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A várólisták témaköre nemzetközileg is rendkívüli figyelemmel követett indikátor az egészségügyi ellátórendszerek összehasonlítása során. A várólisták körében kiemelt jelentőséggel rendelkezik a szürkehályog, mely megszüntetése az egyik legelterjedtebb várólista-köteles beavatkozás világszerte. A vizsgálat célja, hogy elemezze az egynapos sebészeti betegellátás várólista-csökkentési potenciálját a szürkehályog műtét várólistával összefüggésben Magyarországon a 2014-2019 közötti időszakban. Vizsgálati adatbázisunk a Nemzeti Egészségbiztosítási Alapkezelő finanszírozási adatbázisából származik és a 2014-2019 közötti időszak adatait tartalmazta. Az adatbázis a szürkehályog várólistához és a szürkehályog előjegyzési listához kapcsolódó várakozók és előjegyzettek számát, a váró-, illetve előjegyzési listán szereplők tényleges, átlagos várakozási idejét, az ellátott esetszámok ellátási típus szerinti megoszlását, a beavatkozások Orvosi Eljárások Nemzetközi Osztályozási (OENO) rendszerének kódját és megnevezését, valamint az ellátó egészségügyi intézmény típusát tartalmazta. A vizsgált időszak alatt évente átlagosan 6.251 fő volt szerepelt a magyarországi szürkehályog várólistán, azonban számottevő emelkedés nem volt kimutatható 2014-2019 között. Az átlagos tényleges várakozási idő 2014-ben 104 nap volt, mely 2019-ben csupán 39. Az esetek jellemzően egynapos sebészeti ellátásban és aktív fekvőbeteg szakellátásban kerültek elszámolásra. A vizsgálati időszak során a műtéti esetszámok érdemben nem változtak, ugyanakkor az egynapos sebészet esetszámok aránya folyamatos emelkedést mutatott. A legnagyobb mértékben elvégzett beavatkozás az 51474 OENO kóddal rögzített hajlított műlencse-beültetéssel kombinált phacoemulsificatios műtét volt, mely az összes vizsgálatba vont beavatkozás 96%-át jelentette (n=458.326). A várólistán szereplő várakozók száma számottevően nem nőtt az általunk vizsgált időszak alatt; az éves műtéti esetszám nem változott; ugyanakkor az átlagos várakozási idő jelentősen csökkent. Mindez azt igazolja, hogy érdemi műtéti esetszám növekedés nélkül sikerült az átlagos várakozási időt csökkenteni, ami felhívja a figyelmet az ellátás szervezésének fontosságára.

A glükokortikoszteroidok a szemészeti és szisztémás gyulladásos betegségek kezelésében is kulcsfontosságú gyulladáscsökkentők. Hosszan tartó alkalmazásuk azonban szemnyomás-emelkedést és ennek talaján glaucomás neuropathiát okozhat, mely potenciálisan akár vaksággal fenyegető szemészeti szövődmény. A szteroidterápia nemcsak szemészeti készítmények alkalmazásakor emelheti meg a szemnyomást, hanem más alkalmazási módokban is: inhalációs, intranasalis, szisztémás. Jelen közleményünk célul tűzte ki, hogy a legfontosabb irodalmi eredmények és saját klinikai tapasztalataink alapján összefoglaló áttekintést adjon a szteroidterápia indukálta iatrogén glaucoma etiológiájáról, diagnosztikájáról és kezelési lehetőségeiről, részletesen kitérve a különböző kortikoszteroidkezelések alkalmazási módjainak összehasonlítására. A szteroidterápia alkalmazását már kevés szakterületen lehet elkerülni, ezért fontos, hogy ahol elnyújtott szteroidterápia szükséges, minden szakorvosnak gondolnia kell a szteroidok szemnyomásemelő hatására is. A szteroidok szemnyomásemelő hatása függ a hatóanyag típusától, a beadás módjától és az alkalmazás idejétől. Alkalmazási területtől függetlenül rendszeres szemészeti kontroll szükséges, különös tekintettel a glaucomás anamnézisre, hisz a tartós szemnyomás-emelkedés a látóidegrostok visszafordíthatatlan, végső soron akár vakságot okozó károsodását válthatja ki. A szövődmény felismerésének nehézségét fokozza, hogy a szemnyomás általában tünet- és fájdalommentesen emelkedik meg. Amikor a szteroidterápiát nem lehet elkerülni, a lehető legkevésbé szemnyomásemelő hatóanyagot a lehető legrövidebb ideig kell választani a lehető legalacsonyabb dózissal. Amennyiben a szemnyomás-emelkedést nem lehet uralni konzervatív módon, műtéti megoldás jöhet szóba. Orv Hetil. 2022; 163(34): 1345–1352.

