RESUMO
PURPOSE: To analyse the willingness for postmortem cornea donation in Germany. METHODS: Employees in two cities (UKM, UKS), and university hospitals (STM, STE), members of the German Ophthalmological Society (DOG), and employees of an automobile company (BO) participated in a questionnaire about postmortem cornea donation attitudes. The questionnaire consisted of demographic items, motives concerning postmortem cornea donation, general attitudes toward donation, and questions concerning the perceived needs for information about donation. The statistical analyses included logistic regression with the target parameter of 'willingness to donate cornea postmortem'. RESULTS: Of the participants, 67.7 % (UKM, UKS), 70.9 % (STM, STE), 70.8 % (BO), and 79.4 % (DOG) declared their intention to donate their corneas postmortem. Younger age (p < 0.001), poorer general health (p < 0.05), faith in an eternal life (p < 0.05), disagreement with brain death diagnostics (p < 0.001), fear of receiving worse medical treatment (p < 0.001), and fear of the commercialization of organs (p < 0.001) were found to be risk factors for a negative attitude toward postmortem cornea. The majority of participants (57.4 %) indicated that additional information about donation would be appreciated, and the internet (69.9 %) was considered the most appropriate means for conveying this information. CONCLUSIONS: Emotional items were revealed to be the most relevant factors influencing the willingness to donate cornea postmortem, which may be counteracted by means of public education. The relatively low willingness among the medical staff contrasts with previous observations in a professional ophthalmologic society.
Assuntos
Atitude Frente a Saúde , Córnea , Doadores Vivos/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Autopsia , Feminino , Alemanha , Inquéritos Epidemiológicos , Humanos , Masculino , Corpo Clínico Hospitalar , Pessoa de Meia-Idade , Opinião Pública , Inquéritos e QuestionáriosAssuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Aptâmeros de Nucleotídeos/administração & dosagem , Neovascularização de Coroide/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Anticorpos Monoclonais Humanizados , Bevacizumab , Neovascularização de Coroide/diagnóstico , Terapia Combinada , Angiofluoresceinografia , Humanos , Injeções Intraoculares , Masculino , Fotoquimioterapia , Ranibizumab , Retina/efeitos dos fármacos , Retratamento , Tomografia de Coerência Óptica , Acuidade Visual , Corpo Vítreo , Degeneração Macular Exsudativa/diagnósticoRESUMO
PURPOSE: A dummy orbit for enucleated eyes was developed for training residents in diagnostic and surgical procedures. METHODS: Porcine eyes were used to construct the model. The device is made of black anodized metal. The final prototype was tested for ease of use and optical quality. Principal elements are an adjustable eye support, a cylinder, and a removable ring. RESULTS: The dummy orbit and enucleated eye allow direct and indirect ophthalmoscopy; inspection with contact lenses, including gonioscopy; and retinal laser coagulation using contact lenses. Laser trabeculoplasty, argon laser trabeculotomy, Nd:YAG laser iridectomy, and Nd:YAG laser capsulectomy are possible, as well as training in tonometry and ultrasonography techniques. CONCLUSION: The dummy orbit is a valuable aid for teaching and training in diagnostic and laser surgery procedures with nondissected enucleated eyes.
Assuntos
Técnicas de Diagnóstico Oftalmológico , Enucleação Ocular , Modelos Anatômicos , Procedimentos Cirúrgicos Oftalmológicos , Oftalmologia/educação , Órbita/anatomia & histologia , Animais , Educação/métodos , Internato e Residência , SuínosRESUMO
The investigation of the influence of electrical stimulation on the visual system can be sub-divided into empirical, diagnostic and therapeutic phases of development. The first electrical stimulations of the visual system in animals dating back to the eighteenth century represent empirical approaches well before knowledge on the principles of bioelectrical nerve activity was available. Despite this lack of understanding, attempts were made at that time to treat blind people by electrical stimulation. More than 100 years later, with the advancement of technology and knowledge on nerve function, attempts were made to establish various methods of electrical stimulation for the diagnosis of different diseases of the visual system. For more than 30 years attempts to develop electrical devices have been made to by-pass defects of the visual system and to restore basic orientation. Presently nine different groups world-wide are focusing on retinal, optic or cortical implants. A short review on the historical use of electrical stimulation and new therapeutical attempts are given in this paper.
