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1.
Klin Monbl Augenheilkd ; 231(9): 883-9, 2014 Sep.
Article in German | MEDLINE | ID: mdl-25181505

ABSTRACT

Retinal haemorrhages are one of the three cardinal manifestations of the "shaken baby syndrome" or "non-accidental head injury" in childhood. The role of an ophthalmologist in suspected non-accidental head injury has not only medical but also legal aspects and has been discussed controversially in the literature. The differential diagnosis and the specificity of retinal haemorrhages in childhood for an abusive head trauma will be pointed out in this paper.


Subject(s)
Craniocerebral Trauma/diagnosis , Retinal Hemorrhage/diagnosis , Shaken Baby Syndrome/diagnosis , Accidents , Diagnosis, Differential , Humans , Infant , Infant, Newborn , Male
2.
Klin Monbl Augenheilkd ; 229(10): 1003-8, 2012 Oct.
Article in German | MEDLINE | ID: mdl-22961040

ABSTRACT

PURPOSE: Sturge-Weber syndrome is a rare congenital disorder consisting of cutaneous, leptomeningeal and ocular vascular malformations. Glaucoma occurs in 30-70 % of patients. Treatment is challenging due to a high risk of severe complications such as expulsive haemorrhage, massive choroidal effusion and serous retinal detachment. Ocular findings and the occurrence of complications under different treatment modalities have been reviewed. METHODS: A retrospective analysis of a case series of 5 children (5 eyes/mean age 5.6 years) with secondary glaucoma associated with Sturge-Weber syndrome was undertaken. Ocular findings, treatment modalities, intraocular pressure and complications were assessed. RESULTS: Facial port-wine nevus, i.e., nevus flammeus and dilated episcleral vessels were present in all cases. Diffuse choroidal haemangiomas were seen in four eyes. Glaucoma surgery was performed in 4 children, one child was treated with antiglaucomatous medication alone. Reversible uveal effusion and subluxation of the lens appeared postoperatively in one eye, persistent serous retinal detachment occurred 3 years after surgery in another eye (with an intraocular pressure of 10 mmHg). Both complications were found in eyes with diffuse choroidal haemangioma. CONCLUSION: Management of glaucoma associated with Sturge-Weber syndrome is difficult and controversial. Medical treatment often does not decrease intraocular pressure sufficiently. When planning surgical intervention an increased risk of severe complications has to be considered, especially in the presence of diffuse choroidal haemangioma.


Subject(s)
Glaucoma/diagnosis , Glaucoma/therapy , Ophthalmologic Surgical Procedures/methods , Sturge-Weber Syndrome/diagnosis , Sturge-Weber Syndrome/surgery , Child , Child, Preschool , Combined Modality Therapy , Female , Humans , Infant , Infant, Newborn , Male , Treatment Outcome
3.
Klin Monbl Augenheilkd ; 227(9): 694-700, 2010 Sep.
Article in German | MEDLINE | ID: mdl-20845249

ABSTRACT

Retinopathy of prematurity (ROP) is one of the three leading causes of legal blindness in childhood in the developed countries. Improved neonatal care has resulted in the increased survival of extremely immature infants at high risk to develop ROP. Current treatment for ROP with laser may prevent blindness by causing involution of pathological vessels and thus inhibit the development of retinal detachment. But this coagulation of the avascular retina is a destructive therapy and does not otherwise ameliorate retinal development. Recent reports have described vascular endothelial growth factor antibodies as therapy for ROP. This article reports our own experience with this new therapy and gives an overview of the recent literature.


Subject(s)
Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal/administration & dosage , Retinopathy of Prematurity/drug therapy , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Angiogenesis Inhibitors/adverse effects , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Bevacizumab , Combined Modality Therapy , Diseases in Twins/classification , Diseases in Twins/diagnosis , Diseases in Twins/drug therapy , Diseases in Twins/physiopathology , Female , Humans , Infant, Extremely Low Birth Weight , Infant, Newborn , Intravitreal Injections , Laser Coagulation , Male , Off-Label Use , Retinopathy of Prematurity/classification , Retinopathy of Prematurity/diagnosis , Retinopathy of Prematurity/physiopathology , Vascular Endothelial Growth Factor A/physiology
4.
Ophthalmologe ; 107(10): 911-7, 2010 Oct.
Article in German | MEDLINE | ID: mdl-20803019

ABSTRACT

PURPOSE: The purpose of this review is to enhance the physician's awareness of dry eye syndrome and neurotrophic keratitis in children, to describe the most frequently associated conditions and to discuss the diagnostic and therapeutic options available. METHODS: A literature review of the pathogenesis of dry eye syndrome and neurotrophic keratitis in children was carried out, clinical cases from our pediatric ophthalmology office are presented as well as therapeutic strategies. RESULTS: Diseases of the cornea and ocular surface such as dry eye syndrome, neurotrophic keratitis and corneal ulcers are infrequent in children compared to adults. However, they do occur and should be diagnosed and treated as soon as possible in order to prevent long-term complications and amblyopia. CONCLUSIONS: Inflammatory diseases of the ocular surface can be easily overlooked in children due to the often unknown spectrum of differential diagnoses and the frequently reduced cooperation during examination of young children. Correct and early diagnosis is essential for prevention of long-term complications, e.g. corneal ulceration and scarring.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/therapy , Keratitis/diagnosis , Keratitis/therapy , Ophthalmologic Surgical Procedures/methods , Child , Dry Eye Syndromes/etiology , Humans , Keratitis/etiology
5.
Eye (Lond) ; 21(7): 948-51, 2007 Jul.
Article in English | MEDLINE | ID: mdl-16601737

ABSTRACT

PURPOSE: To evaluate whether the amplitude of day-and-night intraocular pressure (IOP) profiles influences the rate of progression of chronic open-angle glaucoma. METHODS: The hospital-based clinical observational study included day-and-night profiles of IOP measurements performed on 458 patients (855 eyes) with chronic open-angle glaucoma or ocular hypertension. The 24-h pressure profiles obtained by Goldmann applanation tonometry contained measurements at 0700, noon, 1700, 2100, and midnight. RESULTS: In the whole study population, IOP amplitude was significantly (P<0.001) and positively associated with the mean (r=0.26), minimal (r=-0.23) and maximal (r=0.59) IOP values. Taking the whole study population, glaucoma progression was not associated with the IOP amplitude (P=0.09). After adjustment for age, neuroretinal rim area and the other IOP measurements, age (P<0.001) and neuroretinal rim area (P=0.05) remained as significant predictive factors in the selected Cox model. In the normal-pressure glaucoma group (n=174 eyes), progression was significantly positive associated with the minimal IOP value (P<0.001), the mean of the IOP values (P=0.024), and, less significantly (P=0.037) and negatively, with the pressure profile amplitudes. In the high-pressure glaucoma group (n=681 eyes), rate of glaucoma progression was not associated with the IOP amplitude (P=0.734) or the other IOP parameters. CONCLUSIONS: Taking into account the highly significant associations between the IOP amplitude and the mean, minimal and maximal IOP values suggests that it is the IOP itself, and less the pressure amplitude, which has the main influence on the rate of the glaucoma progression.


Subject(s)
Circadian Rhythm , Glaucoma, Open-Angle/physiopathology , Intraocular Pressure , Adult , Aged , Disease Progression , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Tonometry, Ocular/methods
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