Search

PURPOSE: Prematurity, prenatal growth restriction, and retinopathy of prematurity (ROP) are associated with altered ocular geometry, such as a steeper corneal shape in childhood, but it is unclear whether perinatal history affects corneal thickness development, so this study investigated whether corneal thickness in adulthood is affected by perinatal history. MARTERIALS AND METHODS: The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. The corneal thickness was measured by Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany), and the relationship between perinatal parameters respective birth weight percentile and corneal thickness at different locations was assessed using uni- and multivariable linear regression models. Covariates included age, sex, mean corneal radius, white-to-white distance, gestational age, birth weight percentile, ROP occurrence, and treatment. The main outcome measures were corneal thickness at the apex, the pupil center, and the corneal periphery. RESULTS: The corneal thickness was measured in 390 participants (754 eyes, mean age 29.7+/-8.7 years, 224 females). In multivariable analyses, a lower birth weight percentile was associated with a lower corneal thickness at the apex (B = 0.20, p = 0.003) and the pupil (B = 0.19, p = 0.007). These effects diminished towards the corneal periphery and were not observed beyond the 4-mm diameter circle around the thinnest corneal position. Neither gestational age, ROP occurrence, or ROP treatment affected the corneal thickness. CONCLUSION: A lower birth weight percentile in subjects born preterm as a proxy for restricted fetal growth is associated with corneal thickness thinning in adults aged 18 to 52 years, indicating that corneal thickness development, particularly in the corneal center, may originate in the fetal stage.

Cat domestication likely initiated as a symbiotic relationship between wildcats (Felis silvestris subspecies) and the peoples of developing agrarian societies in the Fertile Crescent. As humans transitioned from hunter-gatherers to farmers ~12,000 years ago, bold wildcats likely capitalized on increased prey density (i.e., rodents). Humans benefited from the cats’ predation on these vermin. To refine the site(s) of cat domestication, over 1000 random-bred cats of primarily Eurasian descent were genotyped for single-nucleotide variants and short tandem repeats. The overall cat population structure suggested a single worldwide population with significant isolation by the distance of peripheral subpopulations. The cat population heterozygosity decreased as genetic distance from the proposed cat progenitor’s (F.s. lybica) natural habitat increased. Domestic cat origins are focused in the eastern Mediterranean Basin, spreading to nearby islands, and southernly via the Levantine coast into the Nile Valley. Cat population diversity supports the migration patterns of humans and other symbiotic species.

Zusammenfassung Hintergrund Das Ziel der vorliegenden Studie war die Beschreibung der augenärztlichen Versorgung in der Kindheit und Jugend früh- und reifgeborener Personen aus der retrospektiven Sicht der Eltern. Patienten, Material und Methoden Die Gutenberg Prematurity Eye Study (GPES) ist eine retrospektive Kohortenstudie mit einer prospektiven augenärztlichen Untersuchung von früh- und reifgeborenen Personen, die zwischen 1969 und 2002 geboren wurden (aktuelles Alter 18 bis 52 Jahre). Sie schließt eine Befragung von deren Eltern zur augenärztlichen Versorgung ihrer Kinder in der Kindheit und Jugend aus der Retrospektive ein. Die Teilnehmenden und deren Eltern wurden in Personen mit normalem Gestationsalter (GA) ≥ 37 (Kontrollgruppe), Frühgeborene ohne ROP (Retinopathy of Prematurity) mit GA 33 – 36 (Gruppe 2), GA 29 – 32 (Gruppe 3), GA ≤ 28 Wochen (Gruppe 4) und solche mit ROP ohne Behandlung (Gruppe 5) und mit ROP mit Behandlung (Gruppe 6) gruppiert. Die Eltern der Teilnehmenden wurden zur augenärztlichen Versorgung und zur Zufriedenheit damit befragt. Ergebnisse Insgesamt wurden die Daten von 57 reifgeborenen und 131 frühgeborenen Kindern und deren Eltern in die vorliegende Studie eingeschlossen. Die Eltern der Teilnehmenden gaben an, dass eine augenärztliche Untersuchung bis zum 6. Lebensjahr in den jeweiligen Gruppen 1 bis 6 bei 22/57 (38,6%), 33/58 (56,9%), 22/38 (57,9%), 3/6 (50%), 19/21 (90,5%) und 7/8 (87,5%) stattgefunden habe. Insgesamt gaben 83 – 100% der Eltern in den verschiedenen Gruppen an, dass die augenärztliche Betreuung gut gewesen sei. Einen Augenarztwechsel aufgrund von Behandlungsunzufriedenheit berichteten insgesamt 4/57 (7%), 9/58 (15,5%), 8/38 (21,1%), 1/6 (16,7%), 1/21 (4,8%) und 2/8 (25%) in den jeweiligen Gruppen. Schlussfolgerung Die vorliegende Studie zeigt eine gute Behandlungszufriedenheit hinsichtlich der augenärztlichen Betreuung von ehemaligen frühgeborenen Personen, insbesondere Eltern von Kindern mit einer ROP bewerteten diese positiv.

