We conducted an expert-led consensus to develop recommendations on the use of per- and polyfluoroalkyl substances (PFAS)-containing ocular endotamponades (OEs) in vitreoretinal surgery, aiming to promote a more sustainable surgical practice. We used a modified Delphi methodology with panel consisting of fourteen vitreoretinal surgeons and five representatives of companies involved in OEs production and marketing. Based on a literature review and the latest updates on European Union's PFAS restriction proposal, the facilitator prepared a list of statements on PFAS-containing OEs currently used. Each statement was graded individually using a nine-point scale (from 1 "absolutely disagree" to 9 "absolutely agree") and the consensus was defined as a score between 7 and 9 from ≥80% of members. After two rounds, and related discussion, the recommendations highlighted the crucial role of PFAS-containing OEs in surgical practice and the potential negative impact of their ban on patients' outcomes. There was a strong agreement on the need of perfluorocarbon liquids as intraoperative tool, although it was also pointed out that their use should be avoided if possible. Fluorinated gases were deemed essential with no agreement on the possibility to replace SF6 and/or C2F6 with C3F8 at different concentrations. Conversely, semifluorinated alkanes as rinsing solution as well as F6H8 were considered extraneous. No consensus was reached about the current role of heavy silicone oils. Finally, the use of air as alternative and environment-friendly OE was judged not supported by sufficient evidence but worth of further investigation.

Background/Objectives: This monocentric case–control study prospectively recruited patients with foveal hypoplasia (FH) and compared them with retrospectively selected age- and sex-matched healthy controls. It is the first study to employ AngioTool software to quantitatively assess retinal microvascular alterations in FH using Optical Coherence Tomography Angiography (OCT-A). Methods: In total, 19 patients with FH and 19 age- and sex-matched healthy controls were included at Münster University Hospital, Germany, and underwent OCT-A imaging of the macula. The 3 × 3 mm2 angiograms of the superficial (SCP) and deep capillary plexus (DCP) were examined using AngioTool software. Quantified parameters included flow density (FD), number of junctions, total and average vessel length, number of endpoints, and lacunarity. Results: A total of 62 eyes from 38 participants were included in the analysis. Compared with controls, eyes with FH demonstrated significantly lower FD, fewer junctions, shorter total vessel length, and a greater number of endpoints in both SCP and DCP. These differences showed small-to-large effect sizes, depending on the parameter and plexus. Average vessel length remained significantly decreased in the SCP but not the DCP. The difference in SCP lacunarity did not remain significant after adjustment for multiple comparisons. In the exploratory subgroup analysis, there were no significant differences between mild and severe FH in either the SCP or the DCP after correction for multiple testing. Conclusions: FH is associated with alterations of retinal microvasculature involving both the SCP and DCP. These findings are consistent with altered retinal vascular development in FH. OCT-A may provide useful quantitative information for the characterization of FH, although the clinical and prognostic relevance of these vascular parameters remains to be established.

