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Biomedical subjects

Jost B Jonas

Publications and source records attributed to Jost B Jonas.

At least 55 records · Page 3Linked to original sources
PubMed2005

Predictive factors for visual acuity after intravitreal triamcinolone treatment for diabetic macular edema.

OBJECTIVE: To evaluate which factors influence maximum gain in best-corrected visual acuity after intravitreal injection of triamcinolone acetonide as treatment for diffuse diabetic macular edema. METHODS: This prospective clinical interventional study included 53 eyes with diffuse diabetic macular edema receiving an intravitreal injection of about 20 mg of triamcinolone. The mean +/- SD follow-up was 10.2 +/- 7.6 months. RESULTS: In a multiple linear regression analysis, maximum gain in best-corrected visual acuity after the intravitreal injection of triamcinolone was significantly (P < .001) and negatively correlated with an increased degree of macular ischemia and a higher preoperative visual acuity. Improvement in best-corrected visual acuity was significantly and positively correlated with increased degree of macular edema (P = .001). Change in best-corrected visual acuity after the intravitreal triamcinolone injection was statistically independent (P > .15) of age, sex, pseudophakia, and macula grid laser treatment before inclusion into the study. The results were comparable for gain in visual acuity at 6 months after the injection. CONCLUSION: Pronounced macular edema may have a positive impact, and marked macular ischemia and a high preoperative best-corrected visual acuity may have a negative impact, on an increase in best-corrected visual acuity after intravitreal triamcinolone injection in patients with diabetic macular edema.

Adult↗
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↗
PubMed2005

Optic disk size correlated with refractive error.

PURPOSE: To evaluate for which range of refractive error the optic disk size depends on, or is independent of, the refractive error. DESIGN: Clinical observational study. METHODS: The study included 1999 eyes of 1011 subjects with a mean refractive error of -0.97 +/- 2.72 diopters (range, -24.25 to +9.4 diopters). Optic disk photographs were morphometrically evaluated. RESULTS: The relation between optic disk area and refractive error showed a curvilinear shape, with a steep increase toward high myopia starting at -8 diopters, and a decrease toward high hyperopia starting at +4 diopters. CONCLUSION: The optic disk size depends on the refractive error with an increase in highly myopic eyes beyond -8 diopters and a decrease in highly hyperopic eyes beyond +4 diopters. Confirming histomorphometric studies, the limits of -8 diopters and +4 diopters may be discussed to refine the definitions of high hyperopia and high myopia.

Chronic Disease↗
PubMed2005

Triamcinolone acetonide concentration after filtration of the solvent agent.

PURPOSE: To determine the amount of triamcinolone acetonide and the preservative benzyl alcohol after filtration. DESIGN: Laboratory investigation. METHODS: The probes were prepared by two different hospital pharmacies. The probes of the first pharmacy included 20 probes with 25-mg triamcinolone acetonide, unfiltered (n = 5 probes) or filtered (n = 5), or with 4-mg triamcinolone acetonide, filtered (n = 5) or unfiltered (n = 5). The probes for the second pharmacy were filtered (n = 3) probes of 25-mg triamcinolone acetonide. RESULTS: For the probes of the first pharmacy, triamcinolone acetonide dosages were 2.4 +/- 0.8 mg, 3.1 +/- 0.6 mg, 12.8 +/- 0.7 mg, and 23.4 +/- 2.3 mg, respectively, for the filtered 4-mg probes, unfiltered 4-mg probes, filtered 25-mg probes, and unfiltered 25-mg probes, respectively. For the second pharmacy, mean triamcinolone acetonide dosage was 23.8 +/- 0.6 mg for the 25-mg filtered probes and contained benzyl alcohol in a mean concentration of 0.0013 +/- 0.0001 mg/0.1 ml. CONCLUSIONS: Depending on the method employed and the pharmacy, preparation of triamcinolone acetonide including filtration of the solvent agent leads to a marked inter-pharmacy variation and a relatively low intra-pharmacy variation in the reduction of triamcinolone acetonide dosage.

Benzyl Alcohol↗
PubMed2005

Single intraocular pressure measurements and diurnal intraocular pressure profiles.

