603 results on '"U, Pleyer"'
Search Results
152. Clinical and Immunological Characteristics of Oculomucocutaneous Disorders
- Author
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U. Pleyer, B. Mondino, and U. Niesen
- Subjects
Text mining ,Immuno ophthalmology ,business.industry ,Medicine ,Bioinformatics ,business - Published
- 1999
153. Immunobiology of the Cornea
- Author
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U. Pleyer
- Subjects
Pathology ,medicine.medical_specialty ,Cell adhesion molecule ,Corneal Diseases ,Human leukocyte antigen ,Biology ,Pathophysiology ,medicine.anatomical_structure ,Immuno ophthalmology ,Cornea ,Immunology ,medicine ,biology.protein ,Antibody ,Antigen-presenting cell - Published
- 1999
154. [Immune reaction after penetrating keratoplasty. II. Prevention and therapy]
- Author
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U, Pleyer, P, Rieck, T, Ritter, and C, Hartmann
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Graft Rejection ,Clinical Trials as Topic ,Histocompatibility Testing ,Humans ,Immunosuppressive Agents ,Keratoplasty, Penetrating - Published
- 1998
155. Uveitis im Kindesalter
- Author
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R. Keitzer and U. Pleyer
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Ophthalmology - Published
- 2005
156. Uveitis bei Sarkoidose im Kindesalter
- Author
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U Pleyer and R Keitzer
- Subjects
Ophthalmology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Biopsy ,medicine ,MEDLINE ,Sarcoidosis ,medicine.disease ,business ,Dermatology ,Uveitis - Published
- 2005
157. [Apparent wall shear rate and leukocyte-endothelium interaction in iris blood vessels in endotoxin-induced uveitis]
- Author
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H, Baatz, U, Pleyer, C, Hammer, and H J, Thiel
- Subjects
Salmonella typhimurium ,Microcirculation ,Bacterial Toxins ,Iris ,Leukocyte Adherence Inhibition Test ,Uveitis, Anterior ,Rats ,Endotoxins ,Venules ,Rats, Inbred Lew ,Animals ,Female ,Endothelium, Vascular ,Cell Adhesion Molecules ,Blood Flow Velocity - Abstract
Inflammatory stimuli induce the expression of adhesion molecules on leukocytes and endothelial cells. The adhesive forces between leukocytes and the vascular endothelium are antagonized by the shear stress of the flowing blood. The aim of this study was to examine how differences in the apparent wall shear rate measured in iris venules with varying caliber affect leukocyte-endothelium interaction.The microvasculature of the iris in Lewis rats (n = 6) was examined using intravital fluorescence microscopy [2]. Blood flow was visualized with FITC-HES and leukocytes were stained with rhodamine 6G. Venules (n = 110) ranging in diameter from 20-60 microns were analysed with regard to the following parameters: Flux of leukocytes, velocity of leukocytes in the center stream, number of rolling and adherent leukocytes. The apparent wall shear rate was calculated from the center stream velocity and the vessel diameter. Animals were examined 4 h after administration of endotoxin from S. typhimurium (500 mg/kg body wt i.p.), when leukocyte-endothelium interaction is strongly enhanced.The flux of leukocytes, the absolute number of rolling leukocytes and the velocity of leukocytes in the center stream was higher in larger than in smaller venules. The apparent wall shear rate decreased with increasing vessel diameter. Calculated values were 806 +/- 59 s-1 for vessels 20-30 microns in diameter and 483 +/- 34 s-1 for vessels of 50-60 microns (mean +/- SEM). The number of adherent leukocytes per mm2 endothelial surface and the rolling fraction did not show significant differences between vessels with varying caliber.Although the shear rate declined with increasing vessel diameter, we could not observe an increase in rolling and adherent leukocytes. The effects of vessel diameter on leukocyte adhesion to the vascular endothelium in postcapillary iris venules are minimal.
- Published
- 1996
158. [Cogan I syndrome. Audio-vestibular, ophthalmologic findings and therapy in 6 patients]
- Author
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M, Bohndorf, H E, Baykal, P K, Plinkert, and U, Pleyer
- Subjects
Adult ,Keratitis ,Adolescent ,Dose-Response Relationship, Drug ,Hearing Loss, Sensorineural ,Prednisolone ,Syndrome ,Dexamethasone ,Drug Administration Schedule ,Autoimmune Diseases ,Tinnitus ,Humans ,Female ,Cyclophosphamide ,Meniere Disease ,Follow-Up Studies ,Scleritis - Abstract
We report clinical experiences with six patients treated at the University of Tübingen between 1982 and 1994 for symptoms of typical and atypical ocular manifestations of Cogan's syndrome. All cases had systemic symptoms in addition to involvement of the cochleovestibular system. Otologic symptoms were the initial presentation in four cases. Vestibular dysfunction often preceded hearing loss. Five patients had keratitis and also demonstrated signs of ocular inflammation diagnosed as scleritis or episcleritis. In two patients these ocular symptoms were the first signs of Cogan's syndrome, recurred periodically and did not respond to corticosteroids. Three patients were diagnosed early, allowing corticosteroid treatment to begin early with stabilization of hearing. Total bilateral deafness could not be prevented in the remaining patients. The importance of being aware of auditory-vestibular dysfunction occurring in patients with ocular inflammation and the role of early immunotherapy in preventing deafness has to be emphasized.
- Published
- 1996
159. [Autoimmune diseases of the peripheral cornea. Immunopathology, clinical aspects and therapy]
- Author
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U, Pleyer, L, Bergmann, A, Krause, and C, Hartmann
- Subjects
Cornea ,Keratitis ,Vasculitis ,Complement C1 ,Immunoglobulin G ,Antigen-Presenting Cells ,Humans ,Immune Complex Diseases ,Connective Tissue Diseases ,Corneal Ulcer ,Autoimmune Diseases ,Corneal Diseases - Abstract
Noninfectious ulceration of the peripheral cornea remains a major diagnostic and therapeutic challenge. The pathogenesis in most of these disorders is unclear, however, on the basis of systemic connective tissue diseases, autoimmune mechanisms are most likely involved. The peripheral cornea has distinct morphological and immunological characteristics that predispose for inflammatory reactions. Major differences exist regarding humoral and cellular components of the immune system. In the peripheral cornea there is more high-molecular IgM and initial complement component C1 than in the central cornea and may predispose for immune complex formation. The close contact to the conjunctival vasculature provides the basis necessary to generate an immune response. Langerhans cells and macrophages as important antigen presenting and processing cells are present in higher number in the peripheral cornea. Autoimmune diseases that affect the peripheral cornea include collagen vascular diseases and Mooren's ulcer. Although this association is obvious in advanced rheumatoid arthritis more subtle forms of polyarteritis nodosa or systemic lupus erythematosus require careful medical evaluation and workup. Ocular manifestations may present as the initial clinical signs and require careful workup in these potentially lethal disorders.