Introduction: Hurler-Scheie syndrome is a type of mucopolysaccharidosis I (MPS). In MPS I the decreased activity of alpha-L-iduronidase lysosomal enzyme leads to glycosaminoglycan (GAG) deposition in the intra- and extracellular matrix. Excessive amounts of GAG can accumulate in most layers of the cornea, including epithelial cells, stromal keratocytes, and endothelial cells. Case Presentation: A 25-year-old female patient suffering from Hurler-Scheie syndrome with multiple ocular manifestations is reported. Due to significant bilateral corneal opacification, penetrating keratoplasty was performed on both eyes. Histopathologic examination of the corneal buttons showed disorganized collagen fibers with heterogenous thickness and many granule-containing keratocytes with excessive cytoplasm. Despite receiving enzyme replacement therapy, in vivo confocal microscopy revealed characteristic vacuoles in the basal epithelium and corneal stroma 96 months after transplantation. High resolution anterior segment optical coherence tomography demonstrated hyperreflective opacities superficial and deeper in the stroma which was consistent with recurrence of host disease in the graft. Conclusion: To the best of our knowledge, this is the first documented Hurler-Scheie syndrome case of recurrence after penetrating keratoplasty demonstrated by in vivo confocal microscopy. Additionally, this patient manifested severe ocular involvement of MPS which might be an explanation of the progressive course of corneal opacification after transplantation.

The purpose of this study was to evaluate corneal cellular and ultrastructural changes and to quantify the neuroinflammatory process in patients after mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Thirty patients after SARS-CoV-2 infection and 41 age-matched controls were examined. All subjects underwent in vivo confocal microscopy of the corneal cell layers and subbasal nerve fibers with the Heidelberg Retina Tomograph II. Semiautomated analysis of basal epithelial, anterior and posterior stromal keratocyte, and endothelial cell density was performed. Dendritic cell (DC) density and area were also calculated, and subbasal nerve plexus morphology was analyzed.The posterior stromal keratocyte density was significantly lower in patients after SARS-CoV-2 infection ( P = 0.0006). DC density in the central cornea was significantly higher in patients after SARS-CoV-2 infection ( P = 0.0004). There was a significant difference in the DC area between the 2 groups ( P0.0001). Significantly altered subbasal nerve fiber morphology was detected in patients after SARS-CoV-2 infection compared with healthy volunteers ( P0.05).Corneal cellular and ultrastructural changes demonstrated in this study suggest neuroinflammatory consequences of COVID-19 in the cornea in the absence of ophthalmoscopic alterations.

