[New options for digital photo documentation during routine examination for ophthalmologists]. / Neue Möglichkeiten der digitalen Fotodokumentation im klinischen Alltag für Augenärzte.

BACKGROUND: Many clinical investigations cannot be carried out at the examination unit or a slit lamp. Here we present three new options to obtain digital pictures in a routine clinic at a slit lamp and evaluate how user friendly they are. METHODS: A) First, a digital photo documentation is examined at a conventional slit lamp by a modified binocular ray splitter. One ray of the binocular ray splitter is connected to a digital camera, while the second ray in this patented prototype is connected to the light sources of a synchronised flash light. B) A Smartphone generated fundus images via the monocular of a microscope. Macroscopic details up to 60× at the external eye were obtained by a magnifying gadget of the iPhone. C) With a USB microscope, high resolutions pictures were generated without large technical expense directly at the job and digitally were archived over an USB connection. RESULTS: A trained ophthalmologist demonstrated an excellent documentation at a slit lamp using all 3 digital camera systems. The new ray splitter allows enhanced the image quality at the anterior and posterior segments of the eye. Also the Smartphone obtained by its autofocus and automatic exposure control stunningly high resolution images at the fundus. An attached magnifying aperture glass enables documentation with a 20-fold magnification and is already used in dermatology as the "Handyskope". The USB microscope may be used to record macroscopic details with a 200-fold magnification and resolution of 2 million pixels. It is connected to a PC desktop at the workstation and has only a limited depth resolution, requiring a precise focus. CONCLUSION: The increasing distribution of the Smartphone and significant improvement of its digital camera make its use in medicine meaningful. Low-priced attempts and mobile applications open new implications in the evaluation of ophthalmological patients.

[Reliability and safety of intravitreal Ozurdex injections. The ZERO study]. / Zuverlässigkeit und Sicherheit von intravitrealen Ozurdex-Injektionen. Die ZERO-Studie.

BACKGROUND: Since July 2010 Ozurdex® is approved in Germany for treatment of macular edema from retinal vein occlusion (RVO). The objective of this observational study was a systemic summary and analysis of clinical experience regarding complications and side effects of intravitreal administration of dexamethasone. PATIENTS AND METHODS: In a retrospective, multicenter study conducted at 10 centers, 342 eyes with RVO were treated with intravitreal dexamethasone (Ozurdex®, Allergan). After treatment the patients were followed-up over a period of 8 months and intraoperative, perioperative and postoperative complications, such as elevated intraocular pressure and dislocation of implants were systematically recorded. RESULTS: No infections, endophthalmitis, perioperative hypotension, intraoperative lens injuries or retinal detachment occurred. Elevated intraocular pressure was the most common complication accounting for nearly 20 %. In 9 % of patients the intraocular pressure increased by more than 10 mmHg compared to baseline and in 6 patients to > 35 mmHg. In cases of known glaucoma intraocular pressure elevation was not significantly more frequent compared to non-glaucoma patients. In four cases a progression of lens opacity led to phacoemulsification and two implant dislocations in the anterior chamber required surgical repositioning in the vitreous cavity. In two cases a postinterventional macular hole was observed. CONCLUSIONS: In the clinical routine Ozurdex treatment has proven to be a therapy method with minimal side effects. In Ozurdex administration intraocular pressure elevation was observed as the most common side effect; however, this generally did not require surgical intervention. Caution is advised in patients with an anterior chamber lens and iridectomy. Macular holes as a rare complication might result from vitreous traction during the administration process. In summary, even in the clinical routine application of Ozurdex the complication rate was not higher than in registration studies.