Age-related macular degeneration (AMD) is one of the main causes of visual impairment and blindness in patients over 60 years in developed countries. Whilst no effective form of therapy is available for the dry form of AMD, intravitreal application of anti-VEGF substances is able to prevent the progression of neovascular AMD (nAMD) in most cases. Aside from the drugs ranibizumab, aflibercept and brolucizumab, other agents such as bevacizumab are often used off-label in order to save expense. The treatment intervals have also been refined, so as to reduce the burden on patients and health care systems. After fixed injection intervals, the pro re nata-regimen has been developed. Each month, it is decided whether the patient receives intravitreal injections based on fixed criteria. In the treat and extend-protocol, patients receive injections on each visit, but the intervals between injections vary due to the clinical outcomes. The observe-and-plan regime allows scheduling of the injection intervals in blocks, for three consecutive injections at a time. However, results of real-world studies were not able to reproduce those obtained in the pivotal studies. A high number of visits and fear of the injection procedure impose a burden on patients, that is mostly accepted due to fear of vision loss. Caregivers also complain of loss of productivity and income from having to provide regular support to patients. Health care systems worldwide are affected by increasing treatment numbers and the costs involved. The treatment of nAMD constitutes an achievement for modern medicine. However, despite the challenges, it must be evaluated and reviewed repeatedly in order to provide the best therapy for patients.

<b><i>Introduction:</i></b> The aim of this study was to evaluate the relation between choroidal thickness (CT), central retinal thickness (CRT) and best-corrected visual acuity (BCVA) after surgery for idiopathic epiretinal membrane (iERM). <b><i>Methods:</i></b> Patients with 4 severity stages of iERM, who underwent vitrectomy with membrane- and internal limiting membrane peeling, were included in this prospective study. CRT, CT, and BCVA were assessed at baseline (BSL), 1 week, 1 and 3 months postoperatively. <b><i>Results:</i></b> Twenty-one eyes were phakic, 11 eyes pseudophakic at BSL, in 14 cases combined cataract surgery was performed. BCVA was highest in stage 1 and 2, lowest in stage 4 iERM (<i>p</i> &#x3c; 0.001) and correlated with CRT. After surgery, CRT decreased and BCVA increased significantly (<i>p</i> &#x3c; 0.05). CT did not show significant differences among stages (<i>p</i> = 0.23). BSL CRT did not differ between phakic and pseudophakic eyes, the least reduction after surgery was detected in patients who underwent combined cataract surgery and vitrectomy. BSL CT was greater in phakic than in pseudophakic eyes (<i>p</i> = 0.033). Postoperative CT decreased in pseudophakic and phakic eyes, but remained higher after combined surgery (<i>p</i> = 0.0048). <b><i>Conclusion:</i></b> CT is not related to the severity of iERM. Choroidal changes did not influence the BCVA. Additional cataract surgery seems to cause longer recovery in CT and CRT.

Background/Objectives: To evaluate the use of encircling scleral buckling for treating retinal detachment (RD) and its complications as well as success rate within the last decade. Subjects/Methods: This retrospective observational study included 163 eyes receiving encircling scleral buckling (ESB) or ESB combined with vitrectomy (SBV) between 2009 and 2018. Main outcome measures include usage rate of ESB and SBV, indications and mean age. Furthermore, intra-/postoperative complications, intraocular tamponades as well as influences on functional outcome (BCVA) and central retinal thickness (CRT) were evaluated. For statistical analysis, patients were divided into five groups of two years each. Results: ESB and SBV surgeries decreased from initially 32% of all RD-operations between 2009-2010 to 9.2% between 2017-2018 (p<0.001, ANOVA). Mean age at surgery differed significantly over the years from 56.9±17.1 between 2009-2010 to 37.6±28.3 between 2017-2018 (p<0.001, ANOVA). Functional outcome after a mean follow-up time of 43.1±39.5 months increased from 1.34±0.88 logMAR at baseline (BSL) to 0.99±0.87 logMAR at the last follow-up visit. Significant influencing factors on BCVA were BCVA at BSL (p<0.001), duration of RD (p=0.01) and lens status (pseudophakic > phakic > aphakic, p<0.001). Significant impacts on CRT were surgical technique (SBV > ESB, p=0.017) and macula on/off (off > on, p=0.036). Conclusion: After an initial decrease, a rebound in ESB and SBV surgeries was noticed, with a significant reduction in mean age. Indications for surgery shifted over our observational period. No significant differences in functional outcome as well as intra- and postoperative complications were observed.