The Experts below are selected from a list of 102 Experts worldwide ranked by ideXlab platform

Ulrich Kellner - One of the best experts on this subject based on the ideXlab platform.

  • cystoid macular oedema and epiretinal membrane formation during progression of Chloroquine Retinopathy after drug cessation
    British Journal of Ophthalmology, 2014
    Co-Authors: Simone Kellner, Silke Weinitz, Ghazaleh Farmand, Ulrich Kellner
    Abstract:

    Aims To evaluate progression of morphological alterations in Chloroquine (CQ) or hydroxyChloroquine (HCQ) Retinopathy after drug cessation. Methods Eleven female patients (age range at drug cessation 46–78 years; treatment duration 5–20 years) were examined between 2.1 and 7.1 years after drug cessation. In addition to clinical examination, they underwent high-resolution optical coherence tomography (OCT) (spectral domain OCT (SD-OCT); Spectralis OCT, Heidelberg Engineering, Germany), fundus autofluorescence (FAF), near-infrared autofluorescence (NIA; HRA2, Heidelberg Engineering, Germany) and ultra-wide-angle fundus autofluorescence (UW-FAF; Optos 200Tx; Optos PLC, UK). Results Two patients with very limited parafoveal Retinopathy did not present with progression within 3 years. In the remaining nine patients, visual acuity deteriorated and progression of retinal degeneration could be documented. FAF, UW-FAF and NIA changes included an increase of affected area or a regional increase or decrease of FAF or NIA intensity. SD-OCT changes included reduction of retinal thickness, an increased area of photoreceptor or retinal pigment epithelial loss, development or increase of cystoid macular oedema (4/9) or development of epiretinal membranes (5/9). Therapy of cystoid macular oedema was of limited benefit. Conclusions CQ Retinopathy can progress over a long period of time after drug cessation and may be complicated by cystoid macular oedema, epiretinal membrane formation and peripheral involvement.

  • spectral domain optical coherence tomography detects early stages of Chloroquine Retinopathy similar to multifocal electroretinography fundus autofluorescence and near infrared autofluorescence
    British Journal of Ophthalmology, 2009
    Co-Authors: Simone Kellner, Silke Weinitz, Ulrich Kellner
    Abstract:

    Aims: To compare spectral domain optical coherence tomography (sdOCT) to melanin-related near-infrared fundus autofluorescence (NIA, excitation 787nm, emission >800nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488nm, emission >500nm) and multifocal electroretinography (mfERG) in patients with long-term chloroquin (CQ) treatment. Methods: Eight patients with 5.5-22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph). Results: In three patients all test results were normal after 5.5-16 years of CQ treatment. Five patients presented with variably progressed CQ Retinopathy (10-22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction of mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors. Conclusion: MfERG, FAF, NIA and sdOCT detect early stages of CQ Retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ Retinopathy.

  • spectral domain optical coherence tomography detects early stages of Chloroquine Retinopathy similar to multifocal electroretinography fundus autofluorescence and near infrared autofluorescence
    British Journal of Ophthalmology, 2009
    Co-Authors: Simone Kellner, Silke Weinitz, Ulrich Kellner
    Abstract:

    Aims: To compare spectral domain optical coherence tomography (sdOCT) with melanin-related near-infrared fundus autofluorescence (NIA, excitation 787 nm, emission >800 nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm, emission >500 nm) and multifocal electroretinography (mfERG) in patients with long-term chloroquin (CQ) treatment. Methods: Eight patients with 5.5–22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph). Results: In three patients, all test results were normal after 5.5–16 years of CQ treatment. Five patients presented with variably progressed CQ Retinopathy (10–22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction in mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans, the outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors. Conclusion: MfERG, FAF, NIA and sdOCT detect early stages of CQ Retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ Retinopathy.

