Since 06/2022 Consultant ophthalmology specialist at Klinik Donaustadt (SMZ-Ost), Langobardenstraße 122, 1220 Wien
Nov. 2020 – venia docendi for ophthalmology
Since January 2017 Specialist for ophthalmology and optometry. Occupation as a specialist at the Department of Ophthalmology and Optometry of the Medical University of Vienna:
2017, 2018: Outpatient clinic for diabetic retinopathy with ao. Univ. Dr. Christoph Scholda
2018: Outpatient Clinic for the Conservative Treatment of Macular and Retinal Diseases with Assoc. Prof. PD Dr. Stefan Sacu
2019-2022: Outpatient Clinic for Neuroophthalmology with ao. Univ. Dr. Andreas Reitner
2010-2016 Apprenticeship as Ophthalmologist and Optometrist at the Department of Ophthalmology and Optometry of the Medical University of Vienna. Rotations through all special outpatient clinics. Research on modern tomographic imaging (OCT) of retinal changes. Clinical focus on retinal diseases and intraocular tumors.
2009-2010 Research assistant at the Department of Ophthalmology and Optometry of the Medical University of Vienna. Topic: Anti-VEGF for the treatment of diabetic macular edema
Projects
Regular scientific lectures at congresses and other events.
Since 2011 annual organization of a one-day course on optical coherence tomography (OCT) for practicing colleagues, during which the diagnosis is shown and discussed with this fascinating imaging technique (www.ophthalnet.at). In addition, an e-learning platform for several years, where course modules can be visited and completed online.
In addition to clinical activity at the Department of Ophthalmology and Optometry, responsible for the clinical project support of the development of a central ophthalmological image data platform and continuous improvement of the electronic patient information system.
Spoken languages
German, English, Spanish
Publications in scientific journals:
Hilbert-style axiomatic completion: On von Neumann and hidden variables in quantum mechanics
Hilbert-style axiomatic completion: On von Neumann and hidden variables in quantum mechanics
In this paper I provide a detailed history of von Neumann's "No Hidden Variables" theorem, and I argue it is a demonstration that his axiomatization mathematically captures a salient feature of the statistical transformation theory (namely, that hidden variables are incompatible). I show that this reading of von Neumann's theorem is obvious once one recalls several factors of his work. First, his axiomatization was what I call a Hilbert-style axiomatic completion; indeed, it developed from work initiated by Hilbert (and Nordheim). Second, it was responsive to specific mathematical and theoretical problems faced by Dirac and Jordan's statistical transformation theory (then called 'quantum mechanics'). Third, the axiomatization was completed across his 1927 papers and 1932 book when he identified the basic assumptions underwriting quantum mechanics, showed that these suffice for deriving the trace rule, and showed that the trace rule is incompatible with hidden variables. With this reading in mind, his claim that quantum mechanics was in "compelling logical contradiction with causality" appears as a straightforward consequence of his theorem. I conclude by reassessing the theorem's broader historical and scientific significance.
Retinal Layer Thinning After Optic Neuritis is Associated With Future Relapse Remission in Relapsing Multiple Sclerosis
Retinal Layer Thinning After Optic Neuritis is Associated With Future Relapse Remission in Relapsing Multiple Sclerosis
Remission of relapses is an important contributor to both short- and long-term prognosis in relapsing multiple sclerosis (RMS). In MS-associated acute optic neuritis (MS-ON), retinal layer thinning measured by optical coherence tomography (OCT) is a reliable biomarker of both functional recovery and the degree of neuroaxonal damage. However, prediction of non-ON relapse remission is challenging. We aimed to investigate whether retinal thinning after ON is associated with relapse remission after subsequent non-ON relapses.
