[Correlation from Undiluted Vitreous Cytokines of Untreated Central Retinal Vein Occlusion with Spectral Domain Optical Coherence Tomography]. / Korrelation von intravitrealen Zytokinen und OCT-Parametern bei Zentralvenenverschluss.

PURPOSE: To correlate key inflammatory and pro-angiogenic cytokines from undiluted vitreous fluid of treatment-naïve patients with central retinal vein occlusion (CRVO) with SD-OCT parameters. METHODS: Thirty-five patients (age 71.1 years, 24 phakic, 30 non-ischaemic) underwent intravitreal combination therapy, including single-site 23-gauge core vitrectomy. Twenty-eight samples from patients with idiopathic, non-uveitis floaterectomy served as controls. Levels of interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF-A) were correlated with visual acuity (logMar), category of CRVO (ischaemic or non-ischaemic) and morphological parameters, such as central macular thickness (CMT), thickness of neurosensory retina (Tneuro), extent of serous retinal detachment (SRT) and disintegrity of the IS/OS and others. RESULTS: Mean IL-6 was 64.7 pg/ml (SD ± 115.8), mean MCP-1 1015.7 pg/ml (± 970.1), and mean VEGF-A 278.4 pg/ml (± 512.8), which was significantly higher than the control values of IL-6 6.2 ± 3.4 pg/ml (p = 0.06), MCP-1 253.2 ± 73.5 pg/ml (p < 0.0 000 001) and VEGF-A 7.0 ± 4.9 pg/ml (p < 0.0006), respectively. All cytokines correlated highly with one another (correlation coefficient r = 0.82 for IL-6 and MCP-1; r = 0.68 for Il-6 and VEGF-A; r = 0.64 for MCP-1 and VEGF-A). IL-6 correlated significantly with CMT, TRT, SRT, dIS/OS, and dELM. MCP-1 correlated significantly with SRT, dIS/OS, and dELM. VEGF-A did not correlate with changes in SD-OCT, while it had a trend to be higher in the ischaemic versus the non-ischaemic CRVO groups (p = 0.09). CONCLUSIONS: The inflammatory cytokines were more often correlated with morphological changes assessed by SD-OCT, whereas VEGF-A did not correlate with CRVO-associated changes in SD-OCT. VEGF inhibition alone may not be sufficient to decrease the inflammatory response in CRVO therapy.

K-Train--a computer-based, interactive training program with an incorporated certification system for practicing kinetic perimetry: evaluation of acceptance and success rate.

PURPOSE: To evaluate, in an experimental study, an interactive, computer-based teaching procedure for kinetic perimetry that incorporates an evaluation system for scoring examination technique. METHODS AND SUBJECTS: K-Train was developed and based on the original user interface of the new semi-automated kinetic perimetry (SKP) feature of the OCTOPUS 101 perimeter (HAAG-STREIT, Koeniz, Switzerland). The trainer creates a 3D individual "hill of vision" for a specific pathology and the trainee can individually select target characteristics and independently define origin, end and direction of each kinetic stimulus with the help of vectors. Quality of the perimetric examination can be quantitatively assessed by the ratio of intersection area and union area of the trainee's result and the related trainer-defined original isopter. This ratio and other parameters are used to define a score of "perimetric quality". The general acceptance of K-Train was assessed in 30 participants in two perimetric courses. The success rate was examined by comparing the scores before and after a perimetric training session. RESULTS: The K-Train course was graded by the participants with an average score of 1.35 (range 1-3) in a scoring system ranging from 1=excellent to 6=unsatisfactory. The average perimetric quality score increased from 48 before to 59 (max. 100) after the training (27 trainees) indicating that K-Train was able to achieve and also verify a considerable success rate. CONCLUSION: The acceptance of K-Train, a computer-based, interactive tool that allows for certification, education and quality control of kinetic perimetry, is high. K-Train is capable of improving a trainee's individual performance in kinetic perimetry and of verifying this by an appropriate scoring system.