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Zusammenfassung Hintergrund Die Blut-Kammerwasser-Schranke (BKS) grenzt immunprivilegiertes Gewebe des Auges von der Blutzirkulation ab. Die Störung der BKS stellt somit einen Risikofaktor für Abstoßungsreaktionen nach Keratoplastik dar. Ziel der Arbeit Die vorliegende Arbeit bietet eine Übersicht der Arbeiten unserer und anderer Arbeitsgruppen zu BKS-Störungen bei perforierender (PKPL) und posteriorer lamellärer Keratoplastik sowie deren Implikationen für das klinische Ergebnis. Methoden Es erfolgte eine PubMed-Literaturrecherche zur Erstellung einer Übersichtsarbeit. Ergebnis Die Laser-Flare-Photometrie bietet ein objektives und reproduzierbares Verfahren zur Beurteilung der Integrität der BKS. Untersuchungen des Flares nach perforierender und posteriorer lamellärer Keratoplastik belegen eine im postoperativen Verlauf meist rückläufige Störung der BKS, die in Ausmaß und Dauer durch multiple Faktoren beeinflusst wird. Persistierend erhöhte Flare-Werte oder ein Anstieg des Flares nach zunächst postoperativer Regeneration können dabei auf ein erhöhtes Abstoßungsrisiko hinweisen. Diskussion Bei persistierend oder im postoperativen Verlauf rezidivierend erhöhten Flare-Werten nach Keratoplastik ist eine intensivierte (lokale) Immunsuppression möglicherweise sinnvoll. Dies könnte zukünftig, insbesondere beim Monitoring von Patienten nach Hochrisiko-Keratoplastik, Bedeutung erlangen. Ob ein Anstieg des Laser-Flares ein reliabler Frühindikator einer drohenden Immunreaktion nach PKPL oder posteriorer lamellärer Keratoplastik ist, müssen jedoch prospektive Studien zeigen.

ZusammenfassungUveitis ist ein Sammelbegriff für eine Vielzahl unterschiedlicher intraokularer Entzündungen. Dabei variieren die zugrunde liegenden Ätiologien sehr stark in Abhängigkeit vom Subtyp der Uveitis, vor allem vom anatomischen Schwerpunkt. Die Hauptformen der anterioren Uveitis stellen die akute fibrinöse unilaterale Verlaufsform, häufig mit dem HLA-B27-Haplotyp assoziiert, und die granulomatöse Entzündung, typischerweise im Zusammenhang mit einer Sarkoidose oder einer Herpesinfektion, dar. Die intermediäre Uveitis ist meistens idiopathischer Natur, kann jedoch auch mit einer Multiplen Sklerose oder einer Sarkoidose assoziiert sein, während bei Patienten nach dem 45. Lebensjahr auch an ein vitreoretinales Lymphom als Masquerade-Syndrom gedacht werden muss. Die Uveitis posterior wiederum, und ähnlich auch die retinale Vaskulitis und Panuveitis, haben eine sehr breite ätiologische Vielfalt, die aber ebenso befundorientiert eingegrenzt werden kann. So haben Retinitiden häufig eine infektiöse Genese (Toxoplasma und Viren der Herpesgruppe), während es sich bei Chorioiditiden häufig um spezifische, vermutlich autoimmune Entitäten handelt, wobei auch hier Infektionen, z. B. Tuberkulose, zugrunde liegen können. Anamnese und Labordiagnostik sollten bei Patienten mit Uveitis daher maßgeschneidert und orientiert am anatomischen Schwerpunkt der Entzündung (Uveitis anterior, intermedia, posterior oder Panuveitis) und dem klinischen Bild (z. B. granulomatös vs. nicht granulomatös) erfolgen.

Das Corona-Virus-Disease-19 (COVID-19) auslösende Severe-Acute-Respiratory-Syndrome-related Coronavirus‑2 (SARS-CoV-2) führte zu einer weltweiten Pandemie und stellt das Gesundheitssystem insgesamt, aber auch die Augenheilkunde vor große Herausforderungen. Bisherige Studien und Fallberichte deuten darauf hin, dass SARS-CoV‑2 auch die Bindehaut infizieren, eine Bindehautentzündung verursachen und dass infektiöse Viruspartikel in der Tränenflüssigkeit potenzielle Infektionsherde darstellen können. Der Nachweis von SARS-CoV-2-RNA in der Tränenflüssigkeit gelang jedoch bisher selten. Auch wenn eine isolierte Bindehautbeteiligung sehr unwahrscheinlich ist, könnte zum gegenwärtigen Zeitpunkt der COVID-19-Pandemie praktisch jeder Patient, der von einem Augenarzt untersucht wird, mit SARS-CoV‑2 infiziert sein. Daher sollten Schutz- und Hygienemaßnahmen aktuell konsequent eingehalten werden, um das Risiko der Verbreitung des Virus zu minimieren. Aktuell gibt es keinerlei Therapieempfehlungen einer COVID-19-assoziierten Konjunktivitis. Tränenersatzmittel könnten zur Symptomlinderung hilfreich sein, eine Evidenz für eine topische antivirale Therapie liegt nicht vor. Dem Augenarzt könnte in Zukunft eine entscheidende Rolle bei dem Screening von Makulopathien zukommen, die im Rahmen einer COVID-19-Therapie mittels Chloroquin oder Hydroxychloroquin auftreten können.

