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Schlötzer-Schrehardt U, Kruse FE. [Stem cell-based approaches to diseases of the ocular surface]. Ophthalmologe 2017; 114:296-297. [PMID: 28405821 DOI: 10.1007/s00347-017-0476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- U Schlötzer-Schrehardt
- Augenklinik mit Poliklinik der Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland.
| | - F E Kruse
- Augenklinik mit Poliklinik der Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland.
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Abstract
BACKGROUND Conjunctival melanoma is a rare but potentially fatal disease. The 10-year melanoma mortality can be up to 30 %, recurrence rates after treatment up to 50 % and the overall incidence of metastasis is 26 %. Improved treatment options are needed to increase the tumor-free survival of affected patients. OBJECTIVES The aim of the study was to perform clinical and pathological staging using the TNM classification and to correlate the results with treatment modalities and recurrence rates. MATERIAL AND METHODS The study included a case series of 80 eyes from 80 patients (42 females and 38 males, age 28-90 years) with histopathologically proven conjunctival melanoma studied by reviewing medical records, pathology reports and color photographs. The main evaluated characteristics were demographic information, tumor size, thickness, pathological diagnosis, BRAF mutation testing, clinical and pathological staging, recurrence, metastasis and duration of follow-up (mean 48 months). RESULTS The lesions predominantly involved the bulbar conjunctiva (60 %) and other sites that were less often involved were the palpebral conjunctiva (23 %), conjunctival fornix (22 %) and lacrimal caruncle (15 %). Of the tumors 36 % were TNM classified as pTis, 34 % as pT1, 20 % as pT2 (palpebral, fornix and caruncle) and 10 % as pT3. Local recurrences were noted in 36 % of the patients (18 % Tis, 26 % T1, 32 % T2 and 70 % T3) and regional and distant metastasis in 20 % of the patients (0 % Tis, 10 % T1, 15 % T2 and 60 % T3). DISCUSSION In this study increasing T stages were more often associated with recurrences and metastasis. Future studies correlating the TNM staging with histopathological and genetic predictors may help to improve the management of patients with conjunctival melanoma.
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Affiliation(s)
- A I Berta-Antalics
- Universitäts-Augenklinik, Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Deutschland.
| | - F E Kruse
- Universitäts-Augenklinik, Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Deutschland
| | - L Holbach
- Universitäts-Augenklinik, Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Deutschland
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Hos D, Dörrie J, Schaft N, Bock F, Notara M, Kruse FE, Krautwald S, Cursiefen C, Bachmann BO. Blockade of CCR7 leads to decreased dendritic cell migration to draining lymph nodes and promotes graft survival in low-risk corneal transplantation. Exp Eye Res 2015; 146:1-6. [PMID: 26689751 DOI: 10.1016/j.exer.2015.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/25/2015] [Accepted: 12/09/2015] [Indexed: 12/29/2022]
Abstract
The chemokine receptor CCR7 is essential for migration of mature dendritic cells (DCs) to the regional lymph nodes, and it has been shown that blocking of CCR7 improves graft survival after high-risk corneal transplantation in vascularized recipient corneas. However, it is so far unknown whether blocking of CCR7 reduces migration of DCs from the avascular cornea to the draining lymph nodes and whether this leads to improved graft survival also in the low-risk setting of corneal transplantation, which accounts for the majority of perforating transplantations performed. Therefore, in this study, pellets containing Freund's adjuvant and bovine serum albumin (BSA) conjugated to Alexa488 fluorescent dye were implanted into the corneal stroma of BALB/c mice to analyze antigen uptake by corneal DCs and their migration to the regional lymph nodes. After pellet implantation, mice were either treated by local administration of a CCR7 blocking fusion protein that consisted of CCL19 fused to the Fc part of human IgG1 or a control-IgG. In vivo fluorescence microscopy showed uptake of Alexa488-conjugated BSA by corneal DCs within 8 h. Furthermore, analysis of single cell suspensions of draining lymph nodes prepared after 48 h revealed that 2.1 ± 0.3% of CD11c(+) cells were also Alexa488(+). Importantly, DC migration was significantly reduced after topical administration of CCL19-IgG (1.2 ± 0.2%; p < 0.05). To test the effect of CCR7 blockade on graft rejection after allogeneic low-risk keratoplasty, corneal transplantations were performed using C57BL/6-mice as donors and BALB/c-mice as recipients. Treatment mice received two intraperitoneal loading doses of CCL19-IgG prior to transplantation, followed by local treatment with CCL19-IgG containing eye drops for the first two weeks after transplantation. Control mice received same amounts of control-IgG. Kaplan-Meier survival analysis showed that in the CCL19-IgG treated group, 76% of the grafts survived through the end of the 8 week observation period, whereas 38% of the grafts survived in the control group (p < 0.05). Taken together, our study shows that blockade of CCR7 reduces the migration of mature corneal DCs to the draining lymph nodes and leads to improved graft survival in low-risk corneal transplantation.
