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Biomedical subjects

Jost B Jonas

Publications and source records attributed to Jost B Jonas.

At least 19 recordsLinked to original sources
PubMed2026

A Comprehensive Assessment of the Shared Genetic Architecture between Myopia and Open-Angle Glaucoma.

OBJECTIVE: Individuals with high myopia have an increased prevalence of open-angle glaucoma (OAG). We aim to clarify the possibly shared genetic architecture of myopia and OAG, in particular in high myopes with myopic macular degeneration (MMD), where OAG screening is highly challenging. DESIGN: Individual participant data meta-analysis of one-sample Mendelian randomization analyses and pleiotropic analysis under a composite null hypothesis. PARTICIPANTS: A total of 34 825 participants from 6 population-based cohort studies and 1 high myopia case-control study, including 708 OAG and 1953 high-myopia cases. METHODS: First, we calculated and validated genetic risk scores (GRSs) for OAG and myopia in each cohort. We subsequently meta-analyzed linear and logistic regression models for the association of a myopia GRS with OAG, intraocular pressure (IOP), and vertical cup-to-disc ratio (VCDR), and the association of an OAG-GRS with high myopia, axial length, and spherical equivalent. We stratified the analysis of OAG in different stages of axial elongation, and in high myopes with or without MMD. Pleiotropic analysis under a composite null hypothesis was applied to genome-wide association study summary statistics. MAIN OUTCOME MEASURES: Odds ratio (OR) of OAG and high myopia, and mean difference in IOP, VCDR, axial length, and spherical equivalent. RESULTS: One standard deviation (SD) increase in myopia GRS was associated with an OR (95% CI) of 1.18 (1.09, 1.28) for OAG, a beta (95% CI) of 0.04 (0.00, 0.08) mmHg in IOP, and of 0.005 (0.003, 0.007) in VCDR. The OAG-GRS was not significantly associated with high myopia compared to emmetropes, but a 1 SD increase was associated with a beta (95% CI) of 0.05 (0.01, 0.08) mm in axial length and of -0.05 (-0.10, -0.00) diopters in spherical equivalent. One SD increase in OAG-GRS had a substantially larger effect on OAG in high myopes with MMD, with an OR (95% CI) of 3.83 (1.89, 7.78) compared to 1.55 (1.24, 1.94) in emmetropes. Finally, we identified 95 independent pleiotropic single-nucleotide polymorphisms (SNPs). CONCLUSIONS: There is strong evidence for pleiotropy between myopia and OAG. Further research into the biological mechanisms of the identified pleiotropic SNPs is needed. An OAG-GRS might help to clinically estimate OAG risk, in particular in individuals with MMD. FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Axial length↗
PubMed2005

Causes of incident visual field loss in a general elderly population: the Rotterdam study.

OBJECTIVE: To determine the incidence and causes of visual field loss (VFL) in a general elderly population. METHODS: Central visual fields of both eyes were examined with suprathreshold perimetry in 3761 persons aged 55 years or older and free of VFL at baseline from the population-based Rotterdam Study. Goldmann perimetry was performed to confirm suprathreshold VFL. Causes of incident VFL (iVFL) were assessed based on all available ophthalmologic and neurological examination data and medical records. RESULTS: After a mean follow-up time of 6.3 years, 175 persons developed VFL. The overall incidence rate of iVFL was 7.4 per 1000 person-years, increasing to 21.1 per 1000 person-years in those aged 80 years and older. Glaucoma was the leading cause of iVFL in all age categories. The overall incidence of glaucomatous VFL was 2.0 per 1000 person-years. CONCLUSIONS: The incidence of all VFL increased 5-fold between 55 years and 80 years of age or older. After glaucoma, stroke was the second most common cause of iVFL in persons younger than 75 years, followed by age-related macular degeneration and retinal vascular occlusive disease.

Aged↗
PubMed2004

GEE approaches to marginal regression models for medical diagnostic tests.