Zusammenfassung Hintergrund Eine regelmäßige ophthalmologische Untersuchung ist für immer mehr Menschen mit Diabetes gefordert, sei es zur Früherkennung und Kontrolle einer diabetischen Retinopathie. In manchen Ländern kommen bereits automatische Verfahren der Bildauswertung zur Detektion einer behandlungsbedürftigen diabetischen Retinopathie zur Anwendung. Ziel dieser Studie ist es, die Früherkennung diabetischer Augenerkrankungen ohne direkten Arzt-Patienten-Kontakt in Deutschland zu evaluieren und mögliche Barrieren für Patienten zu erkennen. Material und Methoden In dieser prospektiven monozentrischen Studie wurden bisher 93 Patienten eingeschlossen, die sich für ein Screening auf eine diabetische Retinopathie vorstellten. Die Studienteilnehmer nahmen ein Angebot zu einer Untersuchung (Visuserhebung, non-mydriatische kamerabasierte Fundusuntersuchung) ohne Arzt-Patienten-Kontakt wahr. Mittels Fragebogen wurde die Zufriedenheit der Patienten erhoben. Ergebnisse Das durchschnittliche Alter der eingeschlossenen Patienten (n = 93; 49,5 % weiblich) betrug 53,5 Jahre (29 bis 76 Jahre, SD: 13,6 Jahre). Bei 17 Augen (18,3 %) wurde mittels kamerabasierter Fundusuntersuchung eine diabetische Retinopathie festgestellt. In der Stichprobe musste sich kein Patient aufgrund schlechter Bildqualität erneut vorstellen. Insgesamt berichteten die Patienten eine hohe bis sehr hohe Zufriedenheit. Die Akzeptanz des Untersuchungsangebots war hoch. Diskussion In dieser Studie konnte mit einer Screeninguntersuchung ohne direkten Arztkontakt eine hohe Akzeptanz erreicht werden. Qualifiziertes Fachpersonal ermöglichte eine hohe Bildqualität der erhobenen Fundusbilder, sodass der Einsatz von automatischen Algorithmen (künstliche Intelligenz) das Potenzial hat, die bisherigen Angebote zu ergänzen.

Background/Objectives. The pupil regulates the incoming light to reduce glare and to achieve sufficient depth of field. Few is known on the distribution of pupil size and associated conditions in the general population. Therefore, for the first time in a large population-based study, we assess the distribution of physiologic pupil size and identify associated factors. Subjects/Methods. The Gutenberg Health Study (GHS) is a prospective cohort study established at the University Medical Center Mainz, Germany. As part of the 5-year follow-up (2012–2017), 9,559 of 12,432 participants had a valid pupil size measurement. Optical biometry (Lenstar LS900, Haag-Streit, Koeniz, Switzerland) including measurements of physical pupil diameter, central corneal thickness, corneal curvature, anterior chamber depth, and axial length was performed under mesopic light conditions. The associations of ocular geometry, the participants’ demographics, and their history of systemic diseases and medication intake with physical pupil size were assessed using multivariable linear regression models. Results. 18,335 eyes of 9,559 participants aged 40 to 80 years were included in the analysis. Median pupil diameter was 4.19 mm in right eyes and 4.12 mm in left eyes. A smaller pupil was associated with older age, hyperopic refractive error, previous cataract surgery, diabetes, obesity, and ACE inhibitor intake, whereas wider pupil was associated with female gender, arterial hypertension, intake of tricyclic antidepressants, and intake of SNRI and tetracyclic antidepressants. Socioeconomic status and smoking were not associated with pupil size. Conclusion. Individuals of older age, after cataract surgery, under therapy with ACE inhibitors and with diabetes have a smaller pupil. This should be taken into account when planning nonmydriatic fundus photography-based screening programs, for instance, for diabetic retinopathy.

This study analyses whether prematurity, retinopathy of prematurity (ROP), and associated factors lead to altered foveal shape in adulthood and whether these alterations are associated with visual acuity.The Gutenberg Prematurity Eye Study is a German cohort study with a prospective ophthalmologic examination (participants aged 18-52 years) of individuals born preterm and full-term that were examined with spectral domain optical coherence tomography. Participants were grouped according to gestational age (GA) and postnatal ROP status. Multivariable linear regression analyses for foveolar retinal thickness, foveal hypoplasia, and posterior vitreous status were performed.A total of 755 eyes of 414 preterm and full-term individuals were included (aged 28.6 ± 8.6 years, 233 female individuals). Central foveal retinal thickness increased as GA decreased. The prevalence of foveal hypoplasia was 2% (control group), 9% (GA 33-36), 18% (GA 29-32), 48% (GA ≤28), 50% (ROP without treatment), and 82% of eyes (with ROP requiring treatment). In multivariable analyses, central foveal thickness was independently associated with GA and advanced stages of ROP requiring treatment while foveal hypoplasia was only associated with GA. Posterior vitreous was more frequently visible as partially detached in full-term than in preterm individuals. Lower distant-corrected visual acuity correlated with increased foveolar thickness (rho = 0.08; P = 0.03) and with foveal hypoplasia (rho = 0.15, P0.001).Our findings indicate that there are fetal origins affecting foveal shape, resulting in foveal hypoplasia potentially affecting the visual acuity in adulthood.

The use of OCT to monitor intravitreal treatment varies in clinical practice and is not always mandatory. The ALBATROS data collection aimed to clarify the impact of routinely implemented OCT on clinical outcomes and its impact on vision-related quality of life (VRQoL). Methods: An observational cohort study included patients with retinal diseases starting an intravitreal anti-vascular endothelial growth factor treatment in Germany. Treatment followed clinical practice except mandatory OCT examination during the 12-month observation period. VRQoL was assessed by NEI VFQ-25 and compared with respect to OCT examinations and number of intravitreal injections in the different diseases (nAMD, DME, BRVO, CRVO). Results: 1478 patients (74.5 ± 10.9 years, 54.9% female) were included in the analysis. Patients had neovascular AMD (65.2%), DME (18.4%), BRVO (9.5%), or CRVO (6.9%). 8.8 ± 2.6 OCT examinations and 6.1 ± 3.2 intravitreal injections were performed within 12 months. VRQoL differed between indications at baseline, with substantially lower values for neovascular AMD and CRVO. After twelve months, an increase in visual acuity and visual functional scale was observed for nAMD, DME, and BRVO, while in DME only, there was an association between number of OCT examinations and VRQoL. Conclusion: Intravitreal treatment was able to maintain VRQoL over twelve months in a real-world setting. Regular OCT examinations were associated with higher gain in VRQoL in DME patients after 12 months.

