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Purpose A close interaction between neurosensory retina and the retinal pigmentepithelium (RPE) is a prerequisite for normal vision. Glaucomatous damage is characterized by neuroretinal degeneration. As a result, an imbalanced interaction exists. However, there is only limited evidence regarding RPE involvement in glaucoma patients’ eyes. This study investigates the correlation between retinal nerve fiber layer (RNFL) thickness and RPE alterations as detected by widefield fundus autofluorescence (FAF). Methods Peripapillary RNFL thickness was quantified by optical coherence tomography (OCT). The six corresponding retinal areas were defined by a standardized grid and FAF intensity/irregularities were assessed and correlated to RNFL measurements. Results 84 glaucomatous eyes were investigated. A correlation between RNFL thickness and standardized FAF in the corresponding topographic retina segments was observed. Correlation coefficients ranged between -0.12 to 0.35 and were statistically significant in the temporal inferior central field (r=0.35, p=0.02) and the temporal inferior peripheral field (r=0.31, p=0.04). Conclusion This study provides early evidence that in glaucoma RNFL degeneration may be accompanied by corresponding RPE alterations

Purpose Treatment accuracy and patient pain were evaluated using a novel navigating laser (NAVILAS) compared to conventional laser treatment in clinically significant macular edema (CSME). Methods Focal Navilas laser was performed in 42 patients. On color images (CI) and OCT laser spots were analyzed regarding accuracy spot placement compared to planning. Treatment pain was quantified on a visual-analogue-scale (VAS) and compared to a matched control. Up to one year clinical follow-up investigated retreatment and visual acuity compared to a control of 113 patients treated by conventional laser. Results 79% of laserspots were visible on CI, of which 96% were within 100µm from the planned target. OCT confirmed that laser effects were limited to the outer retina . The number of laser spots per patient was 115+/-97 with Navilas, (43+/-36) with conventional laser. Pain on VAS was mean 1.6 (SD 1.0), 4.4 (SD 1.8) for the control. Kaplan-Meier analysis showed separation of the retreatment curves after 4-5 months with less retreatments for Navilas. Conclusion Compared to conventional laser, significantly more laserspots were placed with Navilas, patient reported pain was significantly lower. the tendency for lower retreatment rates tend with Navilas may be important when considering possible combination laser and anti-VEGF drug therapy. Commercial interest

Background Cumulative light exposure is significantly associated with progression of age-related macular degeneration (AMD). Inhibition of vascular endothelial growth factor is the main target of current antiangiogenic treatment strategies in AMD. However, other growth factors, such as platelet-derived growth factor (PDGF) and placenta growth factor (PlGF), have a substantial impact on development of AMD. Previous reports indicate that sorafenib, an oral multikinase inhibitor, might have beneficial effects on exudative AMD. This study investigates the effects of sorafenib on lightinduced overexpression of growth factors in human retinal pigment epithelial (RPE) cells. Methods Primary human RPE cells were exposed to white light and incubated with sorafenib. Viability, expression, and secretion of VEGF-A, PDGF-BB, and PlGF and their mRNA were determined by reverse transcription-polymerase chain reactions, immunohistochemistry and enzyme-linked immunosorbent assays. Results Light exposure decreased cell viability and increased expression and secretion of VEGF-A, PDGF-BB and PlGF. These light-induced effects were significantly reduced when cells were treated with sorafenib at a dose of 1 mg/ml. Conclusion The results show that sorafenib has promising properties as a potential antiangiogenic treatment for AMD.

Purpose To investigate accuracy of a navigating laser photo-coagulator in clinically significant macular edema. Methods Focal laser in 20 patients was digitally planned on fundus images and performed with navigation using Navilas® (OD-OS GmbH, Teltow, Germany). On color images, OCT and autofluorescence we analyzed 784 laser spots (mean 39 per eye) at one week follow-up and determined accuracy of spot placement using an image flicker method. Results 76% of lesions were visible on color images, 95% were within 100 µm from the planned target. OCT confirmed that laser effects were limited to the outer retina. Conclusion Navilas® laser effects were visualized to high percentage on post-treatment images, location showed high concordance to preplanning.