The evaluation of a new medical diagnostic test may focus on two different scientific questions: (1). The new test may replace an existing one because of lower cost or higher validity. A related question would be the selection of the 'best' test(s) from a bundle of new or established measurements. (2). The new test may be used supplementary to other new or established procedures. In a recent publication, Leisenring and co-workers (Stat Med 1997; 16:1263-1281) developed a general marginal regression model for comparisons of diagnostic tests focussing on question (1). i.e. on the selection of the 'best' procedure. They applied the GEE approach of Liang and Zeger (Biometrika 1987; 73:13-22) to adjust for the correlation of data as a nuisance parameter. Using the general framework provided by Leisenring et al., we extend their approach and apply the GEE methodology to question (2). i.e. to the investigation of which of several diagnostic tests should be used supplementary to each other. We analyse data from a longitudinal study concerning pathogenesis, diagnosis and long-term course of the eye disease glaucoma. We find a dependence of the correlation structure of several diagnostic measurements on the severity of the disease. This result may be useful in clinical applications as regards the selection of subsets of diagnostic measurements in individual diagnostic processes but also in investigations concerning the relationship of the pathogenic process and the rationales of the different diagnostic procedures.

Biometry↗
PubMed2004

Intravitreal reinjection of triamcinolone for exudative age-related macular degeneration.

OBJECTIVE: To evaluate the outcome of repeated intravitreal injections of triamcinolone acetonide for the treatment of exudative age-related macular degeneration. METHODS: This prospective, comparative nonrandomized clinical interventional study included 13 patients with progressive exudative age-related macular degeneration with occult, or predominantly occult, subfoveal neovascularization. All patients had shown an increase or stabilization of visual acuity after a first intravitreal injection of 25 mg of triamcinolone acetonide. They received a second intravitreal injection of 25 mg of triamcinolone acetonide 3.1 to 18 months after the first injection. Mean +/- SD follow-up time after the second injection was 5.2 +/- 3.6 months (median, 5.3 months). A control group included 24 patients with exudative age-related macular degeneration who did not receive treatment for their maculopathy. The main outcome measures were visual acuity and intraocular pressure. RESULTS: In the study group, mean +/- SD visual acuity increased significantly (P =.005 and P =.003, respectively) from 0.17 +/- 0.11 to 0.32 +/- 0.26 and from 0.15 +/- 0.14 to 0.23 +/- 0.19, respectively, after the first and second injections. An increase in visual acuity was found for 10 patients (77%) after the first and second injections. In the control group, visual acuity did not vary significantly during follow-up (P =.81). The difference in change in visual acuity between the study group and control group was significant (P =.01 [Snellen lines] and P =.05 [logMAR units]). The peak in visual acuity and, in a chronologically parallel manner, the peak in intraocular pressure elevation occurred 2 to 5 months after each injection. CONCLUSIONS: Repeated intravitreal injection of 25 mg of triamcinolone acetonide may lead to an increase in visual acuity in patients with exudative age-related macular degeneration, with the peak in visual acuity and intraocular pressure elevation occurring about 2 to 5 months after each injection.

Aged↗
PubMed2004

Intraocular availability of triamcinolone acetonide after intravitreal injection.

BACKGROUND: To evaluate the intraocular concentration of triamcinolone acetonide after intravitreal injection. METHODS: The prospective clinical interventional case series study included 17 patients who had received a 20 to 25-mg intravitreal injection of triamcinolone acetonide as treatment for exudative age-related macular degeneration, diffuse diabetic macular edema, or retinal vein occlusions. During a secondary intraocular surgery taking place 4.1 weeks to 25.7 months after the intravitreal injection, aqueous humor samples were obtained. None of the eyes were vitrectomized. RESULTS: In the aqueous humor samples, triamcinolone acetonide was in low, but measurable, concentrations detected up to 1.5 years after the intravitreal injection. Concentrations found in samples obtained during the first 6 months, or 7 to 12 months, respectively, after the injection ranged between 3.0 microg/l and 436 microg/l, and between 0.0 microg/l and 11.2 microg/l, respectively. CONCLUSIONS: After injection of triamcinolone acetonide, triamcinolone can be present in measurable concentrations up to 1.5 years after the application.

