Klinische Monatsblatter fur Augenheilkunde最新文献

Due to the close anatomical, functional and trophic relationships between the optic nerve and retina, a wide variety of diseases affecting both structures have reciprocal effects on each other, which must be considered in the differential diagnosis to avoid misdiagnosis. Therefore, it is essential to assess pathological changes in both structures in context to differentiate the type and location of the primary lesion from its consequences, as well as to correctly classify coincidences and disease-specific lesion patterns in both organ components.This article highlights the typical symptom constellations and lesion patterns of optic neuropathies and retinopathies. An attempt is made to identify the reciprocal characteristic relationships of the respective lesions in both structures in various disease groups, as well as to present their respective roles in the differential diagnosis.In the first part of the article, typical optic neuropathies in the context of various syndromic and non-syndromic retinal dystrophies are initially examined. Subsequently, the relationships between different hereditary and acquired mitochondriopathic optic neuropathies and possible accompanying retinal changes are analysed, and their pathogenesis and relevant differential diagnoses are discussed.It is demonstrated and exemplified how important it is in general, but also specifically in regard to the disease groups discussed in this article, to have a careful and targeted diagnostic approach in each case, considering both the retinal and optic nerve findings, in order to avoid misdiagnosis.

Age-related macular degeneration (AMD) continues to be the most common hereditary disease among older people in the western world. In addition to the clinical examination, multimodal imaging with fluorescein angiography, optical coherence tomography, fundus autofluorescence and fundus photography are crucial for the correct diagnosis and classification. This is particularly important with regard to risk assessment for the development of a late form of the disease. Since the introduction of intravitreal therapy against vascular endothelial growth factor (VEGF), the treatment options for neovascular AMD have increased significantly and the prognosis for patients in terms of maintaining their vision has improved. The hope is to develop stronger and longer-lasting drugs and also to obtain approval for drugs to treat geographic atrophy. It is therefore of great importance to be able to make a quick and correct diagnosis for patients. In this paper we want to present an overview of the pathophysiology, classification and diagnosis of AMD.

Today, microendoscopic minimally invasive therapy techniques, such as laser dacryoplasty (LDP) for complete stenosis and microdrill dacryoplasty (MDP) for incomplete stenoses are therapeutic options for PANDO (primary acquired nasolacrimal duct obstructions). Due to excellent prognosis, external DCR is still "gold standard" especially for patients with complex problems.

Due to the close anatomical, functional and trophic relationships between the optic nerve and retina, a wide variety of diseases affecting both structures have reciprocal effects on each other, which must be considered in the differential diagnosis to avoid misdiagnosis. Therefore, it is essential to assess pathological changes in both structures in context to differentiate the type and location of the primary lesion from its consequences, as well as to correctly classify coincidences and disease-specific lesion patterns in both organ components.This article highlights the typical symptom constellations and lesion patterns of optic neuropathies and retinopathies. An attempt is made to identify the reciprocal characteristic relationships of the respective lesions in both structures in various disease groups, as well as to present their respective roles in the differential diagnosis.In this second part, acquired optic neuropathies in the context of vascular and systemic diseases and possible accompanying retinal findings, as well as symptom constellations and courses, are differentiated, discussing arteritic and non-arteritic (anterior) optic neuropathies, their causes and differential diagnosis. The combined involvement of the optic nerve and retina in the context of posterior infectious and non-infectious uveitis is also shown. Finally, various dysgenetic optic neuropathies, their differentiation and possible retinal sequelae are presented.It is demonstrated and exemplified how important it is in general, but also specifically in regard to the disease groups discussed in this article, to have a careful and targeted diagnostic approach in each case, considering both the retinal and optic nerve findings, in order to avoid misdiagnosis.

Nowadays, sport and exercise play an important role in the daily lives of all age groups of our patients. As doctors, we have the task of seeing patients as individuals, in addition to providing specialist monitoring and support. This requires interdisciplinary thinking. Diabetic disease is a good example of this. As ophthalmologists, we should not only focus on the retina or the lens during check-ups, but also pay attention to the overall constitution of our patients. For example, it can be helpful if, after cataract surgery, exercise/sport is interrupted only briefly and minimally.This paper presents the current recommendations for ophthalmologists. The aim is to be able to give affected patients advice on sport and exercise relatively quickly and easily, even for recurring use in various areas of daily practice.However, the recommendations presented here are not evidence-based due to a lack of research data, but are based on years of experience, the combination of different specialist areas and after consultation with colleagues from different perspectives on sport and exercise.

This study aims to explore the associations and the underlying mechanism among dry eye disease (DED), air pollution, and meteorological conditions. DED is positively correlated with air pollutants (i.e., PM_2.5, PM₁₀, O₃, NO₂, CO, and SO₂) and meteorological conditions (i.e., high altitude and wind speed), while negatively associated with relative humidity. Both low and high air temperatures effect DED. Atmospheric pollutants affect DED mainly through necroptosis or autophagy, inflammatory responses, and oxidative stress. Meteorological factors affect DED not only by their own affects but also by dispersing the concentration of air pollutants, and then reducing the negative exposure. In summary, this review may expand the understanding of the effects of air pollution and meteorological factors on DED and emphasize the importance of air environmental protection.