- Published
- 1996
160. [Erythema exsudativum multiforme major]
- Author
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K, Küper, U, Pleyer, M, Zierhut, and H J, Thiel
- Subjects
Adult ,Male ,Adolescent ,Middle Aged ,Prognosis ,Anti-Bacterial Agents ,Cornea ,Adrenal Cortex Hormones ,Child, Preschool ,Stevens-Johnson Syndrome ,Humans ,Female ,Child ,Conjunctiva ,Keratoplasty, Penetrating ,Aged - Abstract
Erythema exudativum multiforme major (EEMM), also know as Stevens-Johnson syndrome, may cause severe conjunctival and corneal alterations. The etiology remains unknown. The aim of are study was to evaluate the clinical course, therapy and prognosis of ocular involvement.In a retrospective study, we evaluated ten patients with EEMM who were treated between 1986 and 1994 at the University Eye Clinic Tübingen.The age of the four female and six male patients varied between 5 and 70 years. Drugs as a possible precipitating factor were found in all cases (acetylsalicylicacid, sulfonamide, erythromycin, cotrimoxazole, Valproinicacid, paracetamol). Eight patients experienced an infection at the same time. Clinically, we were able to differentiate two groups regarding severity of the disease. Seven patients were characterized by ocular alterations that only involved the conjunctiva, leading to conjunctival scars. In those cases local treatment with antibiotics and corticosteroids was effective. In the second group severe ocular damage occurred, with symblephara, keratinization and consecutive perforating keratoplasty. Secondary infections became evident in a total of six cases from the two groups.Drugs as a possible precipitating factor could be identified in all cases. In eight of ten patients previous infection was known. This agrees with literatures reports of viral infections (e.g. herpes simplex) as cofactors causing EEMM, especially for the aggressive form, remains unresolved. The danger of possible superinfection should always be taken into consideration.
- Published
- 1995
161. [Severe eye involvement in pemphigus vulgaris]
- Author
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H E, Baykal, U, Pleyer, K, Sönnichsen, H J, Thiel, and M, Zierhut
- Subjects
Cornea ,Male ,Fluorescent Antibody Technique, Direct ,Recurrence ,Humans ,Middle Aged ,Conjunctivitis ,Corneal Ulcer ,Conjunctiva ,Keratoplasty, Penetrating ,Pemphigus ,Skin - Abstract
Pemphigus vulgaris (PV) is an immune-mediated vesiculobullous disease of the skin and mucous membranes. Generally, patients with PV present first with oral lesions, which may precede the cutaneous lesions, such as bullae and erosions, by several months. An ocular manifestation is unusual. The most common ophthalmologic involvement in pemphigus is conjunctivitis, but without progressive scarring such as occurs in ocular cictricial pemphigoid. Corneal involvement is very rare. CASE REPORT. We report on severe ocular involvement in a 56-year-old male Turkish patient with PV. Ophthalmologic findings included conjunctival cicatrization, corneal ulceration and corneal perforation, despite immunosuppressive therapy with azathioprine and corticosteroids. A penetrating keratoplasty was performed, but rapidly failed because of corneal vascularization. CONCLUSION. If a chronic bullous dermatosis leads to severe eye involvement, PV should be considered in the differential diagnosis besides ocular cicatricial pemphigoid. Pemphigus vulgaris can be differentiated on the basis of clinical findings and histopathological and immunohistological features. Generally, PV can be treated with steroids or with a combination of an immunosuppressant and steroids. However, the combination of prednisone and azathioprine could not prevent corneal perforation in our patient.
- Published
- 1995
162. Complement-derived anaphylatoxins in human donor corneas treated with excimer laser
- Author
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B P, Gardner, U, Pleyer, B J, Mondino, H L, Sumner, M L, Frieberg, and P S, Imperia
- Subjects
Adult ,Aged, 80 and over ,Anaphylatoxins ,Adolescent ,Radioimmunoassay ,Complement C4a ,Complement C5a ,Middle Aged ,Photorefractive Keratectomy ,Cornea ,Complement C3a ,Humans ,Lasers, Excimer ,Child ,Complement Activation ,Aged - Abstract
An inflammatory response produced by excimer laser photorefractive keratectomy (PRK) may be associated with the subsequent corneal haze and regressions in refractive error observed after treatment. Complement-derived anaphylatoxins, potent mediators of inflammation, may have a role in postoperative healing.Twenty right human donor corneas underwent a 6-D excimer laser PRK treatment. The corresponding left donor corneas served as the controls. After incubation in tissue culture media for 6 hours and elution in phosphate-buffered saline with EDTA for 24 hours, complement-derived anaphylatoxins C3a, C4a, and C5a were measured in corneal eluates by radioimmunoassay.Compared with control corneas, the excimer PRK corneas failed to demonstrate a significant increase in C3a, C4a, or C5a levels (P.05).These results suggest that the excimer laser at this dose does not activate significant complement in the cornea.
- Published
- 1995
163. In vivo study of leukocyte-endothelium interaction in endotoxin-induced uveitis
- Author
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H, Baatz, U, Pleyer, H J, Thiel, and C, Hammer
- Subjects
Lipopolysaccharides ,Salmonella typhimurium ,Rhodamines ,Iris ,Uveitis, Anterior ,Rats ,Chemotaxis, Leukocyte ,Leukocyte Count ,Venules ,Rats, Inbred Lew ,Cell Adhesion ,Image Processing, Computer-Assisted ,Leukocytes ,Animals ,Female ,Endothelium, Vascular ,Fluorescein Angiography ,Fluorescein-5-isothiocyanate - Abstract
To analyze leukocyte-endothelium interaction in iris venules of living rats and to quantify changes of leukocyte dynamics in endotoxin-induced uveitis (EIU).Lewis rats received an intraperitoneal injection of 100 micrograms of lipopolysaccharide (LPS; Salmonella typhimurium). Using intravital fluorescence microscopy, the iris vessels were examined, 2, 4, 6, 10, 14, 24, and 72 hours after LPS injection. A setup for intravital fluorescence microscopy of iris venules in the rat is described. Images are recorded with a video camera and stored on S-VHS videotape for off-line analysis. For contrast enhancement, erythrocytes and plasma were stained with fluorescein isothiocyanate (FITC) and FITC-hydroxyethylstarch, respectively. Rhodamine 6G was used for intravital staining of leukocytes. Resolution and magnification (x850) of the system facilitates observation of individual cells in the bloodstream in real time. Leukocytes were either flowing in the center stream, rolling along the endothelium, or firmly adherent. Image analysis provided data on microvascular leukocyte flux and leukocyte velocity.The percentage of leukocytes rolling on postcapillary venular endothelium increased significantly (P0.05) 4 hours after endotoxin administration, as did the number of firmly adherent cells. Leukocyte-endothelium interaction reached its maximum 6 to 10 hours before an increase of inflammatory cells in the aqueous humor. The response to endotoxin was reversible, subsiding to near-normal values after 72 hours.Intravital fluorescence microscopy provides data on microvascular parameters, including the number of rolling and sticking leukocytes on vascular endothelium. Inflammation of the anterior uvea was characterized with regard to leukocyte recruitment from blood to the vessel wall.
- Published
- 1995
164. [Amphotericin B--bioavailability in the cornea. Studies with local administration of liposome incorporated amphotericin B]
- Author
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U, Pleyer, J, Grammer, J H, Pleyer, P, Kosmidis, D, Friess, K H, Schmidt, and H J, Thiel
- Subjects
Cornea ,Antifungal Agents ,Amphotericin B ,Animals ,Rabbits ,Ophthalmic Solutions - Abstract
Amphotericin B remains an important antifungal agent in the treatment of ocular mycosis. Since topical ocular application is limited because of ocular irritation and poor penetration, we studied the pharmacokinetics of amphotericin B encapsulated in unilamellar liposomes (AmBisome). One drop (20 microliters) of AmBisome or an equivalent concentration of amphotericin B was applied to rabbit eyes. Drug concentrations were measured 15, 60, 120 and 240 min following administration of the agents by HPLC in cornea and aqueous humor. The effect of intact (group A) and debrided corneal epithelium (group B) was also studied. Corneal amphotericin B levels were significantly higher (P0.01) after 15 min in animals receiving amphotericin B as compared to AmBisome in group A. At later time points no differences in the corneal drug levels were found, and the drug levels following AmBisome application were remarkably stable. Epithelial removal resulted in increased corneal drug levels following application of both amphotericin B preparations. Significantly higher drug levels were observed after free amphotericin B treatment at 15-60 min (P0.01). Drug levels in the aqueous humor did not differ between the two amphotericin B preparations and remained below therapeutically effective concentrations. These results suggest that topically delivered AmBisome provides stable corneal drug levels, but has the potential benefit of lowered ocular toxicity.
