Purpose: To quantify outer retina structural changes and define novel biomarkers of inherited retinal degeneration associated with biallelic mutations in RPE65 (RPE65-IRD) in patients before and after subretinal gene augmentation therapy with voretigene neparvovec (Luxturna).
Methods: Application of advanced deep learning for automated retinal layer segmentation, specifically tailored for RPE65-IRD. Quantification of five novel biomarkers for the ellipsoid zone (EZ): thickness, granularity, reflectivity, and intensity.
Purpose: The relative ellipsoid zone reflectivity (rEZR) is an innovative biomarker for photoreceptor alterations and showed association with disease staging in macular telangiectasia type 2 (MacTel). However, its prognostic relevance for the ellipsoid zone (EZ) loss is unclear.
Methods: Longitudinal spectral-domain optical coherence tomography (SD-OCT) imaging of patients with MacTel from an observational natural history study was used for en face determination of manifest EZ loss.
Background/aims: Bleb characteristics in the area around the plate following glaucoma drainage device (GDD) surgery are difficult to evaluate on slit lamp examination. Ultrasound sonography could be used for more detailed visualisation. The aim of this study was to describe bleb configuration after PAUL glaucoma implant (PGI) surgery and evaluate the possible correlation with intraocular pressure (IOP) in order to derive new markers for evaluating GDD function.
View Article and Find Full Text PDFGraefes Arch Clin Exp Ophthalmol
December 2024
Aim: To evaluate a useful, non-contact method for the follow-up of pericardium patch graft changes in patients undergoing PAUL Glaucoma Implant (PGI) surgery using high-resolution anterior segment optical coherence tomography (OCT) to predict tube erosions.
Methods: Prospective analysis over six months of tube pericardium patch graft thickness of PGI surgical cases at the University Eye Hospital Bonn, Germany, from November 2021 to August 2022. In all eyes, Tutopatch (RTI Surgical, United States) pericardium was used to cover the implant intra-operatively.
Prog Neuropsychopharmacol Biol Psychiatry
December 2024
Clinically, patients with depression are at a heightened risk for developing epilepsy, and vice versa, suggesting shared mechanisms for this bidirectional comorbidity. Unfortunately, comorbid depression and epilepsy is associated with worsened quality of life and treatment refractoriness, highlighting the need for novel treatment targets and nonpharmacologic supplements to existing therapies. The present study used the Swim-Low Active rat, a well-validated model of depression and epilepsy comorbidity that was selectively bred based on forced swim test behavior, to assess the safety and efficacy of caloric restriction in treating this comorbidity.
View Article and Find Full Text PDFForensic Sci Med Pathol
October 2024
Unusual findings during an autopsy may come from peculiarities in the position, shape, size, weight, consistency, smell or color of organs. The following study was triggered by an autopsy case in which an unusual blue-green discoloration of organs, which changed during the autopsy, was noticed. A review of the local autopsy database, selected cases including the antemortem clinical documentation and the literature has been performed to clarify the etiology of these conspicuous discolorations and to evaluate their diagnostic value.
View Article and Find Full Text PDFFor disaster victim identification, hundreds of samples of human remains have to be extracted from human bodies rapidly for later DNA analysis, often in situation with high humidity, high temperature and no access to cooling facilities. Genetic typing of these samples may be challenging due to degradation of DNA. Until today, bone and teeth are the preferred biological matrix for genetic identification of decomposed human remains.
View Article and Find Full Text PDFGeographic atrophy (GA), the non-neovascular advanced form of age-related macular degeneration, remains an important disease area in which treatment needs are currently unmet. Recent clinical trials using drugs that target the complement pathway have shown modest yet consistent reductions in GA expansion but without commensurate changes in measures of visual function. In this review, we summarize information from the wide range of studies describing the characteristics of GA morphology and enumerate the factors influencing the growth rates of lesions and the directionality of expansion.
View Article and Find Full Text PDFBackground: In view of the predicted increase in incidence and prevalence of chronic retinal diseases and undersupply of care in the population, telemedicine could contribute to reducing access barriers to healthcare and improving the results of treatment.
Objective: A literature review on remote monitoring of chronic retinal diseases was carried out.
