Immediate Past President of International Council of Ophthalmology(ICO);Academician and former Secretary General of Academia Ophthalmologica Internationalis(AOI);Former Chairman of the Scientific Program of the World ...Immediate Past President of International Council of Ophthalmology(ICO);Academician and former Secretary General of Academia Ophthalmologica Internationalis(AOI);Former Chairman of the Scientific Program of the World Congress of Ophthalmology(WOC);Member of the German Academy of Sciences,former President of German Society of Ophthalmology(DOG);Former Executive Vice President of University of Leipzig and Director of the Eye Hospital;Member of the Club Jules Gonin Executive Committee(2000-2006)。展开更多
AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment...AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment and to discuss the presumed role of the glial scaffold for foveal structure stabilization. METHODS: A retrospective case series of 38 eyes of 35 patients is described. Of these, 17 eyes of 16 patients displayed foveal regeneration after resolution of CME, and 6 eyes of 6 patients displayed CME with ILM detachment. Eleven eyes of 9 patients displayed other kinds of foveal and retinal disorders associated with ILM detachment. RESULTS: The pattern of edematous cyst distribution, with or without a large cyst in the foveola and preferred location of cysts in the inner nuclear layer or Henle fiber layer(HFL), may vary between different eyes with CME or in one eye during different CME episodes. Large cysts in the foveola may be associated with a tractional elevation of the inner foveal layers and the formation of a foveoschisis in the HFL. Edematous cysts are usually not formed in the ganglion cell layer. Eyes with CME and ILM detachment display a schisis between the detached ILM and nerve fiber layer(NFL) which is traversed by Müller cell trunks. ILM detachment was also found in single eyes with myopic traction maculopathy, macular pucker, full-thickness macular holes, outer lamellar holes, and glaucomatous parapapillary retinoschisis, and in 3 eyes with Müller cell sheen dystrophy(MCSD). As observed in eyes with MCSD, cellophane maculopathy, and macular pucker, respectively, fundus light reflections can be caused by different highly reflective membranes or layers: the thickened and tightened ILM which may or may not be detached from the NFL, the NFL, or idiopathic epiretinal membranes. In eyes with short single or multiple CME episodes, the central fovea regenerated either completely, which included the disappearance of irregularities of the photoreceptor layer lines and the reformation of a fovea externa, or with remaining irregularities of the photoreceptor layer lines. CONCLUSION: The examples of a complete regeneration of the foveal morphology after transient CME show that the fovea may withstand even large tractional deformations and has a conspicuous capacity of structural regeneration as long as no cell degeneration occurs. It is suggested that the regenerative capacity depends on the integrity of the threedimensional glial scaffold for foveal structure stabilization composed of Müller cell and astrocyte processes. The glial scaffold may also maintain the retinal structure after loss of most retinal neurons as in late-stage MCSD.展开更多
AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet con...AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet concentrate to treat full-thickness macular holes, and to describe different anatomical outcome. METHODS: A retrospective case series of 8 eyes of 8 patients was described. RESULTS: In all cases investigated, the plateletassisted closure of macular holes was associated with a rapid resolution of cystic cavities in the foveal walls. In two patients, there was a regular regeneration of the foveal morphology after hole closure;the regenerated central fovea had a regular structure with a foveola and photoreceptors. In three other patients, there was an irregular regeneration of the fovea;a foveola was not formed, photoreceptor cells were absent from the foveal center, and the center was composed of Müller and retinal pigment epithelial(RPE) cells. The foveal regeneration after hole closure may proceed with or without a temporary detachment of the foveal center from the RPE, and with or without a direct contact between the central outer nuclear layer(ONL) and the RPE. Contacts between the ONL and RPE were observed only in patients with an irregular foveal regeneration after hole closure.CONCLUSION: The data show that there are different modes of foveal regeneration after closure of macular holes with(re)vitrectomy and platelet concentrate. It is suggested that the regular regeneration of the foveal morphology proceeds by Müller cell-mediated tissue movements without cell proliferation, whereas the irregular foveal regeneration proceeds in part by proliferation of Müller and RPE cells.展开更多
