[ChatGPT and the German board examination for ophthalmology: an evaluation].

Purpose: In recent years artificial intelligence (AI), as a new segment of computer science, has also become increasingly more important in medicine. The aim of this project was to investigate whether the current version of ChatGPT (ChatGPT 4.0) is able to answer open questions that could be asked in the context of a German board examination in ophthalmology.

Impact of the COVID-19 pandemic's first wave on the care and treatment situation of intravitreal injections in a German metropolitan region.

Purpose: This study aims to evaluate the impact of the first coronavirus 2019 (COVID-19) wave in 2020 on patients scheduled for intravitreal injections (IVI) in a German metropolitan region.

Methods: We performed a multicentre prospective survey and retrospective analysis of the records of patients treated with intravitreal injections during the 20-week period from March to July 2020 in all four hospital eye departments in the city of Hamburg using a questionnaire (on treatment adherence, SarsCoV2-related personal, familial and social data) and treatment data.

Results: A total of 1038 patients (2472 IVI, 1231 eyes) and 818 questionnaires were evaluated.

[Bilateral effusion syndrome induced by chlorthalidon].

Uveal effusion can lead to anterior swelling of the choroid up to angle-closure glaucoma. This article reports the case of a 57-year-old male patient who presented with headache, vertigo and bilaterally reduced visual acuity. The examination showed a myopic shift and angle-closure glaucoma caused by uveal effusion.

[Management of anticoagulants in ophthalmic surgery-a survey among ophthalmic surgeons in Germany].

Introduction: As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations.

[Tarsal Kink: Pathognomonic Presentation and Therapy of a Rare Congenital Upper Eyelid Malformation].

Background: Presentation of a congenital abnormality that is rare, but follows a distinct course and can be diagnosed and cured promptly if the pathognomonic presentation is recognized. A congenital tarsal kink leads to a malposition of the upper eyelid margin that must not be missed, as it will lead to ulcerative keratitis if it is not treated.

Case Presentation: An otherwise healthy newborn was presented after delivery with forceps with marked unilateral purulent secretion and blepharospasm.

[Postoperative care and options for scar treatment in eyelid surgery].

Oculoplastic surgery places special demands on postoperative care because of the functional importance of the eyelids for the ocular surface. We present an overview of postoperative care after surgical eyelid interventions. All options, limits and the scientific evidence are discussed with a special focus on the treatment of postoperative edema, analgesia, infection prophylaxis and scar treatment.

[Indications and techniques for intubation of the lacrimal ducts].

There are several well established methods to correct congenital and acquired lacrimal canalicular stenosis. The primary goal of all these surgical methods is the reopening and recanalization of a functional lacrimal pathway. Intubation by bicanalicular or monocanalicular silicone tubes has been established as a means of enhancing the redevelopment of a smooth epithelial surface and keeping the recanalized tear ducts continuously open.

[Lower lid entropion and ectropion. Indication, technique and key points of "classical" surgical methods].

Lower lid malposition is common, increases with age and leads to impaired optical function of the ocular surface through chronic irritation of the conjunctiva and cornea. Numerous techniques have been described to reposition the lid margin to the globe and secure this position while maintaining intact motility. Some of these techniques have passed the test of time and have reached the status of "classic" standard procedures that need to be in the armamentarium of every oculoplastic surgeon.

[Simple rules for orientation in transcutaneous ptosis surgery--a contribution to the surgical anatomy or: how not to get lost in the upper eyelid].

Surgical preparation in the upper eyelid follows well defined anatomic structures. Nevertheless, even an experienced surgeon can loose orientation in the presence of fatty degeneration, oedema or bleeding. Some simple rules can help to stay oriented and identify the landmarks.

Expression profile of aquaporins in human nasolacrimal duct epithelium.

Purpose: To determine whether the epithelium of the human nasolacrimal ducts contains aquaporins (AQPs), a family of membrane proteins that function as selective pores and are able to transport water, glycerol, and other small solutes across the cell plasma membrane.

Methods: Expression of AQPs 0 and 1-10 in human nasolacrimal duct tissue was determined by reverse transcription polymerase chain reaction (RT-PCR). Positive PCR amplification products were verified by direct cDNA sequencing.

[Epiphora. Age-related changes of the ocular surface, eyelid function and the efferent tear ducts].

Symptomatic epiphora is predominantly present in the elderly It is caused either by hypersecretion in ocular surface disorders, mostly as a reflex, by decreased tear transport and mechanical stenosis of the efferent tear ducts. These three different causes have to be taken into consideration by differential diagnosis and lead to different forms of therapy. Ocular surface disorders (wet dry eye) are treated by topical medication, lid malfunctioning and dacryostenosis by surgery and possibly by topical adjuvant anti-inflammatory medication.

Drainage of tears: impact on the ocular surface and lacrimal system.

The human efferent tear ducts are part of the lacrimal system. Because little knowledge exists concerning the physiology of the nasolacrimal system, and hence its patho- physiology, the nasolacrimal system has received almost no consideration as a possible factor in dry eye. The human nasolacrimal ducts consist of the upper and the lower lacrimal canaliculus, the lacrimal sac, and the nasolacrimal duct.