Összefoglaló. Az agy és a szem vascularis katasztrófái számos esetben egymáshoz társuló vagy egymást előre jelző kórképek. Az arteria centralis retinae occlusio az ér rekanalizációjának hiányában a retina szöveteinek irreverzibilis károsodását okozza. Sem a nemzetközi, sem a hazai stroke-irányelvek nem foglalkoznak az ocularis stroke problémakörével, annak ellenére, hogy az arteria centralis retinae occlusio okozta retinalis ischaemia minden tekintetben megfelel az akut ischaemiás stroke definíciójának. Az eddig rendelkezésre álló irodalmi adatok alapján arteria centralis retinae occlusio esetén az intravénás thrombolysis 4,5 órán belül alkalmazva növeli a szignifikáns mértékű visusjavulás esélyét. Az országban jelenleg 4 centrum (Pécsi Tudományegyetem, Szegedi Tudományegyetem, Debreceni Egyetem, Semmelweis Egyetem) tervezi az ocularis stroke kezelésében a thrombolysis bevezetését. A maradandó látásromlás és a szekunder cerebrovascularis események megelőzése érdekében elengedhetetlen az alapellátásban és a társszakmákban dolgozó kollégákkal való szoros együttműködés. Orv Hetil. 2021; 162(47): 1871–1875. Summary. Vascular events of the brain and the eye may occur concomitantly or sequentially. In the absence of recanalization, central retinal artery occlusion causes irreversible damage to the retinal tissues. Even though retinal ischemia secondary to central retinal artery occlusion meets the definition of acute ischemic stroke, neither the international nor the Hungarian stroke guidelines mention ocular stroke. Based on the available literature, intravenous thrombolysis of the central retinal artery within 4.5 hours of occlusion can increase the odds of significant vision improvement. Currently 4 centers (University of Pécs, Debrecen, Szeged, and Semmelweis University) are planning to introduce thrombolysis in the treatment of ocular stroke. To prevent permanent visual loss and secondary cerebrovascular events, timely intervention requires the collaboration between general practitioners and other specialties. Orv Hetil. 2021; 162(47): 1871–1875.

Purpose To study the reproducibility of measurements performed with a recently developed multimodal high resolution swept source optical coherence tomography (SSOCT) and to make comparisons with a partial coherence interferometry (PCI) biometer. Methods One hundred and fifty-two eyes of 152 subjects were involved in this study with a mean age of 65.71 ± 13.86 years (26–85 years). Anterior surface keratometry (K), anterior chamber depth (ACD), white-to-white (WTW) and axial length (AL) values were recorded by the SSOCT (ANTERION, Heidelberg Engineering Ltd, Germany) and PCI (IOLMaster 500, version 5.5, Carl Zeiss Meditec, Germany). Intraocular lens (IOL) power was calculated based on ANTERION and IOLMaster keratometry values by using five traditional vergence formulas. Results Anterior surface simulated keratometry values did not differ significantly between the IOLMaster and ANTERION (P > 0.05). AL measurements were successful in 95% of the cases both with the SSOCT and PCI. No significant difference was disclosed between the two instruments (P = 0.229). For WTW measurements, a significant difference was observed between the two optical biometers (P P Conclusion Our results implicated an overall good reproducibility of anterior keratometry, AL, ACD and WTW measurements for IOLMaster and ANTERION. The discrepancies between their measurements resulted in significant difference in the calculated IOL power for SRK/T, Hoffer and Holladay formulas, but not for Haigis formula.

Purpose The aim of our research was to investigate the reliability and clinical applicability of a modern tear film imaging tool by comparing the inter- and intragrader difference. The further goal was to compare the non-invasive tear break-up time (NIBUT) measured with the LacryDiag® device with traditional tear film break-up time (TBUT). Methods Comprehensive ophthalmological examination was performed, including LacryDiag® (Quantel Medical, France) (lower tear meniscus height measuring (LTMH), superior and inferior eyelid meibography (MeibS MeibI), interferometry (INT), NIBUT), slit lamp examination, and TBUT. Two independent, well-trained graders selected and analyzed the LTMH, MeibI, MeibS, and INT. The second grader reanalyzed the data 1 month later. Intra- and inter-examiner reliabilities were evaluated using intraclass correlation coefficients (ICC), while for categorical variable, Cohen’s kappa statistics were provided. The Bland-Altman plot was used for visualization of the agreement between measurements. Results Fifty healthy volunteers were examined. For LTMH both the inter- and intragrader variabilities were excellent. Between two graders, the ICC of MeibI was poor; however, between two graders, the ICC of MeibS was good, and the intragrader variability in MeibI and MeibS was excellent. For the INT, both intra- and intergrading were in fair and moderate agreement, although the intragrader agreement was higher. Comparing the NIBUT and TBUT, the agreement was slight. Conclusion Based on our results, examination of a patient during follow-up should be performed by the same examiner, because of the slight agreement. The LacryDiag® is a non-invasive, easy-to-use device, which can examine the tear film and save the recordings for easier follow-up.