INTRODUCTION The Italian anatomist Filippo Pacini discovered the internal limiting membrane(ILM) in 1844[1]. The ILM is the basement membrane of the retinal Müller cells representing the structural interface betw...INTRODUCTION The Italian anatomist Filippo Pacini discovered the internal limiting membrane(ILM) in 1844[1]. The ILM is the basement membrane of the retinal Müller cells representing the structural interface between the retina and the vitreous. The macular ILM is thickest, measuring 2.5 μm and progressively thins to 0.5 μm at the vitreous base[2].展开更多
INTRODUCTION Since the beginning of vitreoretinal surgery proliferative vitreoretinopathy(PVR)has been a constant complication.PVR is the major cause for surgical failure after primary rhegmatogenous retinal detachmen...INTRODUCTION Since the beginning of vitreoretinal surgery proliferative vitreoretinopathy(PVR)has been a constant complication.PVR is the major cause for surgical failure after primary rhegmatogenous retinal detachment(RRD)resulting in multiple reoperations and vision loss.So far,there is no proven therapy to treat or prevent PVR.展开更多
Rhegmatogenous retinal detachment(RRD)is the most common retinal emergency,threatening visual acuity,with an incidence of 1/10000[1].The number of RRDs is increasing[2-3].I recently had to prepare two expert reports a...Rhegmatogenous retinal detachment(RRD)is the most common retinal emergency,threatening visual acuity,with an incidence of 1/10000[1].The number of RRDs is increasing[2-3].I recently had to prepare two expert reports about the correct timing of RRD surgery.展开更多
Wound-healing diseases present complex challenges,and proliferative vitreoretinopathy(PVR)has been a problem in the surgical retina for 50y.PVR is a prolonged and abnormal healing response to retinal injury,such as pr...Wound-healing diseases present complex challenges,and proliferative vitreoretinopathy(PVR)has been a problem in the surgical retina for 50y.PVR is a prolonged and abnormal healing response to retinal injury,such as primary retinal detachment(RD)or post-RD surgery,characterized by the formation of pre/subretinal membranes,retinal gliosis and shortening,retinal pigment epithelium cell(RPE)proliferation,and increased activity of glial cells(mainly Müller cells).展开更多
International ophthalmology sometimes appears to be boring as its topics are mostly remote and we all have enough issues in front of our doorstep.However,sometimes important decisions affect all of us.This year’s mot...International ophthalmology sometimes appears to be boring as its topics are mostly remote and we all have enough issues in front of our doorstep.However,sometimes important decisions affect all of us.This year’s motto of World Sight Day(the 2^(nd) Thursday of October)is“Love your eyes”.We should join millions of others who will be doing the same.展开更多
Dear Colleagues,The International Council of Ophthalmology (ICO) is deeply committed to the health and safety of our communities during the COVID-19 pandemic.Unfortunately,due to escalating risks,a physical meeting of...Dear Colleagues,The International Council of Ophthalmology (ICO) is deeply committed to the health and safety of our communities during the COVID-19 pandemic.Unfortunately,due to escalating risks,a physical meeting of our international colleagues and partners at the World Ophthalmology Congress (WOC2020) in Cape Town 26-29 June,is no longer possible.While we are all disappointed that our face-to-face meeting is cancelled,the ICO remains devoted to bringing together the world’s ophthalmologists to learn the latest from one another,and to advance eye care during these extraordinarily challenging times.展开更多