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Affiliation(s)
- D Hos
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - J Dörrie
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - N Schaft
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - F Bock
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - M Notara
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - F E Kruse
- Department of Ophthalmology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - S Krautwald
- Department of Nephrology and Hypertension, University of Kiel, Kiel, Germany
| | - C Cursiefen
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - B O Bachmann
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
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Kruse FE, Bachmann B. Update zur hinteren lamellären Keratoplastik mit Schwerpunkt der neuen endothelialen Transplantation. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1357810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kopsachilis N, Tsinopoulos I, Tsaousis KT, Meiller R, Dimitrakos SA, Kruse FE, Luessen UW. [Cross-linking in an artificial human cornea via induction of tissue transglutaminases]. Ophthalmologe 2012; 109:583-90. [PMID: 22526004 DOI: 10.1007/s00347-012-2538-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE In recent years many three-dimensional cornea models have been developed. However, they show poor collagen stability in the stroma. Transglutaminases (Tgases) are calcium-dependent proteins which play an important role in cross-linking of the corneal stroma. The purpose of this study was to find out whether it is possible to induce in vitro cross-linking of the stroma in an artificial hemicornea model with the help of Tgases. MATERIALS AND METHODS For the construction of the hemicornea, human SV40 adenovector corneal epithelial cells (HCE) and human SV40 adenovector corneal keratocytes (HCK) were cultivated. Confluent HCK cells were treated for 24 h with transforming growth factor beta (TGFb) 1, 2 and 3 at different concentrations as well as with other growth factors and the treated cells were compared to untreated cultivated cells. The quantification of the expression of the Tgases by HCKs was examined with the use of real time PCR, Western blot imaging and immunochemistry. RESULTS All concentrations of TGFbs used resulted in a significant increase of Tgase-mRNA, Tgase protein level and Tgase activity. The Tgases remained unaffected after treatment with other growth factors in comparison to untreated control cells. Treatment of the hemicornea with TGFb2 showed a very strong contraction and haze in comparison to the untreated hemicornea. CONCLUSION It has been shown for the first time that TGFb induces a strong expression of Tgases in HCK cells. This effect caused an undesired contraction and haze of the human hemicornea model. Further research is necessary in order to find out whether the induction of Tgases in the HCK cells can be regulated without losing stability of the constructed hemicornea.
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Affiliation(s)
- N Kopsachilis
- Department of Ophthalmology, Universität Erlangen-Nürnberg, Erlangen, Deutschland.
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Tourtas T, Bachmann BO, Cursiefen C, Kruse FE. Endotheliale Keratoplastik: Vergleich zwischen Transplantation von Stroma und Endothel (DSAEK) und isolierter Descemet'scher Membran (DMEK) – erste Ergebnisse. Klin Monbl Augenheilkd 2011. [DOI: 10.1055/s-0031-1297316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Kruse FE, Tourtas T, Cursiefen C, Bachmann BO. Die Fuchs'sche Hornhaut-Endothel-Dystrophie: Mittelfristige Erfahrungen mit der Transplantation der Descemet'schen Membran (DMEK) bei über 300 Patienten. Klin Monbl Augenheilkd 2011. [DOI: 10.1055/s-0031-1297315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Heindl LM, Treutlein E, Jünemann AGM, Kruse FE, Holbach LM. [Selective lacrimal sac biopsy for external dacryocystorhinostomy: a clinical pathological study]. Ophthalmologe 2011; 107:1139-44. [PMID: 20535481 DOI: 10.1007/s00347-010-2200-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Tumors of the lacrimal drainage system are rare but potentially life-threatening. The purpose of this study was to investigate the applicability of selective lacrimal sac biopsy in 500 cases of external dacryocystorhinostomy for acquired dacryostenosis. PATIENTS AND METHODS Lacrimal sac biopsy was obtained selectively for atypical clinical and/or intraoperative findings. The frequency and spectrum of biopsies were recorded and correlated with the follow-up results. RESULTS Lacrimal sac biopsy was performed in 19 external dacryocystorhinostomies (3.8%) including non-Hodgkin B-cell lymphoma (3), squamous carcinoma (2), mucoepidermoid carcinoma (1), malignant melanoma (1), oncocytoma (1), pyogenic granuloma (4), Wegener's granulomatosis (4) and sarcoidosis (3). Within 5 years none of the patients without biopsy developed systemic inflammatory diseases or lacrimal neoplasms. The 5-year survival was 87% in patients with significant lacrimal sac pathology and 96% in patients without significant pathology. CONCLUSION External dacryocystorhinostomy with selective biopsy for atypical clinical and intraoperative findings allows safe diagnosis and management of potentially life-threatening lacrimal lesions.
