Sebastian Bemme

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

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.

Atrial fibrillation in retinal vascular occlusion disease and non-arteritic anterior ischemic optic neuropathy.

Background Patients with retinal vascular occlusion disease have an increased risk for ischemic stroke and share some risk factors with cerebrovascular disease. The purpose of this study was to analyze the prevalence of atrial fibrillation (AF) in subjects with retinal vascular occlusive disease and anterior ischemic optic neuropathy and to compare these data to an ischemic stroke group. Methods Prospective, observational single-center trial. Subjects with retinal artery occlusion (RAO), retinal vein occlusion (RVO) and anterior ischemic optic neuropathy (AION) were included. Patients with ischemic stroke (IS) from a previous observational trial were used as control. Investigation included 7-day Holter ECG, echocardiography, duplex ultrasonography of the carotid arteries, and 24-hour blood pressure monitoring. Further vascular risk factors were documented. Results During the 1-year study period, 101 patients were recruited. The control group with ischemic stroke consisted of 272 subjects. At inclusion, the prevalence of AF was 12% (RAO), 10.2% (RVO), 11.1% (NAION) and 15.8% (IS). The final prevalence after Holter ECG rose to 16% (RAO), 18.4% (RVO), 14.8% (NAION) and 26.5% (IS). No significant difference was measured between groups. Conclusions We detected a similar prevalence of AF in all groups. RVO patients tended to exhibit a higher AF detection rate and lower number needed to screen than RAO and NAION. The detection of AF rose considerably via Holter ECG. As a consequence, we recommend prolonged ECG monitoring in patients with acute ophthalmic vascular diseases.

Progressive scotoma with perception of photopsia

ZusammenfassungDie akute anuläre äußere Retinopathie (AAOR) ist eine sehr seltene Variante der akuten zonalen okkulten äußeren Retinopathie (AZOOR). Beide Formen sind durch die Wahrnehmung eines progredienten Gesichtsfelddefektes gekennzeichnet und können mit Photopsien einhergehen. Im Gegensatz zur okkulten Form findet sich bei der anulären Form typischerweise eine weißliche ringförmige Begrenzung des betroffenen Netzhautareals, die sich im Verlauf weiter ausdehnt. In der optischen Kohärenztomographie zeigt sich, dass dabei vorwiegend die äußere Netzhautschicht morphologisch verändert ist. Obwohl bisher keine effektive Therapie nachgewiesen wurde, konnte bei dem vorliegenden Patienten die weitere Ausdehnung des betroffenen Areals unter einer antiviralen und immunsuppressiven Kombinationstherapie gestoppt werden.AbstractAcute annular outer retinopathy (AAOR) is a very rare variant of acute zonal occult outer retinopathy (AZOOR). Both variants are characterized by the perception of a progressive visual field defect and can be accompanied by photopsia. In contrast to AZOOR, a progressive whitish and annular demarcation of the involved retina is observed in AAOR using ophthalmoscopy. Optical coherence tomography (OCT) reveals morphological changes predominantly in the outer retinal layers. Although there is no proof of an effective therapy, in the case presented here further progression could be stopped by a combination of antiviral and immunosuppressive therapy.Acute annular outer retinopathy (AAOR) is a very rare variant of acute zonal occult outer retinopathy (AZOOR). Both variants are characterized by the perception of a progressive visual field defect and can be accompanied by photopsia. In contrast to AZOOR, a progressive whitish and annular demarcation of the involved retina is observed in AAOR using ophthalmoscopy. Optical coherence tomography (OCT) reveals morphological changes predominantly in the outer retinal layers. Although there is no proof of an effective therapy, in the case presented here further progression could be stopped by a combination of antiviral and immunosuppressive therapy.

Progredientes Skotom mit Photopsiewahrnehmung

ZusammenfassungDie akute anuläre äußere Retinopathie (AAOR) ist eine sehr seltene Variante der akuten zonalen okkulten äußeren Retinopathie (AZOOR). Beide Formen sind durch die Wahrnehmung eines progredienten Gesichtsfelddefektes gekennzeichnet und können mit Photopsien einhergehen. Im Gegensatz zur okkulten Form findet sich bei der anulären Form typischerweise eine weißliche ringförmige Begrenzung des betroffenen Netzhautareals, die sich im Verlauf weiter ausdehnt. In der optischen Kohärenztomographie zeigt sich, dass dabei vorwiegend die äußere Netzhautschicht morphologisch verändert ist. Obwohl bisher keine effektive Therapie nachgewiesen wurde, konnte bei dem vorliegenden Patienten die weitere Ausdehnung des betroffenen Areals unter einer antiviralen und immunsuppressiven Kombinationstherapie gestoppt werden.AbstractAcute annular outer retinopathy (AAOR) is a very rare variant of acute zonal occult outer retinopathy (AZOOR). Both variants are characterized by the perception of a progressive visual field defect and can be accompanied by photopsia. In contrast to AZOOR, a progressive whitish and annular demarcation of the involved retina is observed in AAOR using ophthalmoscopy. Optical coherence tomography (OCT) reveals morphological changes predominantly in the outer retinal layers. Although there is no proof of an effective therapy, in the case presented here further progression could be stopped by a combination of antiviral and immunosuppressive therapy.Acute annular outer retinopathy (AAOR) is a very rare variant of acute zonal occult outer retinopathy (AZOOR). Both variants are characterized by the perception of a progressive visual field defect and can be accompanied by photopsia. In contrast to AZOOR, a progressive whitish and annular demarcation of the involved retina is observed in AAOR using ophthalmoscopy. Optical coherence tomography (OCT) reveals morphological changes predominantly in the outer retinal layers. Although there is no proof of an effective therapy, in the case presented here further progression could be stopped by a combination of antiviral and immunosuppressive therapy.