- Published
- 1995
165. [Cogan I syndrome: too often detected too late? A contribution to early diagnosis of Cogan I syndrome]
- Author
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U, Pleyer, H E, Baykal, J M, Rohrbach, M, Bohndorf, P, Rieck, J, Reimann, P, Kuhnt, and J, Saal
- Subjects
Adult ,Keratitis ,Adolescent ,Hearing Loss, Sensorineural ,Syndrome ,Middle Aged ,Autoimmune Diseases ,Diagnosis, Differential ,Adrenal Cortex Hormones ,Child, Preschool ,Humans ,Child ,Meniere Disease ,Aged ,Scleritis - Abstract
Cogan's syndrome is an uncommon disease characterized by ocular inflammation, vestibuloauditory dysfunction and symptoms of systemic disease. The etiology is unknown, however there is evidence for an autoimmune pathogenesis. The "typical" Cogan's syndrome presents as bilateral interstitial keratitis and progressing vestibuloauditory dysfunction. The presence of other inflammatory manifestations in addition of keratitis has been termed as "atypical" Cogan's syndrome.We report on six patients presenting with typical as well as atypical ocular manifestations between 1982 and 1994. Typically, the illness was accompanied by systemic symptoms. Each patient had audiovestibular involvement, that was the initial presentation in 4 cases. Vestibular dysfunction often preceded hearing loss. Five of our patients not only presented with keratitis but also demonstrated signs of ocular inflammation diagnosed as scleritis or episcleritis. In two patients these ocular symptoms were the first signs of Cogan's syndrome, recurred periodically and did not respond to corticosteroids.In 3 patients that were diagnosed early and treatment with corticosteroids was initiated early, hearing could be stabilized, in the remaining patients total bilateral deafness could not be prevented.The importance of being aware that vestibuloauditory dysfunction may occur in patients with ocular inflammation, and the fact that early immunotherapy may prevent the risk of deafness, has to be emphasized.
- Published
- 1995
166. Ophthalmomyiasis externa due to the sheep botfly Oestrus ovis (Diptera: Oestridae) in southwest Germany
- Author
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J, Grammer, C, Erb, G, Kamin, M, Wild, C, Riedinger, P, Kosmidis, U, Pleyer, and H J, Thiel
- Subjects
Male ,Myiasis ,Diptera ,Germany ,Larva ,Animals ,Humans ,Eye Infections, Parasitic ,Gentamicins ,Middle Aged ,Conjunctivitis - Abstract
We present a case of ophthalmomyiasis externa in a 54-year-old man in southwest Germany (Baden-Württemberg). After the patient had been attacked by a fly, he complained of a foreign-body sensation and itching in his right eye and developed purulent conjunctivitis. Slit-lamp examination revealed the presence of translucent, rapidly moving insect larvae in the conjunctival sac and on the corneal surface. Following removal of all larvae and instillation of gentamicin, the symptoms completely resolved within 2 days. Two of the nine larvae removed were examined by light microscopy and taxonomically classified as first-instar larvae of the sheep botfly Oestrus ovis L. 1758. Although this fly is the most common causative agent of external ophthalmomyiasis in the world, infestations in central Europe have only rarely been reported. Besides the case report and a detailed description of the larvae, an overview of the literature on European cases of ophthalmomyiasis externa caused by Oestrus ovis is given.
- Published
- 1995
167. Effect of topically applied anti-CD4 monoclonal antibodies on orthotopic corneal allografts in a rat model
- Author
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U, Pleyer, J K, Milani, A, Dukes, J, Chou, S, Lutz, D, Rückert, H J, Thiel, and B J, Mondino
- Subjects
CD4-Positive T-Lymphocytes ,Drug Carriers ,Administration, Topical ,Graft Survival ,Antibodies, Monoclonal ,Rats, Inbred WF ,Rats ,Cornea ,Disease Models, Animal ,Random Allocation ,Rats, Inbred Lew ,Liposomes ,Animals ,Transplantation, Homologous ,Female ,Ophthalmic Solutions ,Keratoplasty, Penetrating - Abstract
Monoclonal antibodies (mAb) have generated interest as therapeutic agents. Limited data are available on the treatment of corneal graft rejection. The purpose of this study was to assess the use of topically applied mAb on experimental corneal grafts.W 3/25, an IgG 1 mouse antirat mAb that recognizes a CD4+ cell subset, was used to treat Lewis recipient rats that received orthotopic corneal grafts of Wistar-Furth donors. Recipients were randomly assigned to receive topically applied drops of liposome-incorporated anti-CD4 mAb (LIP-anti-CD4 mAb), an equivalent amount of free anti-CD4 mAb, an isotype-matched control mAb encapsulated in liposomes (LIP-control mAb), or empty liposomes (emp-LIP) 5 times daily for 10 days. To investigate the immunologic effect of mAb treatment, flow cytometry of the targeted cells and cytotoxic activity of lymphocytes were analyzed.Application of LIP-anti-CD4 mAb was effective in reducing the rejection rate (P.05) and in prolonging the mean survival time of corneal grafts that underwent rejection (P.05). In contrast, no significant effect on graft outcome was observed after the application of control agents. Flow cytometry analysis did not reveal systemic depletion of the targeted lymphocyte subset in any anti-CD4 mAb treated animals. Rejected grafts elicited a cellular cytotoxic immune response in a cell-mediated lymphocytotoxic assay independent of the treatment given.The results suggest that treatment with topically applied LIP-anti-CD4 mAb prolongs graft survival in orthotopic corneal grafts in a rat model. The beneficial effect of LIP-anti-CD4 mAb, probably due to enhanced intraocular delivery, was achieved by using relatively low doses of mAb.
- Published
- 1995
168. [Review of the past year--'cornea']
- Author
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H J, Thiel, M, Zierhut, U, Pleyer, B, Jean, W, Bachmann, and M, Knorr
- Subjects
Cornea ,Corneal Transplantation ,Diagnosis, Differential ,Animals ,Humans ,Refraction, Ocular ,Corneal Diseases - Published
- 1994
169. Ocular absorption of topically applied FK506 from liposomal and oil formulations in the rabbit eye
- Author
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U, Pleyer, S, Lutz, W J, Jusko, K D, Nguyen, M, Narawane, D, Rückert, B J, Mondino, V H, Lee, and K, Nguyen
- Subjects
Immunoassay ,Drug Carriers ,Administration, Topical ,Liposomes ,Animals ,Freeze Fracturing ,Female ,Tissue Distribution ,Rabbits ,Eye ,Tacrolimus ,Absorption - Abstract
To investigate the use of topically applied FK506, a new immunosuppressive compound, systemic and ocular absorption was determined in serum and various ocular tissues.Two drops of 20 microliters FK506 were applied using oil dissolved (OD-FK506) or liposome-bound (LIP-FK506) drug. FK506 concentrations were measured at intervals of 30, 60, and 120 minutes by immunoassay.After application of OD-FK506, the highest concentrations of FK506 were found in the cornea and the conjunctiva (200-1200 ng/g) with substantial drug also present in anterior and posterior sclera. Relatively low concentrations were measured in the aqueous and vitreous humors (0.2-1.0 ng/g) of these animals. Using the same treatment regimen, LIP-FK506 was effective in delivering significantly higher drug concentrations (P0.05) to all ocular tissues and particularly aqueous humor (5-28 ng/g) and vitreous humor (12-22 ng/g) at all time points. During the observation period drug concentrations produced by LIP-FK506 remained well above the therapeutic range. FK506 levels were not detectable in serum (0.2 ng/ml) with either drug formulation.These findings indicate that liposomes may be a promising formulation for topical use of FK506 in ocular immune-mediated diseases.