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Affiliation(s)
- L M Heindl
- Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, Germany.
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Schrems WA, Laemmer R, Hoesl LM, Horn FK, Mardin CY, Kruse FE, Tornow RP. Influence of atypical retardation pattern on the peripapillary retinal nerve fibre distribution assessed by scanning laser polarimetry and optical coherence tomography. Br J Ophthalmol 2011; 95:1437-41. [DOI: 10.1136/bjo.2010.190074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kruse FE. Transplantation der Descemet'schen Membran: Die ersten 150 Patienten. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1267558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kruse FE. Aktuelle Entwicklungen in der posterioren lamellären Keratoplastik. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1249459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kruse FE. Tiefe lamelläre Keratoplastik mit der isolierten Transplantation Descemet'schen Membran. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1243545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Murthum K, Kunze M, Kruse FE, Cursiefen C. GS101-P3-CG – Studie. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1243688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kruse FE. Neuartige Methode der vorderen lamellärer Keratoplastik mit der Femtosekunden-Laser-assistierten – Big Bubble-Technik. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1243544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kruse FE. Die Transplantation nur des Endothels mit Descemet'scher Membran bei der Endotheldystrophie: je dünner desto besser? Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1243686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kruse FE. Neue Techniken in der Hornhautchirurgie. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1242941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zimmermann P, Dietrich T, Bock F, Horn FK, Hofmann-Rummelt C, Kruse FE, Cursiefen C. Tumour-associated lymphangiogenesis in conjunctival malignant melanoma. Br J Ophthalmol 2009; 93:1529-34. [PMID: 19628489 PMCID: PMC2760727 DOI: 10.1136/bjo.2008.147355] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: To evaluate whether tumour-associated lymphangiogenesis, that is the formation of new lymphatic vessels (LVs) induced by a tumour, occurs in and around conjunctival malignant melanoma (MM). Methods: Clinical files and conjunctival specimens of 20 patients with histologically diagnosed conjunctival MM were analysed. Sections were stained with LYVE-1 and podoplanin antibodies as specific lymphatic endothelial markers and Ki67 as proliferation marker. The tumour area and the area covered by LV (LVA), LV number (LVN) and LV density (LVD) were measured within the tumour and in the peritumoural area in digital images of the specimen. The LV results were correlated with the histopathological characteristics, tumour location, recurrence rate, mitomycin C therapy and presence of metastases. Results: LVs were detected in all specimens within the tumour and peritumourally. Significantly more Ki67+ proliferating lymphatic endothelial cells were detected in the tumour and in the peritumoural tissue up to 300 μm compared with the surrounding normal conjunctiva (>300 μm distance). There was a slightly positive correlation between the tumour size and the LVN and LVA in the 50 μm zone adjacent to the tumour. We did not find any significant correlations between LVs and histopathological and clinical characteristics (location, shape, relapses, metastases), possibly due to the small sample sizes. Non-limbal tumours with involvement of tarsus or fornix showed a tendency towards a higher LVD compared with limbal tumours. Conclusion: Conjunctival MMs display tumour-associated LV within and around the tumour. The MM seems to induce lymphangiogenesis not only in the tumour, but also in its proximity.
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Affiliation(s)
- P Zimmermann
- Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany
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Abstract
A 68-year-old woman presented with a 10-month history of right-sided epiphora, bloody tears, and medial canthal mass. Computed tomography revealed a soft tissue mass of the right lacrimal sac with widening of the bony nasolacrimal canal. External dacryocystorhinostomy with incisional biopsy confirmed the diagnosis of malignant melanoma. After staging, further therapy included orbital exenteration, lateral rhinotomy with en bloc resection of the lacrimal drainage apparatus, and adjuvant radioimmunotherapy. One year after surgery, no evidence of local recurrence or metastatic disease could be detected.