ZusammenfassungDas Makulaödem ist die häufigste Ursache einer irreversiblen Visusminderung bei Patienten mit Uveitis. Pathogenetisch führen proinflammatorische Zytokine zu einem Zusammenbruch der Blut-Retina-Schranke. Zur Diagnostik des entzündlichen Makulaödems wird heutzutage überwiegend die optische Kohärenztomografie eingesetzt, welche die Fluoreszenzangiografie jedoch nicht immer zu ersetzen vermag. Die Therapie erfolgt überwiegend mittels intravitreal applizierter Kortikosteroide sowie systemischer immunmodulierender Substanzen und sollte so früh wie möglich einsetzen, um einer Chronifizierung des Makulaödems vorzubeugen.

Since the beginning of 2020, SARS-CoV-2, the pathogen of COVID-19, has led to a global pandemic that also affects ophthalmology. Ophthalmologists can be confronted at any time with potentially COVID-19 associated ocular symptoms or manifestations in patients and also become infected through close patient contact. Even without systemic infection, the ocular surface can come into direct contact with aerosols or liquids containing SARS-CoV-2 particles. A smear infection through hand-to-eye contact is also possible. A purely isolated ocular infection has not yet been shown. Rather, it seems that ocular complications occur in the context of a systemic infection. However, ocular symptoms can also be the first symptom of COVID-19. The most common ocular complication of COVID-19 is mild follicular conjunctivitis. Haemorrhagic conjunctivitis, dry eye disease, episcleritis, or retinal involvement can also occur less frequently. There are currently no evidence-based therapy recommendations for COVID-19 associated diseases of the ocular surface. Artificial tears might be helpful for symptom relief. There is no evidence for antiviral, antibiotic, or anti-inflammatory therapies, but these medications might be used in individual cases. Potential intraocular complications include retinal artery occlusions and haemorrhages, as well as cotton wool spots caused by complement-mediated thrombotic angiopathy. Neuro-ophthalmological complications including Miller-Fisher syndrome or infarct-related central blindness can also occur in very rare cases. Knowledge of potential transmission routes and personal protective equipment is just as essential for each ophthalmologist as a basic knowledge of potential ocular symptoms and complications.SARS-CoV-2, der Erreger von COVID-19, führt seit Anfang 2020 zu einer weltweiten Pandemie, von der auch die Augenheilkunde betroffen ist. Dabei kann ein Ophthalmologe aktuell jederzeit mit potenziell COVID-19-assoziierten okulären Symptomen oder Manifestationen bei Patienten konfrontiert werden und sich aber auch selber durch engen Patientenkontakt anstecken. Auch ohne systemische Infektion kann die Augenoberfläche direkt mit Aerosolen und Flüssigkeiten, die SARS-CoV-2-Partikel enthalten, in Kontakt kommen. Auch eine Schmierinfektion durch Hand-zu-Augen-Kontakt ist möglich. Eine rein isolierte okuläre Infektion ist bisher nicht nachgewiesen. Vielmehr scheint es so, dass okuläre Komplikationen im Rahmen einer systemischen Infektion auftreten können, wobei okuläre Symptome auch Erstsymptom sein können. Die häufigste okuläre Komplikation einer COVID-19-Infektion ist die milde follikuläre Konjunktivitis. Seltener können auch hämorrhagische Konjunktivitiden, eine Keratoconjunctivitis sicca, eine Episkleritis sowie retinale Beteiligungen auftreten. Aktuell gibt es keinerlei evidenzbasierte Therapieempfehlungen für COVID-19-assoziierte Erkrankungen der Augenoberfläche. Tränenersatzmittel könnten zur Symptomlinderung hilfreich sein, eine Evidenz für antivirale, antibakterielle oder antientzündliche Therapien liegt nicht vor, sie können im Einzelfall aber angewendet werden. Zu den potenziellen intraokulären Komplikationen gehören Arterienverschlüsse und retinale Hämorrhagien sowie Cotton-Wool-Spots, verursacht durch eine komplementvermittelte thrombotische Angiopathie. Sehr selten können auch neuroophthalmologische Komplikationen wie das Miller-Fisher-Syndrom oder infarktbedingte zentrale Erblindungen auftreten. Das Wissen um potenzielle Übertragungswege und über die persönliche Schutzausrüstung ist für den Ophthalmologen genauso unerlässlich wie ein Grundwissen über potenzielle okuläre Symptome und Komplikationen.