PURPOSE:The RHONE-X study (ClinicalTrials.gov identifier, NCT04432831) evaluated long-term safety and tolerability (primary end points), and efficacy (exploratory end points) of faricimab, a dual angiopoietin-2 (Ang-2) and vascular endothelial growth factor A (VEGF-A) inhibitor, using a treat-and-extend (T&E) protocol in patients with diabetic macular edema (DME). DESIGN:Global phase 3, multicenter, nonrandomized, 2-year open-label extension study of the YOSEMITE and RHINE (ClinicalTrials.gov identifiers, NCT03622580 and NCT03622593, respectively) studies. PARTICIPANTS:Of 1622 patients who completed YOSEMITE and RHINE, 1474 patients (91%) were included in the RHONE-X trial. METHODS:Patients transitioned from faricimab every 8 weeks (Q8W), faricimab T&E, or aflibercept 2.0 mg Q8W in YOSEMITE and RHINE to the RHONE-X study without requiring monthly initiation doses. All received faricimab T&E at up to 16-week intervals based on best-corrected visual acuity (BCVA) and central subfield thickness (CST), per YOSEMITE and RHINE criteria. Patients attended every month during the initial 4-month masked period, then only for T&E dosing visits (open-label arm). Analysis windows were defined for the RHONE-X study years 1, 1.5, and 2 to account for visit asynchronicity. MAIN OUTCOME MEASURES:The primary end point was incidence and severity of ocular and nonocular adverse events (AEs). Exploratory end points included change from baseline BCVA and CST, proportion of patients with absence of DME (CST < 325 μm), and treatment durability. RESULTS:Overall, 1204 patients (82%) completed the RHONE-X trial. The incidence of AEs leading to treatment discontinuation (1.5%) and rates of intraocular inflammation (1.3%) were low. Overall, faricimab T&E maintained visual and anatomic improvements achieved in YOSEMITE and RHINE. Adjusted mean BCVA improvements from YOSEMITE and RHINE baseline to the end of the RHONE-X trial were +10.1 letters (faricimab T&E), +11.4 letters (faricimab T&E [prior Q8W]), and +9.5 letters (faricimab T&E [prior aflibercept]); CST reductions were -198.3 μm, -202.5 μm, and -204.9 μm, respectively. At study end, more than 90% of patients achieved DME absence, regardless of prior treatment. Median number of injections over the RHONE-X trial (2 years) were 7 (faricimab T&E), 8 (faricimab T&E [prior Q8W]), and 8 (faricimab T&E [prior aflibercept]). By the RHONE-X trial completion, approximately 80% of patients received faricimab at ≥Q12W intervals. CONCLUSIONS:Faricimab, a dual Ang-2 and VEGF-A inhibitor, provided long-term safety, efficacy, and durability in patients with DME treated using a T&E regimen. Sustained visual and anatomic improvements were observed, with extended dosing intervals and reduced treatment burden. Faricimab was well tolerated, with a safety profile consistent with the YOSEMITE and RHINE trials. FINANCIAL DISCLOSURE(S):Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Background/Objectives: This study aimed to investigate the correlation between macular flow density (FD) as well as foveal avascular zone (FAZ) characteristics and optic disc size, quantified by Bruch's membrane opening area (BMOA). In addition, potential differences in FD and FAZ parameters among optic disc size cohorts were evaluated. Methods: In this retrospective, single-centre study, 151 eyes from 151 healthy participants examined at the University Hospital Münster, Germany, were included. Each subject underwent macular and optic disc optical coherence tomography angiography (OCT-A). Rank correlation coefficients for clustered data were computed to assess associations between FD values and BMOA. Further analyses compared FD and FAZ parameters among three optic disc size groups based on their quantiles. Results: Statistical analysis revealed a significant negative correlation between FD in several macular subsectors and BMOA. When stratified by optic disc size, FD in the superficial capillary plexus (SCP) was significantly higher in eyes with the smallest discs compared with intermediate ones, and FD in the deep capillary plexus (DCP) was significantly higher in intermediate discs compared with the largest group. Additionally, both SCP and DCP showed higher absolute FD values in eyes with the smallest optic discs compared with those with the largest. No significant group differences were detected for foveal FD, FAZ area, or FAZ perimeter. Conclusions: This study contributes to normative OCT-A data by incorporating optic disc size as a variable. While FAZ parameters appeared independent of BMOA, eyes with smaller optic discs demonstrated higher FD values in both SCP and DCP.

Intravitreale operative Medikamenteneingaben (IVOMs) im Versorgungsalltag erreichen häufig nicht die in klinischen Studien gezeigten Behandlungsergebnisse. In Deutschland fehlen bislang flächendeckende, repräsentative Real-World-Daten zur IVOM-Versorgung bei Makulaerkrankungen. Vor diesem Hintergrund wurde das oregis-IVOM-Register als Subregister des nationalen oregis-Registers etabliert. Ziel ist die standardisierte Erhebung und Analyse von IVOM-Therapieverläufen im klinischen Alltag in Deutschland, um Langzeitergebnisse abzubilden und Optimierungspotenziale in der Versorgung zu identifizieren. Teilnehmende augenärztliche Zentren können durch ihre Beteiligung aktiv zur evidenzbasierten Weiterentwicklung der IVOM-Versorgung beitragen. Das oregis-IVOM-Register ist eine prospektive, nichtinterventionelle Beobachtungsstudie. Erfasst werden medizinische Versorgungsdaten erwachsener Patienten, die aufgrund einer neovaskulären altersabhängigen Makuladegeneration (nAMD), eines diabetischen Makulaödems (DMÖ), retinaler Venenverschlüsse (RVV) oder choroidaler Neovaskularisation (CNV) eine IVOM-Therapie erhalten. Die Datenerfassung erfolgt webbasiert mittels Remote Date Entry in einer elektronischen Datenbank über REDCap. Struktur, Datensätze und Erhebungsparameter orientieren sich am internationalen Fight Retinal Blindness!-Register. Das oregis-IVOM-Register bietet erstmals eine nationale, strukturierte Plattform, um reale Behandlungsverläufe systematisch zu erheben und auszuwerten. Es schließt eine wichtige Wissenslücke in der IVOM-Versorgungsforschung in Deutschland und ermöglicht regionale und internationale Vergleiche sowie Analysen zu Therapieadhärenz und Versorgungsrealität.