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Affiliation(s)
- L M Heindl
- Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen.
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Händel A, Jünemann AGM, Prokosch HU, Beyer A, Ganslandt T, Grolik R, Klein A, Mrosek A, Michelson G, Kruse FE. [Web-based electronic patient record as an instrument for quality assurance within an integrated care concept]. Klin Monbl Augenheilkd 2009; 226:161-7. [PMID: 19294586 DOI: 10.1055/s-0028-1109193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE A prerequisite for integrated care programmes is the implementation of a communication network meeting quality assurance standards. Against this background the main objective of the integrated care project between the University Eye Hospital Erlangen and the health insurance company AOK Bayern was to evaluate the potential and the acceptance of a web-based electronic patient record in the context of cataract and retinal surgery. METHODS Standardised modules for capturing pre-, intra- and post-operative data on the basis of clinical pathway guidelines for cataract- and retinal surgery have been developed. There are 6 data sets recorded per patient (1 pre-operative, 1 operative, 4-6 post-operative). For data collection, a web-based communication system (Soarian Integrated Care) has been chosen which meets the high requirements in data security, as well as being easy to handle. This teleconsultation system and the embedded electronic patient record are independent of the software used by respective offices and hospitals. Data transmission and storage were carried out in real-time. RESULTS At present, 101 private ophthalmologists are taking part in the IGV contract with the University Eye Hospital Erlangen. This corresponds to 52% of all private ophthalmologists in the region. During the period from January 1st 2006 to December 31st 2006, 1844 patients were entered. Complete documentation was achieved in 1390 (75%) of all surgical procedures. For evaluation of this data, a multidimensional report and analysis tool (Cognos) was used. The deviation from target refraction as one quality indicator was in the mean 0.09 diopter. CONCLUSIONS The web-based patient record used in this project was highly accepted by the private ophthalmologists. However there are still general concerns against the exchange of medical data via the internet. Nevertheless, the web-based patient record is an essential tool for a functional integration between the ambulatory and stationary health-care units. In addition to the telemedicine functions of the system, we achieved the export of the data to a data warehouse system in order to provide a flexible and powerful tool for quality assurance analysis and reporting.
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Affiliation(s)
- A Händel
- Augenklinik, Universitätsklinikum Erlangen, Erlangen.
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Pogorelov P, Cursiefen C, Bachmann BO, Kruse FE. Changes in donor corneal lenticule thickness after Descemet's stripping automated endothelial keratoplasty (DSAEK) with organ-cultured corneas. Br J Ophthalmol 2009; 93:825-9. [DOI: 10.1136/bjo.2008.147389] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bachmann BO, Luetjen-Drecoll E, Bock F, Wiegand SJ, Hos D, Dana R, Kruse FE, Cursiefen C. Transient postoperative vascular endothelial growth factor (VEGF)-neutralisation improves graft survival in corneas with partly regressed inflammatory neovascularisation. Br J Ophthalmol 2009; 93:1075-80. [DOI: 10.1136/bjo.2008.145128] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kruse FE. Ergebnisse nach posteriorer lamellärer Keratoplastik (DSAEK). Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Huchzermeyer C, Brückner K, Laaser K, Kruse FE. Intraoperatives Floppy-Iris-Syndrom (IFIS) durch Tamsulosin. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Händel A, Pogorelov P, Wobbe JA, Kruse FE. QM-Ergebnis-Dokumentation Katarakt-Chirurgie: VISTANET. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jünemann AGM, Bellios N, Lämmer R, Mardin C, Kruse FE, Horn F. Intraokularer Druck und Progression bei Offenwinkelglaukomen – Einfluss der Langzeitvariabilität. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-0028-1104690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kruse FE. Möglichkeiten der Stammzelltherapie zur Rekonstruktion der Augenoberfläche. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-0028-1096393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Roedl JB, Bleich S, Schlötzer-Schrehardt U, von Ahsen N, Kornhuber J, Naumann GOH, Kruse FE, Jünemann AGM. Increased homocysteine levels in tear fluid of patients with primary open-angle glaucoma. Ophthalmic Res 2008; 40:249-56. [PMID: 18437035 DOI: 10.1159/000127832] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Indexed: 11/19/2022]
Abstract
AIMS We assessed homocysteine (Hcy) levels in tear fluid and plasma of patients with primary open-angle glaucoma (POAG). We determined the association between Hcy levels, dry eye syndrome and B vitamin status. METHODS This prospective case-control study included 36 patients with POAG and 36 controls. Hcy concentrations were measured by high-performance liquid chromatography. RESULTS Patients with POAG had significantly higher mean Hcy levels both in tear fluid (205 +/- 84 nmol/l; p < 0.001, t test) and in plasma (13.43 +/- 3.53 micromol/l; p = 0.001, t test) than control subjects (130 +/- 53 nmol/l and 10.50 +/- 3.33 micromol/l, respectively). Hcy in tear fluid was significantly correlated with plasma Hcy in POAG patients (r = 0.459; p = 0.005, Pearson's correlation), but not in controls (r = 0.068; p = 0.695). POAG patients with dry eye disease had significantly higher Hcy levels both in tear fluid and plasma than POAG patients without dry eye disease. There was no association between Hcy levels and B vitamin status in subjects with POAG. CONCLUSIONS The study suggests increased Hcy levels in tear fluid and plasma of patients with POAG. Elevated Hcy levels might be a risk factor for POAG and dry eye syndrome in subjects with glaucoma.