PURPOSE: To evaluate the probability of a single intraocular pressure measurement to be the highest measurement within a diurnal intraocular pressure profile. DESIGN: Hospital-based clinical, observational study. METHODS: The study included 3,025 day-and-night intraocular pressure profiles measured on 1,072 eyes of 547 Caucasian glaucoma patients or glaucoma suspects. Applanation tonometry was performed at 7 am, noon, 5 pm, 9 pm, and midnight. RESULTS: Intraocular pressure measurements were highest at 7 am, noon, 5 pm, 9 pm, and midnight, respectively, in 20.4%, 17.8%, 21.3% 13.9%, and 26.7% of the profiles, respectively. The measurement taken at 7 am was significantly (P < .001) closest to the maximal value of the profile. CONCLUSIONS: Any single intraocular pressure measurement taken between 7 am and 9 pm has a higher than 75% chance to miss the highest point of a diurnal curve. Intraocular pressure may be measured at different times of the day to have the best chance of observing the maximal value.

Circadian Rhythm↗
PubMed2005

Predictive factors for progressive optic nerve damage in various types of chronic open-angle glaucoma.

PURPOSE: To evaluate whether various types of chronic open-angle glaucoma differ in predictive factors for progression of glaucomatous optic nerve damage. DESIGN: Observational cohort study. METHODS SETTING: Prospective observational clinical study. PATIENTS: 517 eyes of 300 Caucasian patients with chronic open-angle glaucoma with elevated intraocular pressure (primary open-angle glaucoma, n = 289; secondary open-angle glaucoma, n = 50) and with normal intraocular pressure (n = 178). OBSERVATION PROCEDURE: During follow-up (median: 49 months, 6 months-130 months), all patients underwent repeated evaluation of color stereo optic disk photographs and white-on-white visual field examination. MAIN OUTCOME MEASURES: Progression of glaucoma was defined as neuroretinal rim loss during the study period. RESULTS: For patients with elevated intraocular pressure, significantly predictive factors for eventual progression were older age, advanced perimetric damage, smaller neuroretinal rim, and larger area of beta zone of parapapillary atrophy. In contrast, in the normal intraocular pressure group, a significant predictive factor was presence of disk hemorrhages at baseline. Within the patients with elevated intraocular pressure, the primary open-angle glaucoma group and the secondary open-angle glaucoma group did not differ in predictive factors for progression of glaucoma. CONCLUSIONS: Open-angle glaucoma patients with normal intraocular pressure and open-angle glaucoma patients with elevated intraocular pressure differ in predictive factors for eventual progression of glaucomatous optic nerve damage. It may have clinical importance and may be helpful in the discussion of the pathogenesis of the glaucomas.

Adolescent↗
PubMed2005

Intereye difference in exudative age-related macular degeneration with minimally classic or occult subfoveal neovascularization after unilateral intravitreal injection of triamcinolone acetonide.

PURPOSE: To report on visual outcome after intravitreal injection of triamcinolone acetonide for exudative age-related macular degeneration. DESIGN: Interventional comparative non-randomized clinical trial. METHODS SETTING: Institutional. PATIENTS: Twenty consecutive patients with bilateral exudative age-related macular degeneration with minimally classic or occult subfoveal neovascularisation. INTERVENTIONS: Unilateral intravitreal injection of about 20 mg triamcinolone acetonide into the eye (study group) more severely affected or showing more pronounced progression of the disease. Mean follow-up was 13.5 +/- 4.1 months. MAIN OUTCOME MEASURES: Visual acuity. RESULTS: In the study group, visual acuity increased significantly (P < 0.001) from 0.96 +/- 0.32 logMar to a mean maximum of 0.76 +/- 0.30 logMar during follow-up. An increase in best visual acuity during follow-up was found in 18 (90%) eyes. In 11 (55%) eyes and 7 (35%) eyes, respectively, best visual acuity increased by at least two Snellen lines and three Snellen lines, respectively. In the control group, visual acuity at baseline and the highest visual acuity measurements during follow-up did not vary significantly (P = 0.90). Comparing study group and control group, visual acuity gain was significantly (P = 0.003) higher in the study group. Correspondingly, the number of eyes with an increase in visual acuity (P = 0.002) and with an increase in visual acuity higher > or = 3 lines compared to a loss of > or = 3 lines was significantly (P = 0.027) higher in the study group. CONCLUSIONS: Intravitreal triamcinolone acetonide may temporarily increase visual acuity in eyes with exudative age-related macular degeneration.