An imbalance of homeostasis in the retina leads to neuron loss and this eventually results in a deterioration of vision. If the stress threshold is exceeded, different protective/survival mechanisms are activated. Numerous key molecular actors contribute to prevalent metabolically induced retinal diseases—the three major challenges are age-related alterations, diabetic retinopathy and glaucoma. These diseases have complex dysregulation of glucose-, lipid-, amino acid or purine metabolism. In this review, we summarize current knowledge on possible ways of preventing or circumventing retinal degeneration by available methods. We intend to provide a unified background, common prevention and treatment rationale for these disorders and identify the mechanisms through which these actions protect the retina. We suggest a role for herbal medicines, internal neuroprotective substances and synthetic drugs targeting four processes: parainflammation and/or glial cell activation, ischemia and related reactive oxygen species and vascular endothelial growth factor accumulation, apoptosis and/or autophagy of nerve cells and an elevation of ocular perfusion pressure and/or intraocular pressure. We conclude that in order to achieve substantial preventive or therapeutic effects, at least two of the mentioned pathways should be targeted synergistically. A repositioning of some drugs is considered to use them for the cure of the other related conditions.

Metabolomics strategies are widely used to examine obesity and type 2 diabetes (T2D). Patients with obesity (n = 31) or T2D (n = 26) and sex- and age-matched controls (n = 28) were recruited, and serum and tear samples were collected. The concentration of 23 amino acids and 10 biogenic amines in serum and tear samples was analyzed. Statistical analysis and Pearson correlation analysis along with network analysis were carried out. Compared to controls, changes in the level of 6 analytes in the obese group and of 10 analytes in the T2D group were statistically significant. For obesity, the energy generation, while for T2D, the involvement of NO synthesis and its relation to insulin signaling and inflammation, were characteristic. We found that BCAA and glutamine metabolism, urea cycle, and beta-oxidation make up crucial parts of the metabolic changes in T2D. According to our data, the retromer-mediated retrograde transport, the ethanolamine metabolism, and, consequently, the endocannabinoid signaling and phospholipid metabolism were characteristic of both conditions and can be relevant pathways to understanding and treating insulin resistance. By providing potential therapeutic targets and new starting points for mechanistic studies, our results emphasize the importance of complex data analysis procedures to better understand the pathomechanism of obesity and diabetes.

Glucocorticosteroids are key anti-inflammatory agents in the treatment of ophthalmic and systemic inflammatory diseases. However, prolonged use may result in an increase in intraocular pressure followed by a potentially vision -threatening ocular complication as glaucomatous neuropathy ultimately leading to blindness. Steroid therapy can increase intraocular pressure not only with ophthalmic preparations, but also with other routes of administration such as inhalational, intranasal and systemic. The aim of this paper is to provide a summary of the etiology, diagnosis, and treatment options for steroid-induced iatrogenic glaucoma, based on key literature findings and our own clinical experience, with a detailed comparison of different corticosteroid treatments. The application of steroid therapy can be avoided in a small number of medical fields, so it is crucial that where prolonged steroid therapy is required, all physicians should consider the intraocular pressure-enhancing effects of steroids. The intraocular pressure-increasing effect of steroids depends on the type of active substance, the route of administration and the time of administration. Regardless of the application of a certain medical field, regular ophthalmic examination is necessary, especially with a history of glaucoma, as persistent elevations in intraocular pressure can cause irreversible damage to ganglion cells and optic nerve fibers, ultimately leading to blindness. The difficulty in recognizing the complication is exacerbated by the fact that the intraocular pressure usually rises asymptomatically and painlessly. When steroid therapy cannot be avoided, the least possible intraocular pressure-increasing agent should be selected for the shortest possible dosage at the lowest possible dose. If the increase in intraocular pressure cannot be controlled conservatively, a surgical solution may be considered.A glükokortikoszteroidok a szemészeti és szisztémás gyulladásos betegségek kezelésében is kulcsfontosságú gyulladáscsökkentők. Hosszan tartó alkalmazásuk azonban szemnyomás-emelkedést és ennek talaján glaucomás neuropathiát okozhat, mely potenciálisan akár vaksággal fenyegető szemészeti szövődmény. A szteroidterápia nemcsak szemészeti készítmények alkalmazásakor emelheti meg a szemnyomást, hanem más alkalmazási módokban is: inhalációs, intranasalis, szisztémás. Jelen közleményünk célul tűzte ki, hogy a legfontosabb irodalmi eredmények és saját klinikai tapasztalataink alapján összefoglaló áttekintést adjon a szteroidterápia indukálta iatrogén glaucoma etiológiájáról, diagnosztikájáról és kezelési lehetőségeiről, részletesen kitérve a különböző kortikoszteroidkezelések alkalmazási módjainak összehasonlítására. A szteroidterápia alkalmazását már kevés szakterületen lehet elkerülni, ezért fontos, hogy ahol elnyújtott szteroidterápia szükséges, minden szakorvosnak gondolnia kell a szteroidok szemnyomásemelő hatására is. A szteroidok szemnyomásemelő hatása függ a hatóanyag típusától, a beadás módjától és az alkalmazás idejétől. Alkalmazási területtől függetlenül rendszeres szemészeti kontroll szükséges, különös tekintettel a glaucomás anamnézisre, hisz a tartós szemnyomás-emelkedés a látóidegrostok visszafordíthatatlan, végső soron akár vakságot okozó károsodását válthatja ki. A szövődmény felismerésének nehézségét fokozza, hogy a szemnyomás általában tünet- és fájdalommentesen emelkedik meg. Amikor a szteroidterápiát nem lehet elkerülni, a lehető legkevésbé szemnyomásemelő hatóanyagot a lehető legrövidebb ideig kell választani a lehető legalacsonyabb dózissal. Amennyiben a szemnyomás-emelkedést nem lehet uralni konzervatív módon, műtéti megoldás jöhet szóba. Orv Hetil. 2022; 163(34): 1345–1352.

