Springer Science and Business Media LLC

Verfasser erläutert die Theorie des Nystagmus als Lockerungsvorgang und Wegfall von regulierenden und zügelnden Wirkungen, für die ein supranucleares Regulationszentrum angenommen wird. Dieses Zentrum hat für seine verschiedenen Aufgaben einen statischen tonisierenden Haltungsapparat, einen dynamischen, motorischen Zwecken dienenden Schaltapparat und einen die beidäugigen Bewegungen regulierenden Apparat, den Koordinationsapparat. Mit der Annahme dieses Zentrums und seinen verschienenen Funktionen werden die Erscheinungen des Nystagmus zu erklären versucht.

To compare the 12-month treatment outcome of ranibizumab with that of aflibercept in cases of neovascular age-related macular degeneration (AMD). This retrospective single-institution study included patients who had been diagnosed with treatment-naïve neovascular AMD and treated using either ranibizumab (ranibizumab group, n = 30) or aflibercept (aflibercept group, n = 21) monotherapy over a 12-month follow-up period. Patients initially received three monthly injections, and were re-treated when neovascularization recurred. The best-corrected visual acuity (BCVA) at diagnosis and at 12 months, as well as the number of injections, were compared between the two groups. In the ranibizumab group, the mean logarithm of the minimum angle of resolution BCVA values at diagnosis and at 12 months were 0.86 ± 0.45 and 0.72 ± 0.56, respectively. The equivalent values were 0.73 ± 0.37 and 0.58 ± 0.41 in the aflibercept group. The mean number of injections was 4.5 ± 1.3 in the ranibizumab group and 4.3 ± 0.9 in the aflibercept group. There was no difference in BCVA between the two groups at either diagnosis (P = 0.560) or 12 months (P = 0.702). There was also no difference between the two groups in the number of injections (P = 0.847). The 12-month treatment outcome of intravitreal ranibizumab was similar to that of intravitreal aflibercept, with a comparable injection frequency. Further prospective studies with a more controlled design are needed to confirm our findings.

A twenty-one year old female with previously unsuspected neurofibromatosis presented for evaluation of a blind painful eye. Histopathologic examination of the enucleated specimen revealed choroidal thickening with ovoid bodies and proliferation of connective tissue with pigment-containing cells and ganglion-like cells. Electron microscopic study of the latter cell population revealed typical morphologic features of ganglion cells, including numerous electron-dense intracellular granules and an abundance of mitochondria and rough endoplasmic reticulum. These pathologic findings were interpreted as consistent with the diagnosis of choroidal ganglioneuroma occurring in the context of ocular neurofibromatosis. The literature concerning this unusual tumor is reviewed and the possible relationship of this lesion to neurofibromatosis and other disorders of neural cresent proliferation are briefly discussed.

Chronic situations like long-term use of topical medications induces conjunctival inflammation and is also a significant risk factor for failure of filtering surgery. We evaluated conjuctival expression of group IIA secretory PLA2 (sPLA2-IIA), group V secretory PLA2 (sPLA2-V), calcium-independent PLA2 (iPLA2) and cytosolic PLA2 (cPLA2). Samples were obtained from non-glaucomatous patients (control subjects), and patients with either primary open-angle glaucoma (POAG) or exfoliation glaucoma (ExG). All the glaucoma patients had been treated with antiglaucomatous medication, and underwent deep sclerectomy surgery. Antibodies against sPLA2-IIA, sPLA2-V, iPLA2 and cPLA2 were used for immunohistochemical staining of frozen tissue sections. In the human conjunctiva of non-glaucomatous patients, immunostaining of sPLA2-IIA, sPLA2-V or cPLA2 was low and positively stained cells were mainly localized in the surface of the epithelium. In contrast, iPLA2 was found to predominate in human normal conjunctiva and it demonstrated strong labeling throughout the epithelium. The stromal staining of iPLA2 was weak. Expression of sPLA2-IIA was significantly increased in stromal fibers of patients with POAG or ExG. No changes were found in levels of sPLA2-V, iPLA2 or cPLA2 between the patient groups and controls. These findings demonstrate that sPLA2-IIA, sPLA2-V, iPLA2 and cPLA2 are expressed in the conjunctiva of non-glaucomatous patients. In the epithelium, sPLA2-IIA, sPLA2-V, and cPLA2 may participate in protection against risks caused by mechanical wear and tear stress whereas iPLA2 may regulate remodeling and maintenance of membrane phospholipids. sPLA2-IIA may also have the important role in the degradation of bacteria. In conjunctival stroma of POAG and ExG patients, sPLA2-IIA may play a role in the development of scar tissue after glaucoma filtration surgery.

Despite surgical reattachment of the retina in infants with severe retinopathy of prematurity (ROP), visual acuity may decline. We performed gonioscopy and applanation tonometry on 26 eyes of 17 infants with severe ROP who were randomly selected and followed prospectively for 2 years. Of these 26 eyes, one eye of one patient had only peripheral retinocryopexy for threshold stage III disease and had an attached retina before enrollment into the study. Sixteen infants subsequently underwent vitrectomy, scleral buckle, or both. Retinal reattachment of the posterior pole was present in at least one eye each of 10 of the 17 infants. Glaucoma was diagnosed in 5 of the 10 patients; all 5 showed a decrease in visual acuity of greater than 1 octave. Of the 5 infants without glaucoma, 3 showed visual improvement, and 2 remained the same. Although we studied a small number of cases, our results suggest that glaucoma may be a cause of visual decline in infants with severe ROP. A decline in visual acuity in infants with severe ROP and surgical retinal reattachment may warn us of glaucoma, as this diagnosis is difficult to make in these small infants.

Im Gefecht bekam der Patient eine Lochwunde von der Nasenwurzel bis in die linke Schläfengegend. In der Schlussbahn wurde der linke Bulbus durchbohrt ohne grosse Zertrümmerung desselben. Klinisch bestand: Blutung im Bulbus, Motilitätsstörung, Amaurose, Chemosis der Bindehaut, leichte Entzündungserscheinung, aber keine Veränderung der äusseren Gestalt des Bulbus. Nach 22 Tagen wurde der Bulbus enucleiert und untersucht, man fand Ein- und Ausschusswunde am nasalen Äquator und etwas hinten vom lateralen Äquator. Die Wunden bildeten schon schwärzliche und nach der Länge laufende Narben. Durch die anatomische Untersuchung wurde bewiesen, dass der Bulbus doppelt perforiert war. Daraus ergibt sich, dass das moderne kleinkalibrige Gewehrgeschoss unter Umständen den Bulbus durchbohrt und zwei Wundöffnungen hervorbringt, ohne bedeutende Zertrümmerung desselben hervorzurufen.