Die Ophthalmologie最新文献

The incidence of cataract is expected to increase, primarily due to an aging population. However, human-induced environmental changes may also contribute. In this narrative review, we explore the connection between climate change, the depletion of the ozone layer, and modifiable risk factors for cataract development such as UV light exposure and pollution-related factors. Finally, we discuss preventative measures at both the individual and the societal level, including strategies to improve cataract care and reduce the carbon footprint of cataract surgery.

The climate change has multiple effects on health. The eyes are not exempt from these effects and components of climate change, such as the temperature, UV radiation or air pollution that can have a relevant impact on retinal pathologies can be worked out. The alterations to the retina include UV light-induced retinal damage, age-related macular degeneration (AMD), choroidal melanoma, diabetic retinopathy, retinal detachment and vascular occlusion. Overall, there is an urgent need for prospective multicenter studies to be able to further analyze the specific impact of components of climate change on the retina.

Purpose: To evaluate the research performance in ophthalmology in Germany based on the findings of the recent research map of the German Ophthalmological Society (DOG) and to suggest strategies for future improvements on a national level both to DOG as well as to politics. The focus is on preclinical and translational clinical research.

Methods: International expert panel evaluation and discussion organized by the Task Force Research of the German Ophthalmological Society (DOG).

Results: The international view on the German ophthalmological research landscape was generally positive. The value for money relationship was judged as very good. As Germany is facing an aging society and vision impairment will create an ever-increasing socioeconomic burden, the reviewers suggested several lines of future activities: an increased activity of securing intellectual property, more lay audience lobbying, intensified collaboration and critical mass building between "lighthouses" of ophthalmic research in Germany, as well as the establishment of a German national eye institute equivalent.

Conclusion: The ophthalmological research performance in Germany was rated to be very good by an international expert panel. Nonetheless significant improvements were requested in the fields of translation (clinical trials, IP), synergy between specialized institutions and governmental funding for a German center for eye research.

Background: The increasing congestion in emergency departments of all specialties is one of the most pressing challenges of our time.

Objective: The aim of this study is to make a well-founded contribution to the development of emergency case numbers in the tertiary sector (specialist clinics) of German ophthalmology. From this, the need to develop new control and triage mechanisms for ophthalmology can be derived.

Material and methods: Retrospectively, > 140,000 emergency treatment cases at the University Eye Hospital Tübingen in the period from 1 January 2010 to 31 December 2023 were analyzed. Sub-analyses were conducted to quantify the impact of the COVID-19 pandemic and differences between weekend and weekday visits. In addition, a questionnaire survey on the referral status of emergency consultations at off-peak times and at weekends was conducted in 2022.

Results: The number of emergency consultations more than doubled between 2010 and 2023 and more than tripled at weekends. The peak load, which is relevant for guaranteeing treatment, has increased to the same extent. In the long term, a shift in emergency treatment from core to off-peak times can be observed, particularly at weekends. The majority of consultations (up to 87%) take place without a referral from a doctor. In 2023, the treatment figures returned to the level before the start of the COVID-19 pandemic.

Discussion: The emergency outpatient clinic at the University Eye Hospital is increasingly exposed to a double burden: providing treatment for emergency cases with specialist referrals and at the same time acting as a catchment basin for general emergencies. New control and triage mechanisms are urgently needed to ensure good care in the long term.

Background: Damage induced by ultraviolet (UV) radiation plays a decisive role in the carcinogenesis of malignant tumors of the eyelids.

Methods: A selective literature search was performed in PubMed and Google Scholar.

Results: Large epidemiological studies show an increase in the prevalence of eyelid tumors in recent decades. The incidence of malignant eyelid tumors has increased especially in the white population over the last 70 years. A UV-induced damage to tumor suppressor genes and oncogenes which play a key role in the carcinogenesis of malignant eyelid tumors has been demonstrated. Strong intermittent UV exposure and sunburn have been identified as risk factors for basal cell carcinoma and malignant melanoma. For squamous cell carcinoma, cumulative UV exposure over a longer period of time is considered a risk factor.

Conclusion: In order to counteract the UV-related increase in malignant eyelid tumors, preventive protective measures, early detection and increased public awareness are essential. On the one hand, changes in behavior, appropriate clothing, wearing hats and sunglasses or contact lenses with UV filters are effective measures for UV protection. On the other hand, the underlying mechanisms of carcinogenesis should be investigated further in order to be able to carry out effective prevention and further develop treatment.