Purpose To examine retinal and corneal neurodegenerative and retinal microvascular changes in patients after mild or asymptomatic COVID-19 disease compared to age-matched controls. Methods Thirty-five (35) patients after PCR-proven SARS-CoV-2 infection and 28 age-matched controls were enrolled. Swept-source optical coherence tomography (OCT), OCT angiography, and in vivo corneal confocal microscopy were performed in both groups. Corneal subbasal nerve plexus was quantified. Vessel density for superficial (SCP) and deep capillary plexus (DCP) and structural OCT parameters were recorded. Results Significantly lower nerve branch density (P = 0.0004), nerve fiber area (P = 0.0001), nerve fiber density (P = 0.0009), nerve fiber length (P P = 0.002) values were observed in patients after COVID-19 compared to healthy controls. VD of the temporal SCP was significantly different between the two groups (P = 0.019). No other SCP and DCP vessel density parameter differed significantly between the two groups. Conclusions Our results suggest that peripheral neurodegenerative changes may occur even after mild or asymptomatic SARS-CoV-2 infection. No relevant microvascular changes were seen with OCT angiography and structural OCT parameters did not show any signs of optic neuropathy in post-COVID patients. In vivo confocal microscopy seems to be an important tool in monitoring peripheral neuropathy in patients after COVID-19.

Metabolomics strategies are widely used to examine obesity and type 2 diabetes (T2D). Patients with obesity (

(1) Background: Diabetes mellitus is one of the most common metabolic disorders and a risk factor for bacterial ocular infections. Our aim was to examine the antibacterial activity of tears from patients with diabetes mellitus with and without diabetic retinopathy and to link this activity to the level of tear proteins. (2) Methods: Non-stimulated basal tears were collected from 39 eyes of 35 subjects. The antibacterial activity of tear pools was tested against pathogenic Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 26922 and Pseudomonas aeruginosa ATCC 27853 strains. The levels of 10 antimicrobial and immunomodulatory proteins were analyzed in the individual tear samples of the studied groups by SRM-based targeted mass spectrometry analysis. (3) Results: Disease stage-specific antimicrobial effect was observed in case of Staphylococcus aureus ATCC 29213 strain, and a non-disease specific inhibitory effect was observed in case of Pseudomonas aeruginosa ATCC 27853 strain. Changes in the levels of the studied antimicrobial and immunomodulatory proteins in the tears of the studied groups were also observed. (4) Conclusions: The higher ocular infection rate observed in diabetic patients may be the consequence of the decreased antimicrobial activity of tears possibly caused by the changes in the levels of antimicrobial and immunomodulatory proteins.

