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2. LASER FLARE PHOTOMETRY IN PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: An Evaluation of 2,487 Cases

Author

Gietzelt, Caroline, Hoerster, Robert, Schiller, Petra, Hermann, Saskia, Kraus, Daria, Holz, Frank G., Guthoff, Rainer, Agostini, Hansjürgen, Spitzer, Martin S., Wiedemann, Peter, Lommatzsch, Albrecht, Boden, Karl T., Bartz-Schmidt, Ulrich, Bemme, Sebastian, Tamm, Svenja, Maier, Mathias, Roider, Johann, Kirchhof, Bernd, Fauser, Sascha, Schaub, Friederike, Altay, Lebriz, Bartz-Schmidt, Karl Ulrich, Callizo, Josep, Dahlke, Claudia, Dimopoulos, Spyridon, Eberwein, Philipp, Ehlken, Christoph, Enders, Philip, Feltgen, Nicolas, Gamulescu, Andreea, Gelisken, Faik, Gutfleisch, Matthias, Haus, Arno, Helbig, Horst, Hermann, Manuel, Januschowski, Kai, Jochmann, Claudia, Kaya, Sema, Kirchhof, Bernd, Krohne, Tim, Lagrèze, Wolf, Lange, Clemens, Lohmann, Chris, Lommatzsch, Albrecht, Macek, Marc Andrej, Maier, Mathias, Märker, David, Mayer, Christian, Meier, Petra, Menzel-Severing, Johannes, Molnar, Fanni, Müther, Philipp, Prahs, Philipp, Purtskhvanidze, Konstantine, Rehak, Matus, Rickmann, Annekatrin, Schick, Tina, Schmitz-Valckenberg, Steffen, Schultheiß, Maximilian, Schweig, Alexandra, Skevas, Christos, Stahl, Andreas, Szurman, Peter, Unterlauft, Jan Darius, Wakili, Philip, and Wozar, Fabian

Published
2024
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5. Intravitreal 5-Fluorouracil and Heparin to Prevent Proliferative Vitreoretinopathy: Results from a Randomized Clinical Trial

Author

Pfeiffer, Andrea, Willms, Sandra, Binder, Susanne, Le Mer, Yannik, Stützer, Hartmut, Lemmen, Klaus-Dieter, Heimke-Brinck, Ralph, Borst, Tobias, Bartz-Schmidt, Karl Ulrich, Callizo, Josep, Dahlke, Claudia, Eberwein, Philipp, Ehlken, Christoph, Feltgen, Nicolas, Gamulescu, Andreea, Gelisken, Faik, Gutfleisch, Matthias, Haus, Arno, Helbig, Horst, Hermann, Manuel, Januschowski, Kai, Jochmann, Claudia, Krohne, Tim, Lagrèze, Wolf, Lange, Clemens, Lohmann, Chris, Macek, Marc Andrej, Märker, David, Mayer, Christian, Meier, Petra, Müther, Philipp, Prahs, Philipp, Purtskhvanidze, Konstantine, Rehak, Matus, Schaub, Friederike, Schick, Tina, Schmitz-Valckenberg, Steffen, Schultheiß, Maximilian, Skevas, Christos, Stahl, Andreas, Szurman, Peter, Unterlauft, Jan Darius, Hellmich, Martin, Kuhr, Katrin, Schiller, Petra, Hoerster, Robert, Kraus, Daria, Holz, Frank G., Guthoff, Rainer, Agostini, Hansjürgen, Spitzer, Martin S., Wiedemann, Peter, Lommatzsch, Albrecht, Boden, Karl T., Dimopoulos, Spyridon, Bemme, Sebastian, Tamm, Svenja, Maier, Mathias, Roider, Johann, Enders, Philip, Altay, Lebriz, Fauser, Sascha, and Kirchhof, Bernd

Published
2022
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6. Normalized Reflectivity of Middle Limiting Membrane on SD-OCT: A Measure of Acute Ischemia in CRVO.

