Ulrich Schaudig

Optical coherence tomography for retinal thickness measurement in diabetic patients without clinically significant macular edema.

BACKGROUND AND OBJECTIVE To evaluate the potential of optical coherence tomography (OCT) as a screening method for retinal thickness measurements in diabetic patients. PATIENTS AND METHODS We used a previously described pattern of six 5 mm OCT scans through the center of fixation in 45 diabetic patients without clinically significant macular edema: 22 patients (group 1) had no diabetic retinopathy (ETDRS classification); 18 (group 2) had nonproliferative retinopathy; 5 patients with peripheral neovascularization did not enter statistical analysis; 25 normal healthy subjects were used as a control group. Retinal thickness was measured at five locations in each scan: in the fovea, at the foveal rim, and outside the macula. Measurements were identified in nonaligned images and taken from raw data A-scans. Locations were grouped into hemispheres, quadrants and rings, and mean values tested for statistically significant differences using Mann-Whitney U-Wilcoxon rank sum W test. RESULTS Differences in retinal thickness were found to be significant in the macula (controls vs group 2 P = 0.0266), at the foveal rim (controls vs group 1 and 2: P = 0.0386 and P = 0.0193), in the nasal and superior hemisphere (controls vs group 2: P = 0.0251 and P = 0.0187), and in the superior nasal quadrant (controls vs group 1 and group 1 vs group 2: P = 0.0022 and P = 0.0462). CONCLUSIONS Significant differences of retinal thickness between patients with diabetic retinopathy and normals can be detected by OCT even in the absence of clinically significant macular edema. Significant differences between diabetic patients with and without retinopathy are most likely to be found in the superior nasal quadrant.

Structural changes of the retina in retinal vein occlusion--imaging and quantification with optical coherence tomography.

BACKGROUND AND OBJECTIVE To evaluate the potential of optical coherence tomography (OCT) for imaging and quantifying structural changes in the retinal architecture following venous occlusive disease. PATIENTS AND METHODS We studied 20 patients with retinal venous occlusive disease: 5 patients suffered from branch retinal vein occlusion (BRVO), and 15 from central retinal vein occlusion (CRVO). Patients with CRVO were studied within 72 hours after the first onset of symptoms. Patients were examined by OCT after a complete ophthalmologic examination including fluorescein angiography. A standard set of linear scans through the center of fixation and individual scans over areas of special interest were performed. Scans were qualitatively evaluated and quantitative measurements were performed on single A-scans at 5 locations of linear scans. Measurements were taken in the center of fixation, at the foveal rim, and at the edge of the scan. We measured total retinal thickness, thickness of cystoid spaces, and thickness of the highly reflective outer band. RESULTS OCT produced detailed images of retinal thickening, intra- and subretinal hemorrhage, intra- and subretinal fluid accumulation, and formation of intraretinal cystoid spaces. Quantitative evaluation revealed a mean central retinal thickness of 274 +/- 181 microm (72-760 microm) in patients with central retinal vein occlusion. Visual acuity did not correlate with central or extrafoveal retinal thickness. CONCLUSION Optical coherence tomography is a useful imaging technique for studying changes of retinal architecture following venous occlusive disease. Even minor changes like localized subretinal fluid accumulation or beginning epiretinal membrane formation can be visualized in detail. In contrast to other diseases like diabetic maculopathy, quantitative assessment of macular thickness does not correlate to visual acuity. Nevertheless, because of detailed imaging, OCT might become a useful tool in the follow-up and treatment of individual patients.

Limitations of imaging choroidal tumors in vivo by optical coherence tomography.

Abstract · Background: Optical coherence tomography (OCT) produces two-dimensional cross-sectional images with a longitudinal resolution of 10 μm. Its capacity for imaging retinal structure has been shown in a variety of diseases. There are no reports on its capacity and limitations in imaging choriocapillary and choroidal structures. · Methods: Twenty-two patients with the diagnosis of malignant melanoma of the choroid were submitted to OCT. We used a prototype and a commercial device, both with an 850-nm superluminescent diode with a bandwidth of 30 nm (reported longitudinal resolution 10 μm). The images were evaluated for retinal thickness, changes in retinal pigment epithelium, subretinal fluid accumulation and changes in choriocapillary or choroidal reflectivity. · Results: Retinal edema and detachment found on biomicroscopic examination for fluorescein angiography was detected by OCT in all such cases. In 2 of 22 cases small retinal detachments were detected only by OCT. Tumor extension through the retinal pigment epithelium was not seen in this series, either by biomicroscopy or by OCT. The pattern of choroidal or choriocapillary reflectivity was nonspecifically lower than that of normal choroid, but did not yield any additional information about tumor histology. When normal retina was present, the OCT appearance of a malignant melanoma resembled that of normal choroid. · Conclusion: OCT may provide information about the retinal structure overlying prominent tumors and the extent of adjacent retinal detachment. In its present state of development, OCT is of little value in the differential diagnosis of choroidal tumors. Its potential value for the follow-up of shallow tumors needs further investigation.

