Various inflammatory and non-inflammatory eye diseases are associated with specific HLA isotypes. Therefore, HLA isotyping can be a useful diagnostic tool for these diseases and has already been shown to reduce the rejection rate of corneal allografts. Unfortunately, the volume of published data and the varying quality of these publications complicate obtaining good overview in this field. This review briefly summarizes the genetic structure of the HLA system and elucidates differences between HLA classes I and II in the context of antigen presentation. Possible mechanisms of HLA associations in the field of ophthalmology are discussed, and finally different tools (e.g. genome wide association studies) for assessing associations of HLA isotypes with different ocular diseases are examined.

An 89-year-old patient presented in an emergency situation with a perforated corneal ulcer of neurotrophic genesis. An operative treatment with a Tutopatch® was performed. In the course of treatment a reorganization of the Tutopatch® into corneal tissue resulted and a subsequent satisfactory defect covering with maintenance of visual acuity. Tutopatch® represents a good alternative for covering perforated corneal ulcers.

BACKGROUND:

Previous studies have proven that long-lasting success in the therapy of neovascular age-related macular degeneration (AMD) and other neovascular retinal diseases depends on monthly follow-up examinations to assess visual acuity and retinal morphology.

MATERIALS AND METHODS:

The interactive database Bonn ophthalmology online network (BOON) offers a platform for patient monitoring, increasing control reliability and providing a tool for permanent communication between treating centers and referring ophthalmologists. The BOON data-based project started in 2009 at the department of ophthalmology at Bonn University and ten referring ophthalmology practices. It was programmed to communicate diagnostic findings, images and patient appointments online. In order to react promptly the system gave immediate notice if patients had missed a follow-up appointment or the condition had worsened. Patients were recruited in 2009 and 2010 and were followed for 1 year. Each patient had an electronic master file with several registers in which, besides personal data, precise diagnostic findings, imaging and reports were quickly and easily entered by means of detailed check box and drop-down menus. Each follow-up was registered and an alert email was sent to the referring physician in cases of missed appointments or disease progression.

RESULTS AND CONCLUSIONS:

The BOON database supports the requirements for a fast and detailed communication between treating and referring physicians in the treatment of patients with AMD as well as other retinal diseases. It was programmed to support data exchange and monthly control visits and thus a better patient management. Results will show whether this helps to enhance long-term treatment success in neovascular diseases.

BACKGROUND:

There is currently no effective therapy for retinal artery branch occlusion (RABO). Transluminal Nd:YAG embolectomy (TYE) was developed to achieve rapid reperfusion; however, it is still a subject of controversy. A Nd:YAG laser is focused on the occluded vessel, the vessel wall is ruptured and the embolism dislocates to the vitreous humor through the opening in the artery.

METHOD:

We retrospectively examined the results of five patients treated with TYE.

RESULTS:

The age of the patients was 26-75 years (mean age 58 years, median 68 years). Initial visual acuity was hand movements to 1.0 and all patients had visual field defects. Treatment was performed between 4 and 30 h from the onset of symptoms. Visual acuity improved markedly in two cases the next day (hand movements to 0.8 and 0.4 to 1.0) and final visual acuity was between 0.8 and 1.25. All treatments led to vitreous hemorrhage but only one patient required surgical treatment. The range of follow-up was 4-42 months.

CONCLUSIONS:

The results are in accordance with those published in the literature. It can be concluded that TYE is a fast, easy and readily available method that should be taken into account especially in cases with low initial visual acuity.

Amniotic membrane transplantation has been used very successfully in ophthalmology since the 1940s for treatment of surface disorders. Over the course of the years the indications for use have been continuously extended. In contrast the operative technique is predominantly invasive, i.e. the amniotic membrane is surgically sutured onto the surface of the eye. In order to avoid surgical trauma the authors have developed a device which allows the amniotic membrane to be stretched in a ring and the amniotic ring can then be placed suture-free on the eye surface. The authors are hopeful that the biological principle of the amniotic membrane can be better utilized by uncomplicated repetitive application.

Ocular myasthenia gravis, although clinically often characterized by typical classical features, can cause considerable diagnostic problems. This article aims to provide a pragmatic approach to the pathogenesis, clinical features, diagnostics and therapeutic strategies in the clinical routine.