Laser-Based Therapy Approaches in the Retina: A Review of Micropulse Laser Therapy for Diabetic Retinopathy
This review aims to elucidate the mechanisms and clinical utility of subthreshold micropulse laser (SML) therapy in the context of retinal care. Subthreshold or "nondestructive" laser therapy encompasses treatment modalities that induce minimal or no harm to retinal or choroidal tissue and leave no visible sings post-application, while achieving clinical efficacy.
[Statement of the Legal Committee of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA) on the Prognosis Assessment in Private Accident Insurance (PUV) - Status: July 2024]
[Statement of the Legal Committee of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA) on the Prognosis Assessment in Private Accident Insurance (PUV) - Status: July 2024]
[Electronic Documentation of Findings in Visual Impairment Counselling Using FIDUS Software]
The increasing use of electronic documentation extends to consultation for the visually impaired. The aim of this project was to develop a set of forms and electronic patient records specifically for low vision care, giving equal consideration to ophthalmological, orthoptic, and optometric specialities, as well as teaching aspects.
Diabetic Macular Oedema - Patient Characteristics and the Reality of Treatment in a German University Hospital
Diabetic macular oedema (DME) is associated with significant loss of visual acuity. Intravitreal VEGF inhibitor injection is the gold standard in treating this disease; second-line treatment consists of intravitreal steroid injections. This treatment has already undergone extensive investigation in large randomised controlled trials. The aim of this study is to evaluate patient population and treatment options in a real-world setting.
An Unusual Presentation of Persistent Cloquet's Canal with Detached Mittendorf Dot: A Case Report
From Trial to Trial: Diminishing Effects Sizes of Interventions for Myopia Control - a Call for Critical Reassessment
Epidemiology of Myopia: Prevalence, Risk Factors and Effects of Myopia
Myopia is the most common cause of visual impairment in children and young adults. In order to assess the consequences for society, it is necessary to know temporal trends in prevalence, incidence and associated factors in childhood and adolescence, as well as the rate of myopia progression, as based on epidemiological research. This paper presents a literature review of publications from 2020 up to March 2024, supplemented by other relevant publications. The prevalence of myopia in children and adolescents in Germany is almost stable and is significantly lower than in Asia. The development of myopia is influenced by outdoor activity, parental myopia, genetics and near work, while insufficient time spent outdoors in childhood is a significant and controllable risk factor for myopia-related complications such as myopic maculopathy, glaucoma, and retinal detachment.
Multifocal Optics for Myopia Control
The rising prevalence of myopia among children and adolescents necessitates effective interventions to mitigate long-term risks, such as retinal detachment and macular degeneration. Traditional approaches like undercorrection with single-vision lenses have proven ineffective. Recent research underscores the significance of peripheral vision in managing myopia progression. While hyperopic defocus in the peripheral retina may encourage axial elongation, multifocal lenses designed to induce peripheral myopic defocus can potentially curb this elongation. Randomized controlled trials (RCTs) have demonstrated that spectacle lenses with peripheral modifications, such as highly aspherical lenslets (HAL) or defocus incorporated multiple segments (DIMS), reduce myopia progression and axial elongation over 2 years. Similarly, multifocal contact lenses, especially those with high-add power (+ 2.50 D), have shown comparable reductions over 3 years. Safety is a critical consideration in myopia control. Multifocal spectacle lenses with peripheral plus designs are generally well tolerated, with only transient side effects, like dizziness and blurred vision. Soft multifocal contact lenses also exhibit a favorable safety profile, with low rates of serious adverse events. Thorough monitoring and reporting in these studies are essential to provide assurance about the safety of these interventions for children. Future research should aim to include more diverse populations in order to ensure the generalizability of findings across various demographic groups. Additionally, real-world data would offer valuable insights into the performance of these treatments in everyday scenarios. Observational studies, less influenced by industry sponsorship, could further validate these findings. Lastly, the clinical significance of the observed effects should be critically assessed to confirm that the reported benefits lead to meaningful reductions in myopia progression.
Eye Injury Incidence in Germany from 2008 to 2022: An Analysis of Hospital Quality Reports
Eye injuries range from minor to severe and may lead to permanent visual impairment. There is still little in the way of epidemiological data on eye injuries in Germany.
Autologous Contralateral and Ipsilateral Rotational Penetrating Keratoplasty - A Case Series and Mini-Review
Corneal stromal opacities can severely impact visual acuity if they are located in the visual axis. Homologous penetrating keratoplasty (HPK) is usually the preferred surgical option in such clinical circumstances. However, autologous penetrating keratoplasty (APK) could be an immunologically safer alternative. The purpose of this study was to report the surgical technique, indications, and (dis)advantages of ipsilateral rotational and contralateral APK, as well as pre- and postoperative clinical findings of four patients who underwent contralateral APK. In ipsilateral rotational APK, eccentric trephination places the central corneal opacity at the excision edge, whereafter the corneal button is rotated to clear the visual axis. Contralateral APK is suitable for more specific clinical situations with corneal opacity in a functionally much better eye. Clear cornea of the (almost) blind eye suffering from a noncorneal pathology is transplanted to the potentially better seeing eye suffering from a corneal pathology, followed by HPK in the (almost) blind donor eye. After 18 months, potentially better-seeing eyes improved from logMAR 1.3 to 0.6 in visual acuity, with most HPK-treated weaker eyes matching preoperative levels. Considering ipsilateral rotational and contralateral APK before moving on straight towards HPK is crucial in select cases. Autologous contralateral keratoplasty should be preferred for patients with (1) corneal scars in a potentially better seeing eye and (2) a clear cornea in an (almost) blind eye, especially in cases of high risk for graft rejection.
Five-Year Data from the Interdisciplinary Giant-Cell Arteritis Registry at the University Hospital of Würzburg: Value of Temporal Artery Biopsy
Giant-cell arteritis (GCA) requires immediate diagnosis and therapy. The University Hospital of Würzburg established the Centre for Giant-cell Arteritis (ZeRi) to improve interdisciplinary collaboration.
Unexpected Intracameral Foreign Bodies During Regular Cataract Surgeries
Unexpected intracameral foreign bodies during regular cataract surgery appear relatively often but seem to be underreported, since they are almost often immediately removed. They rarely remain in the anterior chamber and can be the source of inflammation, infections, or lead to corneal endothelial decompensation. We report two series of cases with different materials of different origins and review the literature.
Glucagon-like Peptide 1 Receptor Agonist: Balancing Alarm and Caution
Role of Artificial Intelligence in Retinal Diseases
Artificial intelligence (AI) has already found its way into ophthalmology, with the first approved algorithms that can be used in clinical routine. Retinal diseases in particular are proving to be an important area of application for AI, as they are the main cause of blindness and the number of patients suffering from retinal diseases is constantly increasing. At the same time, regular imaging using high-resolution modalities in a standardised and reproducible manner generates immense amounts of data that can hardly be processed by human experts. In addition, ophthalmology is constantly experiencing new developments and breakthroughs that require a re-evaluation of patient management in routine clinical practice. AI is able to analyse these volumes of data efficiently and objectively and also provide new insights into disease progression and therapeutic mechanisms by identifying relevant biomarkers. AI can make a significant contribution to screening, classification and prognosis of various retinal diseases and can ultimately be a clinical decision support system, that significantly reduces the burden on both everyday clinical practice and the healthcare system, by making more efficient use of costly and time-consuming resources.
Erratum: RPE65-associated retinal dystrophies: phenotypes and treatment effects with voretigene neparvovec