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Das Motto des DOG(Deutsche Ophthalmologische Gesellschaft)-Kongresses 2019 „Augenheilkunde: Unser Fach mit Zukunft“ wirft die Frage auf, wie „augenheilkundliche Zukunft“ eigentlich aussehen soll, welches ihre treibenden Krafte und welches die Fundamente ihrer Gestaltung sind. Die Gestaltung der Zukunft – gemeinhin meist mit „Fortschritt“ gleichgesetzt – erfolgt naturgemas immer aus der Gegenwart heraus, welche ihrerseits ein Produkt der Vergangenheit ist. Geschichte ist wie Zeit und Evolution also immer ein Kontinuum. Obwohl wir uns das vielleicht nicht immer ganz klarmachen, nimmt die Geschichte daher immer Einfluss auf die Zukunft. „Zukunft durch Geschichte“ entsteht v. a. immer dort, wo aus „historischen Fehlern“ gelernt wird, wo gute, aber vergessene Ideen wiederentdeckt werden und wo Geschichte zum besseren Verstandnis herangezogen wird.

Both high myopia and glaucoma can have devastating effects on the visual function. Diagnostic tests and treatment can be challenging when both diseases are coexistent. This article discusses some of the typical problems in the management of glaucoma in highly myopic patients.

Neben den wissenschaftlichen Leistungen war es v. a. die Personlichkeit, die Albrecht von Graefe (1828–1870) hochstes internationales Ansehen einbrachte. Sowohl bei seinen beiden Grundungen Archiv fur Ophthalmologie 1854 und (Deutsche) Ophthalmologische Gesellschaft (DOG) 1857 als auch in seiner weltberuhmten Klinik in Berlin spielten auslandische Kollegen und Patienten eine grose Rolle. Daher ist an diesen grosen Fachgenossen gerade anlasslich des diesjahrigen Kongresses der DOG mit seinem Tagungsmotto „Deutsche Augenheilkunde international“ zu erinnern.

The motto of the German Ophthalmolological Society (DOG) Congress 2019 "Ophthalmology: our medical discipline with a future" raises the question of what "ophthalmological future" should really be, what are its driving forces and what are the foundations of its design. The design of the future, usually equated with "progress", naturally always takes place out of the present, which itself is a product of the past. History, like time and evolution, is always a continuum. Although we may not always be very clear about this, the history always influences the future. "Future through history" especially arises where lessons are learnt from "historical mistakes", where good but forgotten ideas are rediscovered and where history is used for a better understanding.

Canaloplasty is a recently introduced non-penetrating surgical technique for glaucoma, which seeks to improve the natural outflow of aqueous humor through Schlemm's canal and the collector channels. Just as in all forms of glaucoma surgery there are a certain number of failures of the procedure and further surgery is often needed to reduce the intraocular pressure in these cases. This article describes some of the revision procedures after canaloplasty.

Hintergrund: Bisher ist die genaue Expression des Ephrin-Typ-A2-Rezeptors (EphA2) im Hinblick auf dessen Bedeutung wahrend der Zell-Zell-Adhasion, Zellmigration, Angiogenese und der Formation von VM-Kanalen (VM: Vasculogenic Mimicry) in uvealen Melanomen unter Berucksichtigung der Metastasierungsrate unklar. Material und Methoden: Paraffinschnitte von 50 histopathologisch gut charakterisierten Fallen primarer uvealer Melanome (durchschnittlicher Tumordurchmesser: 16,3 mm) wurden hinsichtlich ihrer Expression von EphA2 evaluiert. Bei 29 Patienten traten systemische Metastasen auf. Die verbleibenden 21 Patienten hatten einen durchschnittlichen Nachuntersuchungszeitraum von 10 Jahren. Zusatzlich wurde die Tumorangiogenese mittels Endoglin-Expression (CD105), das mature Gefassystem (Von-Willebrand-Faktor, vWF) und das Vorhandensein von VM (CD31/PAS-Farbung) untersucht. Ergebnisse: Alle uvealen Melanome exprimierten EphA2 mit einer durchschnittlichen Anzahl positiver Zellen von 95,93 % (± Standardabweichung: 6,3 %). Es war zwar keine signifikante objektive Assoziation von EphA2 und der Metastasierungsrate (p = 0,196) bzw. der Endoglin-Expression (p = 0,652), VM (p = 0,267) oder weiteren klinischen oder histopathologischen Prognosefaktoren (p