Author

Bemme, Sebastian, Büchel, Sheila, Hoerauf, Hans, Feltgen, Nicolas, and van Oterendorp, Christian

Subjects
*RETINAL vein occlusion, *OPTICAL coherence tomography, *VISION, *RHODOPSIN, *NEOVASCULARIZATION
Abstract

AbstractPurposeMethodsResultsConclusionsTo validate the quantification of the prominent middle limiting membrane (PMLM) sign, a marker of mild-to-moderate acute ischemic damage on optical coherence tomography (OCT), by measuring middle limiting membrane (MLM) reflectivity in patients with central retinal vein occlusion (CRVO) and to investigate the prognostic impact of this measure.Spectral Domain (SD)-OCT B-scans of 30 patients with CRVO, either sole CRVO or combined central retinal artery and vein occlusion (CCRAVO), were analyzed retrospectively and graded as PMLM present or absent. Normalized MLM reflectivity was calculated as a ratio of the maximum reflectivity within a MLM target layer and the average reflectivity of the retinal pigment epithelium (RPE).Discrimination between OCT B-scans graded as PMLM present or absent based on ROC analysis was far superior with normalized MLM reflectivity (AUC >0.90) than using MLM reflectivity without normalization (AUC = 0.70). Normalized MLM reflectivity was significantly higher in study eyes than healthy fellow eyes as well as in patients with CCRAVO versus sole CRVO. Although normalized MLM reflectivity correlated significantly with baseline and outcome BCVA, we found no significant difference comparing patients with ischemic CRVO versus non-ischemic CRVO.Quantifying MLM reflectivity requires normalization due to shadowing, which is usually caused by retinal haemorrhages in CRVO. RPE reflectivity proved to be a suitable reference layer. Greater normalized MLM reflectivity as a measure of mild-to-moderate acute ischemic damage indicated a worse prognosis regarding visual function in CRVO, however, it allows no risk assessment regarding the development of capillary non-perfusion or anterior segment neovascularization. [ABSTRACT FROM AUTHOR]

Published
2025
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12. Treated Cases of Retinopathy of Prematurity in Germany

Author

Pfeil, Johanna M., Barth, Teresa, Lagrèze, Wolf A., Lorenz, Birgit, Hufendiek, Karsten, Liegl, Raffael, Breuss, Helge, Bemme, Sebastian, Aisenbrey, Sabine, Glitz, Barbara, Süsskind, Daniela, Gabel-Pfisterer, Ameli, Skevas, Christos, Krohne, Tim U., Kakkassery, Vinodh, Bründer, Marie-Christine, Engelmann, Katrin, Guthoff, Rainer, Walter, Peter, Choritz, Lars, Stahl, Andreas, Michalewicz, Emilia, Baumgarten, Sabine, Lohmann, Tibor, Walter, Peter, Breuß, Helge, Retzlaff, Annekatrin, Bödemann, Melanie, Liegl, Marian, El Moussaoui, Laila, Aisenbrey, Sabine, Saßmannshausen, Marlene, Liegl, Raffael, Engelmann, Katrin, Goldammer, Imke, Fleischer, Ulrike, Ander, Annika, Tietz, Martin, Wienigk, Anja, Li, Jeany Q., Krohne, Tim U., Guthoff, Rainer, Khamees, Ala, Kaya, Sema, Höhn, Thomas, Lohmeier, Klaus, Franzel, Julia, Busik, Valentina, Mais, Christine, Bemme, Sebastian, Khattab, Mohammed, Lauermann, Peer, Meyer, Yulia, Dieks, Jana Katharina, Bründer, Marie-Christine, Grundel, Bastian, Grundel, Milena, Paul, Sebastian, Stahl, Andreas, Tayar, Allam, Heckmann, Matthias, Bahlmann, Hagen, Linnemann, Knud, Skevas, Christos, Hagenau, Felix, Spitzer, Martin, Herden, Jonas, Gröber, Thomas, Haar, Melanie, Mester, Nils, Brockmann, Dorothee, Tode, Jan, Hufendiek, Karsten, Framme, Carsten, Bohnhorst, Bettina, Böhne, Carolin, Peter, Corinna, Pirr, Sabine, Brosig, Anton, Gniesmer, Stefanie, Grisanti, Salvatore, Lüken, Sabine, Piria, Roya, Prasuhn, Michelle, Ranjbar, Mahdy, Rommel, Felix, Schiemenz, Christian, Kakkassery, Vinodh, Heckert, Anni, Choritz, Lars, Glitz, Barbara, Eter, Nicole, Falkenau, Silvia, Gabel-Pfisterer, Ameli, Lindenberg, Ann-Sophie, Mathias, Altmann, Barth, Teresa, Benedikt, Blüml, Isabel, Oberacher-Velten, Patrick, Peters, Herbert, Jägle, Horst, Helbig, Stephan, Döring, Anette, Keller-Wackerbauer, Jochen, Kittel, Holger, Michel, Hugo, Segerer, Sven, Wellmann, Süsskind, Daniela, Partsch, Michael, Völker, Michael, and Hagemann, Ulrike

