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 determine whether recurrent disc hemorrhage (DH) accelerates glaucomatous visual field (VF) loss compared to an isolated, single, detected DH. We evaluated the disc photographs of consecutive patients with ≥5 SITA-Standard fields for DH. Group A had patients with a single DH in one eye, and group B had at least one recurrence in the same eye. Automated pointwise linear regression analysis was used to calculate rates of progression. Logistic regression was used to determine ocular or systemic variables associated with DH recurrence after baseline assessment. One hundred and seventeen patients were enrolled (group A = 72, group B = 45). The mean age was 67.1 ± 10.8 years; most patients were women (65%) of European ancestry (92%) diagnosed with primary open-angle glaucoma (47%). The mean number of VF after the initial DH was 7.9 ± 2.9, spanning a mean of 4.6 ± 2.2 years. None of the ocular or systemic characteristics revealed a significant difference between groups. The mean global rate of progression (group A, −0.8 ± 0.6 vs group B, −0.8 ± 0.7 dB/year, p = 0.93) and number of eyes reaching a progression endpoint (group A, 70% vs group B, 73%, p = 0.80) did not differ between groups. Recurrent DH eyes showed a tendency to be followed longer, with a greater number of disc photographs, which was not significant in the multivariate analysis. The global rates of progression between groups remained non-significant even after adjusting to follow-up time and number of VF tests (p = 0.69). Recurrent DH does not result in a faster rate of VF progression compared to a single detected DH. Eyes with single or recurrent DH have similar risks for future disease progression.

To evaluate in healthy eyes the interchangeability of retinal thickness measurements resulting from different protocols of Spectralis optical coherence tomography (OCT, Heidelberg Engineering, Germany). Three different central volumetric protocols were performed in one session by one single operator in a randomly selected eye of 31 healthy adults (range, 19–30 years): (1) area 6 × 6 mm, 25 scan pattern (SP), (2) area 6 × 6 mm, 49 SP, (3) area 6 × 3 mm, 97 SP. Nine ETDRS areas were analyzed, except outer areas for 97 SP. Interclass correlation coefficients (ICC) and limits of agreement (Bland–Altman) were calculated. Mean minimal foveal thickness was 224.0 ± 15.8 μm and central retinal thickness 280.8 ± 16.5 μm. ICC ranged from 0.973 to 0.993. Ninety-five percent limits of agreement between the protocols were <7 μm in all ETDRS areas. The difference between two measurements never exceeded 9 μm. Spectralis OCT retinal thickness measurements in healthy subjects showed good protocol interchangeability for all tested protocols. Larger differences are to be expected in eyes with macular pathology.

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.