Changes in Visual Function and Correlations with Inner Retinal Structure in Acute and Chronic Leber's Hereditary Optic Neuropathy Patients after Treatment with Idebenone
Changes in Visual Function and Correlations with Inner Retinal Structure in Acute and Chronic Leber's Hereditary Optic Neuropathy Patients after Treatment with Idebenone
Progressive impairment and degeneration of retinal ganglion cells (RGC) and nerve fibers in Leber's hereditary optic neuropathy (LHON) usually cause permanent visual loss. Idebenone is currently the only approved treatment. However, its therapeutic potential in different stages of LHON has not been definitely clarified. We aimed to investigate the changes in visual function and correlations with retinal structure in acute and in chronic LHON patients after treatment with idebenone. Twenty-three genetically confirmed LHON patients were followed during treatment using logMAR charts, automated perimetry and optical coherence tomography (OCT). Mean visual acuity improved significantly in acute patients treated within 1 year from onset (-0.52 ± 0.46 logMAR from nadir), in early chronic patients who started after 1-5 years (-0.39 ± 0.27 logMAR from baseline), and in late chronic patients with treatment initiation after >5 years (-0.33 ± 0.28 logMAR from baseline, < 0.001 all groups). In acute and in chronic patients, strong correlations between OCT and visual function parameters were present only after treatment. This and the sustained visual recovery after treatment may indicate a reactivated signal transduction in dysfunctional RGC that survive the acute phase. Our results support previous evidence that idebenone has therapeutic potential in promoting visual recovery in LHON.
Systematic ultrastructural comparison of swept-source and full-depth spectral domain optical coherence tomography imaging of diabetic macular oedema
Systematic ultrastructural comparison of swept-source and full-depth spectral domain optical coherence tomography imaging of diabetic macular oedema
Optical coherence tomography (OCT) is commonly used to diagnose and assess diabetic macular oedema (DME). Swept-source OCT (SS-OCT) promises improved imaging depth and more independence from media opacities. Heidelberg Spectralis full-depth imaging (FDI) combines details at different depths to one representation. The aim of this study was to determine the comparability of the imaging methods concerning DME ultrastructure.
Short-time effect of intravitreal injections on retinal vascular oxygenation and vessel diameter in patients with diabetic macular oedema or neovascular age-related macular degeneration
Short-time effect of intravitreal injections on retinal vascular oxygenation and vessel diameter in patients with diabetic macular oedema or neovascular age-related macular degeneration
To investigate the short-time effect of intravitreal injections (IVI) of the vascular endothelial growth factor inhibitors ranibizumab and aflibercept on retinal arterial and venous oxygen saturation (SO2a and SO2v), arteriovenous oxygen saturation difference (AVD) and vessel diameter (VDa and VDv) in patients with diabetic macular oedema (DME) and patients with choroidal neovascularization (CNV) due to age-related macular degeneration.
Atrophy of the central neuroretina in patients treated for diabetic macular edema
Atrophy of the central neuroretina in patients treated for diabetic macular edema
To examine the prevalence of central retinal atrophy in patients treated for diabetic macular edema (DME) in a clinical setting.
Retinal and Choroidal Perfusion Status in the Area of Laser Scars Assessed With Swept-Source Optical Coherence Tomography Angiography
Retinal and Choroidal Perfusion Status in the Area of Laser Scars Assessed With Swept-Source Optical Coherence Tomography Angiography
To evaluate the perfusion status of the retina and choriocapillaris in the area of laser scars on swept-source optical coherence tomography angiography (OCTA) images of eyes previously treated with panretinal photocoagulation (PRP).
Comparison of Spectralis and Cirrus spectral domain optical coherence tomography for the objective morphometric assessment of the neuroretinal rim width
Comparison of Spectralis and Cirrus spectral domain optical coherence tomography for the objective morphometric assessment of the neuroretinal rim width
The assessment of cup-disc ratio as a surrogate parameter for the neuroretinal rim width (NRW) of the optic nerve is well established, but prone to human error and imprecision. Objective assessment of the NRW is provided by spectral domain optical coherence tomography (SD-OCT). This study is the first to systematically compare NRW measurements acquired with the Carl Zeiss Meditech Cirrus HD-OCT 5000 and the Heidelberg Engineering Spectralis SD-OCT.