Background: To evaluate the effect of crosslinking (CXL) with riboflavin for keratoconus (KC) therapy on quality of life (QoL): comparison of keratoconus patients with and without treatment. Methods: Prospective monocentric study. We recruited patients with progressive KC and with stable disease. Patients with progressive disease received cross-linking treatment; patients with stable disease were monitored. We compared QoL in both groups over 6 months and detected the influence of cross-linking treatment on QoL. QoL was assessed by NEI-VFQ-25, EQ-5D 5L, and EQ-Visual analog scale (VAS). In the evaluation of the Nei VFQ, the subgroups LFVFS and LFSES were calculated. Results: We enrolled 31 eyes of 31 patients in the intervention group and 37 eyes of 37 patients in the control group. Medians with standard deviations (SD) were calculated. All QoL-tests showed equal scores at baseline in both groups. At V2, one day after the treatment, EQ-VAS (56.4), LFVFS (57.4), and EQ5D5L (0.59) were significantly reduced. At V3 (one week after treatment), all results returned to baseline level. LFSES was not affected by the treatment. It remained stable (V2 85.4, V3 84.3). Comparing the baseline scores with the follow-up scores at month 6, we found a significant increase in QoL in all tests in the intervention group. Otherwise, the quality of life in the control group did not change over time. Conclusions: Cross-linking led only to a short-term reduction in QoL. Although the treatment is painful for a few days, no effect on general quality of life LVSES has been demonstrated. QoL already returned to baseline after one week and the patients were not limited anymore.

Zusammenfassung Hintergrund Die Therapieoptionen beim Glaukom sind vielfältig. Das ruft die Frage hervor, welche Verfahren sich in der Alltagsversorgung als praktikabel und sinnvoll erweisen. Unter den Mitgliedern der Deutschen Ophthalmologischen Gesellschaft (DOG) und des Berufsverbands der Augenärzte Deutschlands (BVA) wurde eine anonymisierte Befragung durchgeführt, um die aktuelle Versorgungspraxis für Deutschland abzubilden. Ziel der Arbeit Diese Publikation gibt ein Meinungsbild unter der deutschen Augenärzteschaft wieder zur aktuellen Glaukomversorgung, Therapiestrategien und der Rolle der Glaukomchirurgie. Material und Methoden Die Befragung wurde durch einen Online-Fragebogen mit 26 Fragen (107 Antwort-Items) zur praktizierten Glaukomversorgung durchgeführt. Vollständige Fragebögen lagen von 1361 Personen vor. Ergebnisse 84,8 % der Befragten formulieren einen Zieldruck „häufig“ bis „eher häufig“. Einen systemischen Therapieansatz verfolgen 44,9 %. Zwei Drittel der Befragten stellen eine Beeinträchtigung der Lebensqualität durch Nebenwirkungen von Augentropfen fest, wovon konjunktivale Rötung und Brennen am häufigsten sind. Durchschnittlich schätzen Augenärzte 32 % der Patienten als non-adhärent in ihrer Therapie ein. Bei 5–10 % der Patienten erfolgt eine glaukomchirurgische Therapie. Unter den interventionellen Therapieverfahren halten über 90 % die Trabekulektomie für sinnvoll, gefolgt von minimal-invasiven Operationsverfahren (MIGS) und der selektiven Lasertrabekuloplastik (SLT). MIGS und SLT werden jedoch am häufigsten durchgeführt. Schlussfolgerung Bei der Wahl der Therapieoption gilt es, die gewünschte Dauerhaftigkeit der Drucksenkung mit der Praktikabilität und Zumutbarkeit der Verfahren zu harmonisieren. Dem Wunsch nach mehr Übersicht und Struktur der Glaukomversorgung sollte Rechnung getragen werden.

Objectives: The COVID-19 pandemic and its protective measures have changed the daily lives of families and may have affected quality of life (QoL). The aim of this study was to analyze gender differences in QoL and to examine individuals living in different partnership and family constellations.Methods: Data from the Gutenberg COVID-19 cohort study (N = 10,250) with two measurement time points during the pandemic (2020 and 2021) were used. QoL was assessed using the EUROHIS-QOL questionnaire. Descriptive analyses and autoregressive regressions were performed.Results: Women reported lower QoL than men, and QoL was significantly lower at the second measurement time point in both men and women. Older age, male gender, no migration background, and higher socioeconomic status, as well as partnership and children (especially in men), were protective factors for QoL. Women living with children under 14 and single mothers reported significantly lower QoL.Conclusion: Partnership and family were protective factors for QoL. However, women with young children and single mothers are vulnerable groups for lower QoL. Support is especially needed for women with young children.

Purpose Anti-retinal autoantibodies are assumed to be associated with age-related macular degeneration (AMD). To our knowledge, this is the first evaluation of autoantibodies in human sera of participants with different stages of AMD in a large population-based, observational cohort study in Germany. Methods The Gutenberg Health Study (GHS) is a population-based, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. Amongst others, non-mydriatic fundus photography (Visucam PRO NM™, Carl Zeiss Meditec AG, Jena, Germany) was performed. Fundus images of the first 5000 participants were graded based on the Rotterdam Eye Study classification. Sera of participants with AMD (n=541) and sera of age-matched participants without AMD (n=490) were analyzed by antigen-microarrays. Besides descriptive statistics, autoantibody-levels were compared by Mann-Whitney-U test and the associations of level of autoantibodies with AMD were calculated by logistic regression analysis. Likewise, possible associations of the autoantibodies and both clinical and laboratory parameters on AMD subjects were analyzed. Results Autoantibodies against transferrin (pp=0.041), glutathione peroxidase 4 (p=0.048), clusterin (p=0.045), lysozyme (p=0.19), protein kinase C substrate 80K-H (p=0.02), heat shock 70 kDa protein 1A (p=0.04) and insulin (p=0.018) show a trend between Control and participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only. Conclusions This study contributes to a growing knowledge of autoantibodies in association with different AMD stages compared to controls in the context of a large population-based study in Germany. Especially autoantibodies against inflammatory proteins were downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only.

