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Past – Present – PersPectives in OPhthalmOlOGy · Diagnostic interventions include fluorescein...

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kwww.augen.co.at MEDICAL NETWORK 2013 53 PRESENT Based on the introduction of intravitreal inhibition of vascular endothelial growth factor (VEGF) in the treatment of the leading retinal patho- logies, the condition for these major blinding diseases has changed com- pletely. Diagnostic interventions include fluorescein angiography (FA) as a mandatory initial step, while optical coherence tomography (OCT) is clearly the method of choice for follow-up. Spectral-domain (SD)-OCT has replaced conventional OCT in clinical practice, but guidance from prospective clinical studies are still lacking. While retinal thickness does not correlate with visual function, qualitative parameters show good results for a prognostic evaluation of disease management. Anti-VEGF-therapy has clearly improved the paradigms in retinal disease, but optimal parameters are still under investigation. Prof. Dr. Ursula Schmidt-Erfurth, Wien The question, which small gauge vitrectomy system has to be favored, is still an open controversy. While in Europe the 23 gauge systems are very well established, the 25 gauge systems are widely in use in the US. Since this is still an ongoing debate, the introduction of the 27 gauge system by Oshima has raised the new question if this system is sufficient and could replace 23 or 25 gauge sys- tems. Current datas allow the following conclusion: By continuous improvement of instrument stability, quality and efficacy, continued miniaturization of vitrectomy as represented by 27 gauge vitrectomy, we could further reduce complications and improve the comfort for the patients with an increasing number of indications. Prof. Dr. Christoph Scholda, Wien ART 2012 FORTSETZUNG SEITE 54 > PAST In the 18th century Paris had been the center of ophthalmology. Now Vienna became the Mecca of eye surgery and every young doctor, who wanted to become proficient as an eye surgeon made the pilgrimage to the Da- nube metropolis. One of them was the Berlin surgeon-general, Carl Ferdinand von Graefe. He had come to Vienna to learn cataract surgery from Beer. When a generation later his son Albrecht spent some time in Vienna, he became friends with Beer‘s son-in-law Friedrich Jaeger, who set important impulses for Graefe‘s later ground-breaking innovations. Prof. Dr. Reinhard Koch, Bonn Die schmerzlindernden Eigen- schaften aus Extrakten der – von Ureinwohnern in Südamerika als „göttliches Geschenk“ gepriesenen – Kokapflanze erkannten und beschrieben zahlreiche Forscher, die sich mit der Droge beschäftigten. Unverständlicher- weise wurde aus ihren wiederholt gemachten Mitteilungen jedoch nicht an die Möglichkeit einer medizinischen Anwendung und an schmerzlos durchführbare operative Eingriffe gedacht, eine Erkenntnis, die erst 1884 durch den Wiener Augenarzt Carl Koller gemacht wurde. Die Erschließung der lokalanästhetischen Eigen- schaften des Kokains war daher ein Meilenstein in der Medizin und die Geburtsstunde der Lokal- und Regionalanästhesie. Nicht nur für die operative Ophthalmologie. Mit der Entdeckung der anäs- thetischen Eigenschaften des Kokains durch Carl Koller wurde ein Menschheitstraum Wirklichkeit: Divinum est sedare dolorem. Prof. Dr. Gisbert Richard, Hamburg, Präsident Euretina PAST – PRESENT – PERSPECTIVES IN OPHTHALMOLOGY FOTOS: DR. E. FEICHTINGER / MEDICAL NETWORK „PAST – PRESENT – PERSPECTIVES IN OPHTHALMOLOGY“ war das Motto der 9. ART (Advanced Retinal Therapy), die stark vom 200-Jahr-Jubiläum der Wiener Universitätsklinik für Augenheilkunde geprägt war. Aus Platzgrün- den können wir hier nur exemplarische Auszüge und kurze Zitate von dieser beeindruckenden Veranstaltung bringen. Mehr Infos finden Sie unter www.artvienna.eu EINE FOTOSTORY VON DER VERANSTALTUNG FINDEN SIE IN DEN NEWS VON: www.medical-network.at
Transcript
  • kwww.augen.co.at Medical Network 2013 53

    PRESENT

    Based on the introduction of intra vitreal inhibition of vascular

    endothelial growth factor (VEGF) in the treatment of the leading retinal pathologies, the condition for these major blinding diseases has changed completely. Diagnostic interventions include fluorescein angio graphy (FA) as a mandatory initial step, while optical coherence tomography (OCT) is clearly the method of choice for followup. Spectraldomain (SD)OCT has replaced conventional OCT in clinical practice, but guidance from prospective clinical studies are still lacking. While retinal thickness does not correlate with visual function, qualitative parameters show good results for a prognostic evaluation of disease management. AntiVEGFtherapy has clearly improved the paradigms in retinal disease, but optimal parameters are still under investigation. Prof. Dr. Ursula Schmidt-Erfurth, wien

    The question, which small gauge vitrec tomy system has to be favored,

    is still an open controversy. While in Europe the 23 gauge systems are very well established, the 25 gauge systems are widely in use in the US. Since this is still an ongoing debate, the introduction of the 27 gauge system by Oshima has raised the new question if this sys tem is sufficient and could replace 23 or 25 gauge systems. Current datas allow the following conclusion: By continuous improvement of instrument stability, quality and efficacy, continued miniaturization of vitrectomy as represented by 27 gauge vitrectomy, we could further reduce complications and improve the comfort for the patients with an increasing number of indications. Prof. Dr. Christoph Scholda, wien

    art 2012

    Fortsetzung seite 54 >

    PAST

    In the 18th century Paris had been the center of ophthalmology.