  • Chloroquine Retinopathy lipofuscin and melanin related fundus autofluorescence optical coherence tomography and multifocal electroretinography
    Documenta Ophthalmologica, 2008
    Co-Authors: Ulrich Kellner, Simone Kellner, Silke Weinitz
    Abstract:

    Purpose To evaluate melanin-related near-infrared fundus autofluorescence (NIA, excitation 787 nm, emission > 800 nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm, emission >500 nm), optical coherence tomography (OCT), and multifocal electroretinography (mfERG) in patients with Chloroquine (CQ) Retinopathy. Methods Two patients with progressed CQ Retinopathy underwent clinical examination, ISCEV mfERG evaluation, and FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) with either a 30° or wide-angle field-of-view. OCT3 imaging was performed in one of these patients. Results In the foveola, FAF and NIA were relatively normal. Parafoveal loss of retinal pigment epithelium (RPE) was indicated by absent FAF and NIA. An area of reduced FAF and NIA surrounded the parafoveal region of RPE loss. In the adjacent area, FAF was increased and increased NIA marked the peripheral border of increased FAF. Wide-field imaging revealed increased FAF in association with retinal vessels. Retinal thickness was markedly reduced in the OCT predominantly in the parafoveal region. Visual field loss and mfERG amplitude reduction corresponded to areas with increased or reduced FAF and NIA. Conclusion Patterns of FAF and NIA indicate different stages of pathophysiologic processes involving lipofuscin and melanin in the RPE. Combined retinal imaging and functional testing provides further insights in the pathogenesis and development of retinal degenerative disease. An association of CQ Retinopathy with retinal vessels architecture is hypothesized.

Simone Kellner - One of the best experts on this subject based on the ideXlab platform.

  • cystoid macular oedema and epiretinal membrane formation during progression of Chloroquine Retinopathy after drug cessation
    British Journal of Ophthalmology, 2014
    Co-Authors: Simone Kellner, Silke Weinitz, Ghazaleh Farmand, Ulrich Kellner
    Abstract:

    Aims To evaluate progression of morphological alterations in Chloroquine (CQ) or hydroxyChloroquine (HCQ) Retinopathy after drug cessation. Methods Eleven female patients (age range at drug cessation 46–78 years; treatment duration 5–20 years) were examined between 2.1 and 7.1 years after drug cessation. In addition to clinical examination, they underwent high-resolution optical coherence tomography (OCT) (spectral domain OCT (SD-OCT); Spectralis OCT, Heidelberg Engineering, Germany), fundus autofluorescence (FAF), near-infrared autofluorescence (NIA; HRA2, Heidelberg Engineering, Germany) and ultra-wide-angle fundus autofluorescence (UW-FAF; Optos 200Tx; Optos PLC, UK). Results Two patients with very limited parafoveal Retinopathy did not present with progression within 3 years. In the remaining nine patients, visual acuity deteriorated and progression of retinal degeneration could be documented. FAF, UW-FAF and NIA changes included an increase of affected area or a regional increase or decrease of FAF or NIA intensity. SD-OCT changes included reduction of retinal thickness, an increased area of photoreceptor or retinal pigment epithelial loss, development or increase of cystoid macular oedema (4/9) or development of epiretinal membranes (5/9). Therapy of cystoid macular oedema was of limited benefit. Conclusions CQ Retinopathy can progress over a long period of time after drug cessation and may be complicated by cystoid macular oedema, epiretinal membrane formation and peripheral involvement.

  • spectral domain optical coherence tomography detects early stages of Chloroquine Retinopathy similar to multifocal electroretinography fundus autofluorescence and near infrared autofluorescence
    British Journal of Ophthalmology, 2009
    Co-Authors: Simone Kellner, Silke Weinitz, Ulrich Kellner
    Abstract:

    Aims: To compare spectral domain optical coherence tomography (sdOCT) to melanin-related near-infrared fundus autofluorescence (NIA, excitation 787nm, emission >800nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488nm, emission >500nm) and multifocal electroretinography (mfERG) in patients with long-term chloroquin (CQ) treatment. Methods: Eight patients with 5.5-22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph). Results: In three patients all test results were normal after 5.5-16 years of CQ treatment. Five patients presented with variably progressed CQ Retinopathy (10-22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction of mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors. Conclusion: MfERG, FAF, NIA and sdOCT detect early stages of CQ Retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ Retinopathy.