Objectives The aims of this study were to evaluate the isolated prevalence of real-time reverse transcriptase-polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 on the ocular surface without systemic infection in hospitalized asymptomatic patients and to determine the risk for ophthalmologists and medical staff to be infected by prescreened asymptomatic patients in a tertiary eye care center. Methods In this prospective, observational study, bilateral swaps of the conjunctiva in the lower fornices as well as nasopharyngeal swaps were collected in 1145 hospitalized asymptomatic patients of a tertiary eye care center. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis was performed for each swap to evaluate the prevalence of SARS-CoV-2. Demographic data and potential risk factors for an isolated infection of the ocular surface were noted. Results Two thousand two hundred eighty-eight (99.9%) of all 2290 tested eyes had negative results in the RT-PCR analysis of the conjunctival swabs. One patient had bilateral false-positive results in the conjunctival swabs. None of the 1145 patients had any positive RT-PCR-confirmed result in the nasopharyngeal swabs. Conclusions The risk for an isolated conjunctival viral activity in patients with a negative nasopharyngeal swab-based RT-PCR seems to be absent or extremely low, suggesting no need to perform additional conjunctival swabs in patients with negative nasopharyngeal swabs. Furthermore, the risk of a work-related SARS-CoV-2 infection due to direct contact with preselected asymptomatic patients in an eye care center is very low, especially when additional hygiene standards and safe distances are respected carefully. This might reassure medical staff and reduce the fear of SARS-CoV-2 infection.

Forest roads are essential for adequate forest management and environmental protection. They enable tourism and recreation activity, while at the same time playing a very important role in fire protection. When open to the local traffic, they significantly supplement the public traffic networks. Costs of constructing permanent roads in forested areas are considerable, because they need to have adequate bearing capacity. Forest roads are predominantly constructed using natural or anthropogenic aggregate stabilised mechanically and chemically. A tangible parameter verifying the proper construction of road structure is provided by its bearing capacity, i.e. the capacity of the pavement to carry loads generated by traffic without excessive strains hindering normal use of the pavement or reducing its durability. Some forest road networks are also constructed as temporary roads composed of cheaper aggregates. It seems reasonable to assume different bearing capacity standards for such roads than for permanent roads.The aim of the studies presented in this paper was to develop bearing capacity standards for forest roads constructed using various technologies. The adopted research hypothesis assumes that each of the analysed technologies is characterised by a different bearing capacity required during road construction inspections. An example of such a structure may be provided by the so-called geotextile mattress and crushed stone constructed on wetland soils. When developing the standards, the analyses included the predicted traffic intensity, assumed operation time before rehabilitation is required, soil conditions and the type of construction material.Bearing capacity of the testing road sections was assessed based on values of strain moduli calculated from the static plate load tests (VSS). As a result, bearing capacity standards were obtained for structures constructed using aggregates and chemical stabilisers as well as geotextiles potentially facilitating reduction of the layer thickness without deterioration of road durability.

PURPOSE The purpose of this study was to investigate the impact of transient elevations in postoperative intraocular pressure (IOP) on the clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) surgery in non-glaucoma patients. METHODS Retrospective analysis from a prospective database of eyes without preexisting glaucoma that underwent DMEK with 90% anterior chamber and 20% sulfur hexafluoride endotamponade. Group A included eyes without postoperative IOP increase (IOP

Macular oedema is the most common cause of irreversible visual loss in patients with uveitis. The pathogenesis is caused by pro-inflammatory cytokines that lead to the breakdown of the blood-retina barrier. For the diagnosis of inflammatory macular oedema, optical coherence tomography is now mainly used, but cannot always replace fluorescein angiography. The therapy is mainly performed with intravitreally applied corticosteroids as well as systemic immunomodulators and should start as early as possible to prevent chronification of macular oedema.Das Makulaödem ist die häufigste Ursache einer irreversiblen Visusminderung bei Patienten mit Uveitis. Pathogenetisch führen proinflammatorische Zytokine zu einem Zusammenbruch der Blut-Retina-Schranke. Zur Diagnostik des entzündlichen Makulaödems wird heutzutage überwiegend die optische Kohärenztomografie eingesetzt, welche die Fluoreszenzangiografie jedoch nicht immer zu ersetzen vermag. Die Therapie erfolgt überwiegend mittels intravitreal applizierter Kortikosteroide sowie systemischer immunmodulierender Substanzen und sollte so früh wie möglich einsetzen, um einer Chronifizierung des Makulaödems vorzubeugen.

