SUMMARYThe age-related changes of the ciliary muscle of human eyes (33-87 years) were studied on histological meridional sections. Eighty-five melanoma eyes and 10 eyes of normal donors were investigated. The total area and the length of the muscle, the area of the three main portions and the distance of the inner apex of the muscle to the scleral spur were determined and correlated with age. Total area and length of the muscle show a continuous and significant decrease with age. The area of the longitudinal and reticular portion continuously decreases, whereas the area of the circular portion significantly increases with age. The decrease in area is more pronounced in the longitudinal portion than in the reticular portion of the muscle, which shows an age-related increase in connective tissue. In addition, the distance of the inner apex of the muscle to the scleral spur shortens continuously. Thus, with increasing age the ciliary muscle adopts an anterior-inward position. A similar form is seen in young eyes after ciliary muscle contraction only. There might be a functional relationship between the observed age-changes in the ciliary muscle system and the phenomenon of the so-called qens paradox' (steepening of the anterior and posterior curvatures of the disaccommodated lens with age).
Anti-VEGF treatment for neovascular age-related macular degeneration (nAMD) has been FDA-approved in 2004, and since then has helped tens of thousands of patients worldwide to preserve vision. Still, treatment responses vary widely, emphasizing the need for genetic biomarkers to robustly separate responders from non-responders. Here, we report the findings of an observational study compromising 179 treatment-naïve nAMD patients and their reaction to treatment after three monthly doses of anti-VEGF antibodies. We show that established criteria of treatment response such as visual acuity and central retinal thickness successfully divides our cohort into 128 responders and 51 non-responders. Nevertheless, retinal thickness around the fovea revealed significant reaction to treatment even in the formally categorized non-responders. To elucidate genetic effects underlying our criteria, we conducted an undirected genome-wide association study followed by a directed replication study of 30 previously reported genetic variants. Remarkably, both approaches failed to result in significant findings, suggesting study-specific effects were confounding the present and previous discovery studies. Of note, all studies so far are greatly underpowered, hampering interpretation of genetic findings. In consequence, we highlight the need for an extensive phenotyping study with sample sizes exceeding at least 15,000 to reliably assess anti-VEGF treatment responses in nAMD.
A 49-year-old patient with relapsing polychondritis, who presented in the first instance to an eye department, is described. The patient had episcleritis, papilloedema and posterior scleritis. Both auricles were red, swollen and tender under pressure. The patient responded well to systemic steroid therapy for two weeks. Relapsing polychondritis is a rare connective tissue disorder. Early diagnosis is important, as progressive disease may cause lesions of vital organs (lung, heart).
ZusammenfassungKlinische Studien mit Arzneimitteln oder Medizinprodukten stellen zunehmend komplexe Anforderungen an Sponsoren und beteiligte Zentren. In den letzten 2 Jahrzehnten delegieren Sponsoren regulatorische sowie organisatorische Studienaufgaben zunehmend an medizinische Auftragsinstitute (engl. Clinical Research Organisation [CRO]). In der Regel sind diese Unternehmen die Hauptschnittstelle für die Zusammenarbeit mit den beteiligten Studienzentren. Hauptzweck der Mitwirkung ist die Unterstützung der Studienzentren zur Erzielung einer maximalen Studienqualität. Die in der Arbeitsgemeinschaft DOG Klinische Studienzentren verbundenen Studienzentren beobachten unterschiedliche Erfahrungen in der Zusammenarbeit mit CROs. Solche Erfahrungen sollen künftig systematisch an den beteiligten Zentren erfasst und vom Leiter der klinischen Studie ausgewertet werden. Die Spiegelung dieser Erfahrungen an die jeweiligen Auftragsinstitute und die sie beauftragenden Sponsoren kann in der Zukunft zur Qualität der Unterstützung durch CROs und damit zur Studienqualität beitragen. Die vorliegende Arbeit stellt vor, welche Bereiche der Zusammenarbeit im Fragebogen erfasst und analysiert werden.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.