Blindeninstitutsstiftung

PurposeTo assess the long-term outcomes of the Trabeculectomy versus Canaloplasty (TVC) study cohort after 11 years. The TVC study was a prospective, single-center, randomized clinical trial comparing the 24-month surgical outcomes of trabeculectomy and canaloplasty in patients with open-angle glaucoma.MethodsThis prospective follow-up study included only patients from the original 2015 TVC cohort. Primary endpoints were complete (without glaucoma medication) and qualified success (with or without glaucoma medication), defined as intraocular pressure (IOP) ≤ 18 mmHg (Definition 1) or IOP ≤ 21 mmHg with ≥ 20% reduction from baseline (Definition 2). Secondary endpoints included changes in IOP, medication use, complications, and revision surgeries.ResultsMean follow-up was 11.9 ± 1.1 years for trabeculectomy (TE) and 11.0 ± 2.0 years for canaloplasty (CP) (15 TE and 13 CP patients). Complete success rates for TE vs. CP were 53.3% vs. 15.4% (Definition 1, p = 0.06) and 46.7% vs. 15.4% (Definition 2, p = 0.22). Qualified success was achieved by 73.3% vs. 69.2% (Definition 1, p = 1.0) and 66.7% vs. 76.9% (Definition 2, p = 0.69). Median IOP was 10.0 (6.0–12.0) mmHg for TE and 14.0 (11.5–17.75) mmHg for CP (p < 0.01). Mean number of compounds was 1.0 ± 1.4 in TE and 1.9 ± 1.5 in CP (p = 0.17). Revision surgeries were needed in 26.7% (TE) vs. 23.1% (CP). The only long-term complication, hypotony maculopathy, occurred in two TE patients (15.4%).ConclusionAfter 11 years, trabeculectomy still demonstrated greater IOP reduction and higher complete success rates but was associated with a higher complication rate. In contrast, canaloplasty offers a safe alternative when slightly higher IOPs and moderate medication use are acceptable.

Ilse Feller, Eberhard Fritz: Württemberg zur Königszeit. Die Fotografien des Herzogs Philipp von Württemberg (1838-1917). - Stuttgart: Theiss, 1990. - 158 S.: 160 Fotos.

Ball grid array (BGA) packaging is a high-density surface mount technology with the advantages of small size, good heat dissipation, and electrical properties, and is widely applied in the production of large-scale integrated circuits. With the rapid development of IC integration, devices assembled using BGA technology generally have greater complexity. However, BGA defects can seriously affect device performance and bring difficulties to product quality inspection. More importantly, in the process of BGA defect inspection, the high complexity of the device brings unprecedented challenges to the precise location of defects, which means that corresponding inspection methods should be improved. To this end, this paper proposes an automatic detection method for BGA defects based on x-ray imaging. First, x-ray imaging technology is utilized to achieve non-destructive detection of the BGA area inside the device and generate image data. On this basis, a set of algorithms including threshold separation, detection filling, and closing operation is designed to complete automatic detection of BGA defects. Furthermore, to objectively evaluate the effectiveness and performance of the proposed method, we conduct a series of comparative experiments using simulated and real data, and generate visual outputs. Through these experiments and analyses, we confirm that the proposed method plays an active and effective role and has robust performance in BGA defect detection. In particular, our method shows the expected performance in precisely finding BGA edge defects and subtle defects.

Long-term coherent integration can significantly improve the ability to detect maneuvering targets by radar. Especially for weak targets, longer integration times are needed to improve. But for non-radially moving targets, the time-varying angle between target moving direction and radar line of sight will cause non-linear range migration (NLRM) and non-linear Doppler frequency migration (NLDFM) within long-time coherent processing, which precludes existing methods that ignore angle changes, and seriously degrades the performance of coherent integration. To solve this problem, an efficient method based on Radon Fourier transform (RFT) with modified variant angle model (ARFT) is proposed. In this method, a new parameter angle is introduced to optimize the target motion model, and the NLRM and NLDFM are eliminated by range-velocity-angle joint three-dimensional searching of ARFT. Compared with conventional algorithms, the proposed method can more accurately compensate for the NLRM and NLDFM, thus achieving better integration performance and detection probability for non-radial moving weak targets. Numerical simulations verify the effectiveness and advantages of the proposed method.

With the rapid development of wireless communication, various kinds of mobile terminals may communicate with each other. To provide sufficient security and privacy, classification of the source terminals is generally critical. In this paper, we set up several scattered sensors collecting the received field strength and capture time for classification. To deal with the unknown propagation environment, imbalanced dataset and irregular sampling time, we propose a terminal classification scheme based on Long Short-Term Memory (LSTM) network. First, the problem of imbalanced dataset is solved by designing a preprocessing method called random interval sampling method, where the samples for class with less terminals are resampled. Then, the information of the irregular sampling time is incorporated into the classification to obtain extra benefit. Experimental results based on real-world data demonstrate that when compared with the exsiting LSTM schemes, the proposed classification model effectively utilizes the irregular time intervals and achieves excellent classification perfomance with imbalanced dataset.