Background: The aim of this study was to examine perceived stress levels in adult patients with uveitis. Patients and Methods: One hundred seventy-three adult consecutive uveitis patients (age range 18 to 85 years) were analyzed in a cross-sectional design for their perceived stress, according to the Perceived Stress Questionnaire (PSQ). Stress levels were classified into normal stress, moderate stress, and high stress. Results: In the majority of uveitis patients a normal stress level (82%) within the last 2 years was detected. In a subgroup analysis, perceived stress of the patients with active uveitis compared with patients with non-active uveitis was significantly higher within the last 2 years (n=80 active/n = 45 non-active; p = 0.005). Conclusions: Overall 18% of the uveitis patient had raised perceived stress, similar to the general population but patients with active uveitis were significantly more stressed. Therefore, consideration of stress levels may be important in the therapy of uveitis patients.

ZusammenfassungTopische Kortikosteroide sind effektive entzündungshemmende Medikamente in der Therapie der anterioren Uveitis. Die intraokulare Effektivität der topischen Steroide ist überwiegend durch ihre Penetrationsfähigkeit ins Auge limitiert. Lipophile Präparate wie Dexamethason oder Prednisolonacetat penetrieren besser in die Vorderkammer als hydrophile. Prednisolonacetat 1% ist das Mittel der Wahl in der Behandlung von Patienten mit anteriorer Uveitis. Loteprednol und Fluorometholon besitzen eine schwächere antientzündliche Wirkung, beeinflussen aber weniger den Augeninnendruck und sind deswegen hilfreich bei Patienten mit Steroidresponse. Die antientzündliche Therapie mit lokalen Steroiden muss individuell angepasst werden in Abhängigkeit von Verlauf und Schweregrad der Uveitis. Die häufigsten unerwünschten Wirkungen der lokalen Kortisontherapie sind das steroidinduzierte Glaukom und die Katarakt. Nicht steroidale Antiphlogistika hemmen das Enzym Zyklooxygenase, das für die Bildung proinflammatorischer Prostaglandine zuständig ist. Sie haben eine ergänzende Rolle bei der Behandlung und Vorbeugung postoperativer Reizzustände nach Kataraktoperation. Eine therapeutische Rolle in der Behandlung der Uveitis und des zystoiden Makulaödems sekundär nach Uveitis konnte bisher nicht etabliert werden.

Background HLA-B27 positive acute anterior uveitis is the most common type of uveitis, and it is an autoimmune disease that can be triggered by infections. The precise mechanism of the interaction between involved microbes (mostly gram negative bacteria) and the host immune system is not clear. The disease probably results from an imbalance between pro- and anti-inflammatory components. Project description This article gives a compact overview about the current knowledge of the clinic and the etiopathogenesis of acute anterior uveitis as a basis for future research approaches. The goal of the current research is to classify the cellular and molecular pathogenetic factors in acute anterior uveitis. In this regard, a project on uveitis within the clinical research unit FOR 2240 "(Lymph)Angiogenesis and Cellular Immunity in Inflammatory Diseases of the Eye", examines the hypothesis that dysregulation of regulatory cell populations and anti-inflammatory cytokines, such as interleukin-10 (IL-10), might contribute to the development of ocular autoimmunity following infections. The goal is to establish new markers for individual susceptibility in the risk group of the HLA-B27 positive population, because only about 1% of the HLA-B27 positive population will eventually develop acute anterior uveitis. Conclusions Translational research approaches to identify predisposed risk groups from the HLA-B27 population could improve patient care both on a prophylactic and a therapeutic level.

Hintergrund Die Augenheilkunde ist ein sehr erfolgreicher Teilbereich der Medizin. Dennoch gibt es Erkrankungen mit fehlendem Krankheitsverstandnis und unzureichender Therapie. Hier kann translationale Forschung helfen. Methoden Die Fordermoglichkeiten fur translationale Forschung unter anderem durch die Deutsche Forschungsgemeinschaft (DFG) werden am Beispiel der Forschergruppe 2240 an der Universitatsaugenklinik in Koln dargestellt. Ergebnisse Das Forderinstrument der Forschergruppe erlaubt es mehreren Arbeitsgruppen an verschiedenen Standorten an einer Kernthematik zusammenzuarbeiten. Des Weiteren kann der wissenschaftliche Nachwuchs durch Rotationsstellen und Anschubfinanzierung erheblich unterstutzt werden. Eine Forschergruppe kann ebenfalls zur Strukturbildung an einer medizinischen Fakultat mit besonderer Starkung z. B. der Augenheilkunde beitragen. Schlussfolgerung Das Instrument einer DFG-Forschergruppe ist in hervorragendem Mase geeignet, translationale Forschung z. B. in der Augenheilkunde voranzutreiben, den wissenschaftlichen Nachwuchs nachhaltig zu fordern und den Stellenwert einer medizinischen Teildisziplin, wie z. B. der Augenheilkunde, im arztlichen Facherkanon zu unterstutzen.