[Optical coherence tomography for macular edema. Classification, quantitative assessment, and rational usage in the clinical practice].

Optical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid. Increase of retinal thickness correlates with decrease in visual acuity. Detailed interpretation of OCT images can replace fluorescein angiography in certain cases, as has been shown for uveitis. In order to obtain correct classification of macular disease in routine clinical use, all images have to be completely assessed and compared to previous investigations and to the measurements of the fellow eye. More accurate normal values of retinal thickness and volume can be expected in the future. The importance of OCT in routine clinical assessment of macular edema will most probably continue to grow.ZusammenfassungDie optische Kohärenztomographie (OCT) ermöglicht die morphologische Beurteilung von Makulaödemen verschiedener Ursache im zweidimensionalen Schnittbild in vivo. Darüber hinaus kann eine quantitative Beurteilung durch die Messung der Netzhautdicke durchgeführt werden. Bei der diabetischen Makulopathie lässt sich die Schädigung der Blut-Retina-Schranke indirekt an der Lokalisation der intraretinalen Flüssigkeit nachweisen und die Entwicklung der Makulopathie über das diffuse und zystoide Ödem bis hin zur Ruptur der Netzhaut ebenso beschreiben, wie die Abhebung der neurosensorischen Netzhaut. Es besteht ein Zusammenhang zwischen der Zunahme der Netzhautdicke und der Visusminderung. Bei detaillierter Auswertung kann die OCT beispielsweise bei Uveitis die Fluoreszeinangiographie ersetzen. In der klinischen Routine muss zur Klassifizierung auf die vollständige Beurteilung aller verfügbaren Scans geachtet, der Seitenvergleich berücksichtigt und der Verlauf miteinbezogen werden. Für die Zukunft sind genauere Normwerte für die Netzhautdicken- und -volumenmessung zu erwarten. Die OCT wird in der Beurteilung des Makulaödems in der klinischen Routine weiter an Bedeutung gewinnen.AbstractOptical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid. Increase of retinal thickness correlates with decrease in visual acuity. Detailed interpretation of OCT images can replace fluorescein angiography in certain cases, as has been shown for uveitis. In order to obtain correct classification of macular disease in routine clinical use, all images have to be completely assessed and compared to previous investigations and to the measurements of the fellow eye. More accurate normal values of retinal thickness and volume can be expected in the future. The importance of OCT in routine clinical assessment of macular edema will most probably continue to grow.

α/β- andγ/δ-T cell-receptor-positive lymphocytes in healthy and inflamed human conjunctiva

Abstract• Background: The possible existence and distribution patterns of α/β- and γ/δ-TCR+ cells, which are important constituents of immune surveillance and act via the CD3+ cell complex have not yet been elucidated in the healthy and inflamed conjunctiva. • Materials and methods: Paraffin-embedded conjunctival specimens included 18 from 18 patients with ocular cicatricial pemphigoid (OCP), 20 from 20 healthy controls, 6 from 6 patients with lye burns, and 6 from 2 patients with Stevens-Johnson syndrome; all were worked up by histology and immunohistochemistry. • Results: α/β-TCR+ cells were visualized in the conjunctival epithelium and stroma of healthy persons, OCP, lye burns and Stevens-Johnson syndrome. α/β-TCR+ cells and a small number of γ/δ-TCR+ cells were observed in the corneal epithelium and stroma of patients who have failing corneal grafts. After ileal mucosa transplantation to the epibulbar conjunctiva, membrane staining changes to nuclear and cytoplasmic staining. Treatment with systemic cytotoxic drugs abolishes all α/β-TCR+ and γ/δ-TCR+ cells. • Conclusions: α/β-TCRu+ cells can be found in the non-infected epithelium and stroma of the healthy and inflamed (OCP, lye burns, and Stevens-Johnson syndrome) conjunctiva, as well as in the corneal epithelium and stroma of failing corneal grafts, whereas γ/δ-TCR+ cells are absent. A small number of γ/δ-TCR+ cells are present in the corneal stroma and adjacent conjunctival epithelium of patients with chronic corneal graft rejection or after transplantation of gut tissue. Further investigations may establish the role, if any, of these T-cell subsets in immune surveillance of the non-infected outer eye and in corneal graft rejection.