Patient-Sharing Relations in the Treatment of Diabetes and Their Implications for Health Information Exchange: Claims-Based Analysis
Patient-Sharing Relations in the Treatment of Diabetes and Their Implications for Health Information Exchange: Claims-Based Analysis
Health information exchange (HIE) among care providers who cooperate in the treatment of patients with diabetes mellitus (DM) has been rated as an important aspect of successful care. Patient-sharing relations among care providers permit inferences about corresponding information-sharing relations.
Optic nerve head morphology in primary open-angle glaucoma and nonarteritic anterior ischaemic optic neuropathy measured with spectral domain optical coherence tomography
Optic nerve head morphology in primary open-angle glaucoma and nonarteritic anterior ischaemic optic neuropathy measured with spectral domain optical coherence tomography
Optic nerve head (ONH) parameters as well as circumpapillary retinal nerve fibre layer (RNFL) thickness values measured with two different spectral domain optical coherence tomography (SD-OCT) machines (Spectralis and Cirrus OCT) have been compared between two patient groups, primary open-angle glaucoma (POAG), nonarteritic anterior ischaemic optic neuropathy (NAION) and healthy controls. A comparison of the performance of the two OCT machines was made.
Early ultrasonographic tumor regression after linear accelerator stereotactic fractionated photon radiotherapy of choroidal melanoma as a predictor for metastatic spread
Early ultrasonographic tumor regression after linear accelerator stereotactic fractionated photon radiotherapy of choroidal melanoma as a predictor for metastatic spread
During extended follow-up (of up to 15 years), approximately fifty percent of patients with choroidal melanoma will develop metastatic disease and eventually die. Thus, continuing research on prognostic factors, early detection and treatment is necessary. Height regression rates both after plaque brachytherapy and proton beam irradiation have been shown to have prognostic value. The purpose of this study was to analyze the influence of early tumor regression rate after treatment of choroidal melanoma with LINAC stereotactic fractionated radiotherapy (SFRT) as an independent risk factor for metastasis.
Detailed analysis of retinal morphology in patients with diabetic macular edema (DME) randomized to ranibizumab or triamcinolone treatment - reply to the letter to the editor
Detailed analysis of retinal morphology in patients with diabetic macular edema (DME) randomized to ranibizumab or triamcinolone treatment - reply to the letter to the editor
Analysis of retinal layer thickness in diabetic macular oedema treated with ranibizumab or triamcinolone
Analysis of retinal layer thickness in diabetic macular oedema treated with ranibizumab or triamcinolone
To evaluate detailed changes in retinal layer thickness in spectral-domain optical coherence tomography (SD-OCT) images during a 1-year follow-up of patients treated for diabetic macula oedema (DME).
[The role of MDK in the German reimbursement system for intensive care medicine]
[The role of MDK in the German reimbursement system for intensive care medicine]
The experts of Medizinischer Dienst der Krankenversicherung (MDK) assess services from different areas of the health care sector, including checks of hospital invoicing. MDK assessors are only employed after being commissioned by a statutory health or nursing insurance. The assessment of intensive medical treatment is made difficult by uncertainties and indistinctness in the regulations, especially the procedure codes for complex intensive care treatment.
Detailed analysis of retinal morphology in patients with diabetic macular edema (DME) randomized to ranibizumab or triamcinolone treatment
Detailed analysis of retinal morphology in patients with diabetic macular edema (DME) randomized to ranibizumab or triamcinolone treatment
Our purpose was to compare the impact in diabetic macula edema (DME) of two intravitreal drugs (0.5 mg ranibizumab vs. 8 mg triamcinolone) on changes in retinal morphology in spectral-domain optical coherence tomography (SD OCT) images, color fundus photography (CF) and fluorescein angiography (FA) images during a 1-year follow-up.
Regional Patterns of Retinal Oxygen Saturation and Microvascular Hemodynamic Parameters Preceding Retinopathy in Patients With Type II Diabetes
Regional Patterns of Retinal Oxygen Saturation and Microvascular Hemodynamic Parameters Preceding Retinopathy in Patients With Type II Diabetes
Alterations in retinal oxygen metabolism and retinal microcirculation are signs of impending diabetic retinopathy (DR). However, if specific retinal regions are primarily affected is so far unknown. The purpose of this study was to investigate if retinal oxygen saturation (SO2) and microvascular hemodynamic parameters follow a distinct regional pattern in patients with diabetes but no DR.
Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in Patients With Dry Age-Related Macular Degeneration Over Time
Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in Patients With Dry Age-Related Macular Degeneration Over Time
To correlate the area of geographic atrophy (GA) and residual foveal sparing (FS), and to identify the minimum FS and maximum GA area allowing sufficient visual acuity (VA) for daily tasks.
RETINAL MORPHOMETRY CHANGES MEASURED WITH SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY AFTER PAN-RETINAL PHOTOCOAGULATION IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY
RETINAL MORPHOMETRY CHANGES MEASURED WITH SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY AFTER PAN-RETINAL PHOTOCOAGULATION IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY
To identify the effects of pan-retinal laser treatment on the integrity of neurosensory retinal layers.
Distribution of intraretinal exudates in diabetic macular edema during anti-vascular endothelial growth factor therapy observed by spectral domain optical coherence tomography and fundus photography
Distribution of intraretinal exudates in diabetic macular edema during anti-vascular endothelial growth factor therapy observed by spectral domain optical coherence tomography and fundus photography
To evaluate changes in the distribution and morphology of intraretinal microexudates and hard exudates (HEs) during intravitreal anti-vascular endothelial growth factor therapy in patients with persistent diabetic macular edema.
SAVE: a grading protocol for clinically significant diabetic macular oedema based on optical coherence tomography and fluorescein angiography
SAVE: a grading protocol for clinically significant diabetic macular oedema based on optical coherence tomography and fluorescein angiography
To analyse a new grading protocol for clinically significant diabetic macular oedema (CSME) based on spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA).
Antivascular endothelial growth factors in age-related macular degeneration
Antivascular endothelial growth factors in age-related macular degeneration
Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in adults aged over 50 years in developed countries. Until recently, argon laser photocoagulation and photo-dynamic therapy (PDT) were the only treatments available for the neovascular form of AMD. The introduction of new intravitreally injectable inhibitors of vascular endothelial growth factor (VEGF) revolutionized the management of the wet form. Pegaptanib was the first anti-VEGF agent to be approved by the US Food and Drug Administration (FDA) for use in neovascular AMD. The VISION study showed that patients receiving pegaptanib lost vision in a smaller rate than those treated with conventional care. Bevacizumab is a full-length recombinant humanized monoclonal antibody which binds to all isoforms of VEGF-A. It is licensed for the intravenous administration for the treatment of malignant solid tumors and is available for off-label use in the treatment of AMD-related CNV. Numerous retrospective studies have shown beneficial effects of bevacizumab in patients with neovascular AMD. Ranibizumab is a recombinant, humanized antibody antigen-binding fragment (Fab) that binds to all known active forms of VEGF-A. The US FDA approved ranibizumab for treatment of all subtypes of choroidal neovascularization secondary to AMD. VEGF trap is a pharmacologically engineered protein that binds VEGF with higher affinity than pegaptanib or ranibizumab and thus prevents VEGF binding to its cellular receptor offering a theoretically longer interval between necessary treatments. A number of studies have shown that OCT imaging allows identification of functionally relevant factors like subretinal fluid or retinal thickness, which are important for the establishment of optimized individual dosing regimen during anti-angiogenesis therapies.
OphthalNet Vienna: constructive quality assurance and resource optimization in ophthalmology
OphthalNet Vienna: constructive quality assurance and resource optimization in ophthalmology
Significant improvements in the field of diagnostic methods and therapeutic options achieved during the last decade allow the early diagnosis, accurate follow-up and individual indication for the treatment with highly efficacious therapeutic agents in a wide range of ophthalmological pathologies. The burden on health care systems is extremely high, as treatment and diagnostic follow up has to be repeated in a regular manner. Whereas the treatment can only be applied in tertiary care centers (eye clinics), follow-up and management mainly depends on the OCT technology, which is becoming available at many field ophthalmologists' practices. This article describes the OphthalNet project, a network which optimizes collaboration between eye clinics and field ophthalmologists based on medical guidelines, workflow support and the future use of electronic infrastructure.