  • spectral domain optical coherence tomography detects early stages of Chloroquine Retinopathy similar to multifocal electroretinography fundus autofluorescence and near infrared autofluorescence
    British Journal of Ophthalmology, 2009
    Co-Authors: Simone Kellner, Silke Weinitz, Ulrich Kellner
    Abstract:

    Aims: To compare spectral domain optical coherence tomography (sdOCT) with melanin-related near-infrared fundus autofluorescence (NIA, excitation 787 nm, emission >800 nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm, emission >500 nm) and multifocal electroretinography (mfERG) in patients with long-term chloroquin (CQ) treatment. Methods: Eight patients with 5.5–22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph). Results: In three patients, all test results were normal after 5.5–16 years of CQ treatment. Five patients presented with variably progressed CQ Retinopathy (10–22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction in mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans, the outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors. Conclusion: MfERG, FAF, NIA and sdOCT detect early stages of CQ Retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ Retinopathy.

  • Chloroquine Retinopathy lipofuscin and melanin related fundus autofluorescence optical coherence tomography and multifocal electroretinography
    Documenta Ophthalmologica, 2008
    Co-Authors: Ulrich Kellner, Simone Kellner, Silke Weinitz
    Abstract:

    Purpose To evaluate melanin-related near-infrared fundus autofluorescence (NIA, excitation 787 nm, emission > 800 nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm, emission >500 nm), optical coherence tomography (OCT), and multifocal electroretinography (mfERG) in patients with Chloroquine (CQ) Retinopathy. Methods Two patients with progressed CQ Retinopathy underwent clinical examination, ISCEV mfERG evaluation, and FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) with either a 30° or wide-angle field-of-view. OCT3 imaging was performed in one of these patients. Results In the foveola, FAF and NIA were relatively normal. Parafoveal loss of retinal pigment epithelium (RPE) was indicated by absent FAF and NIA. An area of reduced FAF and NIA surrounded the parafoveal region of RPE loss. In the adjacent area, FAF was increased and increased NIA marked the peripheral border of increased FAF. Wide-field imaging revealed increased FAF in association with retinal vessels. Retinal thickness was markedly reduced in the OCT predominantly in the parafoveal region. Visual field loss and mfERG amplitude reduction corresponded to areas with increased or reduced FAF and NIA. Conclusion Patterns of FAF and NIA indicate different stages of pathophysiologic processes involving lipofuscin and melanin in the RPE. Combined retinal imaging and functional testing provides further insights in the pathogenesis and development of retinal degenerative disease. An association of CQ Retinopathy with retinal vessels architecture is hypothesized.

Silke Weinitz - One of the best experts on this subject based on the ideXlab platform.

  • cystoid macular oedema and epiretinal membrane formation during progression of Chloroquine Retinopathy after drug cessation
    British Journal of Ophthalmology, 2014
    Co-Authors: Simone Kellner, Silke Weinitz, Ghazaleh Farmand, Ulrich Kellner
    Abstract:

    Aims To evaluate progression of morphological alterations in Chloroquine (CQ) or hydroxyChloroquine (HCQ) Retinopathy after drug cessation. Methods Eleven female patients (age range at drug cessation 46–78 years; treatment duration 5–20 years) were examined between 2.1 and 7.1 years after drug cessation. In addition to clinical examination, they underwent high-resolution optical coherence tomography (OCT) (spectral domain OCT (SD-OCT); Spectralis OCT, Heidelberg Engineering, Germany), fundus autofluorescence (FAF), near-infrared autofluorescence (NIA; HRA2, Heidelberg Engineering, Germany) and ultra-wide-angle fundus autofluorescence (UW-FAF; Optos 200Tx; Optos PLC, UK). Results Two patients with very limited parafoveal Retinopathy did not present with progression within 3 years. In the remaining nine patients, visual acuity deteriorated and progression of retinal degeneration could be documented. FAF, UW-FAF and NIA changes included an increase of affected area or a regional increase or decrease of FAF or NIA intensity. SD-OCT changes included reduction of retinal thickness, an increased area of photoreceptor or retinal pigment epithelial loss, development or increase of cystoid macular oedema (4/9) or development of epiretinal membranes (5/9). Therapy of cystoid macular oedema was of limited benefit. Conclusions CQ Retinopathy can progress over a long period of time after drug cessation and may be complicated by cystoid macular oedema, epiretinal membrane formation and peripheral involvement.