- Published
- 1993
170. Gene therapy in hereditary retinal degeneration and the tower of Babel
- Author
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U Pleyer
- Subjects
Retinal degeneration ,Genetics ,Retina ,medicine.medical_specialty ,Neurology ,business.industry ,Genetic enhancement ,Retinal ,Gene delivery ,medicine.disease ,Bioinformatics ,Sensory Systems ,Cellular and Molecular Neuroscience ,Ophthalmology ,chemistry.chemical_compound ,Refsum disease ,medicine.anatomical_structure ,chemistry ,medicine ,business ,Retinal Dystrophies - Abstract
In the Western world hereditary retinal diseases are the most common cause of blindness in people under 70 years of age, affecting about 1.5 million individuals. Various attempts have been tried but none of the enumerated treatments had any scientifically confirmed beneficial effect.1 Gene therapy holds the promise of revolutionising the treatment of genetic diseases and might be an “ideal” approach to treat many forms of hereditary retinal diseases. Indeed, hereditary retinal diseases meet all of the major requirements for gene therapy.2 Firstly, their genetic basis is well characterised and the biochemical defects are known in several diseases (for example, Refsum disease, gyrate atrophy, Kearns-Sayre syndrome). Secondly, efficient gene delivery techniques that can be relatively well controlled are available and allow even local ocular application. Lastly, reliable animal models of hereditary retinal diseases are available that permit preclinical testing. However, fundamental challenges in gene therapy are still present and it appears that clinical trials in non-life threatening disorders such as retinal dystrophies are far …
- Published
- 2001
171. Corneal graft rejection: incidence, manifestation, and interaction of clinical subtypes
- Author
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U, Pleyer, K P, Steuhl, E G, Weidle, W, Lisch, and H J, Thiel
- Subjects
Corneal Transplantation ,Graft Rejection ,Eye Diseases ,Risk Factors ,Incidence ,Humans ,Prognosis - Published
- 1992
172. [Clinical aspects, follow-up and results of cataract extraction in uveitis]
- Author
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U, Pleyer, J, Pawlikowska, M, Zierhut, W, Lisch, and H J, Thiel
- Subjects
Adult ,Aged, 80 and over ,Lenses, Intraocular ,Male ,Adolescent ,Visual Acuity ,Cataract Extraction ,Middle Aged ,Uveitis ,Postoperative Complications ,Humans ,Female ,Child ,Aged ,Retrospective Studies - Abstract
Over a 5-year period, a consecutive series of 52 eyes in 46 patients with uveitis underwent extracapsular cataract extraction. Twenty-eight of these cases received a posterior chamber intraocular lens (IOL). During an average follow-up of 25 months (range 7 to 58 months) 71% of eyes receiving an IOL achieved postoperatively a visual acuity of 0.5 or better; 54% of aphakic eyes reached this level. Persistent cystoid macular edema limited the visual improvement to 20/200 in 6 patients; none of the patients developed cystoid macular edema postoperatively on clinical observation. Intraocular hypertension occurred postoperatively in 12 eyes, but was limited to a 4-week postoperative period in 9 cases. YAG laser capsulotomy was performed in 2 eyes with opacification of the posterior lens capsule without any further complications. The results suggest that uveitis patients benefit from cataract extraction and in selected cases can tolerate IOL implantation without major complications.
- Published
- 1992
173. Immune response to Staphylococcus epidermidis-induced endophthalmitis in a rabbit model
- Author
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U, Pleyer, B J, Mondino, S A, Adamu, H, Pitchekian-Halabi, R E, Engstrom, and B J, Glasgow
- Subjects
Antigens, Bacterial ,Endophthalmitis ,Enzyme-Linked Immunosorbent Assay ,Staphylococcal Infections ,Antibodies, Bacterial ,Eye Infections, Bacterial ,Retina ,Immunoglobulin A ,Vitreous Body ,Disease Models, Animal ,Anterior Eye Segment ,Immunoglobulin G ,Staphylococcus epidermidis ,Animals ,Female ,Hypersensitivity, Delayed ,Rabbits - Abstract
Although Staphylococcus epidermidis is the most common cause of postoperative pseudophakic endophthalmitis, little is known about the immune response to S. epidermidis-induced endophthalmitis. Using a rabbit model, the immune response to an intravitreal injection of 7000 S. epidermidis (group 1) or 30,000 S. epidermidis (group 2) organisms was investigated. Clinical evaluations showed that rabbits in group 2 had a more severe inflammatory reaction in the conjunctiva, cornea, iris, and vitreous than those in group 1. The inflammatory reaction in group 1 largely resolved by day 30; group 2 continued to show a severe inflammatory response. Histopathologic findings correlated with clinical findings, with rabbits in group 2 showing a more severe inflammatory reaction in both the anterior and posterior segments of the globe. Positive vitreous cultures for S. epidermidis were present in rabbits in group 1 on days 3, 7, 10, 14, and 21 but not thereafter. However, group 2 had higher vitreous colony counts at days 3, 7, and 14 and negative vitreous cultures thereafter. Neither group showed delayed hypersensitivity to S. epidermidis antigens (evaluated by skin tests). Serum immunoglobulin (Ig) G antibody levels to phenol-inactivated S. epidermidis and glycerol teichoic acid (GTA) increased progressively, reached a peak at days 10-14, and then declined in both groups. Serum IgA antibody levels to these antigens were not detected. Group 2 had a more prolonged IgG antibody response in vitreous and aqueous than group 1. Tear fluid showed the weakest IgG and IgA antibody response to S. epidermidis and GTA. S. epidermidis-induced endophthalmitis was associated with a humoral but not a delayed hypersensitivity response to this organism.
- Published
- 1992
174. The effect of systemic decomplementation with cobra venom factor on corneal complement levels in guinea pigs
- Author
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U, Pleyer, B J, Mondino, and H L, Sumner
- Subjects
Cornea ,Elapid Venoms ,Complement Inactivator Proteins ,Guinea Pigs ,Animals ,Complement System Proteins ,Complement Activation ,Complement Hemolytic Activity Assay ,Injections, Intraperitoneal - Abstract
The authors examined the effect of systemic administration of cobra venom factor (CVF) on hemolytic complement levels in guinea pig sera and corneas. Guinea pigs received repeated intraperitoneal injections of CVF. Sera and corneas were obtained before and 1, 2, 5, 8, 10, 12, 16, and 20 d after the initial injection of CVF. Total hemolytic complement activity was measured by lysis of sheep erythrocytes sensitized with rabbit antibodies. There was a significant decrease in serum complement levels at days 1, 2, 5, 8, and 10 after the initial injection of CVF. After this, complement levels rose to levels that exceeded preinjection values. Complement levels in corneas also declined after CVF injections with a significant decrease at days 2, 5, 8, and 10 and a return to normal thereafter. Corneal complement depletion and restoration lagged behind serum. Moreover, the rate of complement depletion and restoration was greater for serum than cornea. Light microscopic examination of representative corneas at each time did not show local tissue changes during decomplementation. This is first study (to the authors' knowledge) to document corneal complement depletion by systemic administration of CVF. Low-to-absent corneal complement levels were present 2 d after the initial injection of CVF and persisted for 6 d. This model could be used to study the influence of complement on traumatic and immunologic injuries to the cornea.