ZusammenfassungSehbehinderung und Blindheit im Alter nehmen aufgrund des demografischen Wandels zu und wirken sich auf viele Bereiche des täglichen Lebens aus. Für die stationäre Altenpflege bedeuten Sehbehinderung und Blindheit eine Herausforderung, die in ihrer Bedeutung bislang oft unterschätzt wird. Die mangelnde augenmedizinische Versorgung in Senioreneinrichtungen konnte durch die Würzburger Studie „Sehen im Alter“ (2012–2015) nachgewiesen werden, in der sich u. a. zeigte, dass jede fünfte Bewohnerin bzw. Bewohner einer Pflegeeinrichtung eine akut behandlungsbedürftige Augenerkrankung aufweist. Ausgehend von diesen Ergebnissen wurde 2016 auf Anregung von sechs bayerischen Pflegekassen in Kooperation mit dem Blindeninstitut Würzburg das Präventionsprogramm „Gutes Sehen in Pflegeeinrichtungen“ ins Leben gerufen. Mit dem Präventionsgesetz (§ 5 SGB XI), das Pflegekassen zur Erbringung präventiver Leistungen in Senioreneinrichtungen verpflichtet, wurde dafür die Voraussetzung geschaffen. Als zentraler Ansatz steht dabei die Prävention in der Lebenswelt im Fokus. Das Konzept des Präventionsprogramms besitzt eine interdisziplinäre und ganzheitliche Ausrichtung und ist damit eng an die Handlungsfelder des Präventionsgesetzes angelehnt. Vor Ort werden Seniorinnen und Senioren untersucht, Angehörige informiert sowie Leitung und Beschäftigte der jeweiligen Einrichtung geschult und beraten. Erste Ergebnisse aus der Praxis des Präventionsprogramms zeigen, dass ein großes Verbesserungspotenzial in der stationären Altenpflege besteht. Besonders die Bereiche der augenmedizinischen Versorgung, des Wissensstandes des Personals und der barrierefreien Gestaltung der Senioreneinrichtungen gilt es zu unterstützen und gezielt zu stärken.

The demographic change in Germany will lead to an increase in irreversible age-related eye diseases. This will increase the need for specialised care facilities for visually impaired people. Due to reduced mobility, residents in such facilities often do not receive adequate ophthalmological care. New concepts must therefore be considered for this group of patients. One approach is to set up an ophthalmological examination unit within the facility combined with regular visits by an ophthalmologist. We now present the experience with such a model in a home for the blind. The project was initiated in 2009. Since then there have been visits by medical staff of the Eye Center at Medical Center, University of Freiburg, every two weeks. All patient records (2010 - 2017) were reviewed systematically. The following data were extracted in a structured and anonymous way: Age at first presentation, gender, ophthalmological diagnoses and if a therapy was initiated. This data set was finally analysed descriptively. Out of 130 residents aged between 48 and 100 years, half were between 78 and 90 years old. The youngest resident was 48, the oldest 100 years old. The median visual acuity was 0.2. Sixty percent of the residents had at least mild visual impairment according to the WHO (visual acuity < 0.5; category 1 - 6). In one of 6 - 7 residents, visual acuity could not be determined using Snellen charts. The most frequent ophthalmological diagnoses included cataract (44%), age-related macular degeneration (36%) and glaucoma (29%). In 67 residents (52%), the ophthalmological examination lead to treatment, such as application of local therapy or planning an operation. In every second resident, the ophthalmologist's visit lead to treatment during the observation period. This underlines the difficulty of providing ophthalmological care even in specialised institutions for the blind and visually impaired, which is possibly due to the residents' mobility problems. The concept presented here has established a low-threshold, sustainable and high-quality ophthalmological service on site. These positive experiences indicate that corresponding measures may also be useful for other locations. However, in order to implement such a project on a larger scale, suitable financing and accounting modalities for the construction measures, the nursing staff and the ophthalmological procedure still need to be developed.

Lamellar macular holes present distinct morphological features including tractional or non-tractional epimacular membranes, foveal tissue alterations, defects of the outer retinal layers, or a separation of the retinal layers. At present, degenerative lamellar holes are differentiated from tractional holes based on the morphological characteristics seen in OCT. The current treatment approach is based on this gross differentiation. Considering the recent developments in high-resolution imaging, this classification needs to be revisited since morphological features may present simultaneously, making it difficult to separate these entities. In addition, a revisited classification may be of value to better standardize the indication for surgical treatment.