Purpose: To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population. Design: Meta-analysis of eleven population-based cohort studies of the European Eye Epidemiology (E3) consortium. Participants: A total of 143240 participants were included in the glaucoma analyses and 47177 participants in the IOP analyses. Methods: We examined associations of four categories of systemic medications (antihypertensive medications: beta-blockers, diuretics, calcium channel blockers [CCBs], alpha-agonists, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers; lipid-lowering medications; antidepressants; antidiabetic medications) with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Multivariable regression analyses were carried out in each study and results were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in diabetic participants only. Main Outcome Measures: Glaucoma prevalence and IOP. Results: In the meta-analyses of our maximally-adjusted multivariable models, use of CCBs was associated with a higher prevalence of glaucoma (odds ratio [OR] with corresponding 95% confidence interval [95% CI]: 1.23 [1.08 to 1.39]). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR [95% CI]: 1.96 [1.23 to 3.12]). The use of other antihypertensive medications, lipid-lowering medications, antidepressants or antidiabetic medications were not clearly associated with glaucoma. Use of systemic beta-blockers was associated with a lower IOP (Beta [95% CI]: -0.33 [-0.57 to -0.08] mmHg). Monotherapy of both selective (Beta [95% CI]: -0.45 [-0.74 to -0.16] mmHg) and non-selective (Beta [95% CI]: -0.54 [-0.94 to -0.15] mmHg) systemic beta-blockers was associated with lower IOP. There was a suggestive association between use of high-ceiling diuretics and lower IOP (Beta [95% CI]: -0.30 [-0.47; -0.14] mmHg), but not when used as monotherapy. Use of other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were not associated with IOP. Conclusions: We identified a potentially harmful association between use of CCBs and glaucoma prevalence. Additionally, we observed and quantified the association of lower IOP with systemic beta-blocker use. Both findings are potentially important given that glaucoma patients frequently use systemic antihypertensive medications. Determining whether the CCB association is causal should be a research priority. published

The insulator–metal transition in liquid hydrogen is an important phenomenon to understand the interiors of gas giants, such as Jupiter and Saturn, as well as the physical and chemical behavior of materials at high pressures and temperatures. Here, the path toward an experimental approach is detailed based on spectrally resolved x-ray scattering, tailored to observe and characterize hydrogen metallization in dynamically compressed hydrocarbons in the regime of carbon–hydrogen phase separation. With the help of time-dependent density functional theory calculations and scattering spectra from undriven carbon samples collected at the European x-ray Free-Electron Laser Facility (EuXFEL), we demonstrate sufficient data quality for observing C–H demixing and investigating the presence of liquid metallic hydrogen in future experiments using the reprated drive laser systems at EuXFEL.

To investigate the 5-year cumulative incidence and progression of myopic maculopathy in the general population in Germany and to analyze potential risk factors.The Gutenberg Health Study (GHS) is a population-based cohort study including 15 010 participants aged 35 to 74 years at baseline.A total of 494 eyes of 323 participants (mean age, 50.2 ± 9.2 years; median, -7.25 diopters [D] myopic refractive error) without myopic maculopathy at baseline and 34 eyes of 27 subjects (mean age, 56.7 ± 9.1 years; median, -8.75 D myopic refractive error) with myopic maculopathy met the inclusion conditions, phakic eyes with spherical equivalent ≤-6 D (baseline), and had gradable fundus photographs at baseline and 5-year follow-up.Myopic maculopathy incidence and progression were assessed by grading of fundus photographs according to a recent international photographic classification system (META-PM). Multivariable logistic regression analysis was used to assess risk factors for progression of myopic maculopathy.Estimates for incidence and progression of myopic maculopathy.The 5-year cumulative incidence of myopic maculopathy was 0.3% (95% confidence interval [CI], 0.02-1.99; n = 1). Progression occurred in 17 of 34 eyes (50%) with prior myopic maculopathy over 5 years with 4 changes in category. The most common types of progression were enlargement of diffuse and patchy chorioretinal atrophy; a new pathology was present in 8 eyes. Higher intraocular pressure (IOP) (odds ratio [OR], 1.62; 95% CI, 1.51-1.59; P = 0.035) was associated with progression of myopic maculopathy. Female gender (OR, 5.54; 95% CI, 0.93-32.92; P = 0.060) and higher myopic refractive error (OR, 1.62 per diopter; 95% CI, 0.99-1.49; P = 0.063) showed a tendency toward progression.Incidence of myopic maculopathy is rare in highly myopic eyes in the general population aged 35 to 74 years in Germany. Progression of myopic maculopathy in the German population occurred in 50% of highly myopic eyes. We presented population-based 5-year follow-up data on incidence and progression of myopic maculopathy in Europe.