- Published
- 1992
175. Device drug delivery to the eye. Collagen shields, iontophoresis, and pumps
- Author
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M L, Friedberg, U, Pleyer, and B J, Mondino
- Subjects
Cornea ,Disease Models, Animal ,Drug Carriers ,Biological Dressings ,Animals ,Humans ,Collagen ,Infusion Pumps, Implantable ,Iontophoresis ,Ophthalmic Solutions ,Absorption - Abstract
External devices have been used to enhance drug delivery. This article reviews the role of collagen shields, iontophoresis, and pumps used to deliver ophthalmic medications. Collagen shields have been used to deliver drugs and promote corneal epithelial healing. Presoaked collagen shields deliver many drugs to the eye as well as or better than traditional methods such as frequent topical therapy or subconjunctival injection. The efficacy of drug delivery by collagen shields was demonstrated in animal models of graft rejection and bacterial keratitis. Iontophoresis uses an electrical current to carry an ionized drug across tissue. Transcorneal iontophoresis delivers high concentrations of a drug to the anterior segment of the eye. Transscleral iontophoresis bypasses the lens-iris diaphragm and produces adequate vitreous levels. Pumps deliver fluid to the eye for extended periods of time via a tube with its distal opening in the conjunctival sac, corneal stroma, anterior chamber, or vitreous cavity. Clinical acceptance of the collagen shield for drug delivery to the anterior segment is better than iontophoresis or pumps, probably because the collagen shield is simpler and more convenient to use.
- Published
- 1991
176. [Keratomalacia in rheumatoid arthritis: immunohistologic and enzyme histochemical studies]
- Author
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J G, Saal, P, Fritz, B, Zymela, M, Zierhut, H, Dürk, C A, Müller, U, Pleyer, and H J, Thiel
- Subjects
Antigens, Differentiation, T-Lymphocyte ,Pancreatic Elastase ,Macrophages ,CD2 Antigens ,CD4-CD8 Ratio ,Cataract ,Arthritis, Rheumatoid ,Immunoenzyme Techniques ,Conjunctivitis, Bacterial ,HLA Antigens ,Humans ,Receptors, Immunologic ,Corneal Ulcer ,Conjunctiva ,Keratoplasty, Penetrating ,Conjunctivitis, Allergic ,Retrospective Studies - Abstract
Corneal and conjunctival biopsies of 13 patients with rheumatoid arthritis and corneal ulceration (RA-keratomalacia) have been characterized by immunohistological and histochemical analysis. Biopsies from 13 patients with bacterial conjunctivitis, 7 patients with allergic conjunctivitis, 15 patients with senile cataract and 15 patients with keratokonus served as controls. The phenotypic composition of the conjunctival inflammatory infiltration of rheumatoid corneal ulceration was not significantly different from the other inflammatory eye diseases studied. However, conjunctival epithelial cells of all RA-patients showed strong de novo expression of HLA-DR- and DP-antigens. HLA-DQ-antigens were only weakly expressed in a minority of patients. In bacterial conjunctivitis a less intense HLA-class-II-expression was found to be restricted to HLA-DR-antigens. Furthermore, in RA patients stromal fibroblasts of the cornea expressed lysosomal elastase. Both observations could be explained by paracrine action of interleukins produced by infiltrating T-lymphocytes and macrophages. Thus, it might be tempting to speculate that immunologically induced, elastase mediated autodegradation of corneal stroma may be an important factor in the pathogenesis of rheumatoid corneal ulceration.
- Published
- 1991
177. [Bromocriptine in therapy of chronic recurrent anterior uveitis]
- Author
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M, Zierhut, H J, Thiel, U, Pleyer, R, Waetjen, and E G, Weidle
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Adult ,Male ,Adolescent ,Double-Blind Method ,Recurrence ,Chronic Disease ,Humans ,Female ,Middle Aged ,Uveitis, Anterior ,Bromocriptine ,Aged - Abstract
In animal studies, bromocriptine (Pravidel) has demonstrated immunosuppression because of inhibition of prolactin. After publication of positive results in the treatment of uveitis in a few case reports and in an uncontrolled study we conducted a double-blind placebo-controlled study in 13 patients with chronic recurrent anterior uveitis who had experienced three or more recurrences during the previous year. Therapy was started gradually during the symptom-free interval and continued for 1 year with 2.5 mg twice daily. Two recurrences or relevant side effects led to discontinuation of the therapy. In the bromocriptine group, 2 of 7 patients had no recurrences during the study period. Two patients had to stop because of two recurrences but, in contrast to earlier recurrences, they responded to local corticosteriod treatment within a few days. The remaining 3 patients (1 with one recurrence, 2 without) had to stop because of the side effects (arterial hypotension, arthritic complaints). In 5 of 6 patients in the placebo group treatment was stopped because of recurrences and in 1 patients because she believed she was experiencing a side effect from bromocriptine (breast atrophy). In summary, bromocriptine seems to have a prophylactic effect on anterior uveitis. Side effects were frequent but mild compared to other immunosuppressives. In case of arterial hypotension, additional therapy could make this drug more tolerable.
- Published
- 1991
178. Kataraktextraktion bei Uveitis
- Author
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J. Pawlikowska, M. Zierhut, U. Pleyer, H.-J. Thiel, and W. Lisch
- Abstract
Die Autoren nahmen eine Auswertung der Ergebnisse der an 58 Augen von 50 Patienten mit verschiedenen Arten von Uveitis vorgenommenen Kataraktextraktionen vor. An 52 Augen wurde die extrakapsulare Kataraktextraktion durchgefuhrt und in 28 Fallen Hinterkammerlinsen implantiert. 6 Patienten wurden mit dem intrakapsularen Verfahren behandelt. Die postoperative Sehscharfe war bei allen Augen besser als praoperativ und lag bei 66% der Augen bei 0,5 und besseren Werten. Wahrend eines durchschnittlichen Nachuntersuchungszeitraumes von 25 Monaten (7–58 Monate) war der klinische Verlauf bei den meisten Patienten mit extrakapsularer Kataraktextraktion gunstig. Komplikationen in einigen Fallen umfasten intraokulare Druckerhohung und Trubung der hinteren Linsenkapsel. Die Ergebnisse lassen darauf schliesen, das Uveitis-Patienten von der Kataraktextraktion profitieren und eine IOL-Implantation ohne grosere Komplikationen in ausgewahlten Fallen vertragen konnen.
- Published
- 1991
179. [Intraocular availability of liposome encapsulated monoclonal antibodies in the rabbit model. Results of a pilot study]
- Author
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U, Pleyer, D, Rückert, W, Bachmann, K H, Schmidt, and H J, Thiel
- Subjects
Drug Carriers ,Microscopy, Electron ,Liposomes ,Animals ,Antibodies, Monoclonal ,Biological Availability ,Freeze Fracturing ,Rabbits ,Eye - Abstract
The results of local application of monoclonal antibodies (mAb) in rabbit eyes are presented. To improve intraocular access of the high-molecular-weight protein it was entrapped in large (0.2 microns) unilamellar, negatively charged liposomes. Concentrations of the free or encapsulated drug were measured by ELISA in different eye compartments following repetitive drop administration or single subconjunctival injection. Although mAb became measurable in specimens of conjunctiva and cornea, it was not detectable (less than 0.5 ng/ml) in aqueous humor, lens or the vitreous body. In contrast, concentrations of the liposome-encapsulated drug were measurable as little as 30 min after topical application in the aqueous humor.