OCT bei Makulaödem

Optical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid. Increase of retinal thickness correlates with decrease in visual acuity. Detailed interpretation of OCT images can replace fluorescein angiography in certain cases, as has been shown for uveitis. In order to obtain correct classification of macular disease in routine clinical use, all images have to be completely assessed and compared to previous investigations and to the measurements of the fellow eye. More accurate normal values of retinal thickness and volume can be expected in the future. The importance of OCT in routine clinical assessment of macular edema will most probably continue to grow.ZusammenfassungDie optische Kohärenztomographie (OCT) ermöglicht die morphologische Beurteilung von Makulaödemen verschiedener Ursache im zweidimensionalen Schnittbild in vivo. Darüber hinaus kann eine quantitative Beurteilung durch die Messung der Netzhautdicke durchgeführt werden. Bei der diabetischen Makulopathie lässt sich die Schädigung der Blut-Retina-Schranke indirekt an der Lokalisation der intraretinalen Flüssigkeit nachweisen und die Entwicklung der Makulopathie über das diffuse und zystoide Ödem bis hin zur Ruptur der Netzhaut ebenso beschreiben, wie die Abhebung der neurosensorischen Netzhaut. Es besteht ein Zusammenhang zwischen der Zunahme der Netzhautdicke und der Visusminderung. Bei detaillierter Auswertung kann die OCT beispielsweise bei Uveitis die Fluoreszeinangiographie ersetzen. In der klinischen Routine muss zur Klassifizierung auf die vollständige Beurteilung aller verfügbaren Scans geachtet, der Seitenvergleich berücksichtigt und der Verlauf miteinbezogen werden. Für die Zukunft sind genauere Normwerte für die Netzhautdicken- und -volumenmessung zu erwarten. Die OCT wird in der Beurteilung des Makulaödems in der klinischen Routine weiter an Bedeutung gewinnen.AbstractOptical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid. Increase of retinal thickness correlates with decrease in visual acuity. Detailed interpretation of OCT images can replace fluorescein angiography in certain cases, as has been shown for uveitis. In order to obtain correct classification of macular disease in routine clinical use, all images have to be completely assessed and compared to previous investigations and to the measurements of the fellow eye. More accurate normal values of retinal thickness and volume can be expected in the future. The importance of OCT in routine clinical assessment of macular edema will most probably continue to grow.

⋅/, und Á/‰-T-Zell-Rezeptor-Analyse an konjunktivalem Gewebe bei Patienten mit okulärem Pemphigoid