Objective The aim of this prospective pilot study is to establish an initial database to register patients diagnosed with different types of childhood glaucoma and the set-up of a national registry for childhood glaucoma (ReCG) in Germany. 28 children with different types of diagnosed childhood glaucoma, who were admitted and treated at the Childhood Glaucoma Center of the University Medical Center Mainz, Germany were included. Main outcome measures were the type of childhood glaucoma, mean intraocular pressure (IOP) and genetic data of the patients. Results The documents and questionnaires for each individual included: informed consent form of the parents, medical history form of the child, patient’s gestational history questionnaire and general anesthesia examination form. Primary congenital and secondary childhood glaucoma were revealed in 11 (39%) and 17 (61%) patients, respectively. The mean IOP measured with Perkins tonometer in all patients under general anesthesia at the time of inclusion was 17.5 ± 11.8 mmHg in the right and 17 ± 8.9 mmHg in the left eyes. In 33% of children with glaucoma mutations in the CYP1B1, FOXC1, LTBP2 and TEK genes were found. The development of specific questionnaires for childhood glaucoma provides detailed baseline data to establish a ReCG in Germany for the first time.

Previous studies reported significantly altered tryptophan catabolite concentrations in major depression. Thus, tryptophan catabolites were considered as potential biomarkers of depression and their modulators as potential targets for psychopharmacotherapy. However, the results were based mainly on studies with small sample sizes limiting their generalizability. Against this background, we investigated the relationship of peripheral tryptophan catabolites with depression in a population-based sample with n = 3,389 participants (with fasting status ≥ 8 h and C-reactive protein N = 248 had clinically significant depression according to a PHQ-9 score of ≥ 10, n = 1,101 subjects had mild depressive symptoms with PHQ-9 scores between 5 and 9, and n = 2,040 had no depression. After multivariable adjustment, clinically significant depression was associated with lower kynurenine and kynurenic acid. Spearman correlation coefficients of the tryptophan catabolites with the severity of depression were very small (rho ≤ 0.080, p ≤ 0.015). None of the tryptophan catabolites could diagnostically separate depressed from not depressed persons. Concerning linear associations, kynurenine and kynurenic acid were associated only with the severity and the cognitive dimension of depression but not its somatic dimension. Tryptophan catabolites were not associated with persistence or recurrence of depression at the 5 year follow-up. The results replicated the association between kynurenine and kynurenic acid with depression. However, the associations were small raising doubts about their clinical utility. Findings underline the complexity of the relationships between depression and tryptophan catabolites. The search for subgroups of depression with a potentially higher impact of depression might be warranted.

Previous evidence suggested that non-COVID-19-related medical care was reduced during the first wave of the COVID-19 pandemic, but it remained unclear whether or to which extent this effect lasted beyond the first wave, or existed in a longer time frame. Here, we consider questionnaire data of the Gutenberg-COVID-19 study together with pre-pandemic baseline data of the Gutenberg Health Study concerning the region around Mainz, Germany, to study the effects of the pandemic on the provision of medical care until April 2021. We observed that the proportion of cancelled medical appointments was low and that the fraction of participants with a medical appointment as an indicator for the number of appointments being made was in line with pre-pandemic levels. Appointments were more likely cancelled by the patient (rather than the provider), and more likely cancelled by medical specialists such as dentists or ophthalmologists (rather than GPs). In conclusion, we found some evidence that, at least with regard to realized appointments, the medical system and the provision of medical care were not harmed by the COVID-19 pandemic on a longer time scale.

BACKGROUND By identifying diseases of the anterior segment of the eye associated with exposure to UV light, recommendations for action can be derived. AIM After reading this review, the reader should be familiar with UV light-associated diseases of the anterior segment of the eye. METHOD Using a selective literature search, UV light-associated diseases of the anterior segment of the eye were identified and protective mechanisms are described. RESULTS The UV light-associated lesions of the anterior segment of the eye include basal cell and squamous cell carcinomas, malignant melanoma of the eyelids and conjunctiva, pterygium, keratoconjunctivitis photoelectrica and climatic droplet keratopathy as well as cortical cataract. CONCLUSION Eyeglasses for filtering UV light, sunglasses and special safety glasses, such as welding helmets and wearing headgear protect against UV light exposure to the anterior segment of the eye and the associated diseases.

BackgroundWhile chronic exposure to high levels of noise was demonstrated to increase the risk of various cardiovascular diseases, the association between noise annoyance and risk of cardiovascular disease remains still inconsistent. Recently, we showed that noise annoyance is associated with prevalent atrial fibrillation in the general population. However, the association between noise annoyance and risk of incident atrial fibrillation as well as potential sex-differences remain still elusive.Methods and results15,010 subjects from a German population-based cohort were examined at baseline (2007 to 2012) and follow-up five years later (2012 to 2017) to investigative the association between noise annoyance due to multiple sources and prevalent and incident atrial fibrillation. After multivariable adjustment, the results from logistic regression analyses revealed overall consistent and positive associations between noise annoyance and prevalent and incident atrial fibrillation in men, whereas this association was weaker in women, in particular with respect to incident atrial fibrillation. For instance, industrial noise annoyance was associated with 21% (95% confidence interval (CI) 9–34%) and 18% (8–29%) higher odds of prevalent atrial fibrillation in men and women, respectively. In prospective analysis, this association remained stable in men (odds ratio (OR) 1.25, 1.07–1.44), while in women no association was observed (OR 1.03, 0.89–1.18).ConclusionsThe findings suggest that noise annoyance can increase the risk of incident atrial fibrillation in a large population-based cohort and that men may be more sensitive to the adverse effects of noise annoyance with regard to the risk of atrial fibrillation.