A 75-year-old female patient presented with bilateral progressive loss of vision. Best corrected visual acuity (BCVA) was hand movements in the right eye and 1/50 in the left eye. The spectral domain optical coherence tomography (SD-OCT) showed thinning of the outer retina suspected to be due to autoimmune retinopathy. A neuroendocrine carcinoma of the uterus was diagnosed during tumor screening. Under systemic therapy with corticosteroids the visual acuity improved to 20/200 in the right eye and 20/80 in the left eye. Cancer-associated retinopathy (CAR) is a paraneoplastic autoimmune retinopathy.

Objectives To evaluate ocular symptoms in European non-hospitalized patients with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and to investigate associations with the demographic data as well as nasal and general physical symptoms. Methods In this prospective, observational study, 108 non-hospitalized patients with polymerase chain reaction (PCR) confirmed SARS-CoV-2 infection not requiring intensive care were asked using a standardized questionnaire regarding disease associated ocular symptoms, demographic data, as well as general physical and nasal symptoms. Total ocular symptom score (TOSS) was evaluated during and retrospectively prior to coronavirus disease 19 (COVID-19) infection. Associations between TOSS and demographic data as well as general and nasal symptoms were evaluated. Results 75 out of the 108 COVID-19 patients (69.4 %) suffered from at least one ocular symptom during COVID-19. The most common symptoms included burning sensations in 36.1% (n=39), epiphora in 34.3% (n=37), and redness in 25.9% (n=28), compatible with conjunctivitis. These symptoms occurred 1.96 ± 3.17 days after the beginning of COVID-19 and were rather mild. TOSS was significantly higher during COVID-19 (1.27±1.85) than prior to the infection (0.33±1.04; p

Inflammatorische Prozesse des Auges gehören zu den häufigsten Entitäten in der Augenheilkunde. Die Anwendung antientzündlicher Substanzen ist daher für den Behandler eine zentrale therapeutische Option. Hierbei kommen zumeist aufgrund der guten Zugänglichkeit des Auges topische Applikationen zur Anwendung. Substanzgruppen wie Antiallergika, nichtsteroidale Antirheumatika, Glukokortikoide, Calcineurininhibitoren, Serumaugentropfen sowie neuere, noch in der Entwicklung befindliche Substanzen werden spezifisch sowohl in schmalen als auch in breiten Indikationsspektren eingesetzt, weshalb die Kenntnis der Wirkmechanismen und der potenziellen Nebenwirkungen von großer Bedeutung ist. Dieser Artikel soll einen Überblick über die derzeitig verfügbaren antiinflammatorisch wirksamen Substanzen geben, die topisch verabreicht werden können. Hierbei wird auf eine detaillierte Anwendungsbeschreibung (Dosis, Applikationshäufigkeit, Dauer usw.) in Bezug auf die einzelnen Krankheitsbilder bewusst verzichtet. Ziel ist es, dem Leser pharmakologisches Basiswissen mit direktem ophthalmologischen Bezug zu vermitteln.

The aim of the research was to verify a common opinion concerning a positive influence of plants on the bearing capacity and durability of forest roads made of unbound aggregates. The surface bearing capacity is defined as the ability to transfer traffic loads without any excessive deformations which would hinder regular use of the surface and shorten its durability. It is a significant functional feature of any road. The article analyzed the influence of road surface plant succession on its bearing parameters. The research was conducted on sections of experimental road constructed using macadam technology and reinforced partly with a biaxial geogrid. Measurements were taken with a lightweight Zorn ZFG 3000 GPS type deflectometer with a 300 mm pressure plate radius and 10 kg drop weight which allowed to measure dynamic deformation modulus (Evd) and s/v parameter regarded as an indicator of compaction accuracy of the studied layer. Evd values and s/v parameters, which were obtained by measuring the road pavement covered in vegetation and after having it mechanically removed (mowed), were submitted to the analysis, next, they were compared with the results of an analysis done on areas naturally deprived of the plant cover and located in the immediate vicinity of the measuring points. The conducted research has indicated unfavorable influence of vegetation succession on the bearing parameters of the analyzed sections. The greatest drop in the mean Evd value was 39%, and s/v parameter deteriorated as much as 9%. Hence, a regular mowing of the road surface (including the maneuvering, storage and passing areas) should be taken as standard and mandatory procedures of forest road maintenance.