Fragestellung: Das Vorkommen und die Verteilung von α/β und γ/δ-T-Zell-Rezeptor(TCR)-positiven Zellen ist an der Konjunktiva von asymptomatischen Personen und Patienten mit okulärem Pemphigoid (OCP) bisher nicht untersucht worden.Patienten und Methode: Bindehautbiopsien von 20 Patienten mit klinisch diagnostiziertem OCP wurden mit 20 Biopsien von asymptomatischen Patienten verglichen. Zusätzlich wurden 3 Präparate von Patienten mit OCP unter Zytostatikatherapie und 8 nach Schleimhauttransplantationen untersucht. Hierfür wurde nach Deparaffinierung mit Antigen retrieval die immunhistochemische Identifizierung von α/β- und γ/δ-TCR-positiven Zellen mit Hilfe von monoklonalen Antikörpern und einem Markierungssystem durchgeführt. Es wurden je 3 Schnitte angefertigt und negative Kontrollseren mitgeführt.Ergebnisse: α/β-TCR-positive Zellen konnten sowohl im konjunktivalen Epithel als auch im Stroma bei allen Kontrollpersonen und bei allen Patienten mit OCP beobachtet werden. γ/δ-TCR-positive Zellen waren nicht bei den Kontrollpersonen, wohl aber bei Patienten mit OCP, und zwar in 4 von 20 Fällen, im Epithel vorhanden. Patienten mit OCP unter Zytostatikatherapie wiesen weder α/β- noch γ/δ-TCR-positive Zellen auf. Nach einer Schleimhauttransplantation änderte sich das Färbeverhalten der α/β-TCR-positiven Zellen von membranständig zu nukleär und der γ/δ-TCR-positiven Zellen von membranständig zu zytoplasmatisch.Zusammenfassung: Die Beobachtungen zeigen, daß bestimmte definierte T-Zell-Populationen in der Konjunktiva von gesunden Personen und Patienten mit okularem Pemphigoid vorkommen. Funktionelle Studien mit frischem Gewebematerial mögen genauere Hinweise auf die Rolle von definierten T-Zell-Populationen bei der Immunpathogenese von Autoimmunerkrankungen des äußeren Auges wie dem okularen Pemphigoid geben.Background: In the conjunctiva of asymptomatic persons and patients with ocular cicatricial pemphigoid the existence and distribution of α/β- and γ/δ-T cell receptor (TCR)-positive cells has not previously been investigated.Patients and methods: Biopsy specimens from 20 patients with clinically diagnosed ocular cicatricial pemphigoid (OCP) were compared with 20 specimens from asymptomatic persons. Additionally, 3 specimens from patients with OCP treated with cytotoxic drugs and 8 specimens from patients who had undergone mucosal transplantation were studied. Antigen retrieval was done in deparaffinized specimens for immunohistochemical identification of α/β- and γ/δ-TCR-positive cells by monoclonal antibodies and an appropriate detection system. All steps were performed in triplicate, and negative control sera were applied.Results: α/β-TCR-positive cells were observed in the conjunctival epithelium and stroma of all the asymptomatic persons and in all patients with OCP. γ/δ-TCR-positive cells were found in 4 out of 20 patients with OCP in epithelial sites, but not in asymptomatic persons. Patients with OCP who had received cytotoxic treatment exhibited neither α/β- nor γ/δ-TCR-positive cells. Staining sites of α/β-TCR-positive cells changed from membrane-bound to nuclear in patients who had undergone mucosal transplantation, and were cytoplasmic rather than membrane-bound in γ/δ-TCR positive cells.Conclusions: This study presents preliminary evidence for the existence of distinct T-cell subsets in the conjunctiva of healthy persons and of patients with OCP. Further functional studies in fresh tissue material may provide better insights into the role of defined T-cell subsets in the immunopathogenesis of autoimmune diseases of the outer eye such as OCP.

Nachweis von Bewegungsartefakten bei der optischen Kohärenztomographie mit dem Fundus-Enhancement-System

