[Central toxic keratopathy after photorefractive keratectomy]. / Zentrale toxische Keratopathie nach photorefraktiver Keratektomie.

Central toxic keratopathy is a rare complication following laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) and may unfavorably influence best-corrected visual acuity and refraction. Because of the growing number of refractive surgical procedures worldwide there may be an increasing incidence of this disorder. A differentiation from an inflammatory or infectious etiology is necessary for the appropriate treatment.

[Choroidal osteoma]. / Aderhautosteom.

Choroidal osteoma is a rare benign osseous tumor of the choroid usually affecting young healthy women. The diagnosis can be confirmed by the clinical appearance and with use of fluorescein or indocyanine angiography, optical coherence tomography, computed tomography or magnetic resonance imaging. A direct therapy of the tumor is indicated only for a few cases. The main reasons for vision loss are choroidal neovascularization, subretinal fluid and changes in the photoreceptor layer or the retinal pigment epithelium. Choroidal neovascularization and subretinal fluid in particular can be treated with laser therapy, photodynamic therapy or vascular endothelial growth factor inhibitors.

[Tuberculosis-associated posterior uveitis]. / Tuberkuloseassoziierte Uveitis posterior.

The commercially available interferon gamma release assays T-SPOT.TB and QuantiFERON-TB Gold/QuantiFERON-TB Gold In-Tube may be important, besides the direct detection with culturing, PCR or the Mantoux skin test, for the diagnosis of tuberculosis as a possible cause of uveitis. It is important to know the limitations of these tests to get a fast and reliable diagnosis which may necessitate initiation of causative treatment of the tuberculosis to prevent further damage to the eye and to avoid multi-drug resistant tuberculosis strains.

[Female patient with Muir-Torre syndrome]. / Patientin mit Muir-Torre-Syndrom.

Muir-Torre syndrome is a rare form of genodermatosis characterized by sebaceous tumours or keratocanthoma and early occurrence of intestinal malignancies. In addition to the patient history immunohistochemical and genetic analysis for microsatellite instability and reduced expression of the mismatch repair gene MSH2 and MLH1 can be used to confirm the diagnosis. Because of this important association, Muir-Torre syndrome should be excluded if a patient presents with a sebaceous tumour.

Helicobacter pylori vacA, iceA, and cagA status and pattern of gastritis in patients with malignant and benign gastroduodenal disease.

OBJECTIVE: Both bacterial virulence factors and the pattern of Helicobacter pylori (H. pylori) gastritis may contribute to the development of clinically relevant gastroduodenal disease. The aim of our study was to investigate the frequency of H. pylori vacA alleles, iceA, and cagA, and the pattern of gastritis in patients with gastric cancer (GC), gastric lymphoma (MALT), duodenal ulcer (DU), and functional dyspepsia (FD). METHODS: H. pylori was cultured from 141 patients (34 GC, 26 MALT, 49 DU, 32 FD). Allelic variants of vacA and iceA, and cagA were identified by polymerase chain reaction. Antrum and corpus biopsies were obtained for assessment of gastritis according to the updated Sydney System. RESULTS: The vacA sl,ml genotype was more frequently detected in H. pylori from GC patients (70.6%) than from MALT, DU, and FD patients (p < 0.05). The frequency of iceA1 and cagA did not differ among the groups. The proportion of patients with severe gastritis in the corpus was significantly higher in patients with GC and MALT compared with patients with DU (p < 0.001). CONCLUSIONS: In a German patient population, only the vacA s1,m1 genotype of H. pylori is associated with GC, and therefore may be useful to identify infected patients being at an increased risk for GC.