- Published
- 1991
180. Subject Index Vol. 40, 2008
- Author
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Ljiljana Otasevic, Pierre-Yves Robert, Kunpeng Pang, Uwe Pleyer, Jinglin Yi, Liqun Du, Arantxa Acera, Elena Vecino, G. Büch, Eckart Bertelmann, Jean-Paul Adenis, U. Pleyer, Pierre-Jean Pisella, Shen-Guo Wang, Yi Gao, Jens Martin Rohrbach, François Denis, Ming-Chun Li, Xinyi Wu, Frédéric Patat, Frédéric Ossant, Shibo Tang, Brigitte Arbeille, Xiaobo Zhu, Virginie Ducher, Karl Ulrich Bartz-Schmidt, Juan A. Durán, Shaofen Lin, Alexandre Denoyer, Pinghong Lai, Léandre Pourcelot, Isabel Lema, Germán Rocha, Hui Xie, X.Q. Li, Sylvie Ranger-Rogez, Matthias Grueb, Franck Fetissof, Stephan Schlickeiser, and Yuping Zou
- Subjects
Cellular and Molecular Neuroscience ,Ophthalmology ,Index (economics) ,Statistics ,Subject (documents) ,General Medicine ,Sensory Systems ,Mathematics - Published
- 2008
181. [Drug-induced exudative erythema multiforme major with a chronic progressive course and bilateral blindness. Clinical and immunohistologic follow-up]
- Author
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H J, Thiel, U, Richter, U, Pleyer, M, Zierhut, and K P, Steuhl
- Subjects
Adult ,Male ,Histocompatibility Antigens Class II ,Mouth Mucosa ,Blindness ,Lymphocyte Activation ,Immunohistochemistry ,Epithelium ,Antimalarials ,Drug Combinations ,Microscopy, Electron ,Pyrimethamine ,Stevens-Johnson Syndrome ,Sulfadoxine ,Humans ,Drug Eruptions ,Conjunctiva ,Follow-Up Studies - Abstract
A 24-year-old male patient who had been received Fansidar developed exudative erythema multiforme major with massive involvement of the skin, mucous membranes, and both eyes. The chronic inflammation led to proliferation of the conjunctiva, with keratinization of the ocular surface and corneal vascularization. The final result was comparable to cicatricial pemphigoid, with blindness of both eyes. In histological sections, massive lympho-plasma-cellular infiltration with circumscribed perivasculitis was seen. The lymphocyte transformation test was still positive 18 months after onset of the disease. Class II antigens were evident in some of the conjunctival biopsies.
- Published
- 1990
182. Brechkraftkalkulation intraokularer Linsen bei Tripeloperationen
- Author
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W. Bachmann, W. Lisch, Egon G. Weidle, H.-J. Thiel, and U. Pleyer
- Abstract
38 Tripeloperationen eines Operateurs werden bezuglich der optischen Bezugsgrosen zur Intraokularlinsenberechnung nachuntersucht. Die Gegenuberstellung pra- und postoperativ erhobener Biometrie- und Keratometriedaten zeigt bei guter Korrelation der axialen Bulbuslange hohe Abweichungen der Hornhautbrechkraft.
- Published
- 1990
183. [Clinical types of immunologic transplant reactions following perforating keratoplasty]
- Author
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U, Pleyer, E G, Weidle, W, Lisch, K P, Steuhl, C, Möhrle, U, Richter, M, Zierhut, and H K, Selbmann
- Subjects
Cornea ,Graft Rejection ,Risk Factors ,Prednisolone ,Humans ,Dexamethasone ,Keratoplasty, Penetrating ,Corneal Diseases ,Follow-Up Studies - Abstract
The incidence of allograft rejection was determined for 740 penetrating keratoplasties performed between 1980 and 1987. All 740 cases were followed up for at least 1 year. The reaction forms of allograft rejection were grouped according to biomicroscopic appearance. The incidence and progression of symptoms are described. Rejection types are subdivided into patients with favorable versus poor prognosis. Of the patients 37.9% demonstrated an immune response (including discrete forms). Clear reaction patterns within the two groups of patients became apparent when reaction variations were carefully differentiated. Epithelial immune reaction was found in 5.2%/10.5% and subepithelial infiltration in 1.7%/4.8% of the patients with favorable/poor prognosis. The largest disparity in frequency occurred in progressive endothelial reaction; 3.8% in patients with favorable versus 36.7% in patients with poor prognosis. Focal endothelial reactions occurred in both groups with comparable frequencies (14.1%/13.3%). The large percentage of immunological reactions, including late manifestations (approximately 12% after 1 year) and some with irreversible progression, warrants continuing efforts to treat and prevent this complication.
- Published
- 1990
184. [Isolated infiltration of the vitreous body as a sign of blast crisis in chronic myeloid leukemia]
- Author
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U, Pleyer, E G, Weidle, U, Richter, M, Haen, H P, Horny, and H J, Thiel
- Subjects
Adult ,Diagnosis, Differential ,Male ,Vitreous Body ,Eye Neoplasms ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,Humans ,Iris - Abstract
A 29-year-old man with chronic myeloid leukemia and two successfully treated blast crises exhibited ocular symptoms. Eighteen months after the diagnosis of leukemia he presented with unilateral hyperplastic iris stroma, anterior chamber inflammation and vitreous infiltration. Uveitis was diagnosed tentatively, and local therapy was begun with corticosteroids. Because the findings remained unchanged an invasive diagnostic evaluation followed. Although iris biopsy revealed only unspecific mononuclear cell infiltration (mainly T-lymphocytes), selectively aspirated vitreous material contained myeloid cells of different stages of maturation and blast cells. Peripheral blood, liquor and bone marrow showed no signs of acceleration or transition of the primary disease. Thus, an extramedullary blast crises with isolated vitreous infiltration was diagnosed.
- Published
- 1990
185. 054 Application topique d’agents immuno-modulateurs les plus récents : Rapamycine (sirolimus) versus mycophenolate mofetil (MMF)
- Author
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U. Pleyer, P. Rieck, E. Bertelmann, and C. Hartmann
- Subjects
Ophthalmology - Published
- 2005
186. Stellenwert der Uveitis im Rahmen demyelinisierender Erkrankungen des Zentralnervensystems.
- Author
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A.-M. Beyer, B. Rosche, U. Pleyer, and K.P. Wandinger
- Abstract
Copyright of Der Nervenarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2007
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187. Immunomodulatory Therapy in Ophthalmology Is There a Place for Topical Application?
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E. Bertelmann and U. Pleyer
- Published
- 2004
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188. Efficiency of Cytokine Gene Transfer in Corneal Endothelial Cells and Organ-Cultured Corneas Mediated by Liposomal Vehicles and Recombinant Adenovirus.
- Author
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E. Bertelmann, T. Ritter, K. Vogt, R. Reszka, C. Hartmann, and U. Pleyer
- Published
- 2003
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189. P 028 Behçet's disease in 39 German and Mediterranean patients
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M. Zierhut, H. Dürk, I. Kötter, U. Pleyer, G. Fierlbeck, and J. G. Saal
- Subjects
German ,Mediterranean climate ,medicine.medical_specialty ,business.industry ,Gastroenterology ,Internal Medicine ,language ,Medicine ,Behcet's disease ,business ,medicine.disease ,Dermatology ,language.human_language - Published
- 1993
190. Successful infliximab treatment of posterior scleritis in a 13-year-old child refractory to other immunosuppressive therapy.