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Affiliation(s)
- J B Roedl
- Department of Ophthalmology, University Eye Hospital, Erlangen-Nuremberg, Germany.
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Heindl LM, Naumann GOH, Kruse FE, Holbach LM. Aggressive metastasising adenocarcinoma of the retinal pigment epithelium with trisomy 21. Br J Ophthalmol 2008; 92:389-91. [DOI: 10.1136/bjo.2007.127886] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meiller R, Horn FK, Kruse FE. Visus und Kontrastempfindlichkeit nach Katarakt-Operation mit Implantation einer aberrationskorrigierten (Acri.Smart 46LC) vs. aberrationskorrigierenden (Acri.Smart 36A) Hinterkammerlinse. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1058031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pollhammer M, Wuellner C, Tornow R, Pogorelov P, Kruse FE. Sekundärstrahlung bei refraktiver Chirurgie mittels UV-Femtosekundenlaser. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1057980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pollhammer M, Pogorelov P, Walker R, Thyzel R, Kruse FE. Nachstar-Prophylaxe durch Ablation von Linsenepithelzellen mit dem ARC-Laser Photolyse-System (ALPS) – Pilotstudie zur klinischen Sicherheit. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1057946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rudolph M, Pogorelov P, Horn F, Kruse FE. Verbesserung der Kontrastsensitivität und Reduktion der Blendempfindlichkeit durch Implantation einer hydrophoben Acryl-Faltlinse Zeiss Hydromax – vorläufige Ergebnisse. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1058033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pogorelov P, Cursiefen C, Kruse FE. Mittelfristige Ergebnisse nach posteriorer lamellärer Keratoplastik mit dem Mikrokeratom (DSAEK). Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1057926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kruse FE, Cursiefen C. Surgery of the Cornea: Corneal, Limbal Stem Cell and Amniotic Membrane Transplantation. Developments in Ophthalmology 2008; 41:159-170. [DOI: 10.1159/000131087] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Schlötzer-Schrehardt U, Dietrich T, Saito K, Sorokin L, Sasaki T, Paulsson M, Kruse FE. Characterization of extracellular matrix components in the limbal epithelial stem cell compartment. Exp Eye Res 2007; 85:845-60. [PMID: 17927980 DOI: 10.1016/j.exer.2007.08.020] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 08/22/2007] [Accepted: 08/23/2007] [Indexed: 12/13/2022]
Abstract
A specialized microenvironment or niche, which regulates maintenance, self-renewal, activation, and proliferation of stem cells by external signals, is one of the key prerequisites for stem cell function. However, the parameters determining the limbal stem cell niche are not yet defined. In order to characterize the role of basement membrane (BM) and extracellular matrix components in the generation of a microenvironmental niche for limbal stem and progenitor cells, we extensively analyzed the topographical variations of the BM zone of human ocular surface epithelia using immunohistochemistry and a large panel of antibodies to most of the presently described intrinsic and associated BM components. Apart from BM components uniformly expressed throughout all ocular surface epithelia (e.g. type IV collagen alpha5 and alpha6 chains, collagen types VII, XV, XVII, and XVIII, laminin-111, laminin-332, laminin chains alpha3, beta3,and gamma2, fibronectin, matrilin-2 and -4, and perlecan), the BM of the limbal epithelium shared many similarities with that of the conjunctival epithelium, including positive labelling for type IV collagen alpha1 and alpha2 chains, laminin alpha5, beta2, and gamma1 chains, nidogen-1 and -2, and thrombospondin-4, whereas type IV collagen alpha3, type V collagen, fibrillin-1 and -2, thrombospondin-1, and endostatin were present in the corneal BM, but lacking or more weakly expressed in the limbal and conjunctival BMs. As compared to both the corneal and conjunctival BMs, the limbal BM showed a markedly