Összefoglaló. Az agy és a szem vascularis katasztrófái számos esetben egymáshoz társuló vagy egymást előre jelző kórképek. Az arteria centralis retinae occlusio az ér rekanalizációjának hiányában a retina szöveteinek irreverzibilis károsodását okozza. Sem a nemzetközi, sem a hazai stroke-irányelvek nem foglalkoznak az ocularis stroke problémakörével, annak ellenére, hogy az arteria centralis retinae occlusio okozta retinalis ischaemia minden tekintetben megfelel az akut ischaemiás stroke definíciójának. Az eddig rendelkezésre álló irodalmi adatok alapján arteria centralis retinae occlusio esetén az intravénás thrombolysis 4,5 órán belül alkalmazva növeli a szignifikáns mértékű visusjavulás esélyét. Az országban jelenleg 4 centrum (Pécsi Tudományegyetem, Szegedi Tudományegyetem, Debreceni Egyetem, Semmelweis Egyetem) tervezi az ocularis stroke kezelésében a thrombolysis bevezetését. A maradandó látásromlás és a szekunder cerebrovascularis események megelőzése érdekében elengedhetetlen az alapellátásban és a társszakmákban dolgozó kollégákkal való szoros együttműködés. Orv Hetil. 2021; 162(47): 1871-1875. Summary. Vascular events of the brain and the eye may occur concomitantly or sequentially. In the absence of recanalization, central retinal artery occlusion causes irreversible damage to the retinal tissues. Even though retinal ischemia secondary to central retinal artery occlusion meets the definition of acute ischemic stroke, neither the international nor the Hungarian stroke guidelines mention ocular stroke. Based on the available literature, intravenous thrombolysis of the central retinal artery within 4.5 hours of occlusion can increase the odds of significant vision improvement. Currently 4 centers (University of Pécs, Debrecen, Szeged, and Semmelweis University) are planning to introduce thrombolysis in the treatment of ocular stroke. To prevent permanent visual loss and secondary cerebrovascular events, timely intervention requires the collaboration between general practitioners and other specialties. Orv Hetil. 2021; 162(47): 1871-1875.

Abstract Purposes To examine corneal nerve and retinal nerve characteristics of participants with type 2 diabetes mellitus (T2DM) compared with obese participants without diabetes to discover potential nerve vulnerabilities. Methods All participants underwent a complete medical examination including a physical examination and blood sample tests. The ophthalmologic examination included best-corrected visual acuity, intraocular pressure, Schirmer test, tear film breakup time, slit-lamp examination, dilated fundus photography, in vivo corneal confocal microscopy (IVCCM), and optical coherence tomography (OCT). Results The study cohort consisted of 83 eyes of 83 individuals: a group of 44 participants with T2DM, and a control group of 39 obese participants with no history of diabetes. Comparing measurements on the two groups, participants with T2DM had lower values with statistical significance for retinal nerve fiber layer (RNFL) nasal superior thickness (p = 0.010) and three corneal nerve (CN) parameters: fiber length (p = 0.025), total branch density (p = 0.013), and fiber area (p = 0.009). There was a borderline significant difference in CN fiber width (p = 0.051) and RNFL nasal inferior thickness (p = 0.056). No other significant differences were observed in the IVCCM and OCT parameters. No statistically significant correlation was found between CN and RNFL parameters. Conclusions Progression from a pre-diabetic obese state to a T2DM condition might entail a loss or diminishment of certain corneal nerve fibers or retinal nerve fibers, but not necessarily a loss of both corneal and retinal nerve fibers simultaneously. Using IVCCM and OCT together enables monitoring of both corneal and retinal health of the eye.