- Author
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K. Weiss, R. Rieger, R. Keitzer, and U. Pleyer
- Subjects
JUVENILE diseases ,EYE diseases ,INFLIXIMAB ,IMMUNOSUPPRESSIVE agents - Abstract
Abstract Background  Posterior scleritis is a potentially blinding inflammatory disorder rarely seen in children. Standard care consists of systemic administration of steroids and immunosuppressants such as methotrexate or ciclosporin A. We describe the case of a young girl suffering from therapy refractory posterior scleritis successfully treated with the tumor necrosis factor (TNF) inhibitor infliximab. Methods  This study was an interventional case report. The medical chart of a 13-year-old child treated with infliximab (5 mg/kg, 10 applications at a 4â8 week interval) was reviewed for changes of visual acuity, fundoscopy, optic choherence tomography, ultrasound imaging, and adverse events. Results  Infliximab therapy (5 mg/kg, 10 applications at a 4â8 week interval) led to a long-term remission of posterior scleritis after unsuccessful therapy with high dose prednisolone, methotrexate, and ciclosporin A. To date no side effects have been reported. Conclusions  Administration of infliximab may be considered under appropriate circumstances to treat children with posterior scleritis. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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191. [Experiences with simultaneous keratoplasty, cataract operation and lens implantation]
- Author
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E G, Weidle, H J, Thiel, and U, Pleyer
- Subjects
Aged, 80 and over ,Corneal Transplantation ,Lenses, Intraocular ,Male ,Corneal Opacity ,Humans ,Female ,Cataract Extraction ,Middle Aged ,Combined Modality Therapy ,Aged - Published
- 1987
192. Topical treatment of severe corneal ulcers with cyclosporin A
- Author
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Weidle Eg, R. Waetjen, Hans-Jürgen Thiel, U. Pleyer, and Manfred Zierhut
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Eye disease ,Administration, Topical ,Topical treatment ,Cyclosporins ,Cellular and Molecular Neuroscience ,Cornea ,Cyclosporin a ,Rheumatic Diseases ,Medicine ,Humans ,Corneal Ulcer ,Aged ,Chemotherapy ,business.industry ,Follow up studies ,Middle Aged ,medicine.disease ,digestive system diseases ,eye diseases ,Sensory Systems ,Surgery ,Oculomucocutaneous syndrome ,Ophthalmology ,medicine.anatomical_structure ,business ,Conjunctiva ,Follow-Up Studies - Abstract
Cyclosporin A eye drops were used on six patients to treat corneal ulcers associated with rheumatic diseases, oculomucocutaneous syndrome, and Sjogren's syndrome. Conjunctival excision was additionally carried out in two cases. All ulcers healed rapidly. The mechanism of ulcer formation involving T-lymphocytes is discussed.
- Published
- 1989
193. [Experiences with the Aachen IOL computer program]
- Author
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M, Wieder, A, Hettlich, and U, Pleyer
- Subjects
Lenses, Intraocular ,Computers ,Humans ,Refraction, Ocular ,Software - Published
- 1985
194. [Nonspecific eye autoantibodies in uveitis]
- Author
-
M, Zierhut, R, Klein, P, Berg, R, Waetjen, A, Frohn, H J, Thiel, and U, Pleyer
- Subjects
Uveitis ,Antibody Specificity ,Antibodies, Antinuclear ,Humans ,Autoantigens ,Autoantibodies - Abstract
Under certain pathologic circumstances autoantigens lead to the formation of autoantibodies. In uveitis, autoimmunologic phenomena will also be discussed. We studied 149 sera of uveitis patients for various organ specific and non-organ specific autoantibodies. We found antisarcolemal autoantibodies (ASA) mainly in patients with acute iritis (59% positive) but also in panuveitis (40%) and iridocyclitis (29%). On the other hand antiendothelial antibodies (AEA) could be found in 43% of patients with chorioretinitis. Antisinusoidal antibodies (SA) have been detected in iritis and panuveitis patients more often than in the control group which show positive autoantibodies in 5% of all cases. Using ELISA we looked for antibodies against keratin, laminin and microsomes. Because antimicrosomal-, antilaminin- and antisarcolemal-antibodies recognize the same epitope, there was a good correlation of these three autoantibodies. Similar clusters of autoantibodies (ASA, AEA and SA) have been found in various infectious diseases and in chronic inflammatory diseases in which an infectious component is discussed. These results may indicate that iritis, iridocyclitis, chorioretinitis and panuveitis are secondary reactions of eye tissue following a systemic primary disease. Especially viruses are well-known for their production of autoantibodies. In patients with intermediate uveitis we could not demonstrate these autoantibodies more often than in the control group, favouring theories which believe in an autoimmune reaction against vitreous elements.
- Published
- 1989
195. [Bromocriptine: a new therapy concept in the treatment of chronic recurrent uveitis?]
- Author
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M, Zierhut, U, Pleyer, R, Waetjen, H J, Thiel, and E G, Weidle
- Subjects
Adult ,Cyclosporins ,Middle Aged ,Iridocyclitis ,Uveitis ,Dogs ,Recurrence ,Chronic Disease ,Ophthalmia, Sympathetic ,Animals ,Humans ,Female ,Uveitis, Intermediate ,Bromocriptine ,Aged - Abstract
Chronic recurrent uveitis still responds unsatisfactorily to therapy. Prolactin, a pituitary hormone that attains high blood levels physiologically in stress situations, has an immune modulating effect. The prolactin antagonist bromocriptine (2 x 2.5 mg/day) was administered prophylactically to prevent recurrence in seven patients with chronic iritis/iridocyclitis or panuveitis (Group A). On this therapy two patients suffered a mild recurrence (in one case in the first month). Another patient developed rebound uveitis after discontinuing bromocriptine medication. Tolerance appears to vary considerably, and in three patients the therapy had to be discontinued because of arterial hypotension and congestive rhinopathy, respectively. The three patients in Group B (with iritis, sympathetic ophthalmia, and intermediate uveitis) received bromocriptine in addition to cyclosporin A after plasmapheresis. This combination resulted in an elevated cyclosporin A plasma level, and the dosage was reduced by 30-50% (plasma level 70-120 ng/ml). With this lower dosage of cyclosporin A, the creatinine level of one of the patients returned to normal. Viewed on the basis of these initial results bromocriptine would appear to reduce the number of recurrences of chronic uveitis. Moreover, the synergism with cyclosporin A, described both theoretically and in an animal model in the literature, appears attainable in therapy.
- Published
- 1989
196. [Use of cyclosporin A eyedrops in the treatment of severe chemical burns]
- Author
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M, Zierhut, H J, Thiel, R, Waetjen, U, Pleyer, and E G, Weidle
- Subjects
Adult ,Male ,Eye Burns ,Burns, Chemical ,Humans ,Cyclosporins ,Middle Aged ,Ophthalmic Solutions - Published
- 1987
197. Ophthalmic Research Moves Online for Submission and Peer Review.
- Author
-
U. Pleyer and N. Orlic
- Published
- 2005
- Full Text
- View/download PDF
198. S3 guideline: Diagnosis and treatment of epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis) - Part 2: Supportive therapy of EN in the acute and post-acute stages.