TFF peptides and mucins are major components of dacryoliths.

Purpose: The study was performed to determine whether trefoil factor peptides (TFF) and/or mucins are components of dacryoliths and to gain further insight into dacryolith composition and formation.

Methods: Twenty dacryoliths found in lacrimal surgery in patients suffering from primary acquired nasolacrimal duct obstruction were analyzed for the presence of TFF peptides (TFF1, 2, 3), mucins (MUC1, 2, 3, 4, 5AC, 5B, 6, 7, 8), defense cells (T- and B lymphocytes, macrophages, neutrophils), and antimicrobial substances (alpha defensins 1-3, secretory phospholipase A(2)) by means of light microscopy, histochemistry, immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR.

Results: All dacryoliths except one revealed clear immunoreactivity for all three TFF peptides.

Differential expression of vascular endothelial growth factor implies the limbal origin of pterygia.

Objective: To study the distribution of isoforms of vascular endothelial growth factor (VEGF) and its receptors VEGFR1 and VEGFR2 in pterygia and to compare it with that in healthy conjunctivas.

Design: Nonrandomized comparative (cadaver controlled) study with histopathologic correlations.

Methods: Tissue specimens from 75 patients treated for primary pterygia were analyzed using immunohistochemical studies as well as different molecular biological examinations.

[Orbital stabilisation with suprabrow myofascial transposition flaps].

Background: Common reasons for orbital defects are midfacial traumas or defects following tumor resection within the sinu-orbital region. In these cases, reconstruction of the medial or inferior orbital wall often is required. Common materials for orbital reconstruction, such as titanium-mesh, are used where epithelialisation problems are frequently encountered.

Upper and lower eyelid reconstruction for severe disfiguring necrobiotic xanthogranuloma.

Background: Necrobiotic xanthogranuloma is a rare disease featuring generalized xanthomatous inflammatory skin lesions associated with paraproteinemia and possible lymphoproliferative diseases. Eyelid involvement can be unilateral or bilateral and ranges from minor xanthelasma-like lesions to severe ulcerative disease with consecutive keratitis and scleritis.

Case Report: The authors report the case of a 67-year-old woman with extensive necrobiotic xanthogranuloma involving the eyelids, head and neck, anterior chest, and both upper and lower extremities.

[Optical coherence tomography for macular edema. Classification, quantitative assessment, and rational usage in the clinical practice].

Optical coherence tomography (OCT) allows for morphological assessment of macular edema of various origins by producing two-dimensional images of the retina. In addition, retinal thickness can be measured quantitatively. In diabetic maculopathy, damage of the blood-retinal barrier can be indirectly assessed by locating the intraretinal fluid accumulation and the progress of maculopathy from diffuse to cystoid edema and even rupture of the retinal structure can be described as well as the formation of neurosensory retinal detachment with subretinal fluid.

[Transposition flaps for reconstruction of deep defects of the medial eyelids. Fasciocutaneous rotations- and transposition flaps and modified pure fascial transposition flap].

Tumor resection in the medial canthal area may result in deep defects with involvement of the ethmoidal bone and destruction of the lacrimal ducts. While shallow defects with little involvement of bone can be covered with the classic glabellar flap, deep defects require larger fasciocutaneous flaps from the forehead that can also be used for the reconstruction of the involved medial parts of the eyelids. The preferred techniques of the median or paramedian transposition flaps and a modified paramedian fascial flap for reconstruction of the medial orbital wall and support of the orbit are described.

[Endovascular treatment of extensive carotid cavernous fistulas by superior ophthalmic vein approach. Technique and illustration of two cases].

Treatment of carotid cavernous fistulas is a domain of interventional neuroradiolgy. In rare cases, however, the cavernous sinus cannot be reached by an endovascular approach, leaving the access via the superior ophthalmic vein as the last therapeutic option. History, diagnostic findings, and operative procedure for a patient with spontaneous, indirect CCF (Barrow type D) and a patient with traumatic, direct CCF (Barrow type A) are described.

[Tear outflow. Impact of mucins and TFF-peptides].

The epithelial lining of the lacrimal sac and the nasolacrimal duct consists of pseudo-stratified, columnar epithelia rich in goblet cells. Major secretory products of the epithelial cells are mucins together with TFF peptides. Expression and distribution of several mucins and TFF peptides in the human efferent tear ducts was investigated by means of reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry.

Characterization of mucins in human lacrimal sac and nasolacrimal duct.

Purpose: Mucins are polymers that may reduce drag and enhance tear outflow. Mucin expression and distribution in human efferent tear ducts were tested in the physiological state, and potential differences in the expression pattern were investigated in the presence of primary acquired dacryostenosis (PANDO).

Methods: Expression of mucins in human lacrimal sac and nasolacrimal ducts was monitored by reverse transcription-polymerase chain reaction analysis.