PurposeData on regional differences in demographics and treatment patterns for treatment-warranted retinopathy of prematurity (ROP) is limited. In this study, data from the two countries with the highest patient numbers in the EU-ROP registry, Germany and Türkiye, are analyzed.MethodsThe non-interventional, multicenter European ROP registry (EU-ROP) was established in 2021 to compare various parameters related to ROP. In this evaluation, 267 treated children (516 eyes) from Germany and 198 treated children (378 eyes) from Türkiye were included. The two cohorts were compared with regard to demographics, ROP treatment parameters and retreatment rates.ResultsInfants in the German cohort had significantly lower gestational age (GA) as well as postmenstrual age (PMA) at initial treatment and (where applicable) at the time of retreatment. In the German cohort, the majority of eyes (56.1%) were treated due to stage 3 ROP in zone II with plus disease (II 3+). In the Turkish cohort, ROP II 3+ (22.0%), aggressive ROP (A-ROP) (17.9%), and ROP II 3- (17.3%) were the most common treatment indications. While ranibizumab was the predominant treatment modality in the German cohort (91.3%), about half of the eyes in the Turkish cohort were treated with laser coagulation (48.2%) while about 40% received intravitreal bevacizumab. Retreatment rates seemed to be comparable between Germany and Türkiye (28.1% vs. 27.3% of eyes) and were depending on the initial treatment method (30.5% after ranibizumab, 36.9% after bevacizumab, 14.2% after laser coagulation), although the retreatment indications [persistent avascular retina (PAR) vs. active ROP] appear to differ significantly between the two cohorts.ConclusionIn the investigated cohorts, ROP demographics, severity and treatment patterns differed significantly between Germany and Türkiye while the retreatment rate seems comparable. Different approaches to treatment of PAR may have contributed to the comparable retreatment rates despite the differences in initial treatment.

Purpose To develop an international consensus on terminology for adult pathologic myopia based on contemporary imaging, with emphasis on optical coherence tomography (OCT). Methods An international panel of 32 experts in myopia and retinal disease from 13 countries was assembled. The writing group reviewed existing classification systems and the published literature and developed candidate statements organized into six domains: atrophic, mechanical expansion, tractional, neovascular, optic nerve, and retinal detachment. A Delphi process with anonymous voting was used. Consensus was defined a priori as ≥75% agreement (Agree or Strongly Agree). Statements not reaching consensus were revised based on structured feedback and re-voted. Results Forty-four consensus statements were developed that met the predefined threshold for agreement after iterative revision. The mean agreement was 90.6% (median 92.5%). The framework emphasizes structural definitions derived from OCT and multimodal imaging rather than fundus appearance. The nomenclature system organizes manifestations of pathologic myopia into six domains reflecting distinct but often overlapping anatomical and biomechanical processes. Key elements include the central role of choroidal thinning in visual function, recognition of focal chorioretinal loss as a structural endpoint across multiple pathways, and integration of mechanical, tractional, and vascular mechanisms in disease expression. Conclusions This consensus establishes a unified, imaging-based lexicon for adult pathologic myopia grounded in structural anatomy and contemporary imaging. By organizing disease features into six domains and defining entities using OCT, the framework reduces ambiguity, improves reproducibility, and provides a foundation for future classification systems, clinical studies, and therapeutic trials.

Equity-scaled Dice (ES-Dice) is the de-facto fairness metric on the Harvard FairSeg cross-modal optic-nerve-head benchmark. We show that ES-Dice on the neuroretinal rim has a structure-size confound, inherited from Dice's normalisation by foreground area, that becomes systematic on progressive-disease benchmarks: in glaucoma, the rim shrinks as the cup expands.On the 2,000-image FairSeg hold-out we run three analyses on a reference colour fundus photography (CFP) to scanning laser ophthalmoscopy (SLO) pipeline: per-image Spearman correlation between Dice and ground-truth structure area (E2); severity-stratified ES-Dice with the vertical cup-to-disc ratio (vCDR) thresholded at 0.5 on the ground-truth mask (high-vCDR n=1,665, low-vCDR n=335, E1); and per-race Hausdorff-95 plus Average Symmetric Surface Distance (E3, both insensitive to absolute area).Per-image Rim Dice correlates with rim area at Spearman ρ=+0.207 (95% CI [+0.165, +0.249], p<10⁻²⁰); per-race ρ values +0.237 / +0.240 / +0.201 share the same direction. Cup-Dice on the high-vCDR stratum is 0.881 versus 0.717 on the low-vCDR stratum (+16.4 pp; evidence of the confound, not a clinical strength claim), with the reverse asymmetry on rim (-3.2 pp). Boundary-distance metrics return ES-HD95 7.18 pixels on rim with a different per-race ranking. The 5% pipeline reaches ES-Rim Dice 0.784; this value identifies the prediction set and inherits the same confound.On FairSeg, ES-Dice on the rim conflates demographic disparity with structure-size variance, and severity-aware plus boundary-distance fairness metrics are required complements to ES-Dice; the mathematical area-normalisation of Dice supports, but the present single-benchmark evaluation does not prove, the same complementation on other progressive-disease segmentation benchmarks.