Assuntos
Cegueira/reabilitação , Terapia por Estimulação Elétrica , Nervo Óptico/fisiologia , Próteses e Implantes , Córtex Visual/fisiologia , Potenciais de Ação/fisiologia , Idoso , Animais , Terapia por Estimulação Elétrica/instrumentação , Eletrodos Implantados , Feminino , Humanos , Implantes Experimentais , Degeneração Macular/reabilitação , Masculino , Microcomputadores , Pessoa de Meia-Idade , Retinose Pigmentar/reabilitação , Percepção Visual/fisiologiaRESUMO
BACKGROUND: Analysis of willingness for postmortem cornea donation by professionals in ophthalmology and their motives in favor of or against donation. PATIENTS AND METHODS: 3887 members of the German Ophthalmological Society received an anonymous questionnaire concerning sociodemographic background, physical health, experiences with organ explantation and their former engagement and motives concerning organ and cornea donation. RESULTS: 722 of the questionnaires were partially and 533 completely answered with an average willingness for cornea donation of 79.4%. Significant parameters for cornea donation were gender, former experience with organ explantation, ophthalmological health and fear of false diagnosis of brain death, worse medical treatment or organ commercialization. Of the participants 53.9% suggested the internet as a favorite source of information in this matter. CONCLUSION: The factors which had a significant impact on cornea donation in this survey seem to be mainly a result of insufficient information. Detailed information regarding this topic should preferentially be presented on internet pages of professional societies and could probably increase donation approval of DOG members.
Assuntos
Atitude do Pessoal de Saúde , Transplante de Córnea/estatística & dados numéricos , Internet/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Médicos/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Diretivas Antecipadas/estatística & dados numéricos , Distribuição por Idade , Idoso , Coleta de Dados , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores SocioeconômicosAssuntos
Neoplasias Oculares/complicações , Neoplasias Oculares/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Complicações na Gravidez/diagnóstico , Oclusão da Veia Retiniana/complicações , Oclusão da Veia Retiniana/diagnóstico , Transtornos da Visão/diagnóstico , Adulto , Doença Crônica , Feminino , Humanos , Gravidez , Transtornos da Visão/etiologiaAssuntos
Eletrorretinografia/efeitos dos fármacos , Macula Lutea/efeitos dos fármacos , Doadores de Óxido Nítrico/efeitos adversos , Doenças Retinianas/induzido quimicamente , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Tomografia de Coerência ÓpticaAssuntos
Astenopia/etiologia , Oftalmopatias/diagnóstico , Loíase/diagnóstico , Adulto , Astenopia/diagnóstico , Dietilcarbamazina/uso terapêutico , Emergências , Oftalmopatias/tratamento farmacológico , Filaricidas/uso terapêutico , Humanos , Loíase/complicações , Loíase/tratamento farmacológico , MasculinoRESUMO
BACKGROUND: In the year 2000, the photodynamic therapy (PDT) was introduced as a new option for the treatment of exudative choroidal neovascularisation (CNV). Since this kind of therapy required the health insurance company's consent, the waiting period for the first therapy varied considerably. MATERIALS AND METHODS: Between July 2000 and September 2004, 133 eyes were treated via PDT. In this study, 59 courses were analysed retrospectively, all of them within the frame of a classic or predominantly classic exudative CNV. RESULTS: At the time of indication for the therapy, 38.46 % of the eyes of patients under the age of 65 and 73.91 % of the eyes of patients over the age of 65 showed a visual acuity (VA) of less than 0.3. Nine eyes lost the VA needed to drive a car (> or = 0.6), eight eyes lost the reading ability (< 0.4) before the first PDT. One eye lost its reading ability, one eye reached the classification of "visually handicapped & blindness" (< or = 0.3) and one eye went blind (< or = 0.02) within 7 days of waiting time. CONCLUSION: Elderly people showed less VA at first investigations by ophthalmologists, which underscores the necessity of an intensive campaign about the classic symptoms of AMD. The results of this study confirm that loss of VA can be caused by CNV progression within seven days. Whether or not rapid treatment with PDT influences the visual and morphological outcome, has to be proven by more extensive studies.
Assuntos
Neovascularização de Coroide/tratamento farmacológico , Fóvea Central , Fotoquimioterapia/métodos , Acuidade Visual/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cegueira/etiologia , Feminino , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
PURPOSE: Demonstrations and practical experiments are important constituents of the teaching of surgical principles and techniques to residents in ophthalmology. The objective was to develop an eye-support device for experimental and didactic use during vitreoretinal microsurgery in vitro. METHODS: Various eye-support devices with different light sources and illumination intensities were designed and tested. The main components of the final prototype are a high-intensity halogen lamp, a flexible light guide, a cylinder with a mirror inside, and a replaceable, transparent eye support with a ring-adapter. Light from the point source is reflected via the light guide into the cylinder and through the eye support transsclerally into the eye. RESULTS: The device illuminates the retina and the vitreous body sufficiently. It accentuates the transparent appearance of the retina and makes the three-dimensional structure more visible, for example, in case of retinal detachment. Subretinal tissue can be visualized and differentiated more precisely. CONCLUSIONS: The device is useful, in the teaching of residents and in experimental vitreoretinal surgery.