Abstract

To analyze changes in demographic parameters and retreatment patterns over a 10-year period in a clinical routine setting of infants with retinopathy of prematurity (ROP) requiring treatment documented in the German Retina.net ROP registry.

Published
2024
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20. Intravitreal 5-Fluorouracil and Heparin to Prevent Proliferative Vitreoretinopathy

Author

Schaub, Friederike, primary, Schiller, Petra, additional, Hoerster, Robert, additional, Kraus, Daria, additional, Holz, Frank G., additional, Guthoff, Rainer, additional, Agostini, Hansjürgen, additional, Spitzer, Martin S., additional, Wiedemann, Peter, additional, Lommatzsch, Albrecht, additional, Boden, Karl T., additional, Dimopoulos, Spyridon, additional, Bemme, Sebastian, additional, Tamm, Svenja, additional, Maier, Mathias, additional, Roider, Johann, additional, Enders, Philip, additional, Altay, Lebriz, additional, Fauser, Sascha, additional, Kirchhof, Bernd, additional, Pfeiffer, Andrea, additional, Willms, Sandra, additional, Binder, Susanne, additional, Le Mer, Yannik, additional, Stützer, Hartmut, additional, Lemmen, Klaus-Dieter, additional, Heimke-Brinck, Ralph, additional, Borst, Tobias, additional, Bartz-Schmidt, Karl Ulrich, additional, Callizo, Josep, additional, Dahlke, Claudia, additional, Eberwein, Philipp, additional, Ehlken, Christoph, additional, Feltgen, Nicolas, additional, Gamulescu, Andreea, additional, Gelisken, Faik, additional, Gutfleisch, Matthias, additional, Haus, Arno, additional, Helbig, Horst, additional, Hermann, Manuel, additional, Januschowski, Kai, additional, Jochmann, Claudia, additional, Krohne, Tim, additional, Lagrèze, Wolf, additional, Lange, Clemens, additional, Lohmann, Chris, additional, Macek, Marc Andrej, additional, Märker, David, additional, Mayer, Christian, additional, Meier, Petra, additional, Müther, Philipp, additional, Prahs, Philipp, additional, Purtskhvanidze, Konstantine, additional, Rehak, Matus, additional, Schaub, Friederike, additional, Schick, Tina, additional, Schmitz-Valckenberg, Steffen, additional, Schultheiß, Maximilian, additional, Skevas, Christos, additional, Stahl, Andreas, additional, Szurman, Peter, additional, Unterlauft, Jan Darius, additional, Hellmich, Martin, additional, and Kuhr, Katrin, additional

Published
2022
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22. Das modifizierte Treat-and-Extend-Schema mit Injektionsblöcken in der IVOM-Therapie

Author

Take, Patricia, Dittmann, Carolin Alisa, Mackerodt, Laura, Callizo, Josep, Striebe, Nina-Antonia, Hoerauf, Hans, Feltgen, Nicolas, and Bemme, Sebastian

Subjects
Diabetic Retinopathy, Age-related macular degeneration, Anti-VEGF, Angiogenesis Inhibitors, Originalien, Macular Edema, Retinal vein occlusion, Treatment Outcome, Treat and extend, Diabetic macular edema, Treat-and-Extend, Retinaler Venenverschluss, Intravitreal Injections, Humans, Altersbedingte Makuladegeneration, Diabetisches Makulaödem, Tomography, Optical Coherence, Follow-Up Studies, Retrospective Studies
Abstract