BACKGROUND:Intravitreal operative medication injection (IVOM) treatment in routine clinical practice often fails to achieve the treatment outcomes demonstrated in clinical trials. In Germany, comprehensive and representative real-world data on IVOM treatment (IVT) for macular diseases are still lacking. OBJECTIVE:Against this background the oregis IVOM registry was established as a subregistry of the national oregis registry. The aim is the standardized collection and analysis of the course of IVOM treatment in the clinical routine in Germany, to evaluate long-term outcomes and identify potential areas for optimizing patient care. In this way participating ophthalmological centers can make an active contribution to the evidence-based development of IVOM treatment. MATERIAL AND METHODS:The oregis IVOM registry is a prospective, noninterventional observational study. Medical routine care data of adult patients receiving IVOM treatment for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion (RVO) or choroidal neovascularization (CNV) are collected. Data acquisition is performed via web-based remote data entry into an electronic database using REDCap. Registry structure, datasets and data collection parameters are aligned with the international Fight Retinal Blindness! registry. CONCLUSION:The oregis IVOM registry provides, for the first time, a nationwide structured platform for the systematic collection and evaluation of real-world IVT data in Germany. It closes an important evidence gap in health services research for IVOM treatment in Germany and enables regional and international comparisons as well as analyses of treatment adherence and real-world care.

Recent advances in retinal imaging have revealed vasculostructural alterations in fellow eyes of patients with Coats disease, thereby challenging the traditional concept of Coats disease as a strictly unilateral disorder. To further explore the phenotype of this retinal disease, this study investigated whether subclinical vascular changes can be detected in fellow eyes using Widefield Optical Coherence Tomography Angiography (WF-OCT-A). This trial prospectively recruited Coats disease patients as well as age- and sex-matched healthy controls from University Hospital Münster. Participants underwent WF-OCT-A imaging, enabling imaging of large peripheral retinal areas. Imaging analysis was carried out using AngioTool. Nineteen patients with Coats disease and nineteen matched healthy controls were included. Quantitative analysis revealed no significant differences in the superficial capillary plexus (SCP) between fellow eyes and control eyes regarding flow density (p = 0.56), number of junctions (p = 0.79), total vessel length (p = 0.61), average vessel length (p = 0.75), number of endpoints (p = 0.96), or lacunarity (p = 0.41). In this cohort, WF-OCT-A did not identify detectable retinal vascular alterations in clinically unaffected fellow eyes of patients with Coats disease. This finding argues against previously noted prominent subclinical retinal vascular abnormalities in these eyes.

INTRODUCTION:EyeMatics (Eye disease "treated" with interoperable medical informatics) is a clinical use case in Germany's Medical Informatics Initiative (MII). The objective of EyeMatics is to improve the understanding of the treatment effects of intravitreal injections, the most frequent procedure to treat retinal diseases. To achieve this, as part of the efforts, medical data of multiple hospital sites must be integrated into a local FHIR repositories using a common set of FHIR profiles. METHODS:A panel of medical and technical experts was formed to create a project-specific core data set. The core data set is compiled from different preliminary work like previously existing data models, the data donation of a synthetic patient encounter scenario, screenshots of UI forms used at the local sites and relevant MII profiles. RESULTS:Complex profiling and custom code systems were required to represent central ophthalmic concepts such as visual acuity using FHIR. A common pattern for representing eye laterality in FHIR Observation resources was established. The resulting profiles are available in a public GitHub repository. CONCLUSION:While our FHIR profiles will be sufficient for EyeMatics, our experience shows that the clinical complexity of basic ophthalmological observations requires some deviations from standard FHIR modelling patterns and would be limited by gaps in terminology if deployed elsewhere. Our experience indicates that project-specific FHIR profile development is possible within a short time frame but may harbor risks of contributing to a growing number of fragmented implementations unless closely coordinated or based on common data models. To counteract this, future ophthalmic MII extension modules should attempt to integrate both profiles described here and international standard data models for ophthalmology.

