Peter Wolfrum

Myopia is a childhood-onset condition driven by excessive axial ocular elongation, associated with increased risk of sight-threatening complications and irreversible visual impairment. Despite rising global prevalence, epidemiological data on long-term trends in Europe remain limited. This study examines temporal trends in myopia prevalence and axial length (AL) across European adult birth cohorts. We conducted a comparative birth-cohort analysis using harmonised data from 28 population-based studies (n = 81,828) across nine countries participating in the European Eye Epidemiology (E3) Consortium. Myopia prevalence (overall, by severity, and sex) were estimated using individual participant data random-effects meta-analysis. AL distributions were assessed by estimating percentiles across birth cohorts. Myopia prevalence more than tripled across 20th-century birth cohorts, rising from 18.0% (95% confidence interval [CI]: 15.2%, 21.3%) in the 1900s to 61.4% (95% CI: 55.5%, 66.9%) in the 1990s (p < 0.001), with increased prevalence across all severity levels. Standardised to the 2024 European population, myopia prevalence was estimated at 42.7% (95% CI: 40.2%, 45.1%). Myopia prevalence was similar between males and females overall. AL was longer in successive decades (1920–1970) across all population centiles (p < 0.001), indicating a population-wide shift. Myopia prevalence and AL have increased markedly across European birth cohorts throughout the twentieth century, affecting all severity levels and both sexes. These findings underscore the importance of preventive strategies targeting modifiable environmental risk factors, alongside continued evaluation of interventions intended to slow myopia progression, as continued increases may strain healthcare systems and society.

Background: Patients affected by neovascular age-related macular degeneration (nAMD) require long-term anti-vascular endothelial growth factor (VEGF) therapy to maintain visual function. This study assessed 10-year functional outcomes as well as the cumulative incidence and progression of complete retinal pigment epithelium and outer retinal atrophy (cRORA) in a real-world cohort. Methods: Treatment-naïve eyes of nAMD patients receiving intravitreal anti-VEGF therapy under a pro re nata regimen over 10 years were retrospectively analyzed. Demographics, visual acuity (VA) (LogMAR), number of injections, macular neovascularization (MNV) subtype, and treatment agents were collected. cRORA incidence was assessed according to the Classification of Atrophy Meeting (CAM) group, and the progression rate was quantified. Factors associated with final VA and cRORA progression rate were further investigated. Results: 35 eyes from 30 patients (63.3% female; mean age 74.9 ± 6.6 years) were analyzed. The median number of injections over 10 years was 69. VA declined by +0.016 logMAR/year, with a significant change compared to baseline only at the 10-year visit ( p < 0.05). Baseline and 5-year VA correlated strongly with final VA ( p < 0.001). cRORA developed in 48.6% of eyes, with a mean progression rate of 0.26 ± 0.11 mm/year. Conclusion: Over 10 years, nAMD-affected eyes receiving anti-VEGF therapy demonstrated only a modest decline in visual function. While cRORA developed in nearly half of the eyes, no association with treatment intensity or MNV type was observed in this cohort. Early VA was significantly associated with long-term functional outcomes.

Background: To assess short-term clinical outcomes in patients with retinal vein occlusion (RVO)-related macular edema switched to Faricimab after a suboptimal response to previous intravitreal therapy. Methods: In our retrospective single-center analysis, functional and anatomical changes of eyes affected by macular edema secondary to RVO were analyzed at baseline and four weeks after completing a three-injection Faricimab upload phase. Visual acuity (LogMAR) was analyzed as functional outcome measure, while central retinal thickness (CRT) and central retinal volume (CRV) were investigated as anatomical outcome measures. Further, a subgroup analysis compared treatment-related factors between patients exhibiting concurrent functional and anatomical improvements (full-responders) and those who did not (reduced-responders). Results: A total of 21 eyes from 20 patients were included. Mean visual acuity improved modestly from 0.50 ± 0.52 to 0.40 ± 0.31 LogMAR, without reaching statistical significance ( p = 0.257). Significant reductions in CRT (350.2 ± 124.5 to 302.6 ± 74.6 µm; p = 0.037) and CRV (2.53 ± 0.46 to 2.34 ± 0.29 mm ³ ; p = 0.011) were noted. A positive correlation between CRT reduction and VA improvement was observed (r = 0.499; p = 0.021). In comparison, full-responders exhibited a significantly worse baseline LogMAR ( p = 0.041) and CRT ( p = 0.026). Conclusion: In our study assessing the short-term effect of switching to intravitreal Faricimab, significant anatomical improvements were observed. Although no significant functional improvements were observed, likely reflecting a ceiling effect, visual acuity remained stable. Further studies are necessary to evaluate especially sustained functional outcomes under long-term Faricimab therapy.

