Search

Background: The use of online information and communication is globally increasing in the healthcare sector. In addition to known benefits in other medical fields, possible specific potentials of eHealth lie in the monitoring of oncological patients undergoing outpatient therapy. Specifically, the treatment with immune checkpoint inhibitors (ICI) requires intensive monitoring due to various possible negative side effects. The present study explores cancer patients' perspectives on eHealth and demonstrates how eHealth applications, from the patients' point of view, can contribute to further improving outpatient immunotherapy. Methods and findings: Our multicenter study was executed at the university hospitals in Bonn and Aachen. A structured questionnaire was distributed to patients receiving outpatient immunotherapy. Contents addressed were (1) the patients' attitude towards eHealth applications, (2) the use of modern information and communications technologies (ICT) in (2a) everyday life and (2b) health-related information search including eHealth literacy, (3) the use of internet-enabled devices as well as (4) socio-demographic data. 164 patients were included in the study, of whom 39.0% were female and 61.0% male and the average age was 62.8 years. Overall, there was a high distribution of internet-enabled devices for everyday use and a great interest in integrating eHealth applications into outpatient immunotherapy. The assessment of eHealth potentials significantly depended on age. The younger participants demonstrated a broader use of modern ICT and a higher affinity for its use in outpatient immunotherapy. In some aspects, level of education and gender were also relevant factors influencing the patients' view on eHealth. Conclusion: This study demonstrates the potential for further integration of eHealth applications into outpatient immunotherapy from the patients' perspective. It indicates a dependency on age and educational level for the further integration of eHealth into patient care in oncology. Due to particular patient needs regarding age, level of education, gender and other subgroups, specific education and training as well as target-group specific digital health interventions are necessary to fully utilize the potentials of eHealth for outpatient immunotherapy. Future studies are required to specifically address target-group specific usability of eHealth applications and eHealth literacy, as well as to address information security and data protection. [ABSTRACT FROM AUTHOR]

Background: Early vitrectomy for postsurgical endophthalmitis may improve visual acuity outcomes. Silicone oil as a tamponade has some potential benefits in the management of endophthalmitis. This study aims to evaluate the use of a silicone oil tamponade in the surgical management of endophthalmitis. Material and Methods: All patients with a pars plana vitrectomy with silicone oil tamponade for postsurgical endophthalmitis at the Department of Ophthalmology, University of Bonn, Germany, between 2017 and 2021 were retrospectively reviewed. We included all preoperative data, including BCVA at diagnosis, clinical findings, and symptoms. For every follow-up visit, we looked at BCVA and complications. Results: In total, 82 patients were included in this study. The mean follow-up was 13.1 months (range 1–58 months). An intravitreal injection was the cause in 42 patients (51.2%) and cataract surgery in 29 patients (35.4%). The mean interval between the causing event and the date of onset was 8.8 days (range, 1–59 days). The most prevalent pathogen was Staphylococcus epidermidis in 16 patients (19.5%). In 47 patients (57.3%), no pathogen was found. The initial best-corrected visual acuity was 2.1 logMAR and improved significantly to 1.0 logMAR after six months (p < 0.001) and 1.1 logMAR after 1 year (p < 0.001). In a multivariate analysis, a low BCVA at diagnosis (p = 0.041) was a significant predictor for poor visual acuity outcomes. A total of 17 patients (20.1%) developed postoperative complications. Five patients (6.1%) needed an anterior chamber washout with repeated injections of antibiotics. Two patients (2.4%) had persistent fibrin and were treated with YAG-laser treatment. Three patients (6.7%) developed a retinal detachment. Two patients (2.4%) had persistent corneal decompensation with endothelial cell loss and received perforating keratoplasty. We performed a matched-pair analysis (n = 30, each group n = 15) to compare a silicone oil tamponade with BSS at the end of surgery. The visual acuity outcome showed no significant differences (BCVA after one year: 1.17 logMAR in eyes with silicone oil and 0.90 logMAR in eyes with BSS; p = 0.684). Conclusions: In our study, a vitrectomy with silicone oil tamponade in the surgical management of postoperative endophthalmitis led to a significant improvement in visual acuity and had a low complication rate. Low BCVA at diagnosis was significantly associated with poor visual acuity outcomes. A comparison of silicone oil and BSS at the end of surgery showed similar results. [ABSTRACT FROM AUTHOR]