Regular treatment with intravitreal operative medication injections (IVOM) and the associated frequent check-ups are a major challenge for many patients, which can lead to treatment discontinuation. The aim of the modified treat and extend (TAE) in blocks scheme is to achieve stable retinal and visual outcomes with as few control visits as possible and thus to minimize the burden for the individual patient.This monocentric retrospective study examined the treatment courses of 387 patients with neovascular age-related macular degeneration, diabetic macular edema and retinal vein occlusion, who were treated by three blocks of intravitreal injections in the TAE regimen. The primary endpoint was achieving an injection interval of 12 weeks.Intravitreal injections in TAE blocks significantly reduced retinal thickness and improved visual acuity. On average, a treatment interval of 2 months was achieved across the various indications.Intravitreal injections in TAE blocks of three injections can reduce patients' burden and lead to stable retinal and visual results.Die regelmäßige Therapie mittels intravitrealer operativer Medikamentenapplikation (IVOM) und die damit verbundenen Kontrolluntersuchungen stellen für viele Patienten eine große Herausforderung dar, die bis zum Behandlungsabbruch führen kann. Das modifizierte blockweise Treat-and-Extend(TAE)-Schema verfolgt das Ziel, mit möglichst wenigen Kontrollvisiten stabile Netzhaut- und Visusbefunde zu erreichen und dadurch die Belastung der Patienten zu minimieren.Diese monozentrische retrospektive Studie untersuchte Behandlungsverläufe von insgesamt 387 Patienten mit neovaskulärer altersbedingter Makuladegeneration (AMD), diabetischem Makulaödem (DMÖ), Venenastverschluss (VAV) und Zentralvenenverschluss (ZVV), bei denen das TAE-Regime jeweils in 3er-Blöcken angewendet wurde. Primärer Endpunkt war das Erreichen eines Injektionsintervalls von 12 Wochen.Durch die blockweise applizierte IVOM konnte die Netzhautdicke signifikant reduziert und der Visus verbessert werden. Über die verschiedenen Indikationen konnte im Mittel ein Behandlungsintervall von 2 Monaten erreicht werden.Ein in 3er-Blöcken angepasstes TAE-Schema im Rahmen der IVOM kann bei reduzierter Patientenbelastung zu stabilen Netzhaut- und Visusbefunden führen.

Published
2020

23. Intravitreal 5-Fluorouracil and Heparin to Prevent Proliferative Vitreoretinopathy Results from a Randomized Clinical Trial

Author

Schaub, Friederike, Schiller, Petra, Hoerster, Robert, Kraus, Daria, Holz, Frank G., Guthoff, Rainer, Agostini, Hansjurgen, Spitzer, Martin S., Wiedemann, Peter, Lommatzsch, Albrecht, Boden, Karl T., Dimopoulos, Spyridon, Bemme, Sebastian, Tamm, Svenja, Maier, Mathias, Roider, Johann, Enders, Philip, Altay, Lebriz, Fauser, Sascha, Kirchhof, Bernd, Schaub, Friederike, Schiller, Petra, Hoerster, Robert, Kraus, Daria, Holz, Frank G., Guthoff, Rainer, Agostini, Hansjurgen, Spitzer, Martin S., Wiedemann, Peter, Lommatzsch, Albrecht, Boden, Karl T., Dimopoulos, Spyridon, Bemme, Sebastian, Tamm, Svenja, Maier, Mathias, Roider, Johann, Enders, Philip, Altay, Lebriz, Fauser, Sascha, and Kirchhof, Bernd

