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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 1/2017

23.06.2016 | Retinal Disorders

Intraretinal changes in the presence of epiretinal traction

verfasst von: Mario R. Romano, Gilda Cennamo, Francesca Amoroso, Daniela Montorio, Carlo Castellani, Michele Reibaldi, Giovanni Cennamo

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 1/2017

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Abstract

Background

To determine the correlation between the area of morphological changes on the macular surface, the depth of intraretinal changes and the best-corrected visual acuity (BCVA) in patients with idiopathic epiretinal membrane.

Methods

In this prospective cross-sectional study, 38 patients underwent BCVA testing with a Snellen eye chart. The depth of traction, photoreceptor outer segment layer (PROS) thickness, central macular thickness (CMT) and presence of intraretinal cysts were measured using the Avanti RTVue XR and 3D Widefield Enface OCT instruments. Enface sections were performed at the inner limiting membrane (ILM) line level (ILM offset). Patients were categorized into two groups: in group 1 (n = 21), the depth of traction was within 90 μm from the ILM, and in group 2 (n = 17) it was beyond 90 μm from the ILM. The main outcome measure was the correlation between area of epiretinal traction and BCVA according to the depth of traction.

Results

In group 1, the depth of traction was 55.15 ± 14.28 μm, the area of traction was 38.95 ± 13.63 mm2, PROS thickness was 51.20 ± 7.23 μm, and CMT was 362.65 ± 41.08 μm. In group 2, the depth of traction was 112.24 ± 10.89 μm, the area of traction was 25.18 ± 4.07 mm2, PROS thickness was 50.24 ± 9.01 μm, and mean CMT was 534.29 ± 126.81 μm. Statistically significant differences in depth of traction, area of traction and CMT were found between the two groups (P < 0.001). The relationship between structure and function between the area of traction and BCVA was better explained in group 2 (r = 0.814, P < 0.001).