BACKGROUND:Data on long-term outcomes of antivascular endothelial growth factor therapy in retinopathy of prematurity (ROP) are still rare. We present 5-year post-treatment ophthalmological and paediatric outcomes of the prospective, multicentre, randomised, double-blinded, controlled pilot study CARE-ROP (Comparing Alternative Ranibizumab Dosages for Safety and Efficacy in Retinopathy of Prematurity). METHODS:14 patients (28 eyes) completed the ophthalmologic and 5 patients completed the paediatric 5-year follow-up assessment. The ophthalmological assessment included best-corrected visual acuity (BCVA), orthoptic status, slit lamp examination, intraocular pressure and funduscopy. The paediatric examination followed the German Neonatal Network protocol and covered cognitive, motor and sensory development. RESULTS:17 of 28 eyes exhibited at least one ocular abnormality, such as optic disc pallor or atrophy of the optic nerve head, retinal pigment epithelium (RPE) pigment changes, persistent tortuosity or macular hypoplasia. Despite this, 19 of 26 eyes demonstrated a logarithm of the Minimum Angle of Resolution (logMAR) BCVA of 0.3 or better. Mean refractive error was -0.9 D (±3.4 D) with only two eyes of one infant having high myopia of < -5 D. The neurodevelopmental results were within the expected range for a population of preterm infants with treatment-warranting ROP but need to be interpreted with caution due to the low number of five patients. CONCLUSION:The 5-year ophthalmologic and paediatric outcomes of the CARE-ROP study confirm the previous results and add important additional information on long-term safety of 0.12 and 0.20 mg ranibizumab for the treatment of ROP. The ophthalmologic functional outcome regarding BCVA and refraction is promising. These exploratory long-term data, however, need to be interpreted with caution due to the low patient number both in the ophthalmologic and paediatric assessment.

To assess ocular microvascular vessel density (VD) in patients with adult-onset dermatomyositis (DM) measured by optical coherence tomography angiography (OCTA). 10 eyes of 10 patients with DM without interstitial lung disease were included in this cross-sectional study. All patients underwent ophthalmological and systemic evaluation, including nailfold capillaroscopy and OCTA examination (RTVue XR Avanti, Optovue Inc., Fremont, California, USA). The VD data of the 3 × 3 mm OCT angiogram of the superficial and deep capillary plexus (SCP, DCP), the choriocapillaris (CC) and radial peripapillary capillary density (RPC) of the optic nerve head (ONH) were extracted and analyzed. The data were compared with a gender- and age-matched healthy control group (10 eyes from 10 healthy individuals). The mean age of the patient group was 56.7 ± 3.11 years and 55.5 ± 10.76 years of the control group (p = 0.68) with 8 female and 2 male subjects per patient group and control group respectively. The VD in the inside disc area of the ONH was significantly reduced in the patient group compared to healthy controls (p = 0.028). A significant positive correlation was found between CC VD and nailfold capillary density (rₛₚ = 0.673, p = 0.033). This exploratory study identifies reduced VD in the ONH region of adult DM patients and suggests a link between ocular and systemic microvascular involvement. OCTA may offer non-invasive insights into microcirculatory changes in DM. Larger, longitudinal studies are warranted to validate these findings and evaluate the utility of OCTA-derived parameters as potential biomarkers in this rare disease.

Background/Objectives: To compare the efficacy and safety of Hydrus® Microstent and iStent inject® W implants, in combination with phacoemulsification, for lowering intraocular pressure (IOP) in patients with glaucoma in a real-world clinical setting. Methods: This retrospective, single-center study analyzed medical records of glaucoma patients who underwent either Hydrus® Microstent or iStent inject® W implantation combined with cataract surgery at the University Hospital Muenster, Germany. Key outcome measures included absolute and relative IOP reduction, reduction in topical antiglaucoma medication use, overall success rate, and complications. A total of 32 eyes were analyzed, 16 in each treatment group, with a 12-month follow-up. Results: Both groups demonstrated significant postoperative IOP reduction (Hydrus: p < 0.001; iStent inject® W: p = 0.032). The Hydrus group achieved significantly greater relative IOP reduction compared to the iStent inject® W group (p = 0.043). The Hydrus group also showed a significant reduction in daily antiglaucoma medication use (p = 0.002), whereas the iStent inject® W group did not achieve statistical significance in this regard (p = 0.054). The overall success rate was higher in the Hydrus group (38