ZusammenfassungHINTERGRUND: Bei Untersuchungen mit der optischen Kohärenztomographie (OCT) sind ausgeprägte Bewegungsartefakte erkennbar, Häufigkeit und Ausprägung geringer Bewegungen sind aber bislang nicht untersucht worden. ZIEL DER STUDIE war es, Häufigkeit und Ausmaß von durch Augenbewegungen während des Untersuchungsprozesses hervorgerufenen Artefakten und Fehlmessungen bei OCT zu untersuchen. METHODEN: Mit Hilfe eines zur Integration von OCT-Bildern in fluoreszenzangiographische Aufnahmen entwickelten Fundusbildsystems (Fundus-Enhancement-System, FES) kann der Scanning-Prozess bei einem konventionellen Zeiss-Stratus-OCT aufgenommen und als Videosequenz verlangsamt wiedergegeben werden. Wir untersuchten mit Hilfe dieses Systems 40 Augen bei 20 gesunden Probanden mit einem Visus von mindestens 1,0; untersucht wurde das Vorhandensein von Bewegungen (Fixationsverlusten) während des Ablaufes des Scans bei je einem 5 mm langen horizontalen und vertikalen Scan durch die Fovea. Gemessene Parameter: Vorhandensein oder Abwesenheit von Augenbewegungen während der Aufnahme und mittlere Abweichung von der geplanten Scanposition in horizontaler oder vertikaler Richtung in Millimeter. ERGEBNISSE: Sieben von 20 gesunden Probanden zeigten überhaupt keine Bewegung während der Untersuchung. Von den übrigen 13 Patienten zeigten vier Bewegungen nur auf einer Seite. Die mittlere Abweichung von der gewünschten Position betrug 0,2 mm bei den horizontalen und 0,28 mm bei den vertikalen Scans. SCHLUSSFOLGERUNG: Konventionelle OCT-Systeme können erweitert werden, um geringe Augenbewegungen während der Untersuchung zu erfassen. In dieser ersten Serie gesunder Probanden mit voller Sehschärfe traten durch Fixationsverlust bedingte Augenbewegungen bei über der Hälfte der Untersuchungen auf. Auch wenn die Abweichungen von der intendierten Scanposition bei Gesunden gering erscheinen, sind weitere Untersuchungen dieses Phänomens notwendig. OCT wird bei Makulaerkrankungen in zunehmendem Maße als Therapiekontrolle verwendet und das Ausmaß bewegungsbedingter Fehler ist bislang nicht untersucht worden.SummaryBACKGROUND: Extensive artefacts due to major eye movements are detectable in optical coherence tomography images (OCT), but frequency and extent of small eye movements have not been studied. PURPOSE: To investigate frequency and extent of irregularities in OCT imaging due to eye movements during the scanning process in OCT. METHODS: A fundus enhancement system (FES) originally designed to improve retinal image quality in a conventional OCT device (Zeiss Stratus OCT) in order to integrate OCT images into fluorescence angiographies was used to record the scanning process and review OCT-scan acquisition in slow motion. A horizontal and a vertical single line scan of 5 mm length through the center of fixation were obtained in 40 eyes of 20 normal healthy subjects, all with a visual acuity of at least 20/20. Scans were investigated for loss of fixation and eye movements during the scanning process. Outcome measures were presence or absence of eye movements during the scanning process and mean deviation from the intended scan position, measured in millimeter. RESULTS: 7 of 20 patients showed no eye movements in both eyes. 4 of the remaining 13 patients showed eye movements only in one eye. In the eyes with detectable movements, the mean deviation from the intended scan position was 0.2 mm in the horizontal and 0.28 mm in the vertical scans. CONCLUSION: Fundus imaging in conventional systems can be enhanced to detect artifacts due to minimal eye movements during the scanning process. In this first series with normal healthy subjects, minimal eye movements were present in the over half of the investigations. Although the distances from the intended scan positions seem to be small in normal eyes, further investigations of the phenomenon are necessary. OCT is increasingly used as the primary tool for controlling therapy in macular diseases and the extent of motion artefacts is not known.

OCT bei Makuladem@@@Optical coherence tomography for macular edema: Klassifizierung, quantitative Beurteilung und rationaler Einsatz in der Praxis@@@Classification, quantitative assessment, and routine clinical use

Optical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid. Increase of retinal thickness correlates with decrease in visual acuity. Detailed interpretation of OCT images can replace fluorescein angiography in certain cases, as has been shown for uveitis. In order to obtain correct classification of macular disease in routine clinical use, all images have to be completely assessed and compared to previous investigations and to the measurements of the fellow eye. More accurate normal values of retinal thickness and volume can be expected in the future. The importance of OCT in routine clinical assessment of macular edema will most probably continue to grow.ZusammenfassungDie optische Kohärenztomographie (OCT) ermöglicht die morphologische Beurteilung von Makulaödemen verschiedener Ursache im zweidimensionalen Schnittbild in vivo. Darüber hinaus kann eine quantitative Beurteilung durch die Messung der Netzhautdicke durchgeführt werden. Bei der diabetischen Makulopathie lässt sich die Schädigung der Blut-Retina-Schranke indirekt an der Lokalisation der intraretinalen Flüssigkeit nachweisen und die Entwicklung der Makulopathie über das diffuse und zystoide Ödem bis hin zur Ruptur der Netzhaut ebenso beschreiben, wie die Abhebung der neurosensorischen Netzhaut. Es besteht ein Zusammenhang zwischen der Zunahme der Netzhautdicke und der Visusminderung. Bei detaillierter Auswertung kann die OCT beispielsweise bei Uveitis die Fluoreszeinangiographie ersetzen. In der klinischen Routine muss zur Klassifizierung auf die vollständige Beurteilung aller verfügbaren Scans geachtet, der Seitenvergleich berücksichtigt und der Verlauf miteinbezogen werden. Für die Zukunft sind genauere Normwerte für die Netzhautdicken- und -volumenmessung zu erwarten. Die OCT wird in der Beurteilung des Makulaödems in der klinischen Routine weiter an Bedeutung gewinnen.AbstractOptical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid. Increase of retinal thickness correlates with decrease in visual acuity. Detailed interpretation of OCT images can replace fluorescein angiography in certain cases, as has been shown for uveitis. In order to obtain correct classification of macular disease in routine clinical use, all images have to be completely assessed and compared to previous investigations and to the measurements of the fellow eye. More accurate normal values of retinal thickness and volume can be expected in the future. The importance of OCT in routine clinical assessment of macular edema will most probably continue to grow.