Conclusions

We found that intraretinal changes were induced by the ERM, and varied according to the depth of traction measured with en face analysis. In the case of traction deeper than 90 μm, we found a significant correlation between the inner area of the epiretinal traction and BCVA. We believe that retinal stress induced by epiretinal traction is better characterized by combining information provided by sagittal and transverse OCT scans, thus defining its prognostic significance in ERM.
Literatur
1.
Zurück zum Zitat Gass JDM (1996) Macular dysfucntions caused by vitreous and vitreretinal interface abnormalities. Stereoscopic atlas of macular diseases. 4th ed. St. Louis, MO: Mosby 938-951. Gass JDM (1996) Macular dysfucntions caused by vitreous and vitreretinal interface abnormalities. Stereoscopic atlas of macular diseases. 4th ed. St. Louis, MO: Mosby 938-951.
2.
Zurück zum Zitat Mitchell P, Smith W, Chey T, Wang JJ, Chang A (1997) Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology 104(6):1033–1040 CrossRefPubMed Mitchell P, Smith W, Chey T, Wang JJ, Chang A (1997) Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology 104(6):1033–1040 CrossRefPubMed
3.
Zurück zum Zitat Aung KZ, Makeyeva G, Adams MK et al (2013) The prevalence and risk factors of epiretinal membranes: the Melbourne Collaborative Cohort Study. Retina 33(5):1026–1034 CrossRefPubMed Aung KZ, Makeyeva G, Adams MK et al (2013) The prevalence and risk factors of epiretinal membranes: the Melbourne Collaborative Cohort Study. Retina 33(5):1026–1034 CrossRefPubMed
4.
Zurück zum Zitat Duan XR, Liang YB, Friedman DS et al (2009) Prevalence and associations of epiretinal membranes in a rural Chinese adult population: the Handan Eye Study. Invest Ophthalmol Vis Sci 50(5):2018–2023 CrossRefPubMed Duan XR, Liang YB, Friedman DS et al (2009) Prevalence and associations of epiretinal membranes in a rural Chinese adult population: the Handan Eye Study. Invest Ophthalmol Vis Sci 50(5):2018–2023 CrossRefPubMed
5.
Zurück zum Zitat Fraser-Bell S, Guzowski M, Rochtchina E, Wang JJ, Mitchell P (2003) Five-year cumulative incidence and progression of epiretinal membranes: the Blue Mountains Eye Study. Ophthalmology 110(1):34–40 CrossRefPubMed Fraser-Bell S, Guzowski M, Rochtchina E, Wang JJ, Mitchell P (2003) Five-year cumulative incidence and progression of epiretinal membranes: the Blue Mountains Eye Study. Ophthalmology 110(1):34–40 CrossRefPubMed
6.
Zurück zum Zitat Fraser-Bell S, Ying-Lai M, Klein R, Varma R (2004) Prevalence and associations of epiretinal membranes in latinos: the Los Angeles Latino Eye Study. Invest Ophthalmol Vis Sci 45(6):1732–1736 CrossRefPubMed Fraser-Bell S, Ying-Lai M, Klein R, Varma R (2004) Prevalence and associations of epiretinal membranes in latinos: the Los Angeles Latino Eye Study. Invest Ophthalmol Vis Sci 45(6):1732–1736 CrossRefPubMed
7.
Zurück zum Zitat Kawasaki R, Wang JJ, Aung T et al (2008) Prevalence of age-related macular degeneration in a Malay population: the Singapore Malay Eye Study. Ophthalmology 115(10):1735–1741 CrossRefPubMed Kawasaki R, Wang JJ, Aung T et al (2008) Prevalence of age-related macular degeneration in a Malay population: the Singapore Malay Eye Study. Ophthalmology 115(10):1735–1741 CrossRefPubMed
8.
Zurück zum Zitat Kawasaki R, Wang JJ, Ji GJ et al (2008) Prevalence and risk factors for age-related macular degeneration in an adult Japanese population: the Funagata study. Ophthalmology 115(8):1376–1381, 1381 e1371-1372 CrossRefPubMed Kawasaki R, Wang JJ, Ji GJ et al (2008) Prevalence and risk factors for age-related macular degeneration in an adult Japanese population: the Funagata study. Ophthalmology 115(8):1376–1381, 1381 e1371-1372 CrossRefPubMed
9.
