3D Mapping of the DMEK Detachment Area from OCT Scans of the Anterior Segment of the Eye - Clinical Applications. / 3D-Kartierung der DMEK-Abhebungsfläche aus OCT-Scans des vorderen Augensegmentes mit klinischen Anwendungen.

Graft detachment is the most common complication after Descemet membrane endothelial keratoplasty (DMEK). To assess the amount of graft detachment, precision is limited when using slit-lamp biomicroscopy. Detachment of DMEK grafts can be assessed automatically on anterior segment optical coherence tomography (AS OCT) images and allows visualization of the area and volume of detachment using 3D maps. This article provides an overview of its applications such as accurately assessing the course of natural graft attachment, identification of potential risk factors for detachment and evaluation of the long-term effect of graft detachment. The 3D map of DMEK detachment may support researchers and clinicians in precise quantification of the area and volume of graft detachment even in large data sets, and the intuitive, fast and reliable evaluation.

ZEISS PLEX Elite 9000 Widefield Optical Coherence Tomography Angiography as Screening Method for Early Detection of Retinal Hemangioblastomas in von Hippel-Lindau Disease.

Purpose: To evaluate early detection of retinal hemangioblastomas (RHs) in von Hippel-Lindau disease (VHLD) with widefield optical coherence tomography angiography (wOCTA) compared to the standard of care in ophthalmologic VHLD screening in a routine clinical setting. Methods: We conducted prospective comparisons of three screening methods: wOCTA, standard ophthalmoscopy, and fluorescein angiography (FA), which was performed only in uncertain cases. The numbers of detected RHs were compared among the three screening methods. The underlying causes for the lack of detection were investigated. Results: In 91 eyes (48 patients), 67 RHs were observed (mean, 0.74 ± 1.59 RH per eye). FA was performed in eight eyes. Ophthalmoscopy overlooked 25 of the 35 RHs detected by wOCTA (71.4%) due to the background color of the choroid (n = 5), small tumor size (n = 13), masking by a bright fundus reflex (n = 2), and masking by surrounding retinal scars (n = 5). However, wOCTA missed 29 RHs due to peripheral location (43.3%). The overall detection rates were up to 37% on the basis of ophthalmoscopy alone, up to 52% for wOCTA, and 89% for FA. Within the retinal area covered by wOCTA, the detection rates were up to 46.7% for ophthalmoscopy alone, up to 92.1% for wOCTA, and 73.3% for FA. Conclusions: The overall low detection rate of RHs using wOCTA is almost exclusively caused by its inability to visualize the entire peripheral retina. Therefore, in unclear cases, FA is necessary after ophthalmoscopy. Translational Relevance: Within the imageable retinal area, wOCTA shows a high detection rate of RHs and therefore may be suitable to improve screening for RHs in VHLD.

IMBA ­ Um instrumento para a prática do profissional de trabalho / IMBA ­ An Instrument for the entrepreneurial practice of the work professional

O texto descreve o projeto IMBA: Integração de Pessoas com Deficiência no Mercado de trabalho e suas diversas aplicações bem sucedidas em diferentes organizações européias e sua iminente introdução no Brasil. IMBA é um procedimento de comparação de perfis de trabalho e de documentação para a capacitação justa da força de trabalho. Com o IMBA as exigências de trabalho e as capacidades humanas podem ser descritas, definidas e comparadas entre si consistentemente. O IMBA considera, desta forma, de maneira especial as necessidades dos mais velhos, de pessoas com necessidades especiais numa visão nova e mais eficiente. O IMBA foi desenvolvido e testado pelo iqpr, Instituto para a Segurança de Qualidade na Prevenção e Reabilitação, e as organizações parceiras Universidade de Siegen e Munda GmbH, Essen, com o apoio financeiro do Ministério Alemão do Trabalho e Assuntos Sociais. A equipe de desenvolvimento é interdisciplinar, formada por cientistas do trabalho, médicos, psicólogos e cientistas do esporte. O IMBA tem atualmente uma versão impressa e outra em software chamada MARIE. O IMBA pode também ser aplicado no contexto da educação profissional e da prevenção, da reabilitação e da integração além de fornecer uma ferramenta adequada para a elaboração do status e da documentação de intervenção. Dependendo do problema pode ser introduzido no âmbito de medidas médicas para colocação inicial de pessoas no trabalho, quando há exigências específicas de habilidades e dimensões. Em suma, o IMBA é uma ferramenta que pode ser utilizada de modo a ajudar o indivíduo dentro de um processo de reabilitação e de integração no trabalho.

The text describes the Project IMBA: Integration of people with disabilities into the workplace and its several successful applications in different European organizations and its imminent introduction in Brazil. IMBA is a profile comparison and documentation procedures for the equitable workforce capacity. With IMBA can job requirements and human capabilities through consistent, defined characteristics be described and compared directly with each other. IMBA considers in this special way the needs of elderly, disabled people a new and more efficient vision. IMBA has been developed and tested by iqpr, Institute for Quality Security in the Prevention and Rehabilitation, and partner organizations University of Siegen and Munda GmbH, Essen, with financial support of the German Ministry of Labour and Social Affairs. The development team consisted of an interdisciplinary team made up of work scientists, physicians, psychologists and sports scientists. IMBA has currently a paper version and a software version called MARIE. Otherwise IMBA can be used in the context of professional education and prevention, rehabilitation and integration and provides an appropriate tool to status and documentation course of intervention. Depending on the problem it may also integrate within the scope of medical measures for early implementation when job-specific skill requirements and dimensions e.g. to reintegrate into the workplace, in the medical rehabilitation process. IMBA is to be applied in a way to help the individual within a necessary rehabilitation and integration process.