Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 68
Filter
2.
Ophthalmologie ; 120(2): 178-183, 2023 Feb.
Article in German | MEDLINE | ID: mdl-35925354

ABSTRACT

BACKGROUND: Bottlenecks in drug supply in the field of ophthalmological are continuously increasing in Germany. So far, these have hardly been communicated and discussed. We see the transparent presentation of the problem as a first step in compiling concepts to counteract this development. AIM OF THE WORK: Presentation of the supply shortages in ophthalmological drugs. MATERIAL AND METHODS: A listing and discussion of the shortages in drug supply to the best of our knowledge are presented. RESULTS: We distinguish between the problems in (1) supply shortages, (2) discontinuation of production, (3) lack of availability in Germany and (4) manufacture of drugs in specialized pharmacies often lacking approval for the ophthalmological indications. DISCUSSION: The reasons for drug supply shortages in ophthalmology are complex and therefore no easy solutions can be expected; however, industrial and regulatory authorities at the national and European levels are called upon to analyze the underlying problems and to find appropriate solutions.


Subject(s)
Ophthalmology , Universities , Germany , Industry
5.
Graefes Arch Clin Exp Ophthalmol ; 260(4): 1415-1425, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34709452

ABSTRACT

PURPOSE: The lacrimal caruncle is composed of numerous structures including different glands as well as hair follicles. Accordingly, the spectrum of benign and malignant lesions is broad, and the clinical diagnosis is often challenging. Here we systematically analyzed excised caruncular tumors over the past 22 years with special emphasis on the clinico-pathological correlation to provide a guidance for clinicians. METHODS: Retrospective evaluation with clinico-pathologic correlation of surgically removed caruncular tumors between 1998 and 2020 at a tertiary referral center. RESULTS: Eighty-two caruncular tumors were identified in the respective period. The patients were between 11 and 85 years of age (mean, 46.8 years; median, 49 years). Nevi (n = 35), cystic lesions (n = 14), oncocytoma (n = 9), papilloma (n = 8), sebaceous gland hyperplasia (n = 8), and reactive lymphoid hyperplasia (n = 4) were observed most frequently. Besides, we are the first reporting herniated orbital fat accompanied by a pyogenic granuloma. 2.4% (n = 2) were malignant tumors (sebaceous gland carcinoma, conjunctival intraepithelial neoplasia with pyogenic granuloma). CONCLUSION: Caruncular tumors show a broad spectrum of mostly benign tumors. They can occur in patients of any age. However, 8/9 oncocytomas and both malignant lesions were detected in patients older than 60 years. Although the clinical diagnosis was confirmed in only 68.3% by the histopathological analysis, the two malignant lesions were identified as such already clinically. Caruncular lesions with a history of growth or other signs of malignancy should be excised followed by detailed histopathological examination to allow a final diagnosis and exclude rare malignant tumors with lethal potential.


Subject(s)
Sebaceous Gland Neoplasms , Skin Neoplasms , Hospitals , Humans , Middle Aged , Retrospective Studies , Sebaceous Gland Neoplasms/pathology , Universities
6.
Clin Genet ; 94(3-4): 398, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30199087
7.
Clin Genet ; 93(5): 952-961, 2018 05.
Article in English | MEDLINE | ID: mdl-28902406

ABSTRACT

Uveal melanoma (UM) is the most frequent primary intraocular tumor in Caucasian adults and is potentially fatal if metastases develop. While several prognostic genetic changes have been identified in UM, epigenetic influences are now getting closer attention. Recent technological advances have allowed to exam the human genome to a greater extent and have improved our understanding of several diseases including malignant tumors. In this context, there has been tremendous progress in the field of UM pathogenesis. Herein, we review the literature with emphasis on genetic alterations, epigenetic modifications and signaling pathways as well as possible biomarkers in UM. In addition, different research models for UM are discussed. New insights and major challenges are outlined in order to evaluate the current status for this potentially devastating disease.


Subject(s)
Biomarkers, Tumor/genetics , Epigenomics , Genome, Human/genetics , Melanoma/genetics , Uveal Neoplasms/genetics , Humans , Melanoma/pathology , Prognosis , Signal Transduction , Uveal Neoplasms/pathology
8.
Ophthalmologe ; 115(2): 107-113, 2018 02.
Article in German | MEDLINE | ID: mdl-29270640

ABSTRACT

Dry eye syndrome and blepharitis are diseases that affect many patients from different age groups. There is not only a great variability in the manifestation between patients but they also show a mixture of associated symptoms. Thus, very different ocular and systemic diseases have to be included in the differential diagnosis of a primary dry eye disorder. This article provides a structured overview of these differential diagnoses and their characteristic appearance as well as the pitfalls and therapeutic options.