  • spectral domain optical coherence tomography detects early stages of Chloroquine Retinopathy similar to multifocal electroretinography fundus autofluorescence and near infrared autofluorescence
    British Journal of Ophthalmology, 2009
    Co-Authors: Simone Kellner, Silke Weinitz, Ulrich Kellner
    Abstract:

    Aims: To compare spectral domain optical coherence tomography (sdOCT) to melanin-related near-infrared fundus autofluorescence (NIA, excitation 787nm, emission >800nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488nm, emission >500nm) and multifocal electroretinography (mfERG) in patients with long-term chloroquin (CQ) treatment. Methods: Eight patients with 5.5-22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph). Results: In three patients all test results were normal after 5.5-16 years of CQ treatment. Five patients presented with variably progressed CQ Retinopathy (10-22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction of mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors. Conclusion: MfERG, FAF, NIA and sdOCT detect early stages of CQ Retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ Retinopathy.

  • spectral domain optical coherence tomography detects early stages of Chloroquine Retinopathy similar to multifocal electroretinography fundus autofluorescence and near infrared autofluorescence
    British Journal of Ophthalmology, 2009
    Co-Authors: Simone Kellner, Silke Weinitz, Ulrich Kellner
    Abstract:

    Aims: To compare spectral domain optical coherence tomography (sdOCT) with melanin-related near-infrared fundus autofluorescence (NIA, excitation 787 nm, emission >800 nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm, emission >500 nm) and multifocal electroretinography (mfERG) in patients with long-term chloroquin (CQ) treatment. Methods: Eight patients with 5.5–22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph). Results: In three patients, all test results were normal after 5.5–16 years of CQ treatment. Five patients presented with variably progressed CQ Retinopathy (10–22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction in mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans, the outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors. Conclusion: MfERG, FAF, NIA and sdOCT detect early stages of CQ Retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ Retinopathy.

  • Chloroquine Retinopathy lipofuscin and melanin related fundus autofluorescence optical coherence tomography and multifocal electroretinography
    Documenta Ophthalmologica, 2008
    Co-Authors: Ulrich Kellner, Simone Kellner, Silke Weinitz
    Abstract:

    Purpose To evaluate melanin-related near-infrared fundus autofluorescence (NIA, excitation 787 nm, emission > 800 nm), lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm, emission >500 nm), optical coherence tomography (OCT), and multifocal electroretinography (mfERG) in patients with Chloroquine (CQ) Retinopathy. Methods Two patients with progressed CQ Retinopathy underwent clinical examination, ISCEV mfERG evaluation, and FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) with either a 30° or wide-angle field-of-view. OCT3 imaging was performed in one of these patients. Results In the foveola, FAF and NIA were relatively normal. Parafoveal loss of retinal pigment epithelium (RPE) was indicated by absent FAF and NIA. An area of reduced FAF and NIA surrounded the parafoveal region of RPE loss. In the adjacent area, FAF was increased and increased NIA marked the peripheral border of increased FAF. Wide-field imaging revealed increased FAF in association with retinal vessels. Retinal thickness was markedly reduced in the OCT predominantly in the parafoveal region. Visual field loss and mfERG amplitude reduction corresponded to areas with increased or reduced FAF and NIA. Conclusion Patterns of FAF and NIA indicate different stages of pathophysiologic processes involving lipofuscin and melanin in the RPE. Combined retinal imaging and functional testing provides further insights in the pathogenesis and development of retinal degenerative disease. An association of CQ Retinopathy with retinal vessels architecture is hypothesized.