1.Uncertainty,risk,and understanding The phrase"Nothing in life is to be feared;it is only to be understood."is attributed to Marie Sklodowska-Curie.Fear often stems from uncer-tainty,which frequently arises...1.Uncertainty,risk,and understanding The phrase"Nothing in life is to be feared;it is only to be understood."is attributed to Marie Sklodowska-Curie.Fear often stems from uncer-tainty,which frequently arises from a lack of knowledge and under-standing.Uncertainty is not an inherent feature of the world-it is rather a reflection of our relationship and interaction with it,shaped by what we know and what we do not.People's perception of risk importance can differ,even when the actual risk remains unchanged,and therefore,people may interpret the same risk differently.Probability is one way to measure and communicate uncertainty or risk.Differences in risk perception are inherent to being human and illustrate why judgment is always involved when we encounter an unknown and must make a decision on how to deal with it.展开更多
1.Introduction Good surgeons are essential for patients.The personal prerequisites,the best way to learn and to teach,and the structural requirements and evaluation criteria for the formation of surgeons are described...1.Introduction Good surgeons are essential for patients.The personal prerequisites,the best way to learn and to teach,and the structural requirements and evaluation criteria for the formation of surgeons are described.A definition of a master surgeon is presented.Even if surgical techniques change in the future,the fundamental relationship between surgeon and patient will remain unchanged.展开更多
文摘Immediate Past President of International Council of Ophthalmology(ICO);Academician and former Secretary General of Academia Ophthalmologica Internationalis(AOI);Former Chairman of the Scientific Program of the World Congress of Ophthalmology(WOC);Member of the German Academy of Sciences,former President of German Society of Ophthalmology(DOG);Former Executive Vice President of University of Leipzig and Director of the Eye Hospital;Member of the Club Jules Gonin Executive Committee(2000-2006)。
文摘AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment and to discuss the presumed role of the glial scaffold for foveal structure stabilization. METHODS: A retrospective case series of 38 eyes of 35 patients is described. Of these, 17 eyes of 16 patients displayed foveal regeneration after resolution of CME, and 6 eyes of 6 patients displayed CME with ILM detachment. Eleven eyes of 9 patients displayed other kinds of foveal and retinal disorders associated with ILM detachment. RESULTS: The pattern of edematous cyst distribution, with or without a large cyst in the foveola and preferred location of cysts in the inner nuclear layer or Henle fiber layer(HFL), may vary between different eyes with CME or in one eye during different CME episodes. Large cysts in the foveola may be associated with a tractional elevation of the inner foveal layers and the formation of a foveoschisis in the HFL. Edematous cysts are usually not formed in the ganglion cell layer. Eyes with CME and ILM detachment display a schisis between the detached ILM and nerve fiber layer(NFL) which is traversed by Müller cell trunks. ILM detachment was also found in single eyes with myopic traction maculopathy, macular pucker, full-thickness macular holes, outer lamellar holes, and glaucomatous parapapillary retinoschisis, and in 3 eyes with Müller cell sheen dystrophy(MCSD). As observed in eyes with MCSD, cellophane maculopathy, and macular pucker, respectively, fundus light reflections can be caused by different highly reflective membranes or layers: the thickened and tightened ILM which may or may not be detached from the NFL, the NFL, or idiopathic epiretinal membranes. In eyes with short single or multiple CME episodes, the central fovea regenerated either completely, which included the disappearance of irregularities of the photoreceptor layer lines and the reformation of a fovea externa, or with remaining irregularities of the photoreceptor layer lines. CONCLUSION: The examples of a complete regeneration of the foveal morphology after transient CME show that the fovea may withstand even large tractional deformations and has a conspicuous capacity of structural regeneration as long as no cell degeneration occurs. It is suggested that the regenerative capacity depends on the integrity of the threedimensional glial scaffold for foveal structure stabilization composed of Müller cell and astrocyte processes. The glial scaffold may also maintain the retinal structure after loss of most retinal neurons as in late-stage MCSD.