Aged↗
PubMed2005

Dynamic contour tonometry for intraocular pressure measurement.

PURPOSE: To compare dynamic contour tonometry as a new method for intraocular pressure measurement with Goldmann applanation tonometry. DESIGN: Clinical observational study. METHODS: The study included 176 eyes of 126 subjects (39 eyes with open-angle glaucoma, 137 normal eyes) and consisted of 528 dynamic contour measurements and 352 Goldmann tonometry measurements. Corneal pachymetry measurements were additionally performed. RESULTS: Mean dynamic contour tonometric measurements (18.71 +/- 5.90 mm Hg) were significantly (P < .001) higher than mean applanation tonometric values (16.98 +/- 5.86 mm Hg), correlating significantly with each other (r(2) = .905, P < .001). The slope of the regression line was 0.95. Correlation with central corneal thickness was significant for applanation tonometry (P = .036), while dynamic contour tonometry was statistically independent of corneal thickness (P = .32). CONCLUSIONS: For measurement of intraocular pressure, dynamic contour tonometry may offer a new technology, which, compared with applanation tonometry, may show a lower dependence on central corneal thickness.

Adolescent↗
PubMed2005

Non-invasive measurement of intraocular pressure by near-infrared spectroscopy.

PURPOSE: To assess a new non-contact method for non-invasive measurement of intraocular pressure (IOP) using near-infrared spectroscopy. DESIGN: Experimental study. METHODS: Eleven porcine eyes were cannulated into the anterior chamber by a needle connected with a water column. Measuring the near-infrared spectrum in diffuse reflectance out of the anterior chamber by near-infrared spectroscopy, IOP was determined and compared with the height of the water column which was varied between 0 cm and 100 cm. RESULTS: In total, 363 near-infrared spectrometric measurement values were obtained. Correlating the near-infrared spectrometric measurements with the height of the water column showed a relationship with a correlation coefficient of r(2) = .858 and a steepness of the regression line of .96. CONCLUSIONS: The results of the present pilot study suggest that near-infrared spectrometric tonometry may present a new technology for non-invasive and non-contact IOP measurement.

Animals↗
PubMed2005

Intraocular pressure in Northern China in an urban and rural population: the Beijing eye study.

PURPOSE: To evaluate intraocular pressure (IOP) and its demographic associations in an urban and rural population in Northern China. DESIGN: Population-based cohort study. METHODS: In the Beijing Eye Study, IOP was measured by noncontact pneumatonometry. Mean age was 56.20 +/- 10.59 years (range, 40-101 years). RESULTS: Mean IOP was 16.11 +/- 3.39 mm Hg (median, 16 mm Hg; range, 7-60 mm Hg). In the rural group and the urban population group, respectively, IOP was significantly (P = .016 and P = .029, respectively) lower in the high-age group (>or=75 years) than in the middle-age group (55-64 years). In the rural group, IOP was additionally significantly lower in the age group of 40 to 44 years than in the middle-age group, which suggests a reversed U-like course. A multiple regression analysis revealed that IOP significantly increased with myopia (P = .024), and that it was statistically independent of rural area vs urban area (P = .12) and gender (P = .71). CONCLUSION: In the Northern Chinese population, mean and median of IOP that is measured by pneumatonometry is 16 mm Hg with a normal range (mean +/- two SDs) of 10 to 22 mm Hg. In cross-sectional analysis, IOP slightly increased towards an age of 55 to 64 years and decreased towards higher ages. IOP increased with myopia. It was not associated with rural vs urban region or gender.

Adult↗
PubMed2005

Central corneal thickness and development of glaucomatous optic disk hemorrhages.