Zurück zum Zitat Kawasaki R, Wang JJ, Mitchell P et al (2008) Racial difference in the prevalence of epiretinal membrane between Caucasians and Asians. Br J Ophthalmol 92(10):1320–1324 CrossRefPubMed Kawasaki R, Wang JJ, Mitchell P et al (2008) Racial difference in the prevalence of epiretinal membrane between Caucasians and Asians. Br J Ophthalmol 92(10):1320–1324 CrossRefPubMed
10.
Zurück zum Zitat Kawasaki R, Wang JJ, Sato H et al (2009) Prevalence and associations of epiretinal membranes in an adult Japanese population: the Funagata study. Eye (Lond) 23(5):1045–1051 CrossRef Kawasaki R, Wang JJ, Sato H et al (2009) Prevalence and associations of epiretinal membranes in an adult Japanese population: the Funagata study. Eye (Lond) 23(5):1045–1051 CrossRef
11.
Zurück zum Zitat Koh V, Cheung CY, Wong WL et al (2012) Prevalence and risk factors of epiretinal membrane in Asian Indians. Invest Ophthalmol Vis Sci 53(2):1018–1022 CrossRefPubMed Koh V, Cheung CY, Wong WL et al (2012) Prevalence and risk factors of epiretinal membrane in Asian Indians. Invest Ophthalmol Vis Sci 53(2):1018–1022 CrossRefPubMed
12.
Zurück zum Zitat Li Y, Xu L, Wang YX, You QS, Yang H, Jonas JB (2008) Prevalence of age-related maculopathy in the adult population in China: the Beijing eye study. Am J Ophthalmol 146(2):329 CrossRefPubMed Li Y, Xu L, Wang YX, You QS, Yang H, Jonas JB (2008) Prevalence of age-related maculopathy in the adult population in China: the Beijing eye study. Am J Ophthalmol 146(2):329 CrossRefPubMed
13.
Zurück zum Zitat McCarty DJ, Mukesh BN, Chikani V et al (2005) Prevalence and associations of epiretinal membranes in the visual impairment project. Am J Ophthalmol 140(2):288–294 CrossRefPubMed McCarty DJ, Mukesh BN, Chikani V et al (2005) Prevalence and associations of epiretinal membranes in the visual impairment project. Am J Ophthalmol 140(2):288–294 CrossRefPubMed
14.
Zurück zum Zitat Ng CH, Cheung N, Wang JJ et al (2011) Prevalence and risk factors for epiretinal membranes in a multi-ethnic United States population. Ophthalmology 118(4):694–699 CrossRefPubMed Ng CH, Cheung N, Wang JJ et al (2011) Prevalence and risk factors for epiretinal membranes in a multi-ethnic United States population. Ophthalmology 118(4):694–699 CrossRefPubMed
15.
Zurück zum Zitat Xie XW, Xu L, Wang YX, Jonas JB (2008) Prevalence and associated factors of diabetic retinopathy. The Beijing Eye Study 2006. Graefes Arch Clin Exp Ophthalmol 246(11):1519–1526 CrossRefPubMed Xie XW, Xu L, Wang YX, Jonas JB (2008) Prevalence and associated factors of diabetic retinopathy. The Beijing Eye Study 2006. Graefes Arch Clin Exp Ophthalmol 246(11):1519–1526 CrossRefPubMed
16.
Zurück zum Zitat You Q, Xu L, Jonas JB (2008) Prevalence and associations of epiretinal membranes in adult Chinese: the Beijing Eye Study. Eye (Lond) 22(7):874–879 CrossRef You Q, Xu L, Jonas JB (2008) Prevalence and associations of epiretinal membranes in adult Chinese: the Beijing Eye Study. Eye (Lond) 22(7):874–879 CrossRef
17.
Zurück zum Zitat You QS, Xu L, Jonas JB (2008) Prevalence of crowded optic discs in adult Chinese. The Beijing Eye Study. Graefes Arch Clin Exp Ophthalmol 246(9):1291–1293 CrossRefPubMed You QS, Xu L, Jonas JB (2008) Prevalence of crowded optic discs in adult Chinese. The Beijing Eye Study. Graefes Arch Clin Exp Ophthalmol 246(9):1291–1293 CrossRefPubMed
18.
Zurück zum Zitat You QS, Xu L, Wang YX, Jonas JB (2009) Prevalence of optic disc drusen in an adult Chinese population: the Beijing Eye Study. Acta Ophthalmol 87(2):227–228 CrossRefPubMed You QS, Xu L, Wang YX, Jonas JB (2009) Prevalence of optic disc drusen in an adult Chinese population: the Beijing Eye Study. Acta Ophthalmol 87(2):227–228 CrossRefPubMed
19.
