The current first-line treatment for active, moderate-to-severe GO is a 12-wk course of high-dose iv glucocorticoid pulses. The response rate of this regimen is approximately 80%. Intravenous glucocorticoids have a statistically significant advantage over oral treatment and cause significantly fewer adverse events. However, major side effects related to preexisting diseases, administered dose, and treatment schedule have been reported. The morbidity and mortality of iv glucocorticoid therapy are 6.5 and 0.6%, respectively. Thus, careful patient selection is warranted. Before iv glucocorticoid administration, patients should be screened for recent hepatitis, liver dysfunction, cardiovascular morbidity, severe hypertension, inadequately managed diabetes, and glaucoma. The cumulative dose should not exceed 8 g, and with the exception of sight-threatening GO the single doses preferably should not be administered on consecutive days. Monthly monitoring during subsequent treatment is warranted.

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The novel Mc4/TSI is a functional indicator of GO activity and severity.

PURPOSE.To analyze the association between myopia and cognitive performance. METHODS.A cohort of the population-based Gutenberg Health Study included 3819 eligible enrollees between 40 and 79 years. We used the Tower of London (TOL) test to assess cognitive performance. Myopia was defined as a spherical equivalent (SE) À0.5 diopters (D) via noncycloplegic autorefractometry. We conducted linear mixed models with the SE as the dependent variable and the age, sex, duration of education, and TOL score as covariates.RESULTS. Complete data were available for 3452 participants (90.4%). The mean TOL score was 14.0 6 3.9 in the myopes versus 12.9 6 4.0 in the nonmyopes (P < 0.001). The mean TOL score increased with the magnitude of myopia: it was 13.9 6 3.9 in low (less than À3 D); 14.2 6 3.7 in moderate (between À3 and À6 D); and 14.6 6 3.5 in high myopia (À6 D and greater; P < 0.001). Both the duration of education and cognitive performance were correlated with the magnitude of myopia (r ¼ À0.21, P < 0.001 and r ¼ À0.15, P < 0.001, respectively). In a linear mixed model, the duration of education significantly predicted myopia (b ¼ À0.14; t ¼ À7.55; P < 0.001), whereas cognitive performance did not (b ¼ À0.017; t ¼ À1.26; P ¼ 0.207). There was a significant effect of age on the SE (b ¼ 0.049; t ¼ 9.89; P < 0.001).CONCLUSIONS. When regarded separately, cognitive performance is linked to myopia. However, duration of education, which may be directly related to the risk factors for myopia, is more directly and strongly related to myopia than is cognitive performance. Cognitive ability may be associated with myopia primarily through its impact on level of education.

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Summary. Objective: To determine the age-and sex-specific prevalence and determinants of retinal vein occlusions (RVOs) in a large population-based German cohort. Methods: The investigation included 15 010 participants (aged 35-74 years) from the Gutenberg Health Study. We determined the prevalence of RVO (central retinal vein occlusion [CRVO] and branch retinal vein occlusion [BRVO]) for the local population by assessing fundus photographs of 12 954 (86.3%; 49.8% women and 50.2% men) participants. Further, we analyzed the associations of RVO with cardiovascular, anthropometric, and ophthalmic parameters. Results: The weighted prevalences of RVO, CRVO, and BRVO were 0.40%, 0.08%, and 0.32%, respectively. Men were 1.7 times more frequently affected by RVO than were women. Prevalence of RVO was 0.2% in participants aged 35-44 and 45-54 years, respectively, 0.48% in those aged 55-64 years, and 0.92% in those aged 65-74 years. Of persons with RVO, 91.5% had one or more cardiovascular risk factor or disease vs. 75.9% of persons without RVO. BRVO was associated with arterial hypertension (odds ratio 2.69, 95% confidence interval 1.27-5.70) and atrial fibrillation (3.37, 1.24-9.12) and CRVO with higher age (7.02, 1.63-30.19) and a family history of stroke (4.64, 1.18-18.25). Median visual acuity (base 10 logarithm of minimum angle of resolution) was 0.2 in persons with RVO vs. 0.05 in those without. Conclusion: The prevalence of RVO in this German population was 0.4%, and men were 1.7 times more frequently affected than women. CRVO was associated with higher age and a family history of stroke, and BRVO was associated with arterial hypertension and atrial fibrillation.

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Productivity loss and a prolonged therapy for GO incur great indirect and direct costs.