The forest cover in Poland reaches almost 30% of the country’s area. Polish forests are characterized by high biodiversity. Unfortunately, in recent years, the forests of Central Europe have been affected by climate change problems, in particular meteorological drought. In Poland, even those stands which consist of species that were widely recognized as drought tolerant and easily adaptable to environmental changes are beginning to die. The article presents engineering methods applicable to forest environment protection, largely developed at the University of Life Sciences in Poznań and implemented by the State Forests—National Forest Holding in Poland, to minimize the effects of drought. Among the issues raised are ways to protect forests against fires, modern technologies for fire road surface construction and small-scale water retention in forests. A comprehensive solution to problems related to progressive drought is a must. Scientists and foresters are observing the dying of large areas of stands and, at the same time, intensification of wildlife migration due to the search for new habitats as a consequence of the drought. Therefore, the issue of building animal crossings during the current dynamic expansion of the road network in Poland has also been presented in the paper. Another subject pointed to in the text is forest tourism. Forests provide opportunities for recreation and rest to society. However, the increasing tourist pressure in some regions may cause adverse environmental effects. Finally, the paper shows some examples of supporting forest environment protection using remote sensing techniques. Generally, the aim of the paper is to present experiences and comprehensive solutions implemented in Poland.

A 75-year-old female patient presented with bilateral progressive loss of vision. Best corrected visual acuity (BCVA) was hand movements in the right eye and 1/50 in the left eye. The spectral domain optical coherence tomography (SD-OCT) showed thinning of the outer retina suspected to be due to autoimmune retinopathy. A neuroendocrine carcinoma of the uterus was diagnosed during tumor screening. Under systemic therapy with corticosteroids the visual acuity improved to 20/200 in the right eye and 20/80 in the left eye. Cancer-associated retinopathy (CAR) is a paraneoplastic autoimmune retinopathy.

The metastatic spread of carcinoma cells is not fully understood. Here, we compare the peripheral blood mononuclear cells (PBMC) and intraocular metastatic cells in parotid gland carcinoma with the PBMCs of healthy donors by immunohistochemistry and flow cytometry. We found Ber-EP4 tumor marker–positive carcinoma cells in the aqueous humor of the patient's right eye and a CD45 and Ber-EP4–expressing PBMC population in his blood. These Ber-EP4–expressing cells exhibited a monocytic-myeloid phenotype with coexpression of CD11b, CD115, and the macrophage marker CD172a (SIRP-α). Uptake of pHrodogreen revealed their phagocytic activity. Our findings suggest that the tumor cells in the anterior chamber originally derived from cell fusions between tumor cells and myeloid cells in the peripheral blood. Thus, metastases of a solid malignancy could use monocytes–macrophages as the Trojan horse to enter the eye. Cancer Immunol Res; 4(2); 92–94. ©2015 AACR.

The paper presents results of studies on seasonal variability of ground water tables recorded in long-term observations of water levels in the Puszcza Zielonka forest complex. The Puszcza Zielonka Forest is located in the middle part of the Warta basin in the central part of the Wielkopolska region. Its western boundary is located approx. 6 km north-east of Poznań. The area is situated in the western part of the Wielkopolska-Mazovian climatic region. The natural landscape is of young glacial type of Pleistocene and Holocene formation. For this reason parent materials for soils in this area were mainly postglacial drifts, deposits coming from the Poznań stage of the Würm glaciation. In terms of granulometric composition these were mainly low clayey sands deposited on loose sands with an admixture of gravel and eroded sandy clay. Scots pine is the dominant species. Oaks, alders, larches and scarce spruces are also found in this area. Predominant sites include fresh mixed forest, fresh mixed coniferous forest, fresh broadleaved forest and alder swamp forest. Seasonal variability in groundwater levels depends mainly on abiotic factors. Characteristics of stands have only a modifying effect on the dynamics of changes in groundwaters. Slightly greater fluctuations in water levels were recorded in the fresh broadleaved forest site in comparison to the alder swamp forest. There are no marked dependencies of fluctuations in groundwater tables on age classes of the tree stands. Generally a negative correlation was found between variability in groundwater levels and the depth of its table below ground surface (b.g.s.). However, in the conducted studies the hypothesis on the marked delay in the variability of groundwater levels between sites, tree species, age of tree stands or depth of ground water tables was not confirmed.

