographs of the optic disc, we compared 20 open-angle glaucoma patients exhibiting cilioretinal arteries in the temporal horizontal disc region with 70 open-angle glaucoma patients without cilioretinal arteries. RESULTS: Eyes with cilioretinal arteries and eyes without cilioretinal arteries did not differ significantly in global visual field indices nor in the mean defect for the central 10 degrees. No differences were detected for the areas of optic disc, neuroretinal rim, ratios of the temporal horizontal area-to-total area of rim and ratio of temporal horizontal rim area-to-nasal rim area. CONCLUSIONS: In contrast to the position of the central retinal vessel trunk, the presence and position of cilioretinal arteries do not markedly influence the pattern of glaucomatous damage.

Adult↗