Both high myopia and glaucoma can have devastating effects on the visual function. Diagnostic tests and treatment can be challenging when both diseases are coexistent. This article discusses some of the typical problems in the management of glaucoma in highly myopic patients.

Numerous systemic diseases can be manifested at the cornea. Sometimes the corneal involvement is the first sign of the systemic process. It may be manifested in many different forms, such as an ulcer in the corneal periphery or a crystalline keratopathy. Therapy is interdisciplinary and primarily directed against the underlying disease.

Not only the scientific successes but also his personality caused Albrecht von Graefe (1828-1870) to gain a worldwide reputation. His two foundations "Archive for Ophthalmology" in 1854 and the "(German) Ophthalmological Society" (DOG) in 1857 as well as his famous eye clinic in Berlin were important for his colleagues and patients from many countries and most continents. The 2017 DOG congress has the motto "German Ophthalmology internationally"; thus, it is worthwhile to be reminded of this great ophthalmologist.

Canaloplasty is a recently introduced non-penetrating surgical technique for glaucoma, which seeks to improve the natural outflow of aqueous humor through Schlemm's canal and the collector channels. Just as in all forms of glaucoma surgery there are a certain number of failures of the procedure and further surgery is often needed to reduce the intraocular pressure in these cases. This article describes some of the revision procedures after canaloplasty.

Little is known about how the expression of Ephrin type-A receptor 2 (EphA2) influences cell-cell adhesion, migration, angiogenesis, and the formation of vasculogenic mimicry (VM) channels in uveal melanomas or how this may be related to the rate of metastasis.Paraffin embedded sections of 50 histopathologically well characterised primary uveal melanomas (mean largest tumour diameter: 16.3 mm) were evaluated with respect to the expression of EphA2. Systemic metastasis was detected in 29 patients. The remaining 21 patients were followed for a mean of 10 years. Tumour angiogensis was analysed by endoglin expression (CD105), the activity of the mature vascular system (von Willebrand factor) and the presence of VM (CD31/PAS staining).All uveal melanomas expressed EphA2, with a mean of 95.93 % positive cells ± SD: 6.3 %. There was no significant association between EphA2 and the rate of metastases (p = 0.196), endoglin expression (p = 0.652), VM (p = 0.267) or with any other clinical or histopathological factors (p 0.05). However, there was significant up-regulation of EphA2 in the nucleus of the metastatic uveal melanoma subgroup, while cytoplasmatic localisation in the subgroup was associated with better prognosis (p = 0.006). There were low levels of EphA2 expression in the specific retinal layers, the ciliary and corneal epithelium, and the choroidal and corneal endothelium.Nuclear expression of EphA2 in this series of large tumours was significantly associated with an increased rate of metastasis. On the other hand, cytoplasmic localisation was associated with a better prognosis. As there was no correlation between EphA2 expression and angiogenesis, the mature vasculature or VM, EphA2 appears to become less important in the advanced stages of the disease.

