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Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: E. Butenko erhielt Forschungsförderung von der Neuro-Ophthalmologischen Gesellschaft e. V. E. Butenko und H. Faber erhielten zudem Forschungsförderung von der Danger Stiftung für Kinderophthalmologie. H. Faber erhielt Forschungsforderung des Carl og Esther Christiansens Fond und ist stellvertretende Sprecherin der DOG-AG Ethik in der Augenheilkunde. H. Thönneßen und F. Schüttauf geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patient/-innen zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern/Vertreterinnen eine schriftliche Einwilligung vor.

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

Background: Mantle cell lymphomas (MCL) represent a rare subclass of Non-Hodgkin Lymphoma affecting the lacrimal gland (GL)., Aim: To extensively describe the immunohistochemical profile of GL-MCL., Material Und Methods: Single center, retrospective electronic records review of 3 patients with biopsy proven LG-MCL., Results: The herein presented case series of three patients comprises a focal case involving solely the lacrimal gland, a symptomatic LG-MCL manifesting as the first sign of a systemic disease as well as a case of LG-MCL presenting as a relapsed systemic lymphoma. The three patients presented positive CD19 and CD20, negative CD10 and CD23. One patient showed an uncommon negativity for CD5. The increased expression of cyclin D1 caused by the classical translocation t(11;14) (q13;q32) in the fluorescence-in-situ-hybridisation were observed in all cases. B-cell-lymphoma-2 protein (BCL-2) and transcription factor SOX-11 (SOX-11) were also overexpressed., Discussion: LG-MCL show an immunohistochemical profile corresponding to the classical profile of MCL. Overexpression of molecules for target therapies was found in all cases (CD20 for rituximab, BCL2 for Bruton-kinase-inhibitors and CD19 for CAR-T cell therapy). The removal of the GL can potentially drive to severe complications, even if aimed to confirm diagnosis. Therefore, the choice between GL-biopsy and exstirpation should be carefully evaluated, especially in cases of suspected lymphoma., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: The question of whether refractive or topographic changes are to be expected after eye muscle surgery is largely unanswered., Materials and Methods: Results of pre- and postoperative objective refraction, Pentacam (Oculus, Menlo Park, CA, USA), and visual acuity tests of 229 eyes are included in the present analysis. The examinations took place preoperatively, on the first postoperative day, and after 3 months., Results: After surgery on one or two extraocular recti muscle, there are significant changes in the cylinder (p < 0.001) on the first postoperative day, although values returned to normal after 3 months. Similar changes also appeared in combined operations of extraocular and oblique muscles., Conclusion: The authors postulate that extensive patient education with regard to temporary changes in the cylinder is necessary, particularly when the extraocular muscles are involved, and that additional refraction and topography control can be useful postoperatively if visual rehabilitation is inadequate., (© 2021. The Author(s).)

Background: Open and minimally invasive tear duct surgery are among the common surgical indications; however, little is known so far about the respective influences on the quality of life., Objective: The aim of this study was to compare the subjective influence on the quality of life of patients after open and minimally invasive surgical techniques for recanalization of dacryostenosis., Material and Methods: From the collective of patients who were surgically treated at the University Medical Center Hamburg-Eppendorf from 2015 to 2018, a total of 169 patients (111 dacryocystorhinostomy, DCR, 58 endoscopy) took part in the survey and answered 9 questions about subjective satisfaction, which were evaluated also comparatively., Results: When asked about postoperative satisfaction, the patients were significantly more satisfied after DCR (p = 0.001) than the patients who underwent a lacrimal endoscopy. There was no significant difference in terms of postoperative complications (p = 0.348). The rate of reoperations, however, was significantly higher in the patient group who underwent lacrimal endoscopy (χ 2 -test, p = 0.004)., Conclusion: In summary it can be said that DCR is not inferior to lacrimal endoscopy in terms of patient satisfaction., (© 2021. The Author(s).)

Background: There is largely a lack of clarity on the question of whether refraction or topography changes are to be expected after blepharoplasty, levator resection, or a lateral tarsal strip procedure., Materials and Methods: Therefore, in the present study, objective refraction, anterior eye segment tomography, and visual acuity tests were carried out pre- and postoperatively in 78 patients and then analyzed. The examination was carried out preoperatively, at suture removal after 10 days, and after 3 months., Results: Neither after blepharoplasty nor after a lateral tarsal strip procedure were significant changes in vision or refraction seen in the topography. In contrast, the Wilcoxon sign test 10 days after levator resection showed a significant increase in the cylinder after 10 days compared to the preoperative level (p = 0.042). However, this change was no longer detectable after 3 months., Conclusion: The authors postulate that extensive patient education with regard to temporary visual changes, particularly in the case of levator resections, is essential and that additional refraction and topography control can be useful postoperatively., (© 2021. The Author(s).)