Aqueous Humor↗
PubMed2004

Enlargement of parapapillary atrophy in follow-up of chronic open-angle glaucoma.

PURPOSE: To assess the frequency of an enlargement of parapapillary atrophy in follow-up of eyes with open-angle glaucoma. METHODS: Prospective observational longitudinal study. SETTING: Institutional. PATIENTS: The study included 978 eyes (511 Caucasian subjects) with open-angle glaucoma (n = 548; including 194 eyes with normal-pressure glaucoma), ocular hypertension (n = 289), or without optic nerve disease (n = 141). Highly myopic eyes with a myopic refractive error exceeding -8 diopters were excluded. Mean follow-up was 4.5 +/- 2.4 years (median, 3.8 years; range: 1.5 to 9.8 years). OBSERVATION PROCEDURES: Optic disk photographs taken annually. MAIN OUTCOME MEASURES: Two examiners compared optic disk slides for enlargement of parapapillary atrophy (zone beta) and for signs of progressive disk damage. RESULTS: An enlargement of parapapillary beta zone was detected in 16 eyes (1.6%) after 3.9 +/- 2.6 (0.6 to 9.1) years of follow-up. It was observed in 15 eyes (2.7%) with open-angle glaucoma, 1 eye (0.3%) with ocular hypertension, and in none of the normal eyes. After excluding eyes with a myopic refractive error exceeding -3 diopters, enlargement of beta zone was significantly more common in eyes with progressive glaucoma (5/81 or 6.2%) than in eyes with nonprogressive glaucoma (3/354 or 0.8%; P <.001). CONCLUSIONS: Parapapillary atrophy (zone beta) enlarges during follow-up of relatively few eyes with chronic open-angle glaucoma. In the refractive range above -3 diopters, enlargement of beta zone occurs significantly more frequently (P <.001) in progressive glaucoma than in nonprogressive glaucoma. In view of its low frequency, enlargement of beta zone may not be a very useful marker for glaucoma progression.

Adolescent↗
PubMed2004

Serum levels of triamcinolone acetonide after intravitreal injection.

PURPOSE: To evaluate serum levels of triamcinolone acetonide after intravitreal high-dose injection. DESIGN: Prospective, interventional case series study. METHODS: For 20 consecutive patients, venous blood samples were taken before and 13 +/- 19 days (range 4 to 92) after an intravitreal injection of 20 to 25 mg triamcinolone acetonide as treatment of edematous macular diseases. RESULTS: Serum levels of triamcinolone acetonide did not differ significantly (P =.174; t test for paired matches) preoperatively (0 microg/l) and postoperatively (0.065 microg/l +/- 0.21 microg/l). In 18 eyes (90%), triamcinolone acetonide could not be detected in serum samples. For two patients (10%), serum samples taken 5 days and 7 days after the injection, respectively, contained 0.5 microg/l triamcinolone acetonide and 0.8 microg/l triamcinolone acetonide, respectively. CONCLUSION: After an intravitreal high-dose injection of 20 to 25 mg triamcinolone acetonide, triamcinolone acetonide is not, or only marginally, detectable in serum samples obtained within 4 to 92 days after the injection.

Adult↗
PubMed2004

Duration of the effect of intravitreal triamcinolone acetonide as treatment for diffuse diabetic macular edema.

