[What can anti-VEGF therapy achieve in clinical routine? : Effectiveness of anti-VEGF therapy in patients with macular diseases in clinical routine on 1492 eyes in Austria]. / Was bringt die Anti-VEGF-Therapie im Klinikalltag? : Wirksamkeit von Anti-VEGF-Therapie bei Patienten mit Makulaerkrankungen in der Klinikroutine an 1492 Augen in Österreich.

BACKGROUND: The aim of this user observational study was to illustrate the effectiveness of intravitreal operative medication administration (IVOM) in the clinical routine. DESIGN: A monocentric, single arm, prospective study. MATERIAL AND METHODS: Included in this study were all patients in whom a macular edema was diagnosed during an ophthalmological examination at the Barmherzigen Brüdern Hospital in Linz from November 2012 to August 2014 and who were treated as outpatients or day clinic patients with IVOM using anti-vascular endothelial growth factor (VEGF). The parameters measured during the clinical routine were as follows: best corrected visual acuity (BCVA) using the early treatment diabetic retinopathy study (ETDRS) chart, central optical coherence tomography (OCT) thickness, diagnosis and possible prior treatment with IVOM. Following diagnosis, the IVOM was administered in 6­week intervals and a final control with measurement of the named parameters (approximately 19 weeks after diagnosis). If edema was present a further 3­stage series (19 weeks) was initiated. In the case of a "dry" condition the further controls were performed by a private practitioner and the patient only presented again if macular edema reoccurred. A control of the patients with "dry" results at regular intervals was not planned. RESULTS: A total of 1492 eyes from 1184 patients with an average age of 75.6 ± 11.3 years were included in the study according to the abovenamed criteria. Choroidal neovascularization (CNV) with age-related macular degeneration (AMD) was diagnosed in 879 eyes and 314 eyes were treated for diabetic macular edema (DME). Of the eyes 122 (8.2%) were affected by branch vein thrombosis (AVT) and 63 (4.2%) from central vein thrombosis (CVT). In 47 (3.2%) eyes macular edema with myopic CNV (mCNV) was detected and 67 eyes (4.5%) were not further classified under "others". In all groups a gain in letters could be achieved in the EDTRS chart even after the first IVOM series: AMD + 3.4, DME + 1.3, AVT + 6.1, CVT + 10.1 and mCNV + 7.0. Patients who were treated with IVOM for the first time showed on average a better response than those previously treated with IVOM. CONCLUSION: As in many other studies our data also underline the necessity for intravitreal injections for treatment of macular edema. Even if a 6­week interval does not nowadays correspond to the current guidelines, we could achieve a stabilization of vision and do not shy away from comparison with large studies, such as the Marina study. In order to provide the increasing numbers of patients the best treatment in the future, an attempt at targeted implementation of resources must be made and if necessary symptoms which can be conservatively treated should be delegated to the private sector.

Regulation of human eye growth by the energy density of the radiation in the retina--a biophysical theory in ophthalmology.

A number of theoretical and experimental models analyze regulation of eye growth in humans and animals. In this article we introduce a biophysical theory to explain human eye growth from an energetic point of view. We find different energy densities of the electromagnetic radiation in the retina for hyperopic, emmetropic and myopic eyes. We postulate a relation between the different energy densities of the radiation in the retina and growth regulation by the retina. Based on this relation between physics and biology we are modeling emmetropization, missing emmetropization in severe hyperopia and development and progression of myopia in correspondence with a number of clinical and experimental results.

Chronic pelvic pain and previous sexual abuse.

OBJECTIVE: To determine whether there is an association between history of sexual abuse and development of chronic pelvic pain. METHODS: We studied 36 women with chronic pelvic pain, 23 with chronic low back pain, and 20 healthy women with reference to experience of sexual abuse, physical violence, and emotional neglect in childhood. Semistructured interviews were used to collect data. Assessment of severity of sexual abuse was based on Russell's criteria, and emotional and physical abuse were determined according to Briere's and Adler's definitions, respectively. RESULTS: In terms of experience of sexual abuse in general, the three groups did not differ statistically significantly from each other (P =.128). However, 22% of patients with chronic pelvic pain were sexually abused before their 15th birthdays, significantly more frequently than the other two groups (chronic low back pain 0%, P =.019, pain-free control 0%, P =.028). Women with chronic pelvic pain were exposed more frequently to physical violence (38%) and suffered more emotional neglect (25%) in their childhoods than women in the pain-free control group (physical abuse 5%, P =.012; emotional abuse 0%, P =.018). With regard to physical abuse and emotional neglect, the women with chronic pelvic pain did not differ from those with chronic low back pain (physical abuse 30.4%, P =.385; emotional abuse 21.7%, P =.571). CONCLUSION: Besides physical and emotional trauma, there is a significant association between sexual victimization before age 15 years and later chronic pelvic pain.