- Author
-
Paulmann M, Heuer R, Annecke T, Behr B, Boch K, Boos AM, Brockow K, French LE, Gille J, Gundlach V, Hartmann B, Höger P, Hofmann SC, Klein T, Lehnhardt M, Liß Y, Maier P, Mandel P, Marathovouniotis N, Marlok F, Mittelviefhaus H, Pleyer U, Pradeau M, Rall K, Rieg S, Rittner H, Sander F, Schnitzler S, Schut C, Stolle A, Vorobyev A, Wedi B, Weiss J, Zepp M, Ziemer M, Mockenhaupt M, and Nast A
- Abstract
Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are rare, predominantly drug-induced, acute life-threatening diseases of skin and mucosae. SJS and TEN are nowadays considered as variants of one disease entity with varying degrees of severity called epidermal necrolysis (EN). EN is associated with high morbidity and mortality and constitutes a major disease burden for affected patients. The guideline "Diagnosis and treatment of epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis)" was developed under systematic consideration of existing scientific literature and in a formal consensus process according to regulations issued by the Association of Scientific Medical Societies in Germany (AWMF) to establish an evidence-based framework to support clinical decision-making. The interdisciplinary guideline commission consisted of representatives from various specialist societies and of patient representatives. The guideline is aimed at specialists in the fields of dermatology, ophthalmology, plastic surgery, intensive care, and pediatrics in hospitals and offices, as well as other medical specialties involved in the diagnosis and treatment of EN. The guideline is also aimed at patients, their relatives, insurance funds, and policymakers. The second part is concerned with the topics of supportive therapy in the acute phase of EN and outpatient follow-up treatment., (© 2024 The Author(s). Journal der Deutschen Dermatologischen Gesellschaft published by Wiley‐VCH GmbH on behalf of Deutsche Dermatologische Gesellschaft.)
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- 2024
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199. S3 guideline: Diagnosis and treatment of epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis) - Part 1: Diagnosis, initial management, and immunomodulating systemic therapy.
- Author
-
Heuer R, Paulmann M, Annecke T, Behr B, Boch K, Boos AM, Brockow K, French LE, Gille J, Gundlach V, Hartmann B, Höger P, Hofmann SC, Klein T, Lehnhardt M, Liß Y, Maier P, Mandel P, Marathovouniotis N, Marlok F, Mittelviefhaus H, Pleyer U, Pradeau M, Rall K, Rieg S, Rittner H, Sander F, Schnitzler S, Schut C, Stolle A, Vorobyev A, Wedi B, Weiss J, Zepp M, Ziemer M, Mockenhaupt M, and Nast A
- Subjects
- Humans, Germany, Immunomodulation, Immunologic Factors therapeutic use, Immunologic Factors adverse effects, Stevens-Johnson Syndrome diagnosis, Stevens-Johnson Syndrome therapy
- Abstract
Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are rare, predominantly drug-induced, acute, life-threatening diseases of skin and mucosae. SJS and TEN are nowadays considered variants of one disease entity with varying degrees of severity called epidermal necrolysis (EN). EN is associated with high morbidity and mortality and constitutes a major disease burden for affected patients. The guideline "Diagnosis and treatment of epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis)" was developed under systematic consideration of existing scientific literature and in a formal consensus process according to regulations issued by the Association of Scientific Medical Societies in Germany (AWMF) to establish an evidence-based framework to support clinical decision-making. The interdisciplinary guideline commission consisted of representatives from various specialist societies and patient representatives. The guideline is aimed at specialists in the fields of dermatology, ophthalmology, plastic surgery, intensive care, and pediatrics in hospitals and offices, as well as other medical speciallved in the diagnosis and treatment of EN. The guideline is also aimed at patients, their relatives, insurance funds, and policymakers. This first part focuses on the diagnostic aspects, the initial management as well as the immunomodulating systemic therapy., (© 2024 The Author(s). Journal der Deutschen Dermatologischen Gesellschaft published by Wiley‐VCH GmbH on behalf of Deutsche Dermatologische Gesellschaft.)
- Published
- 2024
- Full Text
- View/download PDF
200. Treatment strategies for Spondyloarthritis: Implementation of precision medicine - Or "one size fits all" concept?
- Author
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Proft F, Duran TI, Ghoreschi K, Pleyer U, Siegmund B, and Poddubnyy D
- Subjects
- Humans, Precision Medicine methods, Spondylarthritis diagnosis, Spondylarthritis drug therapy, Spondylarthritis therapy, Antirheumatic Agents therapeutic use
- Abstract
Spondyloarthritis (SpA) is a term to describe a group of chronic inflammatory rheumatic diseases, which have common pathophysiological, genetic, and clinical features. Under the umbrella term SpA, two main groups are subsumed: axial SpA (radiographic axSpA and non-radiographic axSpA) and peripheral SpA (with the leading representative being psoriatic arthritis (PsA) but also arthritis associated with inflammatory bowel disease (IBD), reactive arthritis, and undifferentiated pSpA). The key clinical symptom in axSpA is chronic back pain, typically with inflammatory characteristics, which starts in early adulthood, while the leading clinical manifestations of peripheral SpA (pSpA) are arthritis, enthesitis, and/or dactylitis. Furthermore, extra-musculoskeletal manifestations (EMMs) (acute anterior uveitis, psoriasis, and IBD) can accompany axial or peripheral symptoms. All these factors need to be taken into account when making treatment decisions in SpA patients. Despite the major advances in the treatment landscape over the past two decades with the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) and most recently targeted synthetic DMARDs (tsDMARDs), a relevant proportion of patients still does not achieve the desired state of remission (=absence of disease activity). With this implementation of new treatment modalities, clinicians now have more choices to make in the treatment algorithms. However, despite generalized treatment recommendations, all factors need to be carefully considered when deciding on the optimal treatment strategy for an individual patient in clinical practice, aiming at an important first step towards personalized treatment strategies in SpA. In this narrative review, we focus on the efficacy of approved and emerging treatment options in axSpA and PsA as the main representative of pSpA and discuss their selective effect on the different manifestations associated with SpA to provide guidance on drivers of treatment decisions in specific situations., Competing Interests: Declaration of competing interest TID: has nothing to disclose. FP: received grants and personal fees from Novartis, Eli Lilly, and UCB and personal fees from AbbVie, AMGEN, BMS, Celgene, Galapagos, Janssen, Hexal, Medscape, MSD, Pfizer and Roche outside the presented work. KG: received grants or contracts from Bristol Myers Squibb; received consulting fees from Abbvie, Lilly, Almirall, Janssen, Boehringer Ingelheim, Pfizer, Bristol Myers Squibb, and UCB; received payment /honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from Abbvie Allergan Alimera Bayer Novartis Pfizer Roche Santen Thea; received support for attending meetings and/or travel from Abbvie, Almirall, BMS, and Lilly. UP: received grants or contracts from EU, BMBF; received consulting fees from Affibody, Alcon, Allergan, Janssen, Novartis, Panoptes, Pfizer, Roche, Thea, Lilly, Pfizer, Santen. Holds patents EP 19732357.9, PCT/EP2019/066419, PCT/J/2020–570,837.BS: received grants or contracts from Pfizer; received consulting fees from Abbvie, Abivax, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Endpoint Health, Falk Pharma, Galapagos, Gilead, Janssen, Landos, Lilly, Pfizer, and Takeda; received payment /honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from Abbvie, BMS, CED Service GmbH, Eli Lilly, Falk Pharma, Ferring, Galapagos, Janssen, Lilly, Pfizer, and Takeda.DP: received consulting fees from AbbVie, Biocad, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, MSD, Moonlake, Novartis, Pfizer, Samsung Bioepis and UCB; received payment /honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, MSD, Medscape, Novartis, Peervoice, Pfizer and UCB., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
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