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Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Focke Ziemssen hat Honorare für Beratungs- und Referententätigkeit von Abbvie/Allergan, Alimera, Apellis, Bayer Healthcare, Biogen, Boehringer, Johnson & Johnson, NovoNordisk, Novartis, MSD Sharp & Dohme, Sanofi, Stada and Roche/Genentech. Studientätigkeit wurde von Acelyrin, Clearside, Kodiak, Johnson & Johnson, Novartis, Regeneron, Roche und Sandoz finanziert. Horst Helbig hat für Referentätigkeit und Advisory Boards Honorare von Abbvie/Allergan, Alcon, Apellis, Astellas, Bayer, Novartis, Roche and Theapharm erhalten./Focke Ziemssen received lecture fees and consultation honoraria from Abbvie/Allergan, Alimera, Apellis, Bayer Healthcare, Biogen, Boehringer, Johnson & Johnson, NovoNordisk, Novartis, MSD Sharp & Dohme, Sanofi, Stada and Roche/Genentech. Study financing was provided by Acelyrin, Clearside, Kodiak, Johnson & Johnson, Novartis, Regeneron, Roche and Sandoz. Horst Helbig received lecture fees and consultation honoraria from Abbvie/Allergan, Alcon, Apellis, Astellas, Bayer, Novartis, Roche and Theapharm.

Neovascular glaucoma (NVG) is a severe potentially blinding disease, which represents one of the most common types of secondary glaucomas. The majority of cases are caused by ischemic retinal conditions such as diabetic retinopathy, central retinal vein occlusion or ocular ischemic syndrome. If appropriately diagnosed and treated, ideally the development of NVG can be prevented. Since treatment gets increasingly challenging as the disease progresses, early diagnosis is of utmost importance. In this review pathogenesis, diagnosis, treatment and prophylaxis are discussed extensively. A focus is put on the consecutive stages through which the disease progresses and how to diagnose and differentiate them. Ultimately a stage adapted therapy approach is detailed, consisting of the three blocks: 1. treatment of the underlying disease/retinal ischemia, 2. adjunctive medical therapy (anti-VEGF) and 3. therapy of the elevated intraocular pressure., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Honorar/geldwerten Vorteil für Referententätigkeit erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein. Erklärung zu nichtfinanziellen Interessen R. Greslechner: Mitglied DOG, ÖOGH. Helbig: Vorstand RG, Pressesprecher DOG, Fachberater BLAEK, (Thieme. All rights reserved.)

There have been marked increases in the numbers of patients with retinal detachments at individual centres in recent years and this is supported by the subjective impression of many experts. We therefore surveyed the literature on changes in the incidence of retinal detachments worldwide. This revealed quite significant methodological differences between the studies, so that it was difficult to achieve a conclusive comparison of the development of the incidence of retinal detachment. Despite these limitations, all data from recent studies suggest an increase in the number of retinal detachments. The incidence of retinal detachment in the western world currently seems to be more than 20 cases per 100,000 person-years, which is significantly higher than described in earlier decades. It can be assumed that an increase in the number of individuals with myopia, a demographic increase in patients of the typical age group for retinal detachment and an increasing number of cataract surgeries, especially in younger patients, are responsible for the rising incidence of retinal detachment., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht. The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

A variety of retinal diseases can lead to the development of glaucoma. The most common type of these secondary glaucomas is neovascular glaucoma (NVG), which constitutes the main subject of this review. NVG is a severe condition with a poor prognosis. Treatment becomes increasingly challenging as the disease progresses. Thus emphasis is put on early diagnosis and therapy adapted to the disease stage. The review also covers other less frequent secondary glaucomas, such as glaucomas due to intraocular tumours or associated with retinal detachment (Schwartz-Matsuo syndrome) as well as late onset open-angle glaucomas after uncomplicated vitrectomy., Competing Interests: R. Greslechner erklärt, dass er während der letzten 3 Jahre keine wirtschaftlichen oder persönlichen Verbindungen im oben genannten Sinne hatte. H. Helbig erhielt innerhalb der letzten 3 Jahre Berater-, Autoren- und Vortragshonorare von Alcon, Allergan, Apellis, Bayer, Novartis, Thieme Verlag und Theapharm./R. Greslechner declares that he has no conflict of interest. H. Helbig received fees as speaker/author/advisory board member from Alcon, Allergan, Apellis, Bayer, Novartis, Thea Pharm and Georg Thieme Verlag KG in the past 3 years., (Thieme. All rights reserved.)