increased immunoreactivity for laminin alpha1, alpha2, beta1 chains, and agrin, and a specific but patchy immunoreactivity for laminin gamma3 chain, BM40/SPARC, and tenascin-C, which co-localized with ABCG2/p63/K19-positive and K3/Cx43/desmoglein/integrin-alpha2-negative cell clusters comprising putative stem and early progenitor cells in the basal epithelium of the limbal palisades. Components that were particularly expressed in the corneal-limbal transition zone included type XVI collagen, fibulin-2, tenascin-C/R, vitronectin, bamacan, chondroitin sulfate, and versican, all of which co-localized with vimentin-positive cell clusters comprising putative late progenitor cells in the basal epithelium. This pronounced heterogeneity of the BM in the limbal area, both in the region of limbal palisades and the corneal-limbal transition zone, appears to be involved in providing unique microenvironments for corneal epithelial stem and late progenitor cells. Identification of specific niche parameters might not only help to understand limbal stem cell regulation, but also to improve their selective enrichment and in vitro expansion for therapeutic strategies.
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Affiliation(s)
- U Schlötzer-Schrehardt
- Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen, Germany.
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Abstract
The diagnostic classification of most conjunctival tumors is based on case history, inspection, and examination with the slit lamp microscope. Further imaging procedures are rarely indicated when malignant processes are not circumscribed. Clinical classification then also includes palpation and echographic examination of regional lymph nodes. Pigmented and nonpigmented melanocytic nevi are the most frequent conjunctival tumors. An important practical biomicroscopic cardinal symptom of the most frequent nevi is the presence of epithelial pseudocysts. Essential in practice is the histopathological confirmation of the clinical diagnosis, e.g., distinguishing between nonpigmented melanomas and sebaceous gland carcinomas with a pagetoid growth pattern or squamous cell carcinomas. Depending on the course and findings, the following therapeutic measures can be indicated: cryotherapy, chemotherapy, radiotherapy, modified enucleation, orbital exenteration, or a combination of different methods.
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Affiliation(s)
- L M Holbach
- Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen.
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Lütjen-Drecoll E, Kruse FE. [Primary open angle glaucoma. Morphological bases for the understanding of the pathogenesis and effects of antiglaucomatic substances]. Ophthalmologe 2007; 104:167-78; quiz 179. [PMID: 17242882 DOI: 10.1007/s00347-007-1481-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The pathogenesis of glaucomatic illnesses is poorly understood. An increase in ocular pressure can be caused by an increase in the secretion of aqueous humour or a reduction in its outflow. In the elderly, outflow is reduced while at the same time less aqueous humour is produced. This balance is easily disturbed, so that age represents a risk factor for glaucoma in addition to increased ocular pressure. Therapeutic possibilities involve, on the one hand, reducing the secretion of aqueous humour, for example using, beta blockers, carbonic anhydrase inhibitors and clonidine. On the other hand, aqueous humour outflow can also be influenced by drugs. Conventional outflow is increased by the administration of miotics. The uveoscleral outflow can be increased by prostaglandin derivates. Drugs which only influence trabecular outflow are not yet available. Future therapeutic possibilities involve new aspects of the pathophysiology, e.c. the use of growth factors, free radical scavenging enzymes and choroidal blood flow.
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Affiliation(s)
- E Lütjen-Drecoll
- Institut für Anatomie, Lehrstuhl II, Universität Erlangen-Nürnberg, 91054, Erlangen, Germany.