Material And Methods: The medical literature was searched for publications on remote monitoring of chronic retinal diseases.
Purpose: The purpose of this study was to develop a deep learning algorithm for detecting and quantifying incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) and complete retinal pigment epithelium and outer retinal atrophy (cRORA) in optical coherence tomography (OCT) that generalizes well to data from different devices and to validate in an intermediate age-related macular degeneration (iAMD) cohort.
Methods: The algorithm comprised a domain adaptation (DA) model, promoting generalization across devices, and a segmentation model for detecting granular biomarkers defining iRORA/cRORA, which are combined into iRORA/cRORA segmentations. Manual annotations of iRORA/cRORA in OCTs from different devices in the MACUSTAR study (168 patients with iAMD) were compared to the algorithm's output.
Purpose: Specific genetic factors might serve as markers for risk stratification of AMD progression, but their association with key features of AMD has not been fully elucidated. Thus, we investigated the association between overall and pathway-specific genetic risk scores (GRS) and lead loci () with AMD stages and features of high-risk nonlate AMD, including reticular pseudodrusen (RPD) and large drusen area (LDA).
Methods: We performed a cross-sectional analysis of data from the Rhineland Study, a population-based study in Bonn, Germany.
Health Qual Life Outcomes
August 2024
Background: The use of patient-reported outcome measures (PROMs) in clinical research increases and use of heterogeneous instruments reflects how well diverse traits are captured by a medical specialty. In order to reflect the heterogeneity of current PROM use in ophthalmology, we reviewed the available literature.
Methods: The medical literature database Web of Science was searched for the most cited articles in clinical ophthalmology.
Background: The Masterplan Medicine 2020 adopted in 2017 entails many changes to the medical studies curriculum. The new structure affects the content of the coursework and its main focus. A major goal of this masterplan is to prepare young physicians by teaching the skills that are essential for the future profession.
View Article and Find Full Text PDFAdvances in imaging and artificial intelligence (AI) have revolutionized the detection, quantification and monitoring for the clinical assessment of intermediate age-related macular degeneration (iAMD). The iAMD incorporates a broad spectrum of manifestations, which range from individual small drusen, hyperpigmentation, hypopigmentation up to early stages of geographical atrophy. Current high-resolution imaging technologies enable an accurate detection and description of anatomical features, such as drusen volumes, hyperreflexive foci and photoreceptor degeneration, which are risk factors that are decisive for prediction of the course of the disease; however, the manual annotation of these features in complex optical coherence tomography (OCT) scans is impractical for the routine clinical practice and research.
View Article and Find Full Text PDFThe first regulatory approval of treatment for geographic atrophy (GA) secondary to age-related macular degeneration in the USA constitutes an important milestone; however, due to the nature of GA as a non-acute, insidiously progressing pathology, the ophthalmologist faces specific challenges concerning risk stratification, making treatment decisions, monitoring of treatment and patient education. Innovative retinal imaging modalities, such as fundus autofluorescence (FAF) and optical coherence tomography (OCT) have enabled identification of typical morphological alterations in relation to GA, which are also suitable for the quantitative characterization of GA. Solutions based on artificial intelligence (AI) enable automated detection and quantification of GA-specific biomarkers on retinal imaging data, also retrospectively and over time.
View Article and Find Full Text PDFDrusen and drusenoid deposits are a hallmark of age-related macular degeneration (AMD). Nowadays, a multimodal retinal imaging approach enables the detection of these deposits. However, quantitative data on subretinal drusenoid deposits (SDDs) are still missing.
View Article and Find Full Text PDFLesions of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) are associated with disease progression in age-related macular degeneration. However, the corresponding functional impact of these precursor lesions is unknown.We present a cross-sectional study of four patients employing clinical-grade MAIA (stimulus size: 0.
View Article and Find Full Text PDFPrcis: This prospectively collected case series of 56 eyes having PAUL glaucoma implant (PGI) surgery is the first to demonstrate its medium-term safety and effectiveness in what is essentially an exclusively Caucasian population.
Background: To report 2-year outcomes from a single-center cohort undergoing PGI surgery.
Methods: Prospectively collected data on patients undergoing PGI surgery at the University Eye Hospital Bonn, Germany, from April 2021 to September 2021.