PURPOSE To compare vergence, artificial intelligence, and combined intraocular lens (IOL) calculation formulas using a new swept-source optical coherence tomographer (SS-OCT) and to analyze their performance based on manifest and estimated refractive outcomes of cataract surgery. SETTING Department of Ophthalmology, University of Pecs Medical School, Pecs, Hungary. DESIGN Retrospective data analysis. METHODS Optical biometry readings of patients who underwent uneventful cataract removal and implantation of a monofocal acrylic IOL were used to predict IOL power with Barrett Universal II (BUII), Haigis, Hoffer Q, Holladay 1, Radial Basis Function (RBF) 2.0, Kane, Ladas Super Formula, and SRK/T. All the implanted IOLs were calculated by using the Haigis formula. The arithmetic prediction error and median and mean absolute refractive errors for all formulas were computed. The percentage of eyes within ±0.25 diopters (D), ±0.50 D, and ±1.0 D of prediction error was calculated. RESULTS A total of 95 eyes of 95 patients with a mean age of 68.80 ± 7.57 years were included. There was a statistically significant difference in absolute prediction error across the 8 IOL calculation formulas (P < .0001). Haigis showed the lowest mean absolute error, and it differed significantly from the BUII, Hoffer Q, Holladay 1, Ladas, RBF 2.0, and SRK/T formulas (P < .05). In terms of eyes within ±0.25 D, ±0.50 D, and ±1.0 D of prediction error, the Haigis formula showed the overall best performance. CONCLUSIONS The results indicated that a recently developed SS-OCT provided accurate ocular biometry measurements before cataract surgery, and the Haigis formula incorporated in its software enabled precise calculation of IOL refractive power.

Abstract: Ten years have passed since the publication of the DEWS Report that summarized the information based on scientific literature concerning dry eye disease. Hundreds of papers have been published since then and time has come for a new summary. Organized by the Tear Film & Ocular Surface Society, 12 working groups summerized former and recent data. The DEWS II Report was created. The authors of the present publication summarize the most important changes in definition, classification, diagnostics, and therapy concerning dry eye disease. They also disclose the relevant changes on which the non-ophthalmologist specialists have to be informed. The DEWS II Report published by TFOS consists of 11 chapters. Completely new chapters deal with the role of sensation/pain and iatrogenic dry eyes. Orv Hetil. 2018; 159(20): 775–785.

Glaucoma is associated with increased intraocular pressure (IOP), causing the apoptosis of retinal ganglion cells (RGCs) and the loss of their axons leading to blindness. Pituitary adenylate cyclase activating polypeptide (PACAP) is neuroprotective in several neural injuries, including retinopathies. The aim of this study was to investigate the effects of PACAP1-38 eye drops in a model of glaucoma. IOP was elevated bilaterally by injections of microbeads to block the aqueous humor outflow. The control groups received the same volume of saline. Animals were treated with PACAP1-38 (1 µg/drop, 3 × 1 drop/day) or vehicle for 4 weeks starting one day after the injections. Retinal morphology by histology and optical coherence tomography, function by electroretinography, and IOP changes were analyzed. Animals were sacrificed 8 weeks after the injections. Microbeads injections induced a significant increase in the IOP, while PACAP1-38 treatment lowered it to normal levels (~10 mmHg). Significant retinal degeneration and functional impairment were observed in the microbead-injected group without PACAP1-38 treatment. In the microbeads + PACAP1-38 group, the retinal morphology and functionality were close to the normal values. In summary, our results show that PACAP1-38, given in form of eye drops, is neuroprotective in glaucoma, providing the basis for potential future therapeutic administration.

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness among patients with diabetes. The appearance and the severity of the symptoms correlate with the duration of diabetes and poor blood glucose level management. Diabetic retinopathy is also categorized as a chronic low-level inflammatory disease; the high blood glucose level promotes the accumulation of the advanced glycation end products and leads to the stimulation of monocytes and macrophages. Examination of protein level alterations in tears using state-of the art proteomics techniques have identified several proteins as possible biomarkers for the different stages of the diabetic retinopathy. Some of the differentially expressed tear proteins have a role in the barrier function of tears linking the diabetic retinopathy with another eye complication of diabetes, namely the diabetic keratopathy resulting in impaired wound healing. Understanding the molecular events leading to the eye complications caused by hyperglycemia may help the identification of novel biomarkers as well as therapeutic targets in order to improve quality of life of diabetic patients. Biological significance Diabetic retinopathy (DR), the leading cause of blindness among diabetic patients can develop without any serious symptoms therefore the early detection is crucial. Because of the increasing prevalence there is a high need for improved screening methods able to diagnose DR as soon as possible. The non-invasive collection and the relatively high protein concentration make the tear fluid a good source for biomarker discovery helping the early diagnosis. In this work we have reviewed the administration of advanced proteomics techniques used in tear biomarker studies and the identified biomarkers with potential to improve the already existing screening methods for DR detection.

