[Retinal exudative disease in childhood: Coats' disease and familial exudative vitreoretinopathy (FEVR)]. / Retinal exsudative Gefäßerkrankungen im Kindesalter: Morbus Coats und familiär exsudative Vitreoretinopathie (FEVR).

This article reviews the pathophysiology of retinal vascular disease with emphasis on Coats' disease and familial exudative vitreoretinopathy (FEVR). Both Coats' disease and FEVR demonstrate vascular abnormalities and associated exudation. Coats' disease manifests as teleangiectasia and aneurysms. Exudative subretinal lipid deposits can be extensive. Coats' disease is in 90 % unilateral and affects predominantly otherwise healthy young males. If the retina is attached, laser and cryocoagulation are the method of choice. Vitreoretinal surgery is only rarely indicated in advanced cases after a retinoblastoma has been excluded prior to surgery. FEVR inheritance is 56 % dominant (FZD4 und TSPAN12) and 44 % recessive (LRP5 und NDP). Temporal dragging of the vascular arcades and heterotopia of the macula are characteristic for FEVR. Subretinal exudates are indicators for progression of the disease with visual loss due to subsequent exudative or tractive retinal detachment. Exudative forms require treatment and reduction of peripheral ischaemia with laser photocoagulation and cryopexia. In cases of tractive detachments vitreoretinal surgery is necessary. Coats' disease and FEVR are both progressive diseases requiring lifelong follow-up and therapy.

First experimental and clinical results with transscleral optical coherence tomography.

BACKGROUND AND OBJECTIVE: To evaluate the potentials of optical coherence tomagraphy (OCT) using long wavelength to penetrate highly scattering tissues of the eye and visualize the anterior chamber angle and the ciliary body. METHODS: OCT images were generated by an experimental prototype in enucleated porcine eyes using as light source a superluminiscent diode with a wavelength of 1310 nm and a scan frequency of 60 Hz. The number of lateral scans was variable in a range from 100 to 400. RESULTS: Infrared OCT was able to penetrate the sclera. The anterior chamber angle could be visualized completely and the ciliary body could be identified. However, it was not possible to penetrate the highly reflective iris pigment epithelium. CONCLUSION: The use of infrared OCT allows penetration of the sclera, thus, providing complete visualization of the anterior chamber angle and limited demonstration of the ciliary body. Because of its higher resolution, it may represent an interesting noninvasive alternative to ultrasound biomicroscopy.

[Changes in extracellular matrix in the lamina cribosa of patients with secondary glaucoma]. / Veränderungen der Extrazellulärmatrix in der Lamina cribrosa von Patienten mit sekundärem Glaukom.

The aim of this study was to analyze the localization and distribution of extracellular matrix in normal and glaucomatous damaged optic discs using immunohistochemical methods. Five eyes donated for corneal allografting without any history of glaucoma and three other eyes with secondary glaucoma were studied. Immunohistochemical reactions were performed with antibodies against collagen types I, III, IV and VI and against laminin, proliferating antigen KI67 and GFAP. In glaucomatous eyes the characteristic arrangement of collagen fibrils is lacking. Septa of the lamina cribrosa appear enlarged. The immunoreactivity of all examined collagen types is stronger in glaucomatous eyes. The axon basement membranes show an irregular and interrupted pattern. The number of proliferating cells with positive GFAP staining in glaucomatous cribriform plates is distinctly higher. We postulate that fibroblasts and astrocytes in the stroma of glaucomatous lamina cribrosa could be stimulated to increased and uncontrolled proliferation. Associated disorganization and raised secretion of extracellular matrix may lead to axon constriction and, secondarily, to neural degeneration.