文摘AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet concentrate to treat full-thickness macular holes, and to describe different anatomical outcome. METHODS: A retrospective case series of 8 eyes of 8 patients was described. RESULTS: In all cases investigated, the plateletassisted closure of macular holes was associated with a rapid resolution of cystic cavities in the foveal walls. In two patients, there was a regular regeneration of the foveal morphology after hole closure;the regenerated central fovea had a regular structure with a foveola and photoreceptors. In three other patients, there was an irregular regeneration of the fovea;a foveola was not formed, photoreceptor cells were absent from the foveal center, and the center was composed of Müller and retinal pigment epithelial(RPE) cells. The foveal regeneration after hole closure may proceed with or without a temporary detachment of the foveal center from the RPE, and with or without a direct contact between the central outer nuclear layer(ONL) and the RPE. Contacts between the ONL and RPE were observed only in patients with an irregular foveal regeneration after hole closure.CONCLUSION: The data show that there are different modes of foveal regeneration after closure of macular holes with(re)vitrectomy and platelet concentrate. It is suggested that the regular regeneration of the foveal morphology proceeds by Müller cell-mediated tissue movements without cell proliferation, whereas the irregular foveal regeneration proceeds in part by proliferation of Müller and RPE cells.
文摘INTRODUCTION The Italian anatomist Filippo Pacini discovered the internal limiting membrane(ILM) in 1844[1]. The ILM is the basement membrane of the retinal Müller cells representing the structural interface between the retina and the vitreous. The macular ILM is thickest, measuring 2.5 μm and progressively thins to 0.5 μm at the vitreous base[2].
文摘INTRODUCTION Since the beginning of vitreoretinal surgery proliferative vitreoretinopathy(PVR)has been a constant complication.PVR is the major cause for surgical failure after primary rhegmatogenous retinal detachment(RRD)resulting in multiple reoperations and vision loss.So far,there is no proven therapy to treat or prevent PVR.
文摘Rhegmatogenous retinal detachment(RRD)is the most common retinal emergency,threatening visual acuity,with an incidence of 1/10000[1].The number of RRDs is increasing[2-3].I recently had to prepare two expert reports about the correct timing of RRD surgery.
文摘Wound-healing diseases present complex challenges,and proliferative vitreoretinopathy(PVR)has been a problem in the surgical retina for 50y.PVR is a prolonged and abnormal healing response to retinal injury,such as primary retinal detachment(RD)or post-RD surgery,characterized by the formation of pre/subretinal membranes,retinal gliosis and shortening,retinal pigment epithelium cell(RPE)proliferation,and increased activity of glial cells(mainly Müller cells).
文摘International ophthalmology sometimes appears to be boring as its topics are mostly remote and we all have enough issues in front of our doorstep.However,sometimes important decisions affect all of us.This year’s motto of World Sight Day(the 2^(nd) Thursday of October)is“Love your eyes”.We should join millions of others who will be doing the same.
文摘Dear Colleagues,The International Council of Ophthalmology (ICO) is deeply committed to the health and safety of our communities during the COVID-19 pandemic.Unfortunately,due to escalating risks,a physical meeting of our international colleagues and partners at the World Ophthalmology Congress (WOC2020) in Cape Town 26-29 June,is no longer possible.While we are all disappointed that our face-to-face meeting is cancelled,the ICO remains devoted to bringing together the world’s ophthalmologists to learn the latest from one another,and to advance eye care during these extraordinarily challenging times.
文摘1.Uncertainty,risk,and understanding The phrase"Nothing in life is to be feared;it is only to be understood."is attributed to Marie Sklodowska-Curie.Fear often stems from uncer-tainty,which frequently arises from a lack of knowledge and under-standing.Uncertainty is not an inherent feature of the world-it is rather a reflection of our relationship and interaction with it,shaped by what we know and what we do not.People's perception of risk importance can differ,even when the actual risk remains unchanged,and therefore,people may interpret the same risk differently.Probability is one way to measure and communicate uncertainty or risk.Differences in risk perception are inherent to being human and illustrate why judgment is always involved when we encounter an unknown and must make a decision on how to deal with it.
文摘1.Introduction Good surgeons are essential for patients.The personal prerequisites,the best way to learn and to teach,and the structural requirements and evaluation criteria for the formation of surgeons are described.A definition of a master surgeon is presented.Even if surgical techniques change in the future,the fundamental relationship between surgeon and patient will remain unchanged.