Zurück zum Zitat Zhu XF, Peng JJ, Zou HD et al (2012) Prevalence and risk factors of idiopathic epiretinal membranes in Beixinjing blocks, Shanghai, China. PLoS One 7(12):e51445 CrossRefPubMedPubMedCentral Zhu XF, Peng JJ, Zou HD et al (2012) Prevalence and risk factors of idiopathic epiretinal membranes in Beixinjing blocks, Shanghai, China. PLoS One 7(12):e51445 CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Klein R, Klein BE, Wang Q, Moss SE (1994) The epidemiology of epiretinal membranes. Trans Am Ophthalmol Soc 92:403–425, discussion 425-430 PubMedPubMedCentral Klein R, Klein BE, Wang Q, Moss SE (1994) The epidemiology of epiretinal membranes. Trans Am Ophthalmol Soc 92:403–425, discussion 425-430 PubMedPubMedCentral
22.
Zurück zum Zitat Sebag J, Gupta P, Rosen RR, Garcia P, Sadun AA (2007) Macular holes and macular pucker: the role of vitreoschisis as imaged by optical coherence tomography/scanning laser ophthalmoscopy. Trans Am Ophthalmol Soc 105:121–129, discusion 129-131 PubMedPubMedCentral Sebag J, Gupta P, Rosen RR, Garcia P, Sadun AA (2007) Macular holes and macular pucker: the role of vitreoschisis as imaged by optical coherence tomography/scanning laser ophthalmoscopy. Trans Am Ophthalmol Soc 105:121–129, discusion 129-131 PubMedPubMedCentral
23.
Zurück zum Zitat Rutka JT, Murakami M, Dirks PB et al (1997) Role of glial filaments in cells and tumors of glial origin: a review. J Neurosurg 87(3):420–430 CrossRefPubMed Rutka JT, Murakami M, Dirks PB et al (1997) Role of glial filaments in cells and tumors of glial origin: a review. J Neurosurg 87(3):420–430 CrossRefPubMed
24.
Zurück zum Zitat Bringmann A, Pannicke T, Grosche J et al (2006) Muller cells in the healthy and diseased retina. Prog Retin Eye Res 25(4):397–424 CrossRefPubMed Bringmann A, Pannicke T, Grosche J et al (2006) Muller cells in the healthy and diseased retina. Prog Retin Eye Res 25(4):397–424 CrossRefPubMed
25.
Zurück zum Zitat Hiscott PS, Grierson I, Trombetta CJ, Rahi AH, Marshall J, McLeod D (1984) Retinal and epiretinal glia--an immunohistochemical study. Br J Ophthalmol 68(10):698–707 CrossRefPubMedPubMedCentral Hiscott PS, Grierson I, Trombetta CJ, Rahi AH, Marshall J, McLeod D (1984) Retinal and epiretinal glia--an immunohistochemical study. Br J Ophthalmol 68(10):698–707 CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Lu YB, Iandiev I, Hollborn M et al (2011) Reactive glial cells: increased stiffness correlates with increased intermediate filament expression. FASEB J 25(2):624–631 CrossRefPubMed Lu YB, Iandiev I, Hollborn M et al (2011) Reactive glial cells: increased stiffness correlates with increased intermediate filament expression. FASEB J 25(2):624–631 CrossRefPubMed
27.
Zurück zum Zitat Reichenbach A, Bringmann A (2010) Muller cells in the healthy retina. Muller cells in the healthy and diseased retina. London, UK: Springer Science+Business media 53-55. Reichenbach A, Bringmann A (2010) Muller cells in the healthy retina. Muller cells in the healthy and diseased retina. London, UK: Springer Science+Business media 53-55.
28.
Zurück zum Zitat Kenawy N, Wong D, Stappler T et al (2010) Does the presence of an epiretinal membrane alter the cleavage plane during internal limiting membrane peeling? Ophthalmology 117(2):320–323 e321 CrossRefPubMed Kenawy N, Wong D, Stappler T et al (2010) Does the presence of an epiretinal membrane alter the cleavage plane during internal limiting membrane peeling? Ophthalmology 117(2):320–323 e321 CrossRefPubMed
29.
Zurück zum Zitat Zhang Z, Dong F, Zhao C et al (2015) Natural course of vitreomacular traction syndrome observed by spectral-domain optical coherence tomography. Can J Ophthalmol 50(2):172–179 CrossRefPubMed Zhang Z, Dong F, Zhao C et al (2015) Natural course of vitreomacular traction syndrome observed by spectral-domain optical coherence tomography. Can J Ophthalmol 50(2):172–179 CrossRefPubMed
30.
