[Maculopathy with optic nerve pits : Morphological criteria in SD-OCT]. / Makulopathie bei Grubenpapille : Morphologische Kriterien im SD-OCT.

PURPOSE: Optic pit is a congenital anomaly with malformation similar to coloboma of the optic disc. The cause of optic pit maculopathy is controversial. We used high resolution OCT to investigate changes in the vitreoretinal and vitreopapillary transition within optic pit eyes. METHODS: The vitreoretinal and vitreo-papillary transition of 12 eyes was accurately analyzed using SD-OCT. We registered the following criteria: liquefaction of prepapillary vitreous, papillary vitreous traction, discontinuity within the hyaloid cortex and communication spaces between pit and retinal edema. RESULTS: Communication gaps between pit and retinal edema were identified in 8 eyes. 4 eyes had a papillary vitreous traction. 4 showed a discontinuity in the hyaloid cortex. 2 of the 12 patients showed no maculopathy in SD-OCT. Those patients had an adjacent papillary vitreous without prepapillary liquefaction. However all eyes showed vitreous liquefaction at some stage premacullary or prepapillary. CONCLUSION: Yet the cause of optic pit maculopathy is not clearly understood. High resolution OCT imaging provides a very detailed assessment of the vitreoretinal transition prepapillary and premacullary, however with limited penetration depth and analyzation of deeper lying structures. Our observations suggest that prepapillary liquefaction and pressure gradients within cerebrospinal and intraokular pressure could be key factors.

[Unclear retinopathy after intravitreal injection of ocriplasmin]. / Unklare Retinopathie nach intravitrealer Eingabe von Ocriplasmin.

CASE REPORT: This article reports the case of a 50-year-old female patient who presented with reduced visual acuity of 0.8 p and metamorphopsia of the left eye caused by focal vitreomacular traction and who was treated with intravitreal Jetrea® (ocriplasmin). After injection the patient suffered from progressive nyctalopia and visual field defects. Electroretinography (ERG) showed decreased amplitudes and optical coherence tomography (OCT) showed decreased reflectivity in the ellipsoid layer that persisted for 2 months after treatment. CONCLUSION: Before injection of Jetrea® a detailed clarification of such potential side effects is necessary to increase patient compliance in the follow-up.

[Long-term course of immunosuppressive therapy of Vogt-Koyanagi-Harada syndrome]. / Langzeitverlauf unter immunsuppressiver Therapie bei Vogt-Koyanagi-Harada-Syndrom.

This article describes the case of a 22-year old female patient, who first presented with holocephalic headaches and bilateral loss in vision. After diagnosis of a complete Vogt-Koyanagi-Harada syndrome, high-dose corticosteroid therapy was initiated. Due to recurrent headaches 6 weeks later, immunosuppressive therapy was initiated with cyclosporine A. Because of an adverse effect (hirsutism) treatment was changed to azathioprine. In a long-term follow-up over 2 years the patient showed stable clinical findings with good visual acuity.

[Histological, biochemical and spectroscopic changes of articular cartilage in osteoarthritis: is there a chance for spectroscopic evaluation?]. / Arthrosebedingte histologische, biochemische und spektroskopische Veränderungen am hyalinen Gelenkknorpel: Welchen Stellenwert hat die spektroskopische Evaluation?

BACKGROUND: Non-destructive techniques for the detection and classification of pathological changes of cartilage in the early stages of osteoarthritis are required for arthroscopic and open surgery of joints. Biochemical and histological changes in cartilage with different degrees of destruction were analysed and correlated to changes in the spectroscopic characteristics of cartilage. PATIENTS, MATERIAL AND METHODS: 24 patients (n = 25 knees) with severely destructed knee joints received total knee replacement. The cartilage of the resected joints was classified according to the ICRS system. Defined cartilage specimens were investigated spectroscopically employing NIRS (near-infrared spectroscopy). In the following the cartilage specimens were harvested to determine the content of proteoglycan (GAG) and hydroxyproline (HP) as an essential part of collagen. Histological evaluation of the Mankin score and Otte score was performed using haematoxylin/eosin and safranin-O staining. Spearman's rank correlation coefficient was used to characterise links between the parameters investigated. RESULTS: We found significant correlations between spectroscopic, histological and biochemical characteristics. NIRS corresponded to the content of GAG (ρ = 0.58) and HP (ρ = 0.59), as well as to the Mankin (ρ = 0.55) and Otte (ρ = 0.5) scores. Furthermore, the ICRS classification correlated with histological evaluation (Mankin score ρ = 0.725 and Otte score ρ = 0.736), as to be expected. CONCLUSION: Characteristic cartilage changes in different degrees of osteoarthritis can be detected and evaluated by the spectroscopic method NIRS as a non-destructive technique. However, the quality of this technical evaluation cannot compete with biochemical and histological analysis.

[Mineralocorticoid receptor antagonists as treatment option for acute and chronic central serous chorioretinopathy]. / Mineralokortikoidrezeptorantagonisten als Therapieoption bei akuter und chronischer Chorioretinopathia centralis serosa.

BACKGROUND: It is well known that central serous chorioretinopathy (CSCR) is triggered by endogenous and exogenous glucocorticoids but the exact pathomechanism is not completely understood. According to the results of previous studies overactivation of mineralocorticoid receptors may play a decisive role in the pathogenesis of CSCR. METHODS AND RESULTS: Experimental studies have shown that overactivation of mineralocorticoid receptors in endothelial cells of the choroid induces increased permeability. In a pilot study inhibition of mineralocorticoid receptors was successful in treating CSCR. This article reports about the use of spironolactone in the treatment of CSCR. In this observational case series spectral-domain optical coherence tomographv (SD-OCT) showed either reduction or complete reabsorption of subretinal fluid. In pilot studies and in this case series inhibition of mineralocorticoid receptors as a therapeutic option was effective and safe; however, the efficacy is difficult to distinguish from spontaneous recovery, especially in acute CSCR. CONCLUSION: For further assessment of this treatment controlled clinical trials are urgently required as this therapy would offer a new approach for patients with chronic CSCR and no tendency towards recovery.