Prostaglandin analogs are first line therapy in the treatment of glaucoma, but also display side effects during ocular inflammation. In this context, the potential side effects of prostaglandin analogs on the normally avascular cornea, the main application route for eye drops, are so far not fully defined. Therefore, the aim of this study was to evaluate the vascular effects of the prostaglandin analog tafluprost on the healthy and inflamed cornea.For in vitro studies, blood and lymphatic endothelial cells were treated with tafluprost; cell proliferation was assessed after 48 h. For long-term in vivo studies under healthy conditions, naïve corneas of BALB/c mice were treated with tafluprost eye drops for 4 weeks. For short-term in vivo studies under inflammatory conditions, corneal inflammation was induced by suture placement; mice then received tafluprost eye drops for 1 week. Afterwards, corneas were stained with CD31 as panendothelial and LYVE-1 as lymphendothelial (and macrophage) marker.In vitro, tafluprost did not alter blood or lymphatic endothelial cell proliferation. In vivo, there was no change in limbal blood or lymphatic vessel anatomy after long-term treatment with tafluprost. Short-term treatment with tafluprost under inflammatory conditions did not influence the recruitment of LYVE-1 positive macrophages into the cornea. Moreover, treatment of inflamed corneas with tafluprost did not significantly influence corneal hem- and lymphangiogenesis.Tafluprost does not affect blood and lymphatic vessel growth, neither under resting nor under inflammatory conditions. These findings suggest a safe vascular profile of tafluprost eye drops at the inflammatory neovascularized cornea.

A 22-year-old white man presented with photopsia of 3-year duration despite a corrected distance visual acuity of 20/20 in both eyes. Ophthalmic examination revealed multiple irregularly shaped white cortical opacifications of the lens in both eyes but no other significant ocular findings. One year after the photopsia onset, the patient experienced an episode of seizures with generalized tonic-clonic movements. Neurological follow-up examination demonstrated extensive brain calcification in the basal ganglia and frontal lobes, leading to a diagnosis of pseudohypoparathyroidism. Pseudohypoparathyroidism is a rare condition, and there are few reports of ocular findings with this underlying pathology. Our findings clearly demonstrate that even relatively unremarkable ocular signs can lead to diagnosis of severe systemic diseases. Therefore, the cataract surgeon should be aware of these conditions before removing the lens. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.

To assess the risk of pseudophakic cystoid macular edema (PCME) following cataract surgery in patients with allergies and/or atopic disorders. Medical records of 3,850 consecutive eyes that underwent cataract surgery were retrospectively reviewed for prevalence of allergies and atopic status and development of PCME. Patients with any known risk factors for PCME were excluded. Macular examination was performed using spectral-domain optical coherence tomography (SD-OCT) before and at 4, 8, 12, 16, 24, and 36 weeks after surgery. If both eyes in one patient underwent cataract surgery, one eye was randomly selected. Odds ratios and confidence intervals were estimated. Out of 240 patients enrolled in this series, 65 patients (27.1 %) showed positive allergic status, 19 patients (7.9 %) suffered from atopic syndromes, and 11 (4.6 %) showed both (allergies and atopic diseases). PCME occurred in eight patients (12.3 %) of the allergy cohort, whereas no patient (0 %) of the atopy cohort developed PCME. The risk of PCME was comparable in patients with allergies or atopic diseases to patients without allergies or atopy (allergy: p = 0.635; odds ratio (OR) 1.303, 95 % confidence interval (CI) 0.461–3.398; atopy: p = 0.234; OR 0.000, 95 % CI 0–1.815). Positive status of allergy or atopy does not seem to increase the risk of PCME. Therefore, postoperative treatment after cataract surgery does not have to be modified in allergic or atopic patients.

Inflammatorische Prozesse des Auges gehören zu den häufigsten Entitäten in der Augenheilkunde. Die Anwendung antientzündlicher Substanzen ist daher für den Behandler eine zentrale therapeutische Option. Hierbei kommen zumeist aufgrund der guten Zugänglichkeit des Auges topische Applikationen zur Anwendung. Substanzgruppen wie Antiallergika, nichtsteroidale Antirheumatika, Glukokortikoide, Calcineurininhibitoren, Serumaugentropfen sowie neuere, noch in der Entwicklung befindliche Substanzen werden spezifisch sowohl in schmalen als auch in breiten Indikationsspektren eingesetzt, weshalb die Kenntnis der Wirkmechanismen und der potenziellen Nebenwirkungen von großer Bedeutung ist. Dieser Artikel soll einen Überblick über die derzeitig verfügbaren antiinflammatorisch wirksamen Substanzen geben, die topisch verabreicht werden können. Hierbei wird auf eine detaillierte Anwendungsbeschreibung (Dosis, Applikationshäufigkeit, Dauer usw.) in Bezug auf die einzelnen Krankheitsbilder bewusst verzichtet. Ziel ist es, dem Leser pharmakologisches Basiswissen mit direktem ophthalmologischen Bezug zu vermitteln.