PURPOSE: To evaluate whether central corneal thickness influences the development of optic disk hemorrhages in chronic open-angle glaucoma. DESIGN: Prospective observational clinical study. METHODS: The study included 390 eyes of 223 white subjects with chronic open-angle glaucoma observed during a mean follow-up time of 61.3 +/- 36.4 months. Central corneal thickness was measured by corneal pachymetry. RESULTS: The event of optic disk hemorrhages during follow-up was detected in 63 eyes (16.2%). Development of optic disk hemorrhages was, univariately (P = .73) as well as in a multiple Cox regression analysis, controlling for age, sex, normal tension glaucoma, intraocular pressure, neuroretinal rim area, and size of beta zone of peripapillary atrophy, statistically independent (P = .56) of central corneal thickness. CONCLUSIONS: Development of optic disk hemorrhages may not be markedly influenced by central corneal thickness.

Adolescent↗
PubMed2005

Topical anesthesia for transpupillary silicone oil removal combined with cataract surgery.

PURPOSE: To assess safety of topical anesthesia for transpupillary silicone oil removal in combination with cataract surgery. SETTING: Department of Ophthalmology Mannheim, University of Heidelberg, Mannheim, Germany. METHODS: The clinical interventional study included 37 consecutive patients having transpupillary silicone oil removal combined with cataract surgery. Without exception, surgery was carried out in topical anesthesia for all patients. During the study period, there were no patients having transpupillary silicone oil removal in another type of local anesthesia than topical anesthesia. Topical anesthesia was achieved with oxybuprocaine 0.4% eyedrops installed 4 to 5 times prior to surgery. Cataract surgery was performed using the clear cornea technique with implantation of a foldable intraocular posterior chamber lens. Silicone oil was released through a planned posterior capsulotomy during cataract surgery prior to implantation of the intraocular lens (IOL). RESULTS: For all patients, surgery could be carried out in topical anesthesia without switching to peribulbar or any other type of anesthesia. None of the patients complained about severe pain intraoperatively or postoperatively. No severe complications such as expulsive hemorrhage, luxation of the IOL, or iris incarceration were encountered in any of the surgeries. CONCLUSION: Transpupillary silicone oil through a planned posterior capsulotomy during cataract surgery may be performed in topical surgery.

Anesthesia, Local↗
PubMed2005

Intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

PURPOSE: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. DESIGN: Meta-analysis of previously reported data and case series studies. PARTICIPANTS: The study included 272 patients (305 eyes) receiving an intravitreal injection of approximately 20 mg triamcinolone acetonide as treatment for diffuse diabetic macular edema (n = 84 patients), exudative age-related macular degeneration (n = 181 patients), retinal vein occlusions (n = 20 patients), uveitis (n = 9), pseudophakic cystoid macular edema (n = 6), and other reasons (n = 5). Mean follow-up was 10.4+/-6.7 months (median, 7.9 months; range, 3.0-35.7 months). INTERVENTION: Intravitreal injection of approximately 20 mg triamcinolone acetonide. MAIN OUTCOME MEASURE: Intraocular pressure. RESULTS: Intraocular pressure readings higher than 21 mmHg, 30 mmHg, 35 mmHg, and 40 mmHg, respectively, were measured in 112 (41.2%) patients, 31 (11.4%) patients, 15 (5.5%) patients, and 5 (1.8%) patients, respectively. Triamcinolone-induced IOP elevation was treated by antiglaucoma medication in all but 3 (1.0%) eyes, for which filtering surgery was performed. Mean IOP started to rise 1 week after injection and returned to baseline values approximately 8 to 9 months after injection. Younger age (P = 0.029) was significantly associated with triamcinolone-induced ocular hypertension. Triamcinolone responders and triamcinolone nonresponders did not vary significantly in gender (P = 0.42), refractive error (P = 0.86), diabetes mellitus status (P = 0.74), and reason for treatment. CONCLUSIONS: These findings may be useful for comparing risks and benefits of intravitreal triamcinolone acetonide therapy.

Aged↗
PubMed2005

Refractive error in urban and rural adult Chinese in Beijing.