Background/Aims: This study investigated whether there are changes in corneal surface regularity and corneal thickness in adults born small, appropriate, or large for gestational age at term. Methods: This retrospective cohort study involved prospective Scheimpflug imaging of the cornea (Pentacam®) to compare the corneal thickness and aberrations between adults classified as small for gestational age (SGA), normal birth weight (BW), and large for gestational age (LGA). Multivariable linear regression was applied to analyze associations with gestational age, BW percentile, placental insufficiency, preeclampsia, and breastfeeding. Results: In total, 448 eyes of 261 individuals born full term (aged 29.9 ± 9.5 years, 140 females) were examined, including 29 severe SGA (BW < 3rd percentile), 32 moderate SGA (BW between 3rd and 90th and 97th percentile), and 33 severe LGA (BW > 97th percentile). There were no differences between groups in the corneal aberrations of the total cornea as well as of the corneal front surface, except for higher-order aberrations in the front of the cornea (p = 0.032). There was an association between the increased total root mean square of higher-order aberrations and lower birth weight percentile (p = 0.004), with increased higher-order aberrations correlating with lower visual acuity and spherical equivalent. Conclusion: Restricted prenatal growth is associated with increased higher-order aberrations in adulthood.

Distinctive large-scale structures have been identified in the spatial distribution of optical galaxies up to redshift z ~ 1. In the more distant universe, the relationship between the dust-obscured population of star-forming galaxies observed at millimetre wavelengths and the network of cosmic filaments of dark matter apparent in all cosmological hydrodynamical simulations is still under study. Using the NIKA2 dual-band millimetre camera, we mapped a field of ~ 90 arcminutes^2 in the direction of the star GJ526 simultaneously in its 1.15-mm and 2.0-mm continuum wavebands to investigate the nature of the quasi-alignment of five sources found ten years earlier with the MAMBO camera at 1.2 mm. We find that these sources are not clumps of a circumstellar debris disc around this star as initially hypothesized. Rather, they must be dust-obscured star-forming galaxies, or sub-millimetre galaxies (SMGs), in the distant background. The new NIKA2 map at 1.15 mm reveals a total of seven SMGs distributed in projection on the sky along a filament-like structure crossing the whole observed field. Furthermore, we show that the NIKA2 and supplemental Herschel photometric data are compatible with a model of the spectral energy distributions (SEDs) of these sources when a common redshift of 2.5 and typical values of the dust parameters for SMGs are adopted. Hence, we speculate that these SMGs might be located in a filament of the distant `cosmic web'. The length of this candidate cosmic filament crossing the whole map is at least 4 cMpc (comoving), and the separations between sources are between 0.25 cMpc and 1.25 cMpc at this redshift, in line with expectations from cosmological simulations. Nonetheless, further observations to determine the precise spectroscopic redshifts of these sources are required to definitively support this hypothesis of SMGs embedded in a cosmic filament of dark matter., Comment: Article accepted in Astronomy and Astrophysics ; 9 pages, 6 figures

Background During the SARS-CoV-2 pandemic, preventive measures like physical distancing, wearing face masks, and hand hygiene have been widely applied to mitigate viral transmission. Beyond increasing vaccination coverage, preventive measures remain urgently needed. The aim of the present project was to assess the effect of protective behavior on SARS-CoV-2 infection risk in the population. Methods Data of the Gutenberg COVID-19 Study (GCS), a prospective cohort study with a representative population-based sample, were analyzed. SARS-CoV-2 infections were identified by sequential sampling of biomaterial, which was analyzed by RT-qPCR and two antibody immunoassays. Self-reported COVID-19 test results were additionally considered. Information on protective behavior including physical distancing, wearing face masks, and hand hygiene was collected via serial questionnaire-based assessments. To estimate adjusted prevalence ratios and hazard ratios, robust Poisson regression and Cox regression were applied. Results In total, 10,250 participants were enrolled (median age 56.9 [43.3/68.6] years, 50.8% females). Adherence to preventive measures was moderate for physical distancing (48.3%), while the use of face masks (91.5%) and the frequency of handwashing (75.0%) were high. Physical distancing appeared to be a protective factor with respect to SARS-CoV-2 infection risk independent of sociodemographic characteristics and individual pandemic-related behavior (prevalence ratio [PR] = 0.77, 95% confidence interval [CI] 0.62–0.96). A protective association between wearing face masks and SARS-CoV-2 transmission was identified (PR = 0.73, 95% CI 0.55–0.96). However, the protective effect declined after controlling for potential confounding factors (PR = 0.96, 95% CI 0.68–1.36). For handwashing, this investigation did not find a beneficial impact. The adherence to protective behavior was not affected by previous SARS-CoV-2 infection or immunization against COVID-19. Conclusion The present study suggests primarily a preventive impact of physical distancing of 1.5 m, but also of wearing face masks on SARS-CoV-2 infections, supporting their widespread implementation. The proper fit and use of face masks are crucial for effectively mitigating the spread of SARS-CoV-2 in the population.