Bogenförmige retinale Aufhellung bei einer bisher gesunden Patientin

Eine 67-jährige, bisher augengesunde Patientin stellte sich aufgrund einer seit 2 Wochen bestehenden Photopsie und progredienten Gesichtsfeldeinschränkung des linken, 2 Wochen später auch des rechten Auges vor. Drei Jahre zuvor war erstmals eine Polymyalgia rheumatica diagnostiziert worden, zum Vorstellungszeitpunkt bestanden dahingehend keinerlei Beschwerden. Aktuell hatte sie bronchitische Beschwerden, die etwas hartnäckig waren, bislang sei jedoch noch keine Therapie erfolgt. Ansonsten fühlte sich die Patientin gesund und war in einem guten Allgemeinzustand.

Differential Effects of HCN Channel Block on On and Off Pathways in the Retina as a Potential Cause for Medication-Induced Phosphene Perception

Purpose Phosphene perception is a characteristic side effect of heart rate-reducing medication that acts on hyperpolarization-activated cyclic nucleotide-gated (HCN) ion channels. It is hypothesized that these phosphenes are caused by blocking HCN channels in photoreceptors and neurons of the retina, yet the underlying changes in visual signal processing in the retina caused by the HCN channel block are still unknown. Methods We examined the effects of pharmacologic HCN channel block on the encoding of visual signals in retinal ganglion cells by recording ganglion cell spiking activity from isolated mouse retinas mounted on multielectrode arrays. Spontaneous activity and responses to various visual stimuli were measured before, during, and after administration of 3 μM ivabradine. Results Retinal ganglion cells generally showed slower response kinetics and reduced sensitivity to high temporal frequencies under ivabradine. Moreover, ivabradine differentially affected the sensitivity of On and Off ganglion cells. On cells showed reduced response gain, whereas Off cells experienced an increase in response threshold. In line with these differential effects, Off cells, in contrast to On cells, also showed reduced baseline activity during visual stimulation and reduced spontaneous activity. Furthermore, Off cells, but not On cells, showed increased burst-like spiking activity in the presence of ivabradine. Conclusions Our data suggest that pharmacologic HCN channel block in the retina leads to a shift in the relative activity of the On and Off pathways of the retina. We hypothesize that this imbalance may underlie the medication-induced perception of phosphenes.

Progredientes Skotom mit Photopsiewahrnehmung@@@Progressive scotoma with perception of photopsia

ZusammenfassungDie akute anuläre äußere Retinopathie (AAOR) ist eine sehr seltene Variante der akuten zonalen okkulten äußeren Retinopathie (AZOOR). Beide Formen sind durch die Wahrnehmung eines progredienten Gesichtsfelddefektes gekennzeichnet und können mit Photopsien einhergehen. Im Gegensatz zur okkulten Form findet sich bei der anulären Form typischerweise eine weißliche ringförmige Begrenzung des betroffenen Netzhautareals, die sich im Verlauf weiter ausdehnt. In der optischen Kohärenztomographie zeigt sich, dass dabei vorwiegend die äußere Netzhautschicht morphologisch verändert ist. Obwohl bisher keine effektive Therapie nachgewiesen wurde, konnte bei dem vorliegenden Patienten die weitere Ausdehnung des betroffenen Areals unter einer antiviralen und immunsuppressiven Kombinationstherapie gestoppt werden.AbstractAcute annular outer retinopathy (AAOR) is a very rare variant of acute zonal occult outer retinopathy (AZOOR). Both variants are characterized by the perception of a progressive visual field defect and can be accompanied by photopsia. In contrast to AZOOR, a progressive whitish and annular demarcation of the involved retina is observed in AAOR using ophthalmoscopy. Optical coherence tomography (OCT) reveals morphological changes predominantly in the outer retinal layers. Although there is no proof of an effective therapy, in the case presented here further progression could be stopped by a combination of antiviral and immunosuppressive therapy.Acute annular outer retinopathy (AAOR) is a very rare variant of acute zonal occult outer retinopathy (AZOOR). Both variants are characterized by the perception of a progressive visual field defect and can be accompanied by photopsia. In contrast to AZOOR, a progressive whitish and annular demarcation of the involved retina is observed in AAOR using ophthalmoscopy. Optical coherence tomography (OCT) reveals morphological changes predominantly in the outer retinal layers. Although there is no proof of an effective therapy, in the case presented here further progression could be stopped by a combination of antiviral and immunosuppressive therapy.