Zurück zum Zitat Kim JH, Kang SW, Kong MG, Ha HS (2013) Assessment of retinal layers and visual rehabilitation after epiretinal membrane removal. Graefes Arch Clin Exp Ophthalmol 251(4):1055–1064 CrossRefPubMed Kim JH, Kang SW, Kong MG, Ha HS (2013) Assessment of retinal layers and visual rehabilitation after epiretinal membrane removal. Graefes Arch Clin Exp Ophthalmol 251(4):1055–1064 CrossRefPubMed
31.
Zurück zum Zitat Dyer MA, Cepko CL (2000) Control of Muller glial cell proliferation and activation following retinal injury. Nat Neurosci 3(9):873–880 CrossRefPubMed Dyer MA, Cepko CL (2000) Control of Muller glial cell proliferation and activation following retinal injury. Nat Neurosci 3(9):873–880 CrossRefPubMed
32.
Zurück zum Zitat Francke M, Faude F, Pannicke T et al (2001) Electrophysiology of rabbit Muller (glial) cells in experimental retinal detachment and PVR. Invest Ophthalmol Vis Sci 42(5):1072–1079 PubMed Francke M, Faude F, Pannicke T et al (2001) Electrophysiology of rabbit Muller (glial) cells in experimental retinal detachment and PVR. Invest Ophthalmol Vis Sci 42(5):1072–1079 PubMed
33.
Zurück zum Zitat Mamballikalathil I, Mann C, Guidry C (2000) Tractional force generation by porcine Muller cells: paracrine stimulation by retinal pigment epithelium. Invest Ophthalmol Vis Sci 41(2):529–536 PubMed Mamballikalathil I, Mann C, Guidry C (2000) Tractional force generation by porcine Muller cells: paracrine stimulation by retinal pigment epithelium. Invest Ophthalmol Vis Sci 41(2):529–536 PubMed
34.
Zurück zum Zitat McGillem GS, Dacheux RF (1998) Migration of retinal microglia in experimental proliferative vitreoretinopathy. Exp Eye Res 67(3):371–375 CrossRefPubMed McGillem GS, Dacheux RF (1998) Migration of retinal microglia in experimental proliferative vitreoretinopathy. Exp Eye Res 67(3):371–375 CrossRefPubMed
35.
Zurück zum Zitat Erickson PA, Fisher SK, Guerin CJ, Anderson DH, Kaska DD (1987) Glial fibrillary acidic protein increases in Muller cells after retinal detachment. Exp Eye Res 44(1):37–48 CrossRefPubMed Erickson PA, Fisher SK, Guerin CJ, Anderson DH, Kaska DD (1987) Glial fibrillary acidic protein increases in Muller cells after retinal detachment. Exp Eye Res 44(1):37–48 CrossRefPubMed
36.
Zurück zum Zitat Lewis GP, Fisher SK (2003) Up-regulation of glial fibrillary acidic protein in response to retinal injury: its potential role in glial remodeling and a comparison to vimentin expression. Int Rev Cytol 230:263–290 CrossRefPubMed Lewis GP, Fisher SK (2003) Up-regulation of glial fibrillary acidic protein in response to retinal injury: its potential role in glial remodeling and a comparison to vimentin expression. Int Rev Cytol 230:263–290 CrossRefPubMed
37.
Zurück zum Zitat Lewis GP, Guerin CJ, Anderson DH, Matsumoto B, Fisher SK (1994) Rapid changes in the expression of glial cell proteins caused by experimental retinal detachment. Am J Ophthalmol 118(3):368–376 CrossRefPubMed Lewis GP, Guerin CJ, Anderson DH, Matsumoto B, Fisher SK (1994) Rapid changes in the expression of glial cell proteins caused by experimental retinal detachment. Am J Ophthalmol 118(3):368–376 CrossRefPubMed
38.
Zurück zum Zitat Charteris DG, Downie J, Aylward GW, Sethi C, Luthert P (2007) Intraretinal and periretinal pathology in anterior proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol 245(1):93–100 CrossRefPubMed Charteris DG, Downie J, Aylward GW, Sethi C, Luthert P (2007) Intraretinal and periretinal pathology in anterior proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol 245(1):93–100 CrossRefPubMed
39.
Zurück zum Zitat McLeod D, Hiscott PS, Grierson I (1987) Age-related cellular proliferation at the vitreoretinal juncture. Eye (Lond) 1(Pt 2):263–281 CrossRef McLeod D, Hiscott PS, Grierson I (1987) Age-related cellular proliferation at the vitreoretinal juncture. Eye (Lond) 1(Pt 2):263–281 CrossRef
40.