Introduction Prediabetes and type 2 diabetes mellitus (T2DM) are risk factors for heart failure (HF). The association of prediabetes and T2DM to different forms of functional left ventricular impairment and their impact on clinical outcome in the general population needs to be further investigated. In this context, little is known about the prevalences of prediabetes and different HF subtypes in the general population, especially in Europe. Purpose To investigate the prevalence and clinical impact of prediabetes and type 2 diabetes mellitus (T2DM) on functional cardiac disorder (FCD). Methods The participants of the Gutenberg Health Study sample (15,010 subjects, 35–74 years) were stratified in individuals with euglycaemia, prediabetes and T2DM based on clinical information and HbA1c level. FCD included asymptomatic systolic and diastolic dysfunction, symptomatic systolic and diastolic heart failure, asymptomatic diastolic dysfunction and preserved left ventricular ejection fraction (EF), asymptomatic diastolic dysfunction and reduced EF, asymptomatic preserved diastole and reduced EF, symptomatic heart failure with preserved EF (HFpEF) and symptomatic heart failure with reduced EF HFrEF). Using structured follow-up clinical outcome was assessed. Results Overall, 14,870 individuals were included in the present analysis. Among them, 9,426 individuals were categorized in the euglycaemia group, 4,128 participants had prediabetes and in 1,316 individuals T2DM was present. Prevalence of FCD increased from euglycaemia (19.6%) over prediabetes (33.3%) to T2DM (46.8%, p Conclusions In the general population, a high prevalence of asymptomatic FCD is present. Coexisting FCD and prediabetes as well as T2DM result in increased mortality elucidating the need for early detection and prevention of DM development, especially with regard to numerous asymptomatic people concerned. T2DM, but not prediabetes, is a risk factor for incident FCD. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): The Gutenberg Health Study is supported by the government of Rheinland-Pfalz (`Stiftung Rheinland-Pfalz für Innovation'), the research programmes `Wissen schafft Zukunft' and the Centre forTranslational Vascular Biology (CTVB) of the Johannes Gutenberg-University of Mainz, Germany, and its contract with Boehringer Ingelheim and Philips Medical Systems including an unrestricted grant forthe Gutenberg Health Study. P.S.W. and J.H.P. are funded by the Federal Ministry of Education and Research (BMBF 01EO1503). P.S.W. and T.M. are principal investigators of the German Center for Cardiovascular Research (DZHK). P.S.W. is principal investigator of the DIASyM research core (BMBF 161L0217A).

Objectives This study investigated the effects of prematurity and ROP on visual acuity and VRQoL in adults (18–52 years). Methods The Gutenberg Prematurity Eye Study is a retrospective cohort study with a prospective ophthalmologic examination. Preterm and full-term participants at an age from 18 to 52 years were included. Distant corrected visual acuity (DCVA) and VRQoL were assessed in participants (892 eyes of 450 individuals aged 28.6 ± 8.6 years, 251 females) grouped into full-term controls (gestational age [GA] at birth ≥37 weeks), preterm participants without ROP and GA 33–36 weeks (group 2), GA 29–32 weeks (group 3), GA ≤ 28 weeks (group 4), non-treated ROP (group 5) and treated ROP (group 6). Main outcome measures were distant corrected visual acuity (DCVA), VRQoL and prevalence of amblyopia. Results The DCVA of the better eye correlated (p Conclusion Participants with postnatal ROP and its treatment showed decreased visual acuity and VRQol in adulthood, with amblyopia occurring more frequently in more preterm participants with ROP.

Extreme conditions inside ice giants such as Uranus and Neptune can result in peculiar chemistry and structural transitions, e.g., the precipitation of diamonds or superionic water, as so far experimentally observed only for pure C─H and H 2 O systems, respectively. Here, we investigate a stoichiometric mixture of C and H 2 O by shock-compressing polyethylene terephthalate (PET) plastics and performing in situ x-ray probing. We observe diamond formation at pressures between 72 ± 7 and 125 ± 13 GPa at temperatures ranging from ~3500 to ~6000 K. Combining x-ray diffraction and small-angle x-ray scattering, we access the kinetics of this exotic reaction. The observed demixing of C and H 2 O suggests that diamond precipitation inside the ice giants is enhanced by oxygen, which can lead to isolated water and thus the formation of superionic structures relevant to the planets’ magnetic fields. Moreover, our measurements indicate a way of producing nanodiamonds by simple laser-driven shock compression of cheap PET plastics.

The Global Atmospheric Passive Sampling (GAPS) network, initiated in 2005 across 55 global sites, supports the global monitoring plan (GMP) of the Stockholm Convention on Persistent Organic Pollutants (POPs) by providing information on POP concentrations in air on a global scale. These data inform assessments of the long-range transport potential of POPs and the effectiveness evaluation of chemical regulation efforts, by observing changes in concentrations over time. Currently, measurements spanning 5–10 sampling years are available for 40 sites from the GAPS Network. This study was the first time that POP concentrations in air were reported on a global scale for an extended time period and the first to evaluate worldwide trends with an internally consistent sample set. For consistency between sampling years, site- and sample specific sampling rates were calculated with a new, public online model, which accounts for the effects of wind speed variability. Concentrations for legacy POPs in air between 2005 and 2014 show different trends for different organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs). The POPs discussed in this study were chosen due to being the most frequently detected, with detection at the majority of sites. PCB, endosulfan, and hexachlorocyclohexane (HCH) concentrations in air are decreasing at most sites. The global trends reflect global sources and recycling of HCH, ongoing emissions from old stockpiles for PCBs, and recent use restrictions for endosulfan. These chlorinated OCPs continue to present exposure threat to humans and ecosystems worldwide. Concentrations of other OCPs, such as chlordanes, heptachlor and dieldrin, are steady and/or declining slowly at the majority of sites, reflecting a transition from primary to secondary sources (i.e., re-emission from reservoirs where these POPs have accumulated historically) which now control ambient air burdens., This study examines temporal trends of persistent organic pollutants in air on a global scale to assess the effectiveness of restrictions and the impact of secondary source emissions to atmospheric levels.

