We showed that hydrophobic-acrylic lenses differ in their resistance to glistenings, as one group proved to be glistening-free, but the other models revealed varying grades of glistenings. Moreover, we demonstrated that the presence of glistenings results in increased straylight, and that straylight proportionally depends on the glistenings number irrespective of the IOL model. However, more research is needed to confirm that the relationship we found holds for all hydrophobic-acrylic IOLs.

HintergrundDas Waardenburg-Syndrom bezeichnet eine Gruppe vorwiegend autosomal-dominant vererbter Krankheitsbilder, die 1951 vom niederländischen Ophthalmologen Petrus Johannes Waardenburg beschrieben wurden. Bei allen können die folgenden Symptome auftreten: Innenohrschwerhörigkeit, breite Nasenwurzel und Pigmentstörungen der Haare ("graue Stirnlocke" bis hin zur frühzeitigen vollständigen Ergrauung), der Epidermis (Vitiligo) und der Iriden (vollständige oder partielle Heterochromie). Anhand des Vorliegens oder der Abwesenheit weiterer Symptome wird das Waardenburg-Syndrom klinisch in 4 verschiedene Typen eingeteilt [1]: Typ I ist darüber hinaus durch eine Dystopia canthorum, ein kurzes Philtrum und eine kurze Maxilla gekennzeichnet, Typ II durch keine weiteren Symptome, Typ III durch eine Dystopia canthorum und Fehlbildungen vor allem der oberen Extremitäten sowie bisweilen durch Mikrozephalus. Typ IV ist durch das Vorliegen eines Morbus Hirschsprung charakterisiert. Zu beachten ist, dass eine große Variabilität des klinischen Bildes besteht, sodass bei allen 4 Typen jeweils nicht zwingend alle Symptome vorliegen [1].

Purpose To evaluate the rate of misdiagnosis of aneurysmatic pachychoroid type 1 choroidal neovascularization/polypoidal choroidal vasculopathy (PAT1/PCV) among cases diagnosed as non-aneurysmatic pachychoroid neovasculopathy (PNV) and to define optical coherence tomography (OCT) features facilitating their distinction. Methods The database of the Department of Ophthalmology, Ludwig-Maximilians University Munich, was screened for patients diagnosed with PNV. Multimodal imaging was screened for the presence of choroidal neovascularization (CNV) and aneurysms/polyps. Imaging features facilitating the diagnosis of PAT1/PCV were analysed. Results In total, 49 eyes of 44 patients with a clinical PNV diagnosis were included, of which 42 (85.7%) had PNV and 7 (14.3%) represented misdiagnosed PAT1/PCV. SFCT was comparable (PNV: 377 ± 92 vs. PAT1/PCV: 400 ± 83 µm; p = 0.39). Whereas no difference was detected in total pigment epithelium detachment (PED) diameter (p = 0.46), maximum PED height was significantly higher in the PAT1/PCV group (199 ± 31 vs. 82 ± 46, p < 0.00001). In a receiver operating characteristic (ROC) analysis, the optimum cutoff for defining “peaking PED” was 158 µm with an area under the curve of 0.969, a sensitivity of 1.0 (95% CI: 0.59–1.0), and a specificity of 0.95 (95% CI: 0.84–0.99). Sub-retinal hyperreflective material (SHRM; p = 0.04), sub-retinal ring-like structures (SRRLS; p < 0.00001), and sub-RPE fluid (p = 0.04) were significantly more frequent in eyes with PAT1/PCV. Conclusion A relevant percentage of eyes diagnosed with PNV might instead suffer from PAT1/PCV. The detection of a maximum PED height (“peaking PED”) exceeding approximately 150 µm, SHRM, SRRLS, and sub-RPE fluid might greatly aid in the production of a more accurate diagnosis.