Zurück zum Zitat Gupta P, Sadun AA, Sebag J (2008) Multifocal retinal contraction in macular pucker analyzed by combined optical coherence tomography/scanning laser ophthalmoscopy. Retina 28(3):447–452 CrossRefPubMed Gupta P, Sadun AA, Sebag J (2008) Multifocal retinal contraction in macular pucker analyzed by combined optical coherence tomography/scanning laser ophthalmoscopy. Retina 28(3):447–452 CrossRefPubMed
41.
Zurück zum Zitat Shiono A, Kogo J, Klose G et al (2013) Photoreceptor outer segment length: a prognostic factor for idiopathic epiretinal membrane surgery. Ophthalmology 120(4):788–794 CrossRefPubMed Shiono A, Kogo J, Klose G et al (2013) Photoreceptor outer segment length: a prognostic factor for idiopathic epiretinal membrane surgery. Ophthalmology 120(4):788–794 CrossRefPubMed
42.
Zurück zum Zitat Michalewski J, Michalewska Z, Cisiecki S, Nawrocki J (2007) Morphologically functional correlations of macular pathology connected with epiretinal membrane formation in spectral optical coherence tomography (SOCT). Graefes Arch Clin Exp Ophthalmol 245(11):1623–1631 CrossRefPubMed Michalewski J, Michalewska Z, Cisiecki S, Nawrocki J (2007) Morphologically functional correlations of macular pathology connected with epiretinal membrane formation in spectral optical coherence tomography (SOCT). Graefes Arch Clin Exp Ophthalmol 245(11):1623–1631 CrossRefPubMed
43.
Zurück zum Zitat Mitamura Y, Hirano K, Baba T, Yamamoto S (2009) Correlation of visual recovery with presence of photoreceptor inner/outer segment junction in optical coherence images after epiretinal membrane surgery. Br J Ophthalmol 93(2):171–175 CrossRefPubMed Mitamura Y, Hirano K, Baba T, Yamamoto S (2009) Correlation of visual recovery with presence of photoreceptor inner/outer segment junction in optical coherence images after epiretinal membrane surgery. Br J Ophthalmol 93(2):171–175 CrossRefPubMed
44.
Zurück zum Zitat Falkner-Radler CI, Glittenberg C, Hagen S, Benesch T, Binder S (2010) Spectral-domain optical coherence tomography for monitoring epiretinal membrane surgery. Ophthalmology 117(4):798–805 CrossRefPubMed Falkner-Radler CI, Glittenberg C, Hagen S, Benesch T, Binder S (2010) Spectral-domain optical coherence tomography for monitoring epiretinal membrane surgery. Ophthalmology 117(4):798–805 CrossRefPubMed
45.
Zurück zum Zitat Inoue M, Morita S, Watanabe Y et al (2010) Inner segment/outer segment junction assessed by spectral-domain optical coherence tomography in patients with idiopathic epiretinal membrane. Am J Ophthalmol 150(6):834–839 CrossRefPubMed Inoue M, Morita S, Watanabe Y et al (2010) Inner segment/outer segment junction assessed by spectral-domain optical coherence tomography in patients with idiopathic epiretinal membrane. Am J Ophthalmol 150(6):834–839 CrossRefPubMed
46.
Zurück zum Zitat Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T (2012) Associations between metamorphopsia and foveal microstructure in patients with epiretinal membrane. Invest Ophthalmol Vis Sci 53(11):6770–6775 CrossRefPubMed Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T (2012) Associations between metamorphopsia and foveal microstructure in patients with epiretinal membrane. Invest Ophthalmol Vis Sci 53(11):6770–6775 CrossRefPubMed
47.
Zurück zum Zitat Duker JS, Kaiser PK, Binder S et al (2013) The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120(12):2611–2619 CrossRefPubMed Duker JS, Kaiser PK, Binder S et al (2013) The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120(12):2611–2619 CrossRefPubMed
Metadaten
Titel
Intraretinal changes in the presence of epiretinal traction
verfasst von
Mario R. Romano
Gilda Cennamo
Francesca Amoroso
Daniela Montorio
Carlo Castellani
Michele Reibaldi
Giovanni Cennamo
Publikationsdatum
23.06.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 1/2017
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-016-3413-z

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