Background The aim of this study was to evaluate ocular changes in patients with xeroderma pigmentosum (XP) and Cockayne syndrome (CS). Both diseases belong to the progeroid syndromes caused by single gene mutations with premature aging. Both syndromes are very rare autosomal recessive diseases caused by a gene defect leading to deficient DNA repair. Patients 12 patients (4 female, 8 male) with XP between 3 and 67 years old and a 39-year-old female patient with CS were examined. The examination included visual acuity testing, slit lamp biomicroscopy, funduscopy and performance of a Schirmer test. Results Changes of the lids in the XP group included blepharitis in 7 patients, distichiasis in 2, and madarosis in 3 patients. 8 patients had multiple lentigines solares of the lids. One patient showed scars of the lower lids after excision of a squamous cell carcinoma and a basal cell carcinoma. Conjunctival lesions comprised a tumour of unknown origin of the conjunctiva in 1 patient, teleangiectasia of the conjunctiva in 5 patients, pterygia in 4, and pinguecula in 1 patient. Two patients had an intraepithelial melanosis of the conjunctiva, and one showed conjunctival nevi. Two patients had corneal scars and corneal vascularisation, another a significant conjunctivalisation of the cornea. A Schirmer test was feasible only in 3 patients. Tear production was markedly reduced in all these patients. Break-up time was shortened significantly in 6 patients examined. The patient with the CS showed atrophy of the pupillary rim and a subcapsular cataract. Funduscopically there were pigment epithelial changes. Conclusions Patients with XP often exhibit ocular changes. Beside the light-dependent degenerative and inflammatory manifestations at the lids, the conjunctiva and the cornea patients with XP also develop malignancies early in life. The majority of patients suffer from dry eye symptoms.

Background: Lisch corneal dystrophy is an epithelial corneal dystrophy where diffuse gray corneal opacifications are seen in direct illumination that appear in different patterns. Examination in retroillumination shows that these gray changes do consist of multiple densely crowded clear microcysts according to the opacity units. We wanted to investigate if one single case of Lisch corneal dystrophy can be differentiated easily from the other epithelial corneal dystrophies by exact analysis of the opacity units. Patients and Methods: We examined three non-related patients with Lisch corneal dystrophy at the slit-lamp. The epithelial corneal opacities were documented photographically with direct slit-lamp illumination and retroillumination. Results: All three patients showed the characteristic intraepithelial densely crowded clear microcysts in retroillumination. Diffuse gray radial opacities were noted in both corneas of a 15-year-old female patient. A club-shaped opacity was noted in one cornea of a 35-year-old female patient and a feathery gray opacity pattern was found in one cornea of a 49-year-old male patient. All three patients showed the characteristic densely crowded clear microcysts of Lisch corneal dystrophy in retroillumination. Conclusion: Taking the previous literature into account, five different opacity patterns can be summarised: radial, band, flame/feathery, whorled and club-shaped gray epithelial corneal opacities. A single case of Lisch corneal dystrophy can be differentiated from other epithelial corneal dystrophies by means of an exact analysis of the opacity pattern and units by slit-lamp examination.

About 800,000 people in Germany suffer from glaucoma. As the population ages, the prevalence of glaucoma will rise and the socio-economic impact of the disease increase. The costs of glaucoma include those of diagnosis, medical, laser and surgical treatment, and costs of blindness as a result of glaucoma. So far the costs of diagnosis and screening programs are not well known but there is substantial knowledge of the therapeutic costs. Daily therapy costs are about 0.50 to 1.00 euro per patient. Every year the German statutory health insurance system pays about 1,000 euro per glaucoma patient. In addition, blindness due to glaucoma costs the German government over euro 150 million annually in Social Security benefits, lost income tax revenues, and health care expenditures. Demographic changes and scientific progress will even aggravate the socio-economic burden of this disease.

This report describes the case of a 6-year-old girl who presented with painless swelling of the right orbit since 4 weeks and moderate proptosis. Tests revealed visual acuity RE 6/6, LE 6/6, normal intraocular pressure (IOP), anterior and posterior segments normal. Ultrasound examination showed multiple lesions in the spleen, normal liver, no abdominal mass and enlarged abdominal lymph nodes. Fine-needle aspirate results were not available at the time of clinical decision-making. In Malawi the treatment for all stages of Burkitt's lymphoma is intravenous cyclophosphamide (40 mg/kg on day 1 and oral cyclophosphamide 60 mg/kg on days 8, 18 and 28). Intrathecal hydrocortisone (12.5 mg) and methotrexate (12.5 mg) are given with each treatment cycle.