Purpose The inappropriate immune response to harmless foreign and self-antigens is a common feature of allergy, atopy and autoimmune disease. The influence of environmental factors in the initiation of autoimmunity is not well understood. It is conceivable that immune responses to allergens may also serve as a trigger of bystander immune reactions, including autoimmunity such as uveitis. Therefore, we wanted to investigate the prevalence of allergies and atopy in patients with different types of uveitis in comparison to a control cohort. Methods In total, 530 consecutive patients with new-onset anterior, intermediate, posterior and panuveitis were compared to a non-uveitis control cohort consisting of 1.060 consecutive new-referral patients who attended our specialized outpatient clinics for other reasons than uveitis. Allergy and atopy status as well as demographic data (age, gender and ethnicity) were obtained by standardized interviewer-assisted questionnaires. Results Uveitis case cohort and control cohort did not differ significantly in the allergy status (p = 0.910), such as the history of pollen allergy (p = 0.671), history of drug allergy (p = 0.920), history of food allergy (p = 0.941), history of house dust mite allergy (p = 0.197) or history of other allergens (p = 0.593), nor in the atopy status (p = 0.802), such as the history of atopic dermatitis (p = 0.365), history of asthma (p = 0.430) or history of allergic rhinitis (p = 0.115). Conclusions Our results argue against a substantial influence of allergies and atopy on the onset of uveitis.

Purpose: Management of uveitic cataract in patients with juvenile idiopathic arthritis (JIA) is challenging, and intraocular lens (IOL) implantation is controversial. This study investigated the outcome after minimally invasive surgery with IOL implantation. Methods: Retrospective analysis after phacoemulsification with in-the-bag IOL implantation was performed in 16 patients (17 operations) with ANA-positive JIA-associated chronic uveitis. In these patients, 25 G capsulectomy and anterior vitrectomy was performed and they received an intravitreal triamcinolone (TA) injection. Results: Mean age at uveitis onset was 5 ± 2 years, and surgery was performed at a mean age of 11 ± 2.2 years. Preoperatively, uveitis was inactive in all patients, and visual acuity was logMAR 0.8 ± 0.44; additional uveitis complications were present in all patients, and 15 patients were receiving systemic immunosuppression/biologicals. After surgery (mean follow-up 26.5 ± 11.7 months), presence of cystoid macular oedema, papilloedema, ocular hypertension/glaucoma and hypotony did not increase compared with baseline. There was no significant worsening of AC inflammation (by cell numbers and laser flare values). IOL deposits persisted in four patients, and synechiae developed in eight. The visual acuity was improved (≥2 lines) in all patients (mean logMAR 0.3 ± 0.24). Retrolental membrane formation was not noted. Secondary capsular opacification was observed in seven patients, requiring Nd:YAG capsulotomy in five of them. Conclusions: Phacoemulsification and in-the-bag IOL implantation may improve visual outcome in JIA-associated uveitis with minimally invasive surgical technique and intravitreal TA injection. Well-controlled uveitis with appropriate use of topical steroids and systemic immunosuppression or biologicals appears as a perioperative requirement.

A SCIENTOMETRIC ANALYSIS OF LEUKOPLAKIA AND ERYTHROPLAKIABACKGROUND: The oral leukoplakia and erythroplakia is one of the most common epithelial precursor lesions of the oral squamous cell carcinoma. Transformation rates are approximately 0.9-17% in 10 years for leukoplakia and in 14-50% for the erythroplakia. Despite the clinical relevance of these lesions, currently exists no detailed bibliometric analysis. METHODS: The present study combines classical bibliometric tools with novel scientometric and visualizing techniques in order to analyse and categorize research in the field of leukoplakia and erythroplakia. RESULTS: All studies related to leukoplakia and erythroplakia and listed in the ISI database since 1900 were identified by the use of defined search terms. The bibliometric analysis of the collected data shows a continuous increase in quantitative marker such as the number of publications and cooperation and qualitative markers, such as citations and H-index. The combination with density equalizing mapping revealed a distinct global structure of research and citing activity. Radar chart techniques were used to illustrate bi- and multilateral cooperations and institution research collaborations. DISCUSSION: The present study demonstrates the first scientometric approach that visualizes research activities in the area of leukoplakia and erythroplakia. It provides data that can be used for geografical context and research networks.