Infranuclear motility disorders are such of the cranial nerves, the extraocular muscles or changes in the orbit but definitely peripheral to the nuclei of the cranial nerves. Characteristic are movement deficits, a compensatory head posture and the pattern of incomitancy. The secondary angle of deviation is usually larger than the primary. Combined pareses suggest a lesion in the cavernous sinus, orbital apex or a multilocular event. It is essential to rule out supranuclear disorders, especially if the motility deficit is atypical. For clarification, an individual risk assessment is recommended, paying particular attention to risk factors., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: The optimal timing for surgery of congenital nasolacrimal duct obstruction (CNLDO) is controversially discussed . An aspect that has not yet been studied in this context is the path from first symptoms to the initial diagnosis and surgical treatment with respect to social factors and burden of suffering. The aim of this study was a real-life analysis of the entire course of the disease., Methods: Monocentric, retrospective study evaluating children with CNLDO (n = 147) who underwent surgery. The minimum follow-up was 3 months (26 ± 14 months). The patient information was collected by telephone using a questionnaire especially created for this purpose. The famelial suffering was measured on a scale of 1-5., Results: Data were collected from 118 parents with a mean follow-up of 26 months. First symptoms occurred at a median age of 1 month. The diagnosis was confirmed through a pediatrician/ophthalmologist after a median of 6 months. An assignment to a referral center for surgical treatment was performed a median of 18 months after the first presentation. The average age of the patients at the time of surgery was 23 months. Surgery before the age of 13 months showed a 100% success rate. The average age of those who needed revision surgery was 27 months (±12 months). The familial suffering was measured as 4.1 points before surgery and 1.3 after surgery., Conclusion: This study is the first real-life study, which illustrates the path of CNLDO from the first symptoms to rehabilitation, including influential social factors. Early surgery significantly shortens the suffering of both patients and parents. Considering the low operative risks and excellent success rate of operative treatment, an early consultation at a surgical department is recommended., (© 2020. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

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

Background/aims: To provide evidence of statistically significant difference in the surgical outcome of the lateral tarsal strip with everting sutures (LTS + ES) versus the Quickert procedure (QP) in the treatment of involutional entropion., Methods: In a prospective randomized comparative trial, 66 eyelids of 52 patients with primary involutional lower eyelid entropion were recruited. Thirty-six eyelids were randomized to QP, and 30 eyelids were randomized to LTS + ES. Surgery was performed by a single surgeon. Postoperative follow-up was scheduled after 2 weeks, 8 and 14 months. Successful surgery was defined as a normal eyelid position at rest and inability to induce entropion on forced eyelid closure at or before the 14-month follow-up visit., Results: A total of 66 eyelids of 52 patients were enrolled in the study. Three patients did not complete follow-up (1 did not attend the 8 months follow-up visit; 2 did not attend 14 months follow-up visit). Of the 63 patients, a single eyelid [success probability 0.97; confidence interval (CI) 0.92-1] in the QP group and two treated eyelids [success probability of 0.93; CI: 0.85-1] in the LTS + ES group had a recurrence of a lower eyelid entropion after 14 months. There was no statistically significant difference in surgical failure between the LTS + ES versus QP (Log-rank test: p = 0.46)., Conclusion: These data provide strong evidence that success rates at 14 months are similar in patients treated with either techniques (LTS + ES versus QP)., (© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

This report describes the diagnosis and treatment of a 27-year-old patient with neurofibromatosis 1 (NF1) and late progression of a pre-existing optic pathway glioma (OPG) that caused significant reduction in vision. OPG is one of the diagnostic criteria for establishing the diagnosis of NF1. Most common findings of NF1 are café-au-lait spots, axillary and inguinal freckling of the skin, iris hamartoma (Lisch nodules), and tumors of the central nervous system and peripheral nerves. We successfully applied a modified International Society of Paediatric Oncology chemotherapy regimen for low-grade glioma in children with carboplatin dose adjustment according to the area under the plasma drug concentration-time curve calculation. During and after the chemotherapy, a clear improvement of the visual capacity was achieved. Age-adapted chemotherapy for symptomatic adult-onset OPG in patients with NF1 should be considered in individual cases., (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

A 46-year-old woman presented with a sudden onset of non-traumatic periorbital hemorrhage, painless proptosis, conjunctival chemosis and injection as well as motility restriction of the right eye with double vision. Magnetic resonance imaging (MRI) revealed an extraconal mass in the medial orbit with lateral displacement of the medial rectus muscle and the eyeball without optic nerve involvement. A biopsy led to the diagnosis of non-specific inflammation. This case shows that sudden periorbital hemorrhages can be a sign for idiopathic orbital inflammation.

This article reviews the most relevant vital dyes and adjuncts currently available for use in vitreoretinal surgical procedures. The current concepts of intraocular application as well as the staining properties are described, and the issue of biocompatibility is discussed.

Inherited retinal degenerations are a common cause of blindness in Western countries. A mechanism for most retinal degenerations is still unknown; hence, a suitable treatment for most of these diseases has yet to be found. Before one can rationally design a treatment, it is necessary to understand the pathway from a gene mutation to the phenotype in patients. Animal models are crucial to understand this process and to develop a treatment. Some naturally occurring animal models are known. However, over the past few years, transgenic engineering has allowed the generation of a rapidly growing number of animal models. In this review, we give an overview of the broad variety of genetic animal models for retinal degeneration.

Background: Hyperoxic-hypercapnic inhalation is a therapeutic option in vascular disorders of the retina. The effect of hyperoxic and/or hypercapnic inhalation on the perfusion of the retina was examined., Methods: Twenty-five young adults between 18 and 35 years were investigated in a prospective study. They inhaled one of three different mixtures of breathing gases: (1) 100% O2, (2) Carbogen 240 (95% O2 and 5% CO2), (3) 92% O2 with 8% CO2 and were examined by color Doppler imaging of the CRA and OA before and after inhalation. The resistance index (RI) was calculated., Results: The majority of the subjects showed an Increase in the RI in both ophthalmic vessels after inhalation of pure O2, a decrease after breathing in 92% O2 and 8% CO2 and it remained almost constant with inhalation of 95% O2 and 5% CO2., Conclusions: Inhalation of 92% O2 and 8% CO2 is a possibility for decreasing the peripheral resistance of OA and CRA. No change in blood flow was observed with Carbogen 240.