Purpose: This study aimed to evaluate 5‐year longitudinal changes in both central and peripheral corneal thickness and to explore associations with ocular characteristics as well as systemic cardiovascular risk factors (CVRF). Methods: The Gutenberg Health Study is a prospective population‐based cohort study comprising 15 010 participants aged 35–74 years at baseline. Scheimpflug tomography (Pentacam, Oculus, Wetzlar, Germany) was performed during both the 5‐year (2012–2017) and 10‐year (2017–2022) follow‐up examinations. Longitudinal changes in central corneal thickness (CCT) and in concentric rings at 2 mm (D2), 4 mm (D4), 6 mm (D6), 8 mm (D8) and 10 mm (D10) were evaluated in eyes with available measurements at both time points. Additionally, associations between changes in CCT and ocular characteristics as well as systemic CVRFs at the 5‐year FU as well as its 5‐year changes (Δ) were investigated by multivariable linear regression analyses using generalized estimating equations. Results: 8755 eyes of 4857 participants were included and a significant reduction in CCT was observed across all age groups over 5 years. Peripheral corneal thickness remained stable over time. Multivariable analyses identified associations with a change in CCT and ocular characteristics including corneal diameter (B = −0.06, p < 0.0001), axial length (B = 0.04, p < 0.008), pseudophakia at the 5‐year examination (B = −0.18, p < 0.03) as well as systemic CVRF including age (B = −0.04, p < 0.008), HbA1c (B = 0.03; p < 0.040), ΔHbA1c (B = 0.05; p < 0.001), ΔLDL (B = ‐0.03, p < 0.047), ΔHDL (B = −0.05, p = 0.0006), ΔMAP (B = −0.04, p < 0.01) and a continuous smoking status (B = 0.08, p < 0.035). Conclusion: While observing a 5‐year decline in CCT, peripheral corneal thickness remained relatively stable. We observed longitudinal associations between CCT changes and HbA1c, lipid profile, mean arterial pressure and smoking, suggesting that corneal thickness changes may be influenced by cardiovascular and metabolic health and thus may be taken into consideration in glaucoma risk stratification.

Objectives: This study aims to analyze the association between systemic inflammation and clinical outcomes in patients with macular edema secondary to retinal vein occlusion (RVO). Methods: A retrospective analysis of 68 patients with acute RVO, in whom cardiovascular risk factors were assessed, was conducted. Laboratory determinations included levels of C-reactive protein (CRP) and homocysteine to explore the systemic inflammatory status. Optical coherence tomography (OCT) parameters and visual acuity (LogMAR) were collected at baseline. Follow-up visual acuity was determined after 12 months. The number of intravitreal anti-VEGF injections and the performed laser treatment were assessed after 12 and 24 months. Associations of inflammatory markers with clinical outcomes were analyzed by correlation analysis, and patients with or without evidence for inflammation were compared. Results: At baseline, the mean foveal retinal thickness (FRT) was 591 ± 277 µm, the mean average central retinal thickness (CRT) was 580 ± 227 µm, and the mean average central retinal volume (CRV) was 12 ± 3 mm³. The level of CRP at baseline was significantly associated with increased FRT, average CRT, and average CRV (p = 0.024; p = 0.027; p = 0.003). CRP levels were also associated with a lower BCVA at baseline and after 12 months (p = 0.018; p = 0.006). In patients with elevated homocysteine levels, a trend towards a higher number of required laser treatments was observed. No association between increased inflammatory parameters and the number of required intravitreal injections was detected. Conclusions: Systemic inflammation is associated with the severity of macular edema secondary to RVO. CRP concentrations could represent a prognostic marker for the course of the patient’s visual acuity.

