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Johann Friedrich Horner is remembered in ophthalmology due to his brief report in the German scientific journal 'Klinische Monatsblatter fur Augenheilkunde', in which emphasized the clinical value of a cluster of external signs of damage to the cervical sympathetic nerve. Although J .F .Horner was not the first to describe such a syndrome, he was credited with the nomination. For the French, Francois Pourfour du Petit was the pioneer in that case. Born in Zurich, travelled Europe to be further educated, becoming later on Professor and Director of the University Clinic of Ophthalmology in his native city. In conclusion, J .F .Horner's adamantine character, hard work, assiduous teaching and skills in eye surgery made him one of the main contributors for the evolution of ophthalmology in the nineteenth century Central Europe.
Visual acuity is one of the most important functions of the visual system. Visual acuity is the basis of many decisions in clinical practice. The assessment of visual acuity is clearly defined (norm EN ISO 8596). In this study, the presentation of results of visual acuity assessments in the ophthalmological literature was analysed. All the issues of the journals "Klinische Monatsblatter fur Augenheilkunde" and "Der Ophthalmologe" of the years 2002 and 2003 were reviewed especially concerning the procedure of visual acuity assessment, the scaling in the lower visual acuity range, axis scaling and the calculation of mean values of visual acuity. In total, 550 publications were reviewed. Of these papers, 207 contained at least one visual acuity value and 42 papers presented detailed data concerning either the change of visual acuity over a certain time interval, or mean values, or using charts. A linear scale was used in 9 of 28 papers with presentation of visual acuity measurements in a chart. Of 32 publications with visual acuity measurements less than 0.2, only 2 used a logarithmic scale in the lower visual acuity range, while in 14 papers, scaling was rather rough or not numeric (e. g., counting fingers). Sixteen papers used the units "finger counting" or "hand movements" to describe low visual acuities. The way of calculating mean values remained obscure in 36 papers. Regarding a correct assessment of visual acuity and the effect of therapy, the fundamental guidelines of visual acuity assessment and its correct presentation should be considered.
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To delineate the historical steps associated with the genesis of the name and the definition of Vogt-Koyanagi-Harada (VKH) disease. A bibliographical review of the major publications that were relevant to the original development of the name of the clinical entity known today as Vogt-Koyanagi-Harada disease, in the historical context of the early 20th century. Three distinct time periods can be considered to be important in terms of providing a historical perspective on VKH disease. Given that the cutaneous manifestations of VKH disease are so characteristic, these could not have been missed even before the actual clinical entity of VKH was recognized in the early 20th century. Indeed, several authors, including the Arabic doctor Mohammad-al-Ghâfiqî in the 12th century as well as Jacobi, Nettelship and Tay in the 19th century, described poliosis, neuralgias and hearing disorders. Many of these cases were probably due to sympathetic ophthalmia, but some were clearly VKH cases. The second phase is characterized by the surge of articles that appeared early in the 20th century that defined the disease more precisely. A number of these authors subsequently became associated with the disease name, the first being Alfred Vogt from Switzerland, followed by Japanese researchers. Yoshizo Koyanagi was in fact not the first Japanese author to describe the disease; this honor goes to the first Japanese Professor of Ophthalmology at the University of Tokyo, Dr. Jujiro Komoto, who published in a German language journal, Klinische Monatsblätter für Augenheilkunde in 1911. Yoshizo Koyanagi published his first report in the Nippon Ganka Gakkai Zasshi 3 years later, in 1914, but it was a much later article, one published in 1929, that definitively associated his name with the disease. In this review article, Koyanagi reported 16 cases, of which six were his own cases, that beautifully illustrate the natural course of the disease. In this same time period, Einosuke Harada, in an article published in Nippon Ganka Gakkai Zasshi in 1926 that was based on several case studies, comprehensively described a syndrome that included (1) a prodromal phase of malaise and meningeal irritation; (2) bilateral uveitis of diverse intensity; (3) bilateral retinal detachments spontaneously resolving; (4) integumentary changes; (5) lymphocytosis of the spinal fluid; (6) dysacousia. It is now accepted that Vogt-Koyanagi disease and the syndrome described by Harada are one entity with a diverse clinical spectrum bearing the universally accepted name of Vogt-Koyanagi-Harada disease. The third phase and most recent phase is characterized by the rapid progress made in terms of knowledge of the physiopathology of the disease, primarily due to the development of immunological methods. The evidence accumulated to date clearly points towards an autoimmune Th1 disease directed against proteins associated with choroidal melanin. Other analytical techniques, such as indocyanine green angiography, have enabled researchers to monitor more closely the primary lesional process at the level of the choroid, and standardized diagnostic criteria have been generated in the recent past. Those who earn scientific merit in clinical medicine are the ones who are able to visualize an overview based on the synthesis of 'new' medical facts that have been made available, usually reported singly by several, unassociated authors concomitantly. This is certainly the case for Yoshizo Koyanagi and Einosuke Harada. Conversely, Alfred Vogt was primarily lucky in that he encountered and subsequently precisely described the first case in the literature.