Subject(s)
Blepharitis , Diagnosis, Differential , Dry Eye Syndromes , Humans
10.
Pathologe ; 38(4): 231-240, 2017 Jul.
Article in German | MEDLINE | ID: mdl-28455614

ABSTRACT

The investigation of fetal eyes is a subspecialty, which is performed by only a few ophthalmic pathologists and pathologists in specialized centers. If a certain fetal syndrome is suspected, the fetal eyes should be removed and submitted for ophthalmic pathological investigation in a specialized center. This can provide additional diagnostic information allowing a final classification of a syndrome and the comprehensive genetic counselling of parents with respect to future pregnancies. This article provides an overview of the histopathological findings in fetal eyes, which are of particular relevance for the pediatric pathological autopsy. In addition, the basic points of ocular development, the preparation of fetal eyes and frequent artifacts are presented.


Subject(s)
Eye Diseases/embryology , Eye Diseases/pathology , Eye/embryology , Eye/pathology , Fetal Diseases/pathology , Eye Diseases/genetics , Female , Fetal Diseases/genetics , Genetic Counseling , Humans , Infant, Newborn , Pregnancy , Specialization , Syndrome
11.
Ophthalmologe ; 114(11): 1027-1030, 2017 Nov.
Article in German | MEDLINE | ID: mdl-27999931

ABSTRACT

A 67-year old patient presented with persistent wound dehiscence after evisceration. The scleral shell and the implant were removed. The histopathological and immunohistochemical examination of the tumor revealed epithelial ingrowth and infection of the implant. Even if the intervention is known since the 16th century, technics and materials are still undergoing improvements and discussions. Incarceration or tension on the suture should be avoided in order to prevent secondary complications.


Subject(s)
Epithelium/pathology , Epithelium/surgery , Eye Evisceration , Orbital Implants , Postoperative Complications/surgery , Prosthesis-Related Infections/surgery , Re-Epithelialization/physiology , Aged , Female , Humans , Postoperative Complications/pathology , Prosthesis-Related Infections/pathology , Sclera/pathology , Sclera/surgery
12.
Ophthalmologe ; 114(3): 224-236, 2017 Mar.
Article in German | MEDLINE | ID: mdl-27752782

ABSTRACT

The treatment options for basal cell carcinoma (BCC) have recently been augmented with the introduction of novel chemotherapeutic drugs. New S2 guidelines on the disease have also been published. The aim of this article is to present a comprehensive state of the art description of the features of ocular BCC and an overview of the various therapeutic options. Particular emphasis is placed on the clinical signs, the diagnostic tools to identify periocular BCC and interpretation of the different histopathological subtypes. Tumor staging, TNM classification, interdisciplinary tumor conference reviews as well as psycho-oncological services play an important role in patients with pronounced periocular BCC. Surgical removal with a histological R0 resection is an important component of therapy options in this disease and includes the microsurgical excision into healthy tissue and the subsequent covering of the defect. A special focus of this article is the treatment of locally extensive and metastasized BCC.


Subject(s)
Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/therapy , Eye Neoplasms/diagnosis , Eye Neoplasms/therapy , Medical Oncology/standards , Ophthalmology/standards , Practice Guidelines as Topic , Dermatologic Surgical Procedures/standards , Evidence-Based Medicine , Humans , Microsurgery/standards , Ophthalmologic Surgical Procedures/standards , Treatment Outcome
14.
Ophthalmologe ; 113(12): 1070-1073, 2016 Dec.
Article in German | MEDLINE | ID: mdl-27033228

ABSTRACT

Neuromas of the eyelid margin and lower lip were diagnosed in a 29-year-old man. As the combination of these lesions is indicative of multiple endocrine neoplasia type 2b (MEN2b) syndrome, the presence of a medullary thyroid carcinoma or a pheochromocytoma were excluded by a systematic work-up. A mutation in the RET proto-oncogene was not found by genetic testing. In summary, the patient presented with neuromas on the eyelid margin and lower lip without an association to a syndrome; however, patients with such neuromas should be screened for MEN2b syndrome due to the high mortality.


Subject(s)
Eyelid Neoplasms/diagnosis , Eyelid Neoplasms/genetics , Lip Neoplasms/diagnosis , Lip Neoplasms/genetics , Neuroma/diagnosis , Neuroma/genetics , Adult , Diagnosis, Differential , Humans , Male , Multiple Endocrine Neoplasia Type 2b/diagnosis , Multiple Endocrine Neoplasia Type 2b/genetics , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/genetics , Proto-Oncogene Mas
15.
Ophthalmologe ; 113(9): 779-82, 2016 Sep.
Article in German | MEDLINE | ID: mdl-26801324

ABSTRACT

A 52-year-old patient presented with a painless nodular tumor of the upper left eyelid, which was first noticed 6 months prior to the initial presentation. The histopathological and immunohistochemical examination of the excised tumor revealed a mucinous sweat gland carcinoma. This very rare neoplasm (1/150,000 skin lesions) is located within the ocular adnexa in 40 % of cases. If completely excised the prognosis is usually good; however, due to the histological similarity to metastases of an adenocarcinoma, a hitherto unknown primary tumor at another site should be excluded.