Abstract

Purpose: Proliferative vitreoretinopathy (PVR) is the major cause for surgical failure after primary rhegmatogenous retinal detachment (RRD). So far, no therapy has been proven to prevent PVR. Promising results for 5-fluorouracil (5-FU) and low-molecular weight heparin (LMWH) in high-risk eyes have been reported previously. The objective of this trial was to examine the effect of adjuvant intravitreal therapy with 5-FU and LMWH compared with placebo on incidence of PVR in high-risk patients with primary RRD. Design: Randomized, double-blind, controlled, multicenter, interventional trial with 1 interim analysis. Participants: Patients with RRD who were considered to be at high risk for PVR were included. Risk of PVR was assessed by noninvasive aqueous flare measurement using laser flare photometry. Methods: Patients were randomized 1:1 to verum (200 mg/ml 5-FU and 5 IU/ml dalteparin) and placebo (balanced salt solution) intravitreally applied during routine pars plana vitrectomy. Main Outcome Measures: Primary end point was the development of PVR grade CP (full-thickness retinal folds or subretinal strands in clock hours located posterior to equator) 1 or higher within 12 weeks after surgery. For grading, an end point committee assessed fundus photographs. Secondary end points included bestcorrected visual acuity and redetachment rate. A group sequential design with 1 interim analysis was applied using the O'Brien and Fleming boundaries. Proliferative vitreoretinopathy grade CP incidence was compared using a Mantel-Haenszel test stratified by surgeon. Results: A total of 325 patients in 13 German trial sites had been randomized (verum, n = 163; placebo, n = 162). In study eyes, mean laser flare was 31 +/- 26 pc/ms. No significant difference was found in PVR rate. Primary analysis in the modified intention-to-treat population results were: verum 28% vs. placebo 23% (including not assessable cases as failures); odds ratio [OR], 1.25; 95% confidence interval [CI], 0.76

Published
2022

26. Incidence and risk factors for macular oedema after primary rhegmatogenous retinal detachment surgery: a prospective single‐centre study.

Author

Gebler, Marie, Pfeiffer, Sebastian, Callizo, Josep, Hoerauf, Hans, Feltgen, Nicolas, and Bemme, Sebastian

Subjects
MACULAR edema, RETINAL detachment, RETINAL surgery, OPTICAL coherence tomography, LONGITUDINAL method, CATARACT surgery
Abstract

Purpose: To assess the incidence of cystoid macular oedema (CME) diagnosed by spectral domain optical coherence tomography (SD‐OCT) after primary rhegmatogenous retinal detachment (RRD) surgery. Methods: From April 2016 to October 2017, 150 eyes of 150 patients presenting with primary RRD were included consecutively in this prospective single‐centre study. Patients with the following characteristics were excluded: previous vitreoretinal surgery, combined cataract surgery, preoperatively presentation with any intraocular or systemic inflammatory condition, visible macular oedema or epiretinal membrane (ERM) on funduscopy. SD‐OCT (Spectralis, Heidelberg Engineering) was conducted 3 and 6 weeks after surgery. Results: One hundred and twenty‐eight of the 150 patients completed the study, of whom 107 (age: 61.7 ± 11.5 years, mean ± SD) showed successful retinal attachment during follow‐up visits. The most frequent operation method was scleral buckling (54.2%), followed by vitrectomy (25.2%) and the combination of both techniques (20.6%). Postoperative SD‐OCT revealed CME, neurosensory detachment and ERM in 18.7, 31.8 and 32.7% of all cases, respectively. The risk of postoperative CME was significantly elevated in patients with ERM (42.9 versus 6.9%, p < 0.001). In addition, patients with initial detachment of the macula had more postoperative CME (26.5 versus 11.1%, p = 0.044). BCVA improvement was significantly lower in patients with CME compared to patients without 6 weeks after surgery for macula‐on RRD. Conclusions: This prospective study confirmed that postoperative CME is a frequent complication after RRD surgery; we identified ERM and macula‐off RRD as potential risk factors. As CME potentially delays visual recovery, postoperative follow‐ups should include SD‐OCT. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Distance-Thresholded Intercapillary Area Analysis Versus Vessel-Based Approaches to Quantify Retinal Ischemia in OCTA

Author

Lauermann, Peer, van Oterendorp, Christian, Storch, Marcus W., Khattab, Mohammed H., Feltgen, Nicolas, Hoerauf, Hans, and Bemme, Sebastian