Chong Lee - One of the best experts on this subject based on the ideXlab platform.

  • relative sensitivity and specificity of 10 2 visual fields multifocal electroretinography and spectral domain optical coherence tomography in detecting hydroxyChloroquine and Chloroquine Retinopathy
    Clinical Ophthalmology, 2014
    Co-Authors: David J Browning, Chong Lee
    Abstract:

    BACKGROUND The purpose of this study was to determine the relative sensitivity and specificity of 10-2 visual fields (10-2 VFs), multifocal electroretinography (mfERG), and spectral domain optical coherence tomography (SD-OCT) in detecting hydroxyChloroquine Retinopathy. METHODS A total of 121 patients taking hydroxyChloroquine (n=119) or Chloroquine (n=2) with 10-2 VF, mfERG, and SD-OCT tests were retrospectively reviewed. Rates of test abnormality were determined. RESULTS Retinopathy was present in 14 and absent in 107. Eleven of 14 (78.6%) patients with Retinopathy were overdosed. Twelve (85.7%) had cumulative dosing greater than 1,000 g. The sensitivities of 10-2 VF, mfERG, and SD-OCT in detecting Retinopathy were 85.7%, 92.9%, and 78.6%, respectively. The specificities of 10-2 VF, mfERG, and SD-OCT in detecting Retinopathy were 92.5%, 86.9%, and 98.1%, respectively. Positive predictive values of 10-2 VF, mfERG, and SD-OCT in detecting Retinopathy were less than 30% for all estimates of hydroxyChloroquine Retinopathy prevalence. Negative predictive values were >99% for all tests. CONCLUSION Based on published estimates of hydroxyChloroquine Retinopathy prevalence, all three tests are most reliable when negative, allowing confident exclusion of Retinopathy in patients taking ≤6.5 mg/kg/day. Each test is less useful in allowing a confident diagnosis of Retinopathy when positive, especially in patients taking ≤6.5 mg/kg/day.

David J Browning - One of the best experts on this subject based on the ideXlab platform.

  • relative sensitivity and specificity of 10 2 visual fields multifocal electroretinography and spectral domain optical coherence tomography in detecting hydroxyChloroquine and Chloroquine Retinopathy
    Clinical Ophthalmology, 2014
    Co-Authors: David J Browning, Chong Lee
    Abstract:

    BACKGROUND The purpose of this study was to determine the relative sensitivity and specificity of 10-2 visual fields (10-2 VFs), multifocal electroretinography (mfERG), and spectral domain optical coherence tomography (SD-OCT) in detecting hydroxyChloroquine Retinopathy. METHODS A total of 121 patients taking hydroxyChloroquine (n=119) or Chloroquine (n=2) with 10-2 VF, mfERG, and SD-OCT tests were retrospectively reviewed. Rates of test abnormality were determined. RESULTS Retinopathy was present in 14 and absent in 107. Eleven of 14 (78.6%) patients with Retinopathy were overdosed. Twelve (85.7%) had cumulative dosing greater than 1,000 g. The sensitivities of 10-2 VF, mfERG, and SD-OCT in detecting Retinopathy were 85.7%, 92.9%, and 78.6%, respectively. The specificities of 10-2 VF, mfERG, and SD-OCT in detecting Retinopathy were 92.5%, 86.9%, and 98.1%, respectively. Positive predictive values of 10-2 VF, mfERG, and SD-OCT in detecting Retinopathy were less than 30% for all estimates of hydroxyChloroquine Retinopathy prevalence. Negative predictive values were >99% for all tests. CONCLUSION Based on published estimates of hydroxyChloroquine Retinopathy prevalence, all three tests are most reliable when negative, allowing confident exclusion of Retinopathy in patients taking ≤6.5 mg/kg/day. Each test is less useful in allowing a confident diagnosis of Retinopathy when positive, especially in patients taking ≤6.5 mg/kg/day.