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41
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Roedl JB, Bleich S, Reulbach U, Rejdak R, Naumann GOH, Kruse FE, Schlötzer-Schrehardt U, Kornhuber J, Jünemann AGM. Vitamin deficiency and hyperhomocysteinemia in pseudoexfoliation glaucoma. J Neural Transm (Vienna) 2007; 114:571-5. [PMID: 17238009 DOI: 10.1007/s00702-006-0598-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Accepted: 10/28/2006] [Indexed: 01/18/2023]
Abstract
Pseudoexfoliation syndrome (PEX) is a systemic disorder characterized by the deposition of an abnormal fibrillar material in ocular and various extraocular tissues. It represents the most common identifiable cause of glaucoma (PEX glaucoma = PEXG). Due to similar pathogenetic mechanisms, glaucoma has been called "ocular Alzheimer's disease". PEXG and Alzheimer's disease share common associations such as the higher prevalence of hyperhomocysteinemia in both disorders. In order to investigate the cause of hyperhomocysteinemia in PEXG, we evaluated B-vitamin levels (folate, B12, B6) and their associations with homocysteine (Hcy) in plasma of 70 PEXG patients and 70 control subjects. Folate, vitamin B12 and B6 levels were significantly decreased and associated with elevated Hcy levels in PEXG. Low B-vitamin levels in PEX might also help explain, at least in part, the higher prevalence of B-vitamin deficiency in disorders associated with PEX such as Alzhemier's disease.
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Affiliation(s)
- J B Roedl
- Department of Ophthalmology and University Eye Hospital, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.
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Pollhammer M, Cursiefen C, Rummelt C, Walker R, Thyzel R, Kruse FE. Nachstarprophylaxe durch In-vivo-Ablation von Linsenepithelzellen am Kaninchenauge mit dem ARC-Laser-Photolyse-System. Klin Monbl Augenheilkd 2007. [DOI: 10.1055/s-2007-976227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rössler C, Pogorelov P, Laaser K, Meiller R, Kruse FE. Neue Verfahren zur Hornhautpachymetrie (Vergleich zwischen Visante OCT, Orbscan II, Pentacam, OCP Pachymeter, AC Master und Ultraschall). Klin Monbl Augenheilkd 2007. [DOI: 10.1055/s-2007-976236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kruse FE, Cursiefen C. Neue Verfahren zur lamellären Keratoplastik – Tiefe lamelläre Keratoplastik. Klin Monbl Augenheilkd 2007. [DOI: 10.1055/s-2007-976203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mardin C, Kruse FE. Avastin in der Therapie der altersassoziierten Makuladegeneration (AMD). Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-954628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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46
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Knorr HLJ, Kruse FE. Retinologische Versorgung von Traumata. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-954634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kruse FE. Hornhaut-, Oberflächen-, refraktiver Chirurgieeinfluss auf Pars-plana-Vitrektomie. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-954638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Roedl JB, Bleich S, Reulbach U, von Ahsen N, Schlötzer-Schrehardt U, Rejdak R, Naumann GOH, Kruse FE, Kornhuber J, Jünemann AGM. Homocysteine levels in aqueous humor and plasma of patients with primary open-angle glaucoma. J Neural Transm (Vienna) 2006; 114:445-50. [PMID: 16932990 DOI: 10.1007/s00702-006-0556-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2006] [Accepted: 07/06/2006] [Indexed: 11/29/2022]
Abstract
We determined homocysteine (Hcy) levels in aqueous humor (AH) and plasma and their association with B-vitamin levels in patients with primary open-angle glaucoma (POAG) and controls. Both AH Hcy and plasma Hcy levels were significantly increased in POAG, and elevation of AH Hcy and plasma Hcy was a significant risk factor for POAG. In contrast to controls, neither plasma nor AH Hcy of POAG patients demonstrated a significant association with important non-genetic determinants of elevated Hcy such as low B-vitamin levels, increasing age and caffeine consumption. Considering that Hcy is a neurotoxin that induces apoptotic retinal ganglion cell death via stimulation of the N-methyl-D-asparate (NMDA) receptor, increased Hcy concentrations in AH and plasma might contribute to the optic nerve damage in POAG.
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Affiliation(s)
- J B Roedl
- Department of Ophthalmology and University Eye Hospital, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany
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Kruse FE, Schloetzer-Schrehardt U, Braunger B, Dietrich T, Bachmann B, Cursiefen C. Neue Methoden zur Oberflächenrekonstruktion: Ex-vivo-kultivierte Stammzellen. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-948233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kruse FE, Hanisch C, Themel S, Jacobi C, Pollhammer M, Meiller R. Neue Entwicklungen in der Kataraktchirurgie. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-948240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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