    Now Vienna became the Mecca of eye surgery and every young doctor, who wanted to become proficient as an eye surgeon made the pilgrimage to the Danube metropolis. One of them was the Berlin surgeongeneral, Carl Ferdinand von Graefe. He had come to Vienna to learn cataract surgery from Beer. When a generation later his son Albrecht spent some time in Vienna, he became friends with Beer‘s soninlaw Friedrich Jaeger, who set important impulses for Graefe‘s later groundbreaking innovations. Prof. Dr. Reinhard Koch, Bonn

    Die schmerzlindernden Eigenschaften aus Extrakten der – von

    Ureinwohnern in Südamerika als „göttliches Geschenk“ gepriesenen – Kokapflanze erkannten und beschrieben zahlreiche Forscher, die sich mit der Droge beschäftigten. Unverständlicherweise wurde aus ihren wiederholt gemachten Mitteilungen jedoch nicht an die Möglichkeit einer medizinischen Anwendung und an schmerzlos durchführbare operative Eingriffe gedacht, eine Erkenntnis, die erst 1884 durch den Wiener Augenarzt Carl Koller gemacht wurde. Die Erschließung der lokalanästhetischen Eigenschaften des Kokains war daher ein Meilenstein in der Medizin und die Geburtsstunde der Lokal und Regionalanästhesie. Nicht nur für die operative Ophthalmologie. Mit der Entdeckung der anästhetischen Eigenschaften des Kokains durch Carl Koller wurde ein Menschheitstraum Wirklichkeit: Divinum est sedare dolorem.

    Prof. Dr. Gisbert Richard, Hamburg, Präsident euretina

    Past – Present – PersPectives in OPhthalmOlOGy

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    „Past – PreseNt – PersPectives iN oPHtHalMologY“ war das Motto der 9. art (advanced retinal therapy), die stark vom 200-Jahr-Jubiläum der wiener Universitätsklinik für augenheilkunde geprägt war. aus Platzgrün-den können wir hier nur exemplarische auszüge und kurze Zitate von dieser beeindruckenden veranstaltung bringen. Mehr infos finden sie unter www.artvienna.eu

    eiNe FotostorY voN Der veraNstaltUNg FiNDeN sie iN DeN News voN: www.medical-network.at

  • 54 Medical Network 2013 kwww.augen.co.at

    art 2012

    PROGRESS

    Laser Refractive Cataract Surgery can be performed safely without

    significant complications. The capsulorhexis is superior to the manual. Special conditions such as PEX shacky or loose zonules are very good candidates. The technology still has to evolve further. It will be seen in the future whether medical or economical reasons will dominate the discussion on the use of femtosecondlasers.

    Prof. Dr. Gerd U. Auffarth, Heidelberg

    Retinal imaging has been avail able since the first ophthalmo scopes

    in the 1850s. For approximately 100 years ophthalmologists depended upon recordings such images by draw ings and paintings. In the late fourties fundus photographs became available. The last half century has seen an explosion in novel devices for imaging the retina and in particular OCT has played a major role. We now enter the era of objective analysis of retinal images.

    Prof. John Marschall, london

    PERSPECTIVES

    We are developing and testing a device that combines the simpli

    city of binoculars, the automation and usability of an ATM, the versatility of software „apps“ and the capabilities of optical coherence tomography (OCT) into a single, lowcost device, so that patients can complete a comprehensive, digital eyeexam anytime and anywhere without outside assistance. A binocular design was chosen to allow patients to selfalign the optical axes of the device with the optical axes of their eyes. Binocular imaging also enables binocular testing such as pupillometry and ocular alignment testing. Customdesigned software applications were implemented to perform the functions of numerous pieces of hardware, such as visual field machines, autorefractors, corneal topographers and biometers. WholeeyeOCT is being implemented to substantially reduce our reliance on conventional slit lamp biomicroscopes. Finally a different revenue model is being proposed that, like mobile phones, should allow people around the world to afford this device.

    Alexander Walsh, los angeles

    Immense opportunities exist in developing new methods of show

    ing information to users in the form of wearable display systems. As these systems are further miniaturized eventually reaching the form of a contact lens in the future, the same systems may be used to collect biomarker information from the surface of the eye to provide a window to the person’s health for management of chronic conditions.

    Prof. Babak A. Parviz, seattle

    Die top-Funktionäre des heimischen wissenschaftsbe-triebes, prominente ophthalmologen, Politiker, Präsi-denten von internationalen augenarzt-organisationen und nicht zuletzt ein Feuerwerk der sinne im abend-programm verliehen der art 2012 besonderen glanz.

    PAST – PRESENT – PERSPECTIVES IN OPhThAlMOlOGyPeoPle

    informationsstände der sponsoren ergänzten das angebot der art 2012.

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