Connecting cloud-based personal health records with an XDS affinity domain to provide additional information at the point-of-care
Connecting cloud-based personal health records with an XDS affinity domain to provide additional information at the point-of-care
Due to the increasing use of Electronic Health Records by healthcare providers and the trend towards the use of Personal Health Records by patients the potential need to integrate these two types of medical documentation emerged. The introduction of the ELGA (Elektronische Gesundheitsakte, EHR) during the next few years is reason enough to propose possibilities to directly involve the patient into the data acquisition process in form of generating personal health data (e.g. vital signs, etc.) at home. In particular patients with chronic diseases will benefit from this integrated architecture. Furthermore, patients could archive all documents for their own use and responsibility. This article reviews literature about integration possibilities for personal and electronic health records and proposes an architecture which integrates data from patient-side into an affinity domains' XDS document repository.
eHealth 2015 Special Issue: Impact of Electronic Health Records on the Completeness of Clinical Documentation Generated during Diabetic Retinopathy Consultations
eHealth 2015 Special Issue: Impact of Electronic Health Records on the Completeness of Clinical Documentation Generated during Diabetic Retinopathy Consultations
Two years ago, the Diabetic Retinopathy (DRP) and Traumatology clinic of the Department of Ophthalmology and Optometrics at the Medical University of Vienna, Austria switched from paper-based to electronic health records. A customized electronic health record system (EHR-S) was implemented.
Clinical Decision Support for the Classification of Diabetic Retinopathy: A Comparison of Manual and Automated Results
Clinical Decision Support for the Classification of Diabetic Retinopathy: A Comparison of Manual and Automated Results
The management of diabetic retinopathy, a frequent ophthalmological manifestation of diabetes mellitus, consists of regular examinations and a standardized, manual classification of disease severity, which is used to recommend re-examination intervals. To evaluate the feasibility and safety of implementing automated, guideline-based diabetic retinopathy (DR) grading into clinical routine by applying established clinical decision support (CDS) technology. We compared manual with automated classification that was generated using medical documentation and an Arden server with a specific medical logic module. Of 7169 included eyes, 47% (n=3373) showed inter-method classification agreement, specifically 29.4% in mild DR, 38.3% in moderate DR, 27.6% in severe DR, and 65.7% in proliferative DR. We demonstrate that the implementation of a CDS system for automated disease severity classification in diabetic retinopathy is feasible but also that, due to the highly individual nature of medical documentation, certain important criteria for the used electronic health record system need to be met in order to achieve reliable results.
Disease Monitoring Related Adherence and Its Association with Mortality in Lower Austrian Diabetes Patients
Disease Monitoring Related Adherence and Its Association with Mortality in Lower Austrian Diabetes Patients
Patient adherence is an important component of an efficient therapy. For diabetes patients it may contribute to controlled glucose values and reduction of adverse outcomes.
Association of Cerebrospinal Fluid Parameters and Neurofilament Light Chain With Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis
Association of Cerebrospinal Fluid Parameters and Neurofilament Light Chain With Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis
Multiple sclerosis (MS) pathophysiology comprises both inflammatory and neurodegenerative characteristics. Cerebrospinal fluid (CSF) analysis allows for assessment of inflammation while neurofilament light chain can indicate neuroaxonal damage. Retinal thinning is a robust prognostic biomarker for neurodegeneration in MS. To date, an association between CSF parameters upon MS diagnosis and retinal thinning has not been investigated.
Evaluation of Retinal Layer Thickness Parameters as Biomarkers in a Real-World Multiple Sclerosis Cohort
Evaluation of Retinal Layer Thickness Parameters as Biomarkers in a Real-World Multiple Sclerosis Cohort
Retinal layer thickness parameters measured by optical coherence tomography (OCT) are emerging biomarkers of neuroaxonal degeneration and inflammation in multiple sclerosis (MS). We aimed to evaluate the value of retinal layer thickness for prediction of disability worsening and relapse in a real-world MS cohort.