Subject(s)
Adenocarcinoma, Mucinous/pathology , Adenocarcinoma, Mucinous/surgery , Eyelid Neoplasms/pathology , Eyelid Neoplasms/surgery , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/surgery , Adenocarcinoma, Mucinous/complications , Diagnosis, Differential , Eye Pain/diagnosis , Eye Pain/etiology , Eye Pain/prevention & control , Eyelid Neoplasms/complications , Female , Humans , Middle Aged , Sweat Gland Neoplasms/complications , Treatment Outcome
16.
Ophthalmologe ; 113(7): 602-5, 2016 Jul.
Article in German | MEDLINE | ID: mdl-26362570

ABSTRACT

An 82-year-old male patient presented with a salmon-pink colored conjunctival tumor of the left eye. A circumscribed, dense and whitish portion was detected by clinical examination. The histophological and immunhistochemical examination of the biopsy tissue revealed a CD20+ marginal zone lymphoma of the conjunctiva with amyloid deposits. Extranodal marginal zone lymphoma at this site is the most common lymphoma of the ocular adnexa and accounts for 5-10% of malignant diseases. An association with amyloid production is very rare and according to the current state of knowledge has no known impact on the outcome.


Subject(s)
Amyloid/metabolism , Conjunctiva/pathology , Conjunctival Neoplasms/pathology , Lymphoma, B-Cell, Marginal Zone/pathology , Aged, 80 and over , Antigens, CD20/metabolism , Cell Proliferation , Humans , Male , Neoplasm Staging , T-Lymphocytes/pathology
17.
Ophthalmologe ; 111(8): 772-4, 2014 Aug.
Article in German | MEDLINE | ID: mdl-24046173

ABSTRACT

A 24-year-old female patient was admitted to hospital with a deep stromal corneal defect on the right eye and a melting marginal keratitis on the left eye with a differential diagnosis of Mooren's ulcer. Despite intensive topical and systemic therapy, the ulcer perforated 3 days later and perforating keratoplasty à chaud was performed. The histological examination of the cornea showed a mainly intact corneal structure with a sharp demarcation line between the melting process close to the limbus and the unaffected tissue. The limbal area was interspersed with inflammatory cells. During the subsequent clinical course, despite intensive immunosuppressive therapy with Cellcept, systemic and local cyclosporin and methotrexate the left eye perforated and was subsequently treated by perforating keratoplasty. Under immunosuppression with methotrexate and local steroids no recurrence or progression has occurred so far.


Subject(s)
Corneal Ulcer/diagnosis , Corneal Ulcer/therapy , Immunosuppressive Agents/administration & dosage , Keratoplasty, Penetrating/methods , Adult , Combined Modality Therapy/methods , Female , Humans , Rupture, Spontaneous/diagnosis , Rupture, Spontaneous/therapy , Treatment Outcome
18.
Ophthalmologe ; 108(1): 68-72, 2011 Jan.
Article in German | MEDLINE | ID: mdl-20803020

ABSTRACT

Clinical features of Fuchs' corneal endothelial dystrophy combined with lattice dystrophy were found in an 81-year-old patient who had been treated with anti-inflammatory phosphate-rich eye drops. Histological analysis of the corneal button revealed Fuchs' corneal endothelial dystrophy, no evidence of lattice dystrophy but calcium deposits in the deep corneal stroma. This case demonstrates that calcium deposits can be incorporated in a grid-like pattern mimicking lattice dystrophy and supports the cautious use of phosphate-containing eye drops in the presence of chronic blepharoconjunctivitis and epithelial keratopathy.


Subject(s)
Fuchs' Endothelial Dystrophy/chemically induced , Fuchs' Endothelial Dystrophy/diagnosis , Ophthalmic Solutions/adverse effects , Phosphates/adverse effects , Aged, 80 and over , Anti-Inflammatory Agents/adverse effects , Diagnosis, Differential , Female , Humans , Phosphates/therapeutic use
20.
Ophthalmologe ; 107(11): 1051-8, 2010 Nov.
Article in German | MEDLINE | ID: mdl-20533048

ABSTRACT

OBJECTIVE: Information on the evaluation of prenatal ocular findings is sparse. This article provides an overview of the morphology in a cohort of human fetal eyes, with particular emphasis on interesting findings. METHODS: The study investigated 216 eyes from 115 human fetuses. RESULTS: The majority of fetal eyes presented with a regular phenotype. Rarely, unexpected findings were discovered in fetuses with or without systemic malformations. CONCLUSION: Routine evaluation of fetal eyes reveals-albeit rarely-new aspects providing further knowledge and occasionally enabling the exact classification of syndromes.


Subject(s)
Eye Abnormalities/pathology , Fetal Diseases/pathology , Abnormalities, Multiple/embryology , Abnormalities, Multiple/genetics , Abnormalities, Multiple/pathology , Eye/embryology , Eye/pathology , Eye Abnormalities/embryology , Eye Abnormalities/genetics , Female , Fetal Diseases/genetics , Gestational Age , Humans , Male , Pregnancy , Retina/abnormalities , Retina/pathology , Syndrome
SELECTION OF CITATIONS
SEARCH DETAIL
...