Subjects
retina, Articles, OCT-angiography, ischemia
Abstract

Purpose: To develop and compare different analytic approaches for quantifying ischemia in OCT-angiography (OCTA), including vessel-based approaches and intercapillary area analysis. Methods: En face OCTA (6 × 6) images of the superficial plexus of 20 healthy eyes and 20 eyes with different ischemic retinal diseases were analyzed retrospectively. Included retinal diseases were diabetic retinopathy (n = 9), central (n = 5) and branch retinal vein occlusion (n = 4), hypertensive retinopathy (n = 1), and occlusive retinal vasculitis in sarcoidosis (n = 1). Vessel-based approaches consisted of the mean gray scale, perfusion density, and vessel density. Intercapillary areas (ICAs) were analyzed measuring the distance of each intercapillary pixel from the surrounding vessels. In particular, we applied a vector method to measure the shortest, the mean, and the longest distance in eight predefined directions. Size of ICAs was determined applying different global or local distance thresholds. Results: All approaches revealed significant differences between ischemic and healthy retinae (P < 0.001, with Bonferroni-Holm correction P = 0.001-0.025; Wilcoxon-Mann-Whitney test). Discrimination between the healthy and ischemic retinae based on ROC curves was best in the ICA analysis using a locally set threshold of the shortest distance. Conclusions: In the present study, ICA analysis was superior to vessel-based approaches in the quantification of retinal ischemia when defining a local or global distance threshold. Translational Relevance: In order to establish OCTA imaging in everyday clinical and scientific practice, standardized, device-independent image analysis methods are necessary. Open-Access-Publikationsfonds 2019 peerReviewed

Published
2019

33. The German ROP Registry: data from 90 infants treated for retinopathy of prematurity.

Author

Walz, Johanna M., Bemme, Sebastian, Pielen, Amelie, Aisenbrey, Sabine, Breuß, Helge, Alex, Anne F., Wagenfeld, Lars, Schiedel, Susanne, Krohne, Tim U., Stahl, Andreas, Akman, Stella H., Bajor, Anna, Biermann, Julia, Bohnhorst, Bettina, Brockmann, Dorothee, Diehl, Thilo Alexander, Eter, Nicole, Feltgen, Nicolas, Framme, Carsten, and Gesser, Caroline

Subjects
*RETROLENTAL fibroplasia, *EPIDEMIOLOGY, *OPHTHALMOLOGY, *LASER therapy, *VASCULAR endothelial growth factors, *THERAPEUTICS
Abstract

Purpose The German retinopathy of prematurity ( ROP) Registry collects data on treated ROP in a multicentre approach to analyse epidemiology and treatment patterns of severe ROP. Methods Nine centres entered data from 90 treated ROP infants (born between January 2011 and December 2013) into a central database. Analysis included incidence rate of severe ROP, demographic data, stage of ROP, treatment patterns, recurrence rates, relevant comorbidities and ophthalmological or systemic complications associated with treatment. Results Treatment rate for ROP was 3.2% of the screened population. The most frequent ROP stage at time of treatment was zone II, stage 3 + (137 eyes). Treatment was bilateral in 97% of infants. Treatment patterns changed over time from 7% anti-vascular endothelial growth factor (VEGF) monotherapy in 2011 to 32% in 2014. Overall, laser treatment was the predominant treatment. However, all infants with zone I disease received anti- VEGF treatment. About 19% of infants required retreatment (16% of laser-treated and 21% of anti- VEGF treated infants). Mean time between first and second treatment was 3.8 weeks (± 11 days) for laser-treated and 10.4 weeks (± 60 days) for anti- VEGF-treated infants. Conclusion This study is the first multicentre analysis of severe ROP in Germany. The identified treatment patterns find laser as the most prevalent form of therapy, with an increasing use of anti- VEGF therapy over recent years. Recurrence rates were relatively high overall with slightly higher recurrence rates and later recurrence times in the anti- VEGF group. Anti- VEGF was predominantly used for high-risk stages like AP- ROP and zone I disease. [ABSTRACT FROM AUTHOR]

Published
2016
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