PURPOSE: To evaluate the duration of the effect of intravitreal triamcinolone acetonide on visual acuity in patients with diffuse diabetic macular edema. DESIGN: Clinical interventional case series. METHODS: Subjects were 31 patients (38 eyes) with diffuse diabetic macular edema who received an intravitreal injection of 20- to 25-mg triamcinolone acetonide. Mean follow-up time was 13.2 +/- 6.0 months (6.03-25.2 months). RESULTS: Visual acuity and intraocular pressure began to increase significantly (P =.003) within the first week, reaching a plateaulike maximum at 1 to 7 months postinjection, returning to baseline values 8 to 9 months postinjection. CONCLUSIONS: The effect of an intravitreal injection of approximately 20- to 25-mg triamcinolone acetonide in patients with diffuse diabetic macular edema lasts approximately 7 to 8 months. This information may be helpful in determining the optimal dosage of intravitreal triamcinolone acetonide for the treatment of diffuse diabetic macular edema.

Aged↗
PubMed2004

Optical coherence tomography and confocal scanning laser tomography for assessment of macular edema.

PURPOSE: To compare optical coherence tomography (OCT) and confocal scanning laser tomography (cSLT) for quantitative retinal thickness mapping of the macula and their ability to detect macular edema. DESIGN: Prospective, comparative, clinical observational study. METHODS: The study population of 138 eyes (97 patients) was divided into a study group consisting of 45 (32.6%) eyes with macular edema and a control group consisting of 93 (67.4%) eyes without macular edema. All patients underwent OCT and cSLT of the macula. Retinal thickness measurements obtained by OCT were compared with signal width and edema index, determined by cSLT. RESULTS: The OCT measurements and cSLT edema index were significantly (P <.001) correlated with each other. Correlation coefficients decreased (P <.001) with increasing diameter of the measurement circle. In the macular edema group, correlation coefficients were significantly (P <.001) higher than in the control group. To separate the study and control groups, receiver operator characteristic curves covered a larger area for OCT measurements than for cSLT measurements. Retinal thickness measurements and edema index correlate with visual acuity (correlation coefficient r = -.653 for OCT, r = -.608 for cSLT; P <.001). CONCLUSIONS: Macular edema can be quantitatively mapped by OCT and cSLT. The retinal thickness and edema index measurements correlate with visual acuity. The fast and standard examination modes of OCT give similar measurements. Both OCT and cSLT can differentiate between eyes with and without macular edema, with OCT showing a higher predictive value.

Aged↗
PubMed2004

Safety of intravitreal high-dose reinjections of triamcinolone acetonide.

PURPOSE: To report side effects after intravitreal high-dose reinjections of triamcinolone acetonide. DESIGN: Clinical interventional case series. METHODS: Forty-six patients (47 eyes) received at least two intravitreal injections of approximately 20 to 25 mg triamcinolone acetonide for treatment of diabetic macular edema (n = 6 eyes), exudative age-related macular degeneration (n = 23), and other diseases. Intervals between injections were 6.7 +/- 3.4 months, 8.0 +/- 4.6 months, and 10.2 months, respectively, before the second (n = 47 eyes), third (n = 9), and fourth (n = 2) injection. Mean follow-up was 20.7 +/- 8.9 months. RESULTS: After no reinjection were complications detected, other than those known to occur after a single intravitreal injection. After the first, second, and third injection, respectively, intraocular pressure remained normal in 24 (51%), 25 (53%), and 5 (56%) eyes. CONCLUSIONS: Intravitreal high-dosage reinjections of triamcinolone acetonide may be tolerated within a mean follow-up of approximately 21 months.

Glucocorticoids↗
PubMed2004

Inter-eye difference in diabetic macular edema after unilateral intravitreal injection of triamcinolone acetonide.