Introduction: Polypoidal choroidal vasculopathy (PCV) is a vascular disease of the choroid. Diagnosis is mainly based on polypoidal aneurysm-like lesions seen in indocyanine green (ICG) angiography. Various therapeutic options have been proposed., Methods: Outcomes of 10 cases with extrafoveal PCV and consecutive macular edema treated with thermal laser are reported. Diagnosis of PCV was confirmed by ICG angiography., Results: Upon successful occlusion of the polyps in 10 eyes after thermal laser treatment demonstrated in ICG angiography, a regression of central foveal edema was seen in optical coherence tomography and color fundus photography. Visual acuity improved from logMAR 0.8 to logMAR 0.3. Follow-up ranged from 4 months to 15 years, with a median of 1 year. Two eyes had a recurrence of exudative maculopathy 5 and 7 years after laser treatment, respectively., Conclusion: A careful differentiation between various subforms of exudative maculopathy using fluorescein and ICG angiography can identify certain selected patients with extrafoveal PCV, for whom thermal laser monotherapy can be a therapeutic option., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Diabetic retinopathy (DR) is a vision-threatening microvascular complication of diabetes and the leading cause of blindness in working-age people. At the beginning of the metabolic disorder and in early stages of DR the patient's eyesight is often not affected. Depending on the duration of diabetes and in more advanced stages of DR the vision is compromised through the presence of diabetic macular edema (DME) and/or proliferative retinal complications. The management of DR comprises regular ophthalmic examinations according to clinical guidelines, the targeted application of multimodal imaging, and the specific treatment of DME and proliferative DR including secondary disorders such as neovascular glaucoma or persistent vitreous haemorrhage. Innovative ocular imaging techniques like optical coherence tomography (OCT), OCT angiography (OCT-A) and ultrawide field imaging play an important role in the assessment of diabetic patients. Various non-invasive imaging modalities have become part of the routine clinical work-up and help to identify new biomarkers for early diagnosis and long-term prognosis. In early stages of DR, the multifactorial intervention including glucose level and blood pressure control as well as optimizing the patient's cardiovascular risk profile is essential. A specific ophthalmic therapy is available for DME and proliferative DR (PDR). In patients with PDR the treatment regime includes panretinal laser photocoagulation or alternatively intravitreal anti-VEGF (vascular endothelial growth factor)-injections accompanied by close-meshed clinical monitoring. In patients with both, DME and PDR, it is suggested to start with Anti-VEGF drugs. In severe PDR with persistent vitreous haemorrhage, tractional maculopathy or tractional retinal detachment vitreoretinal surgery is recommended., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Honorar/geldwerten Vorteil für Referententätigkeit erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein. Erklärung zu nichtfinanziellen Interessen T. Barth: Mitglied der DOGH. Helbig: Vorstand RG, Pressesprecher DOG, (Thieme. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Diabetic macular edema (DME) is a chronic retinal disease, which requires intensive clinical monitoring. Within the last ten years the intravitreal anti-VEGF (vascular endothelial growth factor) therapy has become the standard of care to improve and stabilize vision in patients with centre involving DME. Long-acting intravitreal corticosteroids can achieve similar visual results with fewer injection rates. Because of steroid-induced side effects (progression of cataract, glaucoma) these drugs are regarded as second-line medication. Since the introduction of anti-VEGF-medication the focal laser photocoagulation is no longer considered as first-line therapy for DME. However, a focal laser treatment can sometimes be a possible alternative in specific situations. In patients with proliferative diabetic retinopathy and DME, the intravitreal anti-VEGF therapy is approved for both conditions. In ischemic maculopathy the functional outcome is restricted. For the indication of anti-VEGF-treatment for DME with accompanying central ischemia not only visual acuity and optical coherence tomography parameters should be considered, the amount of ischemia seen on fluorescein angiography should also be taken into account. In tractional macular edema due to epiretinal membranes and vitreomacular adhesions a pars-plana vitrectomy with membrane peeling is indicated., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Honorar/geldwerten Vorteil für Referententätigkeit erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein. Erklärung zu nichtfinanziellen Interessen T. Barth: Mitglied der DOGH. Helbig: Vorstand RG, Pressesprecher DOG, (Thieme. All rights reserved.)

