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Peer Lauermann,1 Anthea Klingelhöfer,1 Dorothee Mielke,2 Dirk Bahlmann,1 Hans Hoerauf,1 Juergen Koscielny,3 Christoph Sucker,4 Nicolas Feltgen,1 Christian van Oterendorp1 1Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany; 2Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany; 3Gerinnungsambulanz mit Hämophiliezentrum im Ambulanten Gesundheitszentrum (AGZ), Charité Universitätsmedizin Berlin, Berlin, Germany; 4COAGUMED Coagulation Center, Berlin, GermanyCorrespondence: Peer Lauermann, Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch Str. 40, Goettingen, 37075, Germany, Email peer.lauermann@med.uni-goettingen.dePurpose: To evaluate the influences and risk factors for severe bleeding complications during glaucoma surgery, and to investigate the role of antiplatelet (AP) and anticoagulant (AC) agents.Methods: This prospective study enrolled patients undergoing trabeculectomy, trabeculotomy (with Trabectome® or Kahook Dual Blade®), viscocanaloplasty and Ahmed or Baerveldt implants. Bleeding severity was graded on an ordinal scale ranging from 0 to 5. Immediately after surgery and one day later, the incidence and severity of bleeding events was documented on a standardized form. A grade ≥ 3 was defined as severe bleeding. The influence of known systemic disorders, the type of anesthesia, surgical procedure, intraoperative blood pressure, and the use of or change in AP or AC agents on intraoperative bleeding were analyzed.Results: Data from 89 eyes undergoing glaucoma procedures were included (age 71.3y ± 10.5). We observed severe intraoperative bleeding in 8 eyes (9%) and found that concomitant diseases such as the history of a deep vein thrombosis or peripheral arterial occlusive disease, and the type of surgical procedure (trabeculectomy and viscocanaloplasty) were significantly associated with severe bleeding events. By contrast, the use of AP/ AC agents had no significant influence on severe intraoperative bleeding events.Conclusion: According to the results of our study cohort, glaucoma procedures entailing scleral manipulations (trabeculectomy and viscocanaloplasty) and concomitant diseases such as the history of a deep vein thrombosis or peripheral arterial occlusive disease influence the risk of severe intraoperative bleeding events, we detected no increased risk related to concomitant antiplatelet and/ or anticoagulant medication use.Keywords: glaucoma surgery, severe bleeding complications, antiplatelet agents, anticoagulant agents

Marcus Werner Storch,1 Greta Zinser,1 Peer Lauermann,1 Mohammed Haitham Khattab,1 Anna Nguyen-Höhl,1 Dirk Raddatz,2 Katja Gollisch,2 Josep Callizo,1 Hans Hoerauf,1 Nicolas Feltgen1 1Department of Ophthalmology, University of Göttingen, Göttingen, Niedersachsen, Germany; 2Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University of Göttingen, Göttingen, Niedersachsen, GermanyCorrespondence: Marcus Werner Storch, Department of Ophthalmology, University of Göttingen, Robert-Koch-Str. 40, Göttingen, 37075, Germany, Tel +49-551-39-63580, Fax +49-551-39-63582, Email marcus.storch86@googlemail.comPurpose: To correlate functional and morphological parameters with foveal avascular zone’s (FAZ) size in diabetic patients with mild to moderate stage nonproliferative diabetic retinopathy.Methods: Monocentric and prospective study of a consecutive case series of diabetic patients. Medical history, best corrected visual acuity (BCVA), best corrected high/low contrast visual acuity (BChcVA/BClcVA), mean sensitivity (MS) and mean defect (MD) in central visual field testing, and FAZ size in fluorescein-angiography (FAG) were recorded. Macular thickness (central point thickness CPT, central subfield thickness CST) and volume measurements (central subfield volume CSV, total macular volume) were taken from SD-OCT (6x6mm ETDRS-grid). Groups were categorised as presenting FAZ sizes smaller (G1) or larger (G2) than 0.35mm2. Smallest (Q1) and largest quartiles (Q3) were also compared.Results: Thirty-six of 40 patients were included. MS differed significantly between G1 (n = 6) and G2 (n = 30), and BChcVA/BClcVA as well as TMV correlated significantly with FAZ size in correlation analysis. Mean HbA1c tended to be lower in G1 than G2. Patients in G1 were slightly older than in G2. Treatment period with insulin was shorter in G1/Q1 than in G2/Q3. CPT and TMV were lower in G1/Q1 than in G2/Q3. Our analysis of the FAZ in terms of patient age, HbA1c, disease duration and insulin therapy duration revealed no significance. That lack of significance also applies to BCVA, MS, MD, CPT, CST and CSV.Conclusion: As significantly associated, contrast sensitivity, central visual field parameters and potentially retinal thickness or volume seem to be suitable to detect early macular ischaemia. However, we failed to establish any correlation between FAZ and BCVA.Keywords: foveal avascular zone, contrast vision, visual acuity, fluorescein angiography, diabetic retinopathy, ischemia

Josep Callizo,1 Focke Ziemssen,2 Thomas Bertelmann,3 Nicolas Feltgen,3 Jessica Vögeler,4 Mirja Koch,4 Nicole Eter,5 Sandra Liakopoulos,6 Steffen Schmitz-Valckenberg,7 Georg Spital8 1Department of Ophthalmology, Georg-August University, Goettingen, Germany; 2Center for Ophthalmology, Eberhard Karl University of Tuebingen, Tuebingen, Germany; 3Georg-August-University Goettingen, University Eye Hospital, Goettingen, Germany; 4Novartis Pharma GmbH, Clinical Research, Nuremberg, Germany; 5Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; 6Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; 7Department of Ophthalmology, University of Bonn, Bonn, Germany; 8Augenzentrum Am St. Franziskus Hospital, Muenster, GermanyCorrespondence: Josep CallizoDepartment of Ophthalmology, Georg-August University, Robert-Koch-Str. 40, Goettingen 37075, GermanyTel +495513966776Fax +495513966787Email josep.callizo@med.uni-goettingen.dePurpose: The non-interventional OCEAN study (NCT02194803) evaluated frequency and monitoring of ranibizumab injections for retinal vein occlusion (RVO) in routine practice in Germany.Methods: RVO patients (including branch and central RVO (BRVO/CRVO)) receiving ranibizumab were included. Best-corrected visual acuity (BCVA) testing, imaging and treatment were performed at the investigators’ discretion and documented over 24 months.Results: Overall, 744 RVO patients (27% BRVO, 16% CRVO, remaining unspecified RVO) were included. For 74% of patients, data were available for the 12-month visit and for 56% for the 24-month visit. Mean baseline BCVA was 52.0 Early Treatment for Diabetic Retinopathy Study (ETDRS) letters (BRVO: 55.9, CRVO: 43.9). BCVA improved rapidly within the first 3 months, reaching 64.3 letters at 12 months and 64.7 at 24 months. CRVO patients showed less improvement than those with BRVO. Patients received a median of 4 (5) injections over 12 (24) months, with 100% of patients receiving injections at baseline, 70% at Month 1 and 81% at Month 2. Overall, 40% of patients demonstrated a ≥15 letter increase within the first 3 months (42% BRVO, 46% CRVO). Patients with low initial BCVA (