PURPOSE: To report on visual outcome of patients receiving intravitreal triamcinolone acetonide for treatment of diffuse diabetic macular edema. DESIGN: Prospective, comparative clinical interventional study. METHODS SETTING: Institutional. patient population: The study included 25 consecutive patients (50 eyes) with bilateral diabetic macular edema. Intervention procedure: Unilateral intravitreal injection of about 20 mg triamcinolone acetonide into the eye (study group) more severely affected by diabetic maculopathy. The contralateral eyes served as control group. Mean follow-up was 7.1 +/- 4.1 months. MAIN OUTCOME MEASURE: Visual acuity, intraocular pressure. RESULTS: In the study group, visual acuity increased significantly (P < or = .001) by 3.0 +/- 2.6 Snellen lines to a peak at two to six months after the injection, and decreased significantly (P = .001) towards the end of follow up. At the end of follow-up, visual acuity was higher, not significantly (P = .18) higher, than at baseline. An increase in visual acuity was found in 23 eyes (92%). In the control group, differences between visual acuity at baseline and at any of the re-examinations during follow-up were not significant (P > .10). In an intra-individual inter-eye comparison, gain in visual acuity was significantly (P < .05) higher in the injected eyes, for the measurements obtained up to four months after injection. CONCLUSIONS: Intravitreal triamcinolone acetonide may temporarily increase visual acuity in eyes with diabetic macular edema.

Aged↗
PubMed2004

Femtosecond laser LASIK flap preparation with conical incision and positional spikes.

PURPOSE: To describe the creation of corneal flaps for laser in situ keratomileusis (LASIK) with conical incisions and positional spikes that may increase postoperative rotational flap stability. SETTING: University Eye Department. METHODS: A corneal flap was prepared in 5 freshly enucleated porcine eyes using a femtosecond laser. In the first step, the flap bed with a diameter of 8.0 mm was created by an intrastromal incision running parallel to the corneal surface. In the second step, a posterior-anterior incision was created with a diameter of 8.0 mm at the level of the first incision and 7.0 mm at the corneal surface. In addition, a hinge and 3 spikes were prepared in the flap with corresponding notches in the surrounding tissue. RESULTS: In all eyes, the corneal flaps were prepared easily within 5 minutes. CONCLUSION: Femtosecond laser technology allowed a new type of LASIK flap formation with conical incisions and positional spikes.

Animals↗
PubMed2004

Phototoxic maculopathy after secondary intraocular lens implantation.

We report phototoxic maculopathy in 2 aphakic patients after secondary, scleral-sutured intraocular lens implantation. This rare complication may have been triggered by drugs that increased the photosensitivity of the tissue. Careful preoperative assessment is necessary to question the receipts of photosensitizing drugs and identify diseases that predispose patients to phototoxic injuries.

Aged↗
PubMed2004

Intravitreal triamcinolone acetonide for treatment of sympathetic ophthalmia.

PURPOSE: To report on the treatment of long-standing sympathetic ophthalmia by intravitreal triamcinolone acetonide. DESIGN: Clinical interventional case report. METHODS: A 47-year-old patient who suffered from sympathetic ophthalmia and who was treated with intensive systemic immunosuppressive therapy received an intravitreal injection of 25 mg of triamcinolone acetonide. Before injection, intraocular pressure ranged between 5 and 8 mm Hg; visual acuity measured 6/20. RESULTS: Within the first 4 weeks after the injection, visual acuity improved from 6/20 to 6/12, intraocular pressure increased to values between 10 mm Hg and 13 mm Hg, and intraocular flare measurements decreased by approximately 50%. Systemic immunosuppressive treatment was reduced to 10 mg prednisolone/day at the first postoperative day and could not be stopped due to an adrenal insufficiency. Three months after the injection, visual acuity regressed to 6/20, intraocular pressure was reduced to values between 5 mm Hg and 10 mm Hg, and anterior chamber flare increased. The patient received a second intravitreal injection of 25 mg of triamcinolone acetonide after which intraocular pressure increased again to values between 10 mm and 13 mm Hg, and anterior chamber flare decreased. After the injection, perimetry revealed a marked enlargement of the originally constricted visual field with a decrease in mean visual field defect from approximately 11 dB to values lower than 7 dB. CONCLUSIONS: Intravitreal injections of triamcinolone acetonide may be an additional tool in the treatment for sympathetic ophthalmia.

Humans↗