Letzter klinischer Anlass und Ätiologie bei 1023 EnukleationenDeskriptive Datenbankauswertung mittels SPSS-Software im Antwortvariablenmodus mit Platzhaltervariablen

ZusammenfassungHintergrund. Die Entwicklung einer ophthalmopathologischen Datenbank mit einem mehrstelligen Datencode soll komplexe klinisch-pathologische Rückschlüsse von Diagnosen und Befunden anhand von klinischen (Mehrfach)anlässen und histopathologischen (Mehrfach)ätiologien ermöglichen und Neuzugänge einfach erfassen helfen. Patienten und Methoden. Von 1975–1996 wurden 2890 enukleierte Patientenaugen histopathologisch untersucht und die Hauptdiagnosen und Stammdaten der Patienten erfasst. Für die Erstellung der Datenbank wurde ein Zeitraum von 10 Jahren mit 1023 Bulbi gewählt. Die jeweiligen Häufigkeiten der histologischen Diagnosen und klinischen Anlässe wurden mit Hilfe eines deskriptiven Verfahrens im SPSS-Multiresponse-Modus der Software SPSS ermittelt. Ergebnisse. Die Hauptgruppen (z. B. histologische Diagnosen zur Ätiologie) und Untergruppen (z. B. Trauma, Neoplasie, Operationen, Systemerkrankungen, Entzündungen) wurden definiert und zu 798 unterschiedliche Diagnosen korreliert. Aus den im Durchschnitt mit 11 Diagnosen/Befunden beschriebenen Fälle ergaben sich 11.198 Nennungen. Schlussfolgerungen. Mit Hilfe des vorgestellten ophthalmopathologischen Datenbanksystems ist die vergleichende Untersuchung komplexer Enukleationsätiologien und -anlässe von verschiedenen Kliniken einer Region möglich. Die Darstellung der Komplexität seltener Befundungen und deren Einbindung in eine übergeordnete Struktur kann mit Hilfe der erarbeiteten Datenbank gelingen. Eine chronologisch und demographisch ausgerichtete Findung von Enukleationsgründen ist so möglich.AbstractBackground. A new data bank developed for ophthalmopathology using a computer-generated, multidigital data code is expec-ted to be able to accomplish complex clinicopathologic correlations of diagnoses and signs, as provided by (multiple) clinical events and histopathologically proven etiologies, and to facilitate the documentation of new data. Patients and methods. In the ophthalmopathology laboratory 2890 eyes were examined between January 20, 1975 and December 12, 1996. The main diagnoses and patient data from this 22-year period were recorded. To facilitate the presentation of data, a 10-year period with eyes of 976 patients enucleated from December, 1986 to December, 1996 was chosen. Principal and secondary diagnoses served for establishing the data bank. The frequencies of successive histologic and clinical diagnoses were evaluated by a descriptive computing program using an SPSS-multiresponse mode with dummy variables and a categorical variable listing of the software (SPSS version 10.0) classified as (a) nonfiltered random, (b) filtered by multiple etiologies, and (c) filtered by multiple events. Results. The principal groups (e.g., histologic diagnoses concerning etiology) and subgroups (e.g., trauma, neoplasia, surgery, systemic diseases, and inflammations) were defined and correlated with 798 separate diagnoses. From 11 diagnoses/events ascribed to the clinical cases, 11,198 namings resulted. Conclusions. Thus, a comparative study of complex etiologies and events leading to enucleation in different hospitals of a specific area may be performed using this electronic ophthalmopathologic data bank system. The complexity of rare diseases and integration into a superimposed structure can be managed with this custom-made data bank. A chronologically and demographically oriented consideration of reasons for enucleation is thus feasible.