Introduction: Ischemic choroidal diseases are an underdiagnosed entity. The clinical pattern varies according to the size and the localisation of the affected vascular structure., Clinical Presentation: In eyes with occlusion of the long posterior ciliary arteries, characteristic triangular patches of choroidal ischemia (Amalric sign) are seen, which in the course of time merge into well-defined areas of atrophy of the retinal pigment epithelium. Above the non-perfused choroidal areas, hyperpigmented, grouped lines appear (Siegrist streaks). Circumscribed ischemia of smaller choroidal arterioles and capillary vessels appears as multifocal, yellowish lesions in the posterior fundus (Elschnig spots). Vortex vein occlusion becomes manifest as exudative haemorrhagic choroidal swelling in the periphery., Causes of Choroidal Ischemia: Apart from arterial hypertension as a major risk factor, some immunological disorders such as giant cell arteritis and systemic lupus erythematosus and haematological pathologies also affect choroidal perfusion. Furthermore, choroidal ischemia occurs due to local inflammation, as found in eyes with acute multifocal posterior placoid pigment epitheliopathy (APMPPE). Rarely, choroidal infarction is of iatrogenic origin or drug-induced. Recent advances in imaging, such as the introduction of enhanced depth imaging optical coherence tomography (EDI-OCT) and OCT angiography (OCT-A), have improved the visualisation of the choroidal vasculature and complement the classical angiographic procedures. In patients with age-related macular degeneration (AMD) and diabetes, some changes in choroidal blood flow and vascular structure have also been noted. While in AMD the choroidal pathologies correlate with the disease progression and the functional prognosis, the pathophysiological relationship between diabetic choroidopathy and retinopathy is currently unclear., Management and Conclusion: With regard to the limited therapeutic options for choroidal ischemia, optimisation of the cardiovascular risk profile and the management of accompanying ocular and systemic diseases are essential., Competing Interests: PD Dr. med. Teresa Barth received research funding from non-academic institution in the past 3 years. Prof. Dr. med. Horst Helbig received research funding, fees as speaker/advisory board member and travel grants from non-academic institutions in the past 3 years./PD Dr. med. Teresa Barth hat in den letzten 3 Jahren Forschungsförderung (persönlich oder zur persönlichen Verfügung) von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.) erhalten. Prof. Dr. med. Horst Helbig hat in den letzten 3 Jahren Forschungsförderung (persönlich oder zur persönlichen Verfügung) von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.) erhalten, hat in den letzten 3 Jahren ein Honorar oder geldwerte Vorteile, z. B. eine Kostenerstattung (Reise-/Übernachtungskosten) oder die Übernahme von Teilnehmergebühren als passiver Teilnehmer einer Veranstaltung erhalten und war bezahlter Berater/interner Schulungsreferent von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.)., (Thieme. All rights reserved.)

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Vorträge und Beratertätigkeit für Novartis, Bayer, Implandata.

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Interessenkonflikt: Honorare für Vorträge und Beratung von Bayer und Novartis.

Background: A very light planoconcave (0.3 g) and biconcave (0.27 g) contact lens of corundum monocrystal is presented for simplification of pars plana vitrectomy., Material and Methods: Corundum monocrystal is corrosion-resistant and extremely hard and mar-proof. It can be sterilised by all conventional procedures without changing its shape or transparency. Corundum monocrystal is transparent like glass and has a high refractive index of n = 1.76 like sapphire., Results: The high refractive index enables strong prismatic deflection and thus provides a good view of the peripheral retina. The lens is placed on the cornea over a drop of methylcellulose and requires no scleral fixation or irrigation system. An erect image is formed., Conclusion: Compared to other systems, the two contact lenses have the advantage of easy handling with excellent optical quality.

Diabetic tractional retinal detachment is a severe complication in diabetic retinopathy. The decision for a surgical intervention has to consider the spontaneous course of the disease, intraoperative and postoperative complications and the expected functional results. An extramacular tractional detachment can remain stable for a long time and can be observed as long as the centre of the macula is not threatened. Traction to the macula can cause oedema and reduced vision, even if the macula itself is not detached. In these cases vitreous surgery can improve vision. Retinal breaks due to tractional membranes can cause a traction-rhegmatogenous retinal detachment which is usually rapidly progressive and requires early surgery. For cases with tractional detachment of the macula there is no alternative to surgery. In cases with long-standing and complete tractional detachment with severe retinal ischaemia the functional prognosis even after anatomically successful surgery is poor and it may be better not to operate.