Anna Maria Welzel

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.

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.

Genome-wide association studies have revealed many loci linked to glaucoma. The aim of this study was to explore the associations between a glaucoma polygenic risk score (GPRS) with glaucoma prevalence, intraocular pressure (IOP), and peripapillary retinal nerve fibre layer thickness (pRNFL) on a population-based level. Participants of the Gutenberg Health Study (aged 40-80 years) and the AugUR Study (aged 70-95 years), two German population-based studies, were included. Of participants with genetic assessment 12,147 had glaucoma grading, 8938 data on IOP, and 7844 data on pRNFL. Spectral-domain optical coherence tomography was used to measure pRNFL thickness and noncontact tonometry for IOP measurements. Glaucoma was graded according to the classification of the International Society for Geographic and Epidemiological Ophthalmology. GPRS was calculated using 2453 locus lead variants. Linear regression was conducted to evaluate the association of GPRS with IOP and pRNFL thickness and Poisson regression analysis for the association of GPRS with glaucoma prevalence. Age groups were divided in quartiles: 40-51, ≥52-62, ≥63-72, and ≥73-95 years. Increased GPRS was significantly associated with increased glaucoma prevalence (Prevalence ratio: 1.84, 95% confidence interval [CI], 1.60-2.11; P = 2 × 10-16) and higher IOP (B-estimate = 0.54 mm Hg per SD of GRPS; 95% CI, 0.48-0.59; P = 2 × 10-16). Higher GPRS was associated with thinner global pRNFL (B-estimate = -0.61 µm per SD of GPRS on global pRNFL; 95% CI, -0.86 to -0.36; P = 1.2 × 10-6) with increasing age. There was an association in temporal-inferior, temporal-superior, nasal-inferior, nasal-superior, and nasal pRNFL sector. Higher GPRS is associated with glaucoma prevalence, higher IOP and thinner pRNFL in two population-based studies in Germany. These associations were particularly seen in older participants.

Zusammenfassung Das Glaukom ist eine der Hauptursachen für Sehbehinderung und Blindheit in Deutschland und weltweit. Der mögliche Einfluss von Ernährung sowie Nahrungsergänzungsmitteln auf den Verlauf und die Therapie dieser Erkrankung werden im klinischen Alltag häufig erfragt. Im Rahmen dieses Artikels soll ein Überblick über die aktuelle Literatur gegeben werden.

Background: Polyneuritis cranialis is a rare condition than can be caused by various diseases. We report the first case of multiple cranial nerve paralysis resulting in neurotrophic keratopathy with corneal ulceration as a sequel of polyneuritis cranialis due to actinomycosis. Case presentation: An 84-year-old German woman developed corneal ulceration with a high risk of perforation because of neurotrophic keratopathy due to polyneuritis cranialis. Actinomycosis of a wisdom tooth causing polyneuritis cranialis was detected on computed tomography and magnetic resonance imaging and was treated with systemic antibiotics. Penetrating keratoplasty with simultaneous amniotic membrane transplantation was performed successfully after conservative treatment failure. Conclusions: To the best of our knowledge, we report on the first case of multiple cranial nerve failure due to actinomycosis and requiring ophthalmological intervention.

This study reports on alterations of the peripapillary retinal nerve fiber layer (pRNFL) in long-term childhood cancer survivors (CCS) for the first time. In the Cardiac and Vascular Late Sequelae in Long-Term Survivors of Childhood Cancer-Study (CVSS), a cross-sectional study, 1002 CCS (aged 23-48 years) diagnosed with neoplasia before the age of 15 years were prospectively enrolled in an ophthalmological examination including pRNFL-measurements with spectral-domain optical coherence tomography. An age- and sex-matched sample of the population-based Gutenberg Health Study (GHS) served as the comparison group. Differences in pRNFL in CCS with cancer types and treatments were explored. Four hundred forty-nine CCS had pRNFL imaging and were included with a mean follow-up of 28.9 years. The pRNFL was 3.38 µm thinner in CCS compared with the GHS controls (P < 0.0001). The pRNFL was thinner in CCS with central nervous system tumors (P < 0.001), leukemia (P < 0.001), renal tumors (P = 0.004), neuroblastoma (P < 0.001), soft-tissue sarcoma (P = 0.003), and malignant bone tumor (P = 0.004), but not different after lymphoma and germ cell tumor. Treatment with platin derivates (P = 0.02) and cranial radiation (P = 0.02) were negatively associated with pRNFL. Subgroup analysis revealed a thinner pRNFL in leukemia CCS and treatment with anthracyclines (P < 0.001) and methotrexate (P = 0.01). No association was found for ifosfamide, vinca alkaloids, asparaginase chemotherapy, and cardiac radiation. The pRNFL is thinner in CCS with most common tumor entities, except lymphoma and germ cell tumors. Cranial radiation and platin derivates had negative effects on the pRNFL thickness. Follow-ups are needed to evaluate if this might result in increased risk for neurodegenerative ophthalmic diseases, like glaucoma.

Zusammenfassung Offenwinkelglaukome sind eine der Hauptursachen für Sehbehinderung und Blindheit weltweit wie auch in Deutschland. Da es sich beim Offenwinkelglaukom um einen unumkehrbaren Untergang von retinalen Ganglienzellen und deren Axone handelt und Gesichtsfeld- und Visuseinschränkungen somit irreversibel bestehen bleiben, ist ein rechtzeitiges Erkennen der Erkrankung von entscheidender Bedeutung. In diesem Beitrag werden Epidemiologie sowie Risikofaktoren für das Offenwinkelglaukom dargelegt und bewertet.

This study compares the one-year outcomes of standalone Ahmed glaucoma valve (AGV) implantation and standalone Paul glaucoma implant (PGI) in adult patients with primary and secondary glaucoma. A retrospective, single-center, comparative study was conducted on adult patients who underwent standalone PGI and AGV at the University Medical Center Mainz. The primary outcome measures were the changes of IOP and the number of antiglaucoma eye medication at one year postoperatively. Secondary outcome measures included complete and qualified success rates, failure rates, visual acuity logMAR and the incidence of adverse events. A total of 24 adult patients were included in the AGV group and 28 in the PGI group. The median preoperative intraocular pressure decreased from 29.5mmHg (Interquartile range (IQR) 21–42) to 16.0mmHg (IQR 7–37) in the AGV group, and from 34.0 mmHg (IQR 13–56) to 16.0 (IQR 7–21) mmHg in the PGI group at the one-year follow-up. The median number of classes of intraocular pressure-lowering medications reduced from 3.5 to 0 in the AGV group, and from 3.0 to 0 in the PGI group. There were no statistically significant differences between the groups for any success criteria or failure. The AGV produced more encapsulation than the PGI, and the latter more tube exposures. Both the Ahmed Glaucoma Valve and the Paul Glaucoma Implant effectively reduce IOP and the number of antiglaucoma medications at one year with comparable safety profiles.