PURPOSE: To evaluate refractive error and its demographic associations in an urban and rural population in northern China. DESIGN: Epidemiological study. PARTICIPANTS: The Beijing Eye Study is a population-based cohort study in northern China including 4439 subjects. Excluding pseudophakic and aphakic patients, the present study involved 4319 subjects. It was divided into a rural part (1905 [44.1%] subjects) and an urban part (2414 [55.9%] subjects). Mean age was 55.85+/-10.33 years (range, 40-90). METHODS: Standardized ophthalmologic examination. For statistical analysis, the spherical equivalent was converted to binary variables, and logistic regression was used to investigate the association with continuous or categorical independent variables. MAIN OUTCOME MEASURE: Refractive error. RESULTS: Mean refractive error measured -0.33+/-2.22 diopters (D) (range, -20.88 to +7.88). Myopia of >-0.50 D, -1.0 D, >-6.0 D, and >-8 D, respectively, occurred in 22.9% (95% confidence interval [CI], 21.7-24.2), 16.9% (95% CI, 15.8-18.0), 2.6% (95% CI, 2.2-3.1), and 1.5% (95% CI, 1.1-1.9) of the subjects, respectively. Myopic refractive error was associated significantly with younger age (P<0.001), urban region (vs. rural region) (P<0.001), higher educational background (P<0.001), higher degree of nuclear cataract (P<0.001), decreasing uncorrected visual acuity (UCVA) (P<0.001), decreasing best-corrected visual acuity (BCVA) (P<0.001), and female gender (P<0.001). Prevalence of high myopia (myopic refractive error >-8 D) was associated with age (P<0.001), female gender (P = 0.020), urban region (P = 0.023), and lower BCVA (P<0.001). Mean anisometropia was 1.09+/-2.03 D (median, 0.38; range, 0-22.0). Prevalence of anisometropia of > or =1 D was associated significantly with age (P<0.001), refractive error (P<0.001), BCVA (P<0.001), and region (P<0.001). Mean astigmatic error measured 0.62+/-0.90 D (median, 0.25; range, 0-7.50). Astigmatism of > or =1 D was associated significantly with age (P<0.001), lower UCVA (P = 0.003), lower BCVA (P<0.001), urban area (P<0.001), and degree of cortical cataract (P = 0.027). CONCLUSIONS: As in other population-based studies on Chinese, myopia was more prevalent in younger subjects. Myopia was associated with urban region, educational background, female gender, decreasing visual acuity, and nuclear cataract. If longitudinal studies confirm the association of refractive error with age, refractive surgery may achieve emmetropia only for a limited time.

Adult↗
PubMed2005

Clinical implications of peripapillary atrophy in glaucoma.

PURPOSE OF REVIEW: To elucidate peripapillary atrophy in glaucomatous optic neuropathy; its ranking in the morphologic diagnosis of the glaucoma, and its value for the differentiation of various types of chronic open-angle glaucoma, for the separation of glaucomatous eyes from nonglaucomatous eyes, and for the detection of progression of glaucoma. RECENT FINDINGS: Recent studies showed an association of peripapillary atrophy with glaucoma and the eventual development of glaucomatous disc hemorrhages independent of a small neuroretinal rim area, and an association between increasing peripapillary atrophy and progressive glaucoma. A ranking of optic disc parameters to detect glaucomatous damage revealed that the alpha and beta zones of peripapillary atrophy, compared with neuroretinal rim parameters, are less useful. Pseudoexfoliation syndrome without glaucoma is not a risk factor for peripapillary atrophy. In arteritic anterior ischemic optic neuropathy, peripapillary atrophy does not enlarge. Peripapillary atrophy does not differ markedly between Europeans and South Indians. In contrast to the position of the central retinal vessel trunk, the presence and position of cilioretinal arteries do not markedly influence the progression of peripapillary atrophy in glaucoma. SUMMARY: Peripapillary chorioretinal atrophy is one among several morphologic variables to detect glaucomatous abnormalities. Ranking optic disc variables for the detection of glaucomatous optic nerve damage, peripapillary atrophy is a variable of second order. It is useful for the differentiation of various types of chronic open-angle glaucomas. In contrast to glaucomatous eyes, eyes with nonglaucomatous optic nerve atrophy, including eyes after arteritic anterior ischemic optic neuropathy, do not show an enlarged peripapillary atrophy.

Animals↗