[PresbyLASIK: treatment approaches with the excimer laser]. / PresbyLASIK: Behandlungsansätze mit dem Excimerlaser.

Presbyopia represents the most common refractive error. There is currently no surgical treatment for presbyopia, which is effective, reliable, and safe. Excimer laser surgery has become a routine procedure for the correction of myopia, hyperopia, and astigmatism for years. Various treatment strategies for presbyopia have been brought forward using the excimer lasers. Besides monovision, creation of a multifocal cornea represents an attractive option. This procedure is also called "PresbyLASIK." Different ablation profiles to form a multifocal cornea are reviewed here and first clinical results are summarized."PresbyLASIK" is a new, interesting treatment strategy, with a huge potential for the future. At the present it should be used in controlled studies only because of some unsolved questions.

Molecular imaging system for possible prediction of active retinopathy in patients with Diabetes mellitus.

OBJECTIVE: The deposition of advanced glycation end products is enhanced in Diabetes mellitus (DM) and has been linked to diabetic complications such as a microvascular disease. Glycated proteins have receptors on mononuclear blood cells (MBCs) and have been shown to generate reactive oxygen species altering gene expression and modifying cellular targets, such as endothelial cells. Retinal angiopathy is a frequently observed microvascular complication in DM-patients. Because of the central role of activated MBCs, we hypothesised a functional link between specific alterations in gene expression of MBCs, an increased activity of matrix proteases in serum, and the extent of retinal angiopathy in DM. MATERIAL AND METHODS: An appearance and proliferation index of diabetic retinopathy was evaluated in 38 DM-patients using fluorescein angiography. Alterations of gene transcription levels in MBCs were investigated using hybridisation of individual mRNA-pools to Atlas Array with a concomitant quantification of specific cDNAs by "Real-Time"-PCR. The activity of matrix metalloproteinases MMP-2 and MMP-9 in individual serum samples was measured by zymography combined with densitometric imaging system. RESULTS AND CONCLUSIONS: Hybridisation to Atlas Array of mRNA-pools isolated from MBCs revealed an enhanced expression of recoverin in DM-patients compared to the control group. "Real-Time"-PCR showed the highest recoverin levels in the DM-subgroup with a high proliferation index. MMP-2 activity was highly increased in 36% of all patients, and in 44, 44, and 19% of patients with proliferative retinopathy, advanced proliferative retinopathy, and no detectable proliferation respectively. In those 3 groups MMP-9 activity was highly increased in 56, 67, and 31% of patients respectively, and in 44% of all DM-patients. In contrast to patients with active proliferation, the simultaneous high activation of all three genes was not observed in patients without active proliferation. The ex vivo molecular imaging system developed in this work may be helpful for the prediction of active proliferative retinopathy in DM.

[Ocular involvement in systemic Loa-Loa filariasis. Case report and review of the literature]. / Okuläre Beteiligung bei systemischer Loa-Loa-Infektion. Fallbericht und Literaturübersicht.

BACKGROUND: Within the last few years there is more and more evidence for nonspecific ocular symptoms caused by "exotic" pathogens. We herewith report another case of such an infection to underline the increasing importance and diagnostic relevance even of rare diseases. PATIENT: A 35-year-old female German patient presented with recurrent left retrobulbar "feeling of pressure" after a 6-month-stay in Central Africa 5 years ago. In addition, she reported on repeated swelling of the skin and joints of her hands and arms. Multiple ophthalmologic and rheumatologic investigations had been carried out without diagnostic results. Her ophthalmologist referred her with the presumed diagnosis of a subconjunctival worm. RESULTS: Slit-lamp biomicroscopy confirmed the original suspicion, and after topical anesthesia a female Loa-Loa worm was easily removed with forceps through a conjunctival incision. The general examination showed symptoms of systemic infection (calabar swelling, eosinophilia). Classification and initiation of treatment with diethylcarbamazine and mebendazole were carried out by the University Institute of Parasitology. CONCLUSION: Loa-Loa is a parasitic infection endemic in the tropical rain forests of Western, Central, and Eastern Africa. It is transmitted by the Chrysops fly. An increasing number of oculosystemic infections in non-African patients with Loa-Loa are being published. Therefore, any patient with an unclassifiable eye affection should also be investigated for those rare pathogens.