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Background: The gold standard of surgical interventions in medically uncontrolled glaucoma is trabeculectomy. Cyclophotocoagulation is often performed only as a secondary/tertiary surgery. Since trabeculectomy demands a high degree of postsurgical compliance to achieve satisfying results, some patients do not qualify for trabeculectomy., Patients and Methods: During cyclophotocoagulation, the ciliary processes were coagulated using a transscleral diode laser. 49 eyes of 47 patients (25 women and 22 men) were included in our study. Patients were regularly followed up for 24 months. During follow-up, IOP, best corrected visual acuity and number of antiglaucoma drugs were recorded., Results: The mean age was 69.27 ± 14.45 years. The diagnosis was open-angle glaucoma in 15 eyes, pseudoexfoliative glaucoma in 12 eyes, secondary rubeotic glaucoma in 7 eyes and secondary glaucoma without further specification in 15 eyes. On average, cyclophotocoagulation reduced intraocular pressure by 14.45 ± 11.77 mmHg (-42.7%, p < 0.001). Medication could be reduced by 1.31 ± 1.27 (-52%, p < 0.001). On average, visual acuity deteriorated by 0.383 LogMAR (± 0.848, p = 0.004)., Conclusion: For selected glaucoma patients, cyclophotocoagulation could be an option as primary surgical intervention to lower intraocular pressure., (Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Serum immunoglobulin G4 (IgG4)-related systemic disease is a newly found entity and should be considered as a further differential diagnosis to the big pool of unspecific orbital inflammation. We describe clinical appearance and treatment options., Patients and Methods: We retrospectively analyzed all patients with the diagnosis IgG4-related orbital inflammation who were examined in our outpatient clinic. We compared symptoms, clinical and histological findings and therapy., Results: In the last 17 months five patients were diagnosed with IgG4-related orbital disease. Biopsies were performed of most affected areas as seen in the computerised tomography scan. Histology revealed marked infiltration with IgG4-positive plasma cells. Serum IgG4-levels were partly significantly elevated. Based on these findings diagnosis of an IgG4-related disease was agreed and treatment with oral prednisone installed. In one patient a therapy with Rituximab was successfully started., Conclusion: Extended unspecific orbital inflammation, especially when bilateral and associated with systemic disease should be considered to be IgG4-related. Histological proof of IgG4-positive plasma cells and elevated IgG4 serum levels do confirm this diagnosis. Strict follow-up and interdisciplinary work-up is recommended., (Georg Thieme Verlag KG Stuttgart · New York.)

We present clinical images of a case of Leber's idiopathic stellate neuroretinitis (LISN). A 34-year-old male presented with acute-onset unilateral blurred vision for 5 days. Clinical examination revealed sectorial papillary edema and extensive macular edema in the affected eye. Using optical coherence tomography we detected intraretinal fluid in the outer retinal layers and subretinal fluid under the fovea. Seven days later, the macular edema was completely resolved, and disseminated retinal exudates had appeared, resembling a macular star figure. No underlying systemic disease was identified. Follow-up examination after 3 months demonstrated almost complete spontaneous resolution of fundus changes and near-normalization of visual acuity.