Background/Objectives: To investigate the non-inferiority of preservative-free (PF) tafluprost eye drops (Taflotan sine^®) compared to latanoprost eye drops (Xalatan^®) in reducing mean 24 h intraocular pressure (IOP) on the second day of a diurnal IOP measurement. Methods: In this retrospective monocentric cohort study, patients suffering from primary open-angle glaucoma, ocular hypertension, normal tension glaucoma, pigment dispersion glaucoma, or pseudoexfoliation glaucoma who had undergone inpatient diurnal IOP measurement were included. Patients of cohort 1 used latanoprost eye drops as monotherapy; patients of cohort 2 used preservative-free tafluprost eye drops. Data from 7 January 2005 to 9 July 2019, inclusive, were analyzed. Results: Ninety-three eyes were included (n = 59 latanoprost group, n = 34 PF tafluprost group). Mean 24 h IOP on day 2 was 14.1 mmHg (SD 2.3) in the latanoprost group and 14.5 mmHg (SD 3.4) in the PF tafluprost group. The non-inferiority of PF tafluprost eye drops to latanoprost eye drops in efficacy on mean 24 h IOP could not be confirmed (95% CI −1.5, ∞, p = 0.235). The average difference in mean IOP at the individual measurement times between both cohorts was 0.24 mmHg (SD 0.17) on day 1 and 0.44 mmHg (SD 0.6) on day 2. The non-inferiority of PF tafluprost compared to latanoprost regarding fluctuation range could not be demonstrated for both days. Conclusions: The data suggests slight inferiority of PF tafluprost to latanoprost eye drops. There were similar mean 24 h IOP values in both cohorts. PF tafluprost eye drops remain a useful treatment option as long as the patient’s individual target pressure is achieved. Furthermore, according to the literature, it is also a treatment option for patients with symptoms of ocular surface disease and other side effects affecting the ocular surface while receiving preservative-containing topical therapy.

Purpose To analyse real-world clinical outcomes and influence of the spherical equivalent (SE) on anti-vascular endothelial growth factor (VEGF) therapy in patients affected by myopic choroidal neovascularisation (mCNV). Patients and Methods A retrospective investigation was conducted on treatment-naïve mCNV patients receiving anti-VEGF therapy at the Department of Ophthalmology, University Medical Center Mainz, Germany, between January 2018 and March 2024. Safety, functional and morphological changes in visual acuity (VA), central retinal thickness (CRT), and central retinal volume (CRV) were evaluated over a two-year period. Further, we analysed how baseline VA and CRT relate to itʼs final outcome measures. Finally, a subgroup analysis assessed the impact of SE above and below − 10 D. Results Significant improvements in VA, CRT, and CRV were observed. VA improved from 0.5 ± 0.27 logMAR to 0.38 ± 0.31 logMAR (p = 0.005) at 6 months and remained stable at 2 years. CRT and CRV decreased from 344.4 ± 115.0 µm to 284.2 ± 45.2 µm (p < 0.001) and 0.27 ± 0.09 mm³ to 0.22 ± 0.04 mm³ (p < 0.001), respectively, four weeks after the initial injection, with stability maintained thereafter. Baseline VA correlated strongly with final VA, whereas CRT did not. No adverse events were reported. The subgroup analysis showed no significant outcome differences based on SE. Conclusion Anti-VEGF therapy in mCNV patients proved to be safe and effective in our study with sustained improvement in functional and anatomical measures. Baseline VA strongly predicted final VA, whereas baseline and final CRT showed no association. No differences in treatment outcomes were observed as based on a varying SE.