We have previously used in vivo corneal confocal microscopy (IVCCM) to demonstrate significant alterations in the corneal epithelial cells, stromal keratocytes, and subbasal nerves in young patients with type 1 diabetes mellitis (T1DM), especially those with diabetic retinopathy (DR). We have evaluated the change in corneal cellular and subbasal nerve morphology over 2 years in young patients with T1DM with or without DR.A total of 19 patients with T1DM, without (n = 12) and with (n = 7) DR and 19 age- and sex-matched healthy control subjects underwent quantification of corneal cellular and subbasal nerve plexus morphology by using IVCCM at baseline and after 2 years.There was no significant change in corneal basal epithelial, posterior stromal keratocyte, or endothelial cell densities over 2 years. However, there was a significant reduction in corneal nerve branch (P = 0.03) and total nerve branch density (P = 0.04) in patients without DR and a significant reduction in corneal nerve fibre density (P = 0.004) in those with DR.IVCCM can detect a progressive loss of corneal nerve fibers in young patients with T1DM and may allow the identification of individuals at risk of neuropathy progression for more active risk factor reduction.

Ten years have passed since the publication of the DEWS Report that summarized the information based on scientific literature concerning dry eye disease. Hundreds of papers have been published since then and time has come for a new summary. Organized by the Tear FilmOcular Surface Society, 12 working groups summerized former and recent data. The DEWS II Report was created. The authors of the present publication summarize the most important changes in definition, classification, diagnostics, and therapy concerning dry eye disease. They also disclose the relevant changes on which the non-ophthalmologist specialists have to be informed. The DEWS II Report published by TFOS consists of 11 chapters. Completely new chapters deal with the role of sensation/pain and iatrogenic dry eyes. Orv Hetil. 2018; 159(20): 775-785.

Purpose: To examine whether ultra-widefield (UWF) retinal imaging can identify biomarkers for Alzheimer’s disease (AD) and its progression. Methods: Images were taken using a UWF scanning laser ophthalmoscope (Optos P200C AF) to determine phenotypic variations in 59 patients with AD and 48 healthy controls at baseline (BL). All living participants were invited for a follow-up (FU) after 2 years and imaged again (if still able to participate). All participants had blood taken for genotyping at BL. Images were graded for the prevalence of age-related macular degeneration-like pathologies and retinal vascular parameters. Comparison between AD patients and controls was made using the Student t test and the χ2 test. Results: Analysis at BL revealed a significantly higher prevalence of a hard drusen phenotype in the periphery of AD patients (14/55; 25.4%) compared to controls (2/48; 4.2%) [χ2 = 9.9, df = 4, p = 0.04]. A markedly increased drusen number was observed at the 2-year FU in patients with AD compared to controls. There was a significant increase in venular width gradient at BL (zone C: 8.425 × 10–3 ± 2.865 × 10–3 vs. 6.375 × 10–3 ± 1.532 × 10–3, p = 0.008; entire image: 8.235 × 10–3 ± 2.839 × 10–3 vs. 6.050 × 10–3 ± 1.414 × 10–3, p = 0.004) and a significant decrease in arterial fractal dimension in AD at BL (entire image: 1.250 ± 0.086 vs. 1.304 ± 0.089, p = 0.049) with a trend for both at FU. Conclusions: UWF retinal imaging revealed a significant association between AD and peripheral hard drusen formation and changes to the vasculature beyond the posterior pole, at BL and after clinical progression over 2 years, suggesting that monitoring pathological changes in the peripheral retina might become a valuable tool in AD monitoring.

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