Purpose The 4. generation fluorochinolon moxifloxacin covers most isolates causing endophthalmitis. It is safe and effective for systemic and topical use, however only very limited data is available on prophylactic intracameral administration to prevent endophthalmitis. This study investigates the safety of Viagamox (moxifloxacin) for intracameral application in a cell culture model Methods Endothelial toxicity of Vigamox (moxifloxacin) was evaluated in cultured human corneas. Toxic effects regarding primary human RPE, trabecular meshwork cells (TMC) and corneal endothelial cells (CEC) were evaluated after 24h and under conditions of oxidative stress. By treating cells with TNF-a, LPS and IL-6 the effects of moxifloxacin on viability under conditions of inflammation were investigated. Toxicity was evaluated by measuring the inhibition of cell proliferation (MTT). Cell viability was quantified by a microscopic live dead assay Results No corneal endothelial toxicity could be detected after 30 days treatment with 500µg/mL moxifloxacin. RPE,TMC,and CEC showed adverse effects on proliferation and viability at concentrations higher than 150µg/mL moxifloxacin only. Preincubation with TNF-a, LPS, IL-6 or H2O2 and subsequent treat with moxifloxacin concentrations up to 150µg/ml for 24h had no significant effect on proliferation and viability Conclusion Moxifloxacin concentrations up to 150µg/mL had no significant toxicity on RPE, TMC, CEC and human corneas. The MIC90 of moxifloxacin for common pathogens of endophthalmitis is known to be in the range of 0.25 - 2.5µg/mL. Therefore, intracameral use of moxifloxacin at concentrations up to 150µg/mL may be safe and effective to prevent endophthalmitis after intraocular surgery

Purpose: Primary open-angle glaucoma (POAG) is one of the leading cause for blindness. Activation of optic nerve head astrocytes (ONHA) and loss of trabecular meshwork cells (TMC) are pathognomonic for this disease. Oxidative stress (OS) and elevated levels of TGF-beta play an important role in the pathogenesis of this neurodegenerative disease. This study investigates possible anti-apoptotic and cytoprotective effects of Minocycline (M) on TMC and ONHA under OS and TGF-beta. Methods: TMC and ONHA were treated with 1μM to 150μM M. Possible toxic effects and IC50 were evaluated after 24h (MTT). To investigate possible protective effects of M on TMC and ONHA, cell proliferation and viability was examined. Expression of XIAP, Survivin as well as Bcl-2 and their mRNA was assessed by RT-PCR 24h after treatment with M alone, additional incubation with TGF-beta-2 and OS. Results: M concentrations from 1μM to 75μM showed no toxic effects on TMC and ONHA. Under conditions of OS both TMC and ONHA showed an increase in viability and ability to proliferate when treated with 20-40μM M. RT-PCR yielded an overexpression of XIAP, Survivin and Bcl-2, when TMC or ONHA cells were treated with 20-40μM M for 24 hours, under OS and when additionally incubated with TGF-beta2. Conclusions: We could show that M does not have toxic effects on TMC and ONHA cells up to 75μM. The observed increase in viability and proliferation under OS and TGF-beta2 and the overexpression of XIAP, Survivin and Bcl-2 after treatment with 20-40μM M might prevent apoptotic-cell-death in response to cellular stress and may be a protective pathway for TMC and ONHA to avoid progression of glaucomatous degeneration.

Purpose: To compare and correlate imaging of classic subfoveal choroidal neovascularization (CNV) with noninvasive 3-dimensional imaging by the retinal thickness analyzer (RTA) to conventional fluorescein angiography (FA). Methods: A total of 29 eyes of 29 consecutive patients with predominantly classic CNV eligible for photodynamic therapy underwent FA and RTA imaging. The FA dimensions of the CNV were measured independently by two graders. With the RTA, masked to FA the size of the CNV itself as imaged in 3-dimensional reconstruction, the size of significantly thickened retina overlying the CNV and the maximum retinal thickness were measured. Results: The mean diameter of the CNV determined from 3-dimensional RTA reconstructions showed an excellent correlation with measurements from FA (r = 0.91, p < 0.001). The area of retinal thickening was by a mean of 0.7 mm in diameter larger and correlated moderately well with the size of the CNV on FA (r = 0.65, p < 0.001). In contrast, there was no correlation between the absolute retinal thickness and the CNV size on FA. Conclusions: Noninvasive quantitative mapping of predominantly classic CNV by RTA is feasible and also allows 3-dimensional measurement of the lesion itself. The results correlate well with FA assessment but visualize different properties of the disease.