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To highlight the four International Curricula of Ophthalmic Education developed by the Task Forces of the International Council of Ophthalmology, published in Klinische Monatsblätter für Augenheilkunde in November 2006. A global perspective of developing educational curricula as tools to improve eye care. Review of the experience and conclusions of the four international panels. The Task Force on Resident and Specialist Education developed a curriculum consisting of 15 topics in basic, standard, and advanced levels to provide flexibility of educational programs of the ophthalmic specialist in different locations across the world. The curricula were designed to be an educational tool to stimulate multiple levels of training of the ophthalmic specialist. The Task Force on Ophthalmic Education of Medical Students designed a curriculum covering 11 topics and provides illustrative materials for teachers and students. The Task Force strongly advocates the ophthalmology curriculum to be part of the core program of general medical schools education. The Task Force on Para-ophthalmic Vision Specialist Education developed a curriculum to highlight the importance of a team approach to eye care, consisting of ophthalmic specialists and paraophthalmic personnel to produce maximum efficiency. The Task Force on Continuing Medical Education (CME) designed a curriculum exploring the principles, elements, categories, and administration of CME activities in a variety of topics. These curricula shifted the traditional apprentice system of education to a curriculum-based training program in which goals, expectations, competencies, and technical training are defined to improve eye care worldwide.
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Publications in Germany, Austria, and Switzerland by Japanese authors are hitherto noticed insufficiently. We have made an evaluation of ophthalmological journals in the German language. Four hundred and twenty-five original publications in German language by Japanese authors in the preiod from 1886 to 1941 were evaluated. The publications appeared most frequently in "Klinische Monatsblätter für Augenheilkunde" with 196 and in "Graefe's Archiv für Ophthalmologie" with 137 original works, less frequently in "Archiv für Augenheilkunde" with 55 and in "Zeitschrift für Augenheilkunde" and "Ophthalmologica" with 15 publications each; in the journal "Centralblatt für praktische Augenheilkunde" 14 and in "Beiträgen zur Augenheilkunde" 8 original articles had been published. Review articles and congress reports of the Japanese Ophthalmological Society were also published in "Klinische Monatsblätter für Augenheilkunde". Visits in Japan by Julius Hirschberg (1892) und Theodor Axenfeld (1930) intensified contacts between German-speaking Japanese ophthalmologists. Y. Koyanagi (Sendai) published 46 excellent works. We also found many important publications by T. Inouye (Tokyo), J. Komoto (Tokyo), S. Miyashita (Tokyo), B. Nakamura (Osaka), Ch. Oguchi (Tokyo), S. Suganuma (Tokyo), Y. Sugita (Nagoya) und H. Yamaguchi (Tokyo). We point to many important publications by Japanese ophthalmologists who had contacts to German, Austrian and Swiss colleagues mainly in the first half of the last century.
The medical database MEDLINE contains only a part of all published randomized controlled (RCTs) and controlled clinical (CCTs) trials. The validity of a systematic review depends on the complete consideration of all studies pertaining to a clinical question. Therefore, a manual systematic search in medical journals is mandatory. The last 30 years of the three peer-reviewed German-language ophthalmological journals Der Ophthalmologe, Klinische Monatsblätter für Augenheilkunde, and Spektrum der Augenheilkunde were retrospectively searched for controlled trials. All identified RCTs and CCTs were classified according to their ophthalmological subspecialty. The quality of the studies was evaluated using the CONSORT Statement. Moreover, a comparison was made of how many of the studies identified by hand searching are registered in MEDLINE and correctly classified as RCTs/CCTs. In total 984 RCTs and CCTs were identified; 62% of the trials were from the subspecialty anterior eye segment, 14% belonged to the subspecialty posterior eye segment, and 18% belonged to glaucoma. A sample size calculation was reported in less than 2% of the full-text publications and 34% reported a blinded study design. A randomization process was described in 23% of the RCTs. Most controlled trials were published in the 1990s in all three journals. From 1998 onward, there was a decrease in the number of published controlled trials in the reviewed German literature. About 63% of the studies registered in MEDLINE are correctly classified. In the specialty of ophthalmology there are many important studies which provide basic information for compilation of systematic reviews and clinical guidelines. However, many of the identified clinical trials in German-language journals show deficiencies in the study quality. Only a part of the identified controlled trials are correctly classified in MEDLINE. Therefore, a retrospective registration is essential to complete the electronic database in ophthalmology.
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The life and work of Carl Wilhelm von Zehender are discussed in the light of recent information. As a pupil and friend of Albrecht von Graefe, he took part in the foundation of the Heidelberg Ophthalmological Society, which was, right from its start, an international association. He was the first editor of "Klinische Monatsblätter für Augenheilkunde" (1863). In 1862, he was nominated professor of ophthalmology and otology at Berne, Switzerland, but already in 1866, he accepted a call to the newly created chair of ophthalmology at Rostock, Mecklenburg. There, he initiated ophthalmic microsurgery and--in the field of social medicine--scientific expert judgment of damage to the eyes. Hirschberg's rather depreciating criticism of von Zehender appears no longer valid.