Trabeculectomy represents the glaucoma surgical procedure that achieves the greatest reduction in intraocular pressure and enables a low pressure regulation especially in normal pressure glaucoma. For the beginner the operation is challenging due to potential intraoperative and postoperative difficulties. With this in mind this article explains how to learn to perform a trabeculectomy and explains the various steps from assessing the indications via training, performing the surgery independently and follow-up care. The article points out the challenges during the procedure and the possible solutions and explains the individual aftercare using the Mainz treatment scheme as an example. In this way, the risk of serious complications can be reduced to a minimum and in the vast majority of patients a sufficient regulation of intraocular pressure can be achieved without the need for eye drops.Die Trabekulektomie stellt die glaukomchirurgische Maßnahme dar, die die größte Drucksenkung erzielt und insbesondere bei Normaldruckglaukom eine niedrige Druckregulation ermöglicht. Für den Anfänger stellt die Operation aufgrund möglicher intraoperativer und postoperativer Schwierigkeiten eine Herausforderung dar. Vor diesem Hintergrund erläutert dieser Beitrag das Vorgehen beim Erlernen einer Trabekulektomie und erklärt die verschiedenen Schritte von Indikationsstellung über das Anlernen und die selbstständige Durchführung der Operation bis hin zur Nachsorge. Der Beitrag weist auf Herausforderungen bei der Operation und deren Lösungsmöglichkeiten hin und erklärt die individuelle Nachsorge am Beispiel des Mainzer Therapieschemas. Hierdurch kann das Risiko für schwerwiegende Komplikationen auf ein Minimum gesenkt und bei den allermeisten Patienten eine ausreichende Tensioregulation ohne Augentropfennotwendigkeit erzielt werden.

Prematurity and the presence of retinopathy of prematurity (ROP) increase the risk for the occurrence of amblyogenic risk factors in childhood and adolescence.The aim of the present study was to evaluate ocular morbidities and the ophthalmological care of former preterm and full-term persons in adulthood.The Gutenberg prematurity eye study (GPES) is a retrospective cohort study with a prospective ophthalmological examination of individuals formerly born preterm and full term between 1969 and 2002 (now aged 18-52 years). All participants underwent a detailed ophthalmological examination and were asked about the frequency of ophthalmological care. Participants were grouped into those with normal gestational age (GA) ≥ 37 weeks (control group), preterm individuals without ROP and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤ 28 weeks (group 4), and those with ROP without treatment (group 5) and with ROP with treatment (group 6). All participants were asked if they had an ophthalmological examination within the last 12 months.In total, data from 140 term and 310 preterm adults were included in the present study. Strabismus was present in 2.1 % (3/140), 6.6 % (9/137), 17.4 % (16/92), 11.1 % (2/18), 27.1 % (13/48) and 60 % (9/15) in groups 1-6, respectively. The proportion of subjects with an ophthalmological examination within the last 12 months was highest in the groups of extremely preterm persons with and without ROP compared with the control group. Overall, 33.3 % (1/3) of the term and 57.1 % (28/49) of the preterm subjects with strabismus and 0 % (0/3) of the term and 46.9 % (15/32) of the preterm individuals with amblyopia had an ophthalmological examination within the past 12 months.Extremely preterm adults with and without postnatal ROP showed the highest rate of eye diseases as well as the highest rate of ophthalmological check-ups within the last 12 months. This suggests that extremely preterm adults particularly with the occurrence of postnatal ROP perceive more frequent ophthalmological check-ups throughout their lives.HINTERGRUND: Frühgeburtlichkeit und das Auftreten der Frühgeborenenretinopathie (ROP) erhöhen das Risiko für das Auftreten von amblyogenen Risikofaktoren in der Kindheit und Jugend.Das Ziel der vorliegenden Studie war die Beschreibung der augenärztlichen Versorgung und der Augenerkrankungen ehemaliger früh- und reifgeborener Personen im Erwachsenenalter.Die Gutenberg Prematurity Eye Study (GPES) ist eine retrospektive Kohortenstudie mit einer prospektiven augenärztlichen Untersuchung von ehemaligen früh- und reifgeborenen Personen, geboren zwischen 1969 und 2002 (aktuelles Alter 18 bis 52 Jahre). Alle Teilnehmenden wurden hinsichtlich amblyogener Parameter wie z. B. dem Vorliegen eines Strabismus und von Refraktionsfehlern untersucht. Die Teilnehmenden wurden gruppiert in Personen mit normalem Gestationsalter (GA) ≥ 37 (Kontrollgruppe), Frühgeborene ohne ROP mit GA 33–36 (Gruppe 2), GA 29–32 (Gruppe 3), GA ≤ 28 Wochen (Gruppe 4) und solche mit ROP ohne Behandlung (Gruppe 5) und mit ROP mit Behandlung (Gruppe 6). Es wurde von allen Teilnehmenden erhoben, wie oft sie innerhalb der letzten 12 Monate bei einer augenärztlichen Untersuchung gewesen sind.Insgesamt wurden die Daten von 140 reifgeborenen und 310 frühgeborenen Erwachsenen in die vorliegende Studie eingeschlossen. Ein Strabismus lag bei 2,1 % (3/140), 6,6 % (9/137), 17,4 % (16/92), 11,1 % (2/18), 27,1 % (13/48) und 60 % (9/15) in den jeweiligen Gruppen 1 bis 6 vor. Der Anteil an Probanden mit augenärztlicher Untersuchung innerhalb der letzten 12 Monate war in den Gruppen der extrem Frühgeborenen mit und ohne ROP im Vergleich zur Kontrollgruppe am höchsten. Insgesamt waren 33,3 % (1/3) der Reifgeborenen und 57,1 % (28/49) der Frühgeborenen mit Strabismus und 0 % (0/3) der Reifgeborenen und 46,9 % (15/32) der Frühgeborenen mit Amblyopie innerhalb der letzten 12 Monate bei einer augenärztlichen Untersuchung.Extrem frühgeborene Personen mit und ohne postnatale ROP zeigten die höchste Rate an Augenerkrankungen sowie die höchste Rate an augenärztlichen Kontrolluntersuchungen innerhalb der letzten 12 Monate. Dies deutet darauf hin, dass extrem frühgeborene Personen insbesondere mit postnataler ROP insgesamt lebenslang häufigere augenärztliche Kontrolluntersuchungen wahrnehmen.