Background: To report one‐year outcomes from a single‐centre cohort undergoing PAUL® Glaucoma Implant (PGI) surgery. Methods: Retrospective review of patients undergoing PGI surgery at the University Eye Hospital Bonn, Germany, from April 2021 to September 2021. Results: Forty‐five eyes of 41 patients were included. Qualified and complete success rates (95% CI) were 95.6% (88.9%–100%) and 73.3% (60%–86.7%) for Criterion A (IOP ≤ 21 mmHg), 84.4% (73.3%–93.3%) and 74.4% (51.1%–80.0%) for Criterion B (IOP ≤ 18 mmHg), 62.2% (48.9%–75.6%) and 46.7% (31.2%–62.2%) for Criterion C (IOP ≤ 15 mmHg) and 26.7% (13.3%–40.0%) and 22.2% (11.1%–33.3%) for Criterion D (IOP ≤ 12 mmHg), respectively. Mean IOP decreased from 26.1 mmHg (7–48 mmHg) to 12.0 mmHg (3–24 mmHg) (reduction of 48.83%) after 12 months with a reduction of IOP‐lowering agents from 0.5 (0–3). One eye (2.2%) needed an injection of viscoelastic due to significant hypotony with AC shallowing, and four eyes (8.9%) developed choroidal detachments due to hypotony which resolved without further interventions after 6 weeks. Three patients (6.7%) developed tube exposure which required conjunctival revision with an additional pericardial patch graft. An intraluminal prolene stent was removed in 19 eyes (42.2%) after a mean time period of 8.4 months (2–12 m). Mean IOP before the removal was 21.9 mmHg (12–38 mmHg) and decreased to 11.3 mmHg (6–16 mmHg). Conclusions: PGI surgery is an effective procedure for reducing IOP and pressure‐lowering therapy. An intraluminal prolene stent impedes hypotony in the early postoperative phase and enables further IOP lowering without additional interventions during the postoperative course. [ABSTRACT FROM AUTHOR]

Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: COVID-19 has had a tremendous impact on our everyday life. A growing body of evidence indicates that subsequent lockdowns and fear of exposure may have impacted patient care. We analyzed data on incidence and time to surgery in cases of rhegmatogenous retinal detachments (RRD) at three defined time points before, during, and 1 year after the first lockdown period in Germany. Methods: In this single-center study, we identified all patients who were admitted and treated for a primary RRD in April and May 2020, the time of the first lockdown period in Germany, and compared them with cases of the same time period in the years 2019 and 2021. The time from first occurrence of symptoms to surgery as well as visual outcome was analyzed. Results: A total of 192 patients presented to our tertiary academic referral center with a RRD during the months of April and May in 2019 (72 patients), 2020 (62 patients), and 2021 (58 patients) and were included in this study. There were no significant differences with regard to gender and age. In 2019, the time interval between occurrence and presentation to our hospital amounted to a mean of 5.96 days and in 2021 to mean of 5.45 days. However, in 2020, the time between occurrence and presentation was significantly longer with a mean of 15.36 days. The number of patients presenting with a macula-on retinal detachment was also lowest in 2020 (39.2%) compared to 2019 (50.7%) and 2021 (50.0%). Furthermore, with 1.24 logMAR the mean BCVA upon initial presentation was lower in 2020 compared to 0.93 logMAR in 2019 and 1.06 logMAR in 2021. Six to twelve weeks following surgery, visual acuity had improved in 56.1% of patients in 2019 and 60.0% of patients in 2021 as compared to 59.0% in 2020. Conclusion: We found significant differences in terms of elapsed time from first symptoms to surgical management for patients in 2020 in comparison with the same time period in 2019 and 2021. Less strict lockdown policies appear to impact patient behavior and patient care. Further measures, such as questionnaires, might help address which measures may provide safer circumstances for patients to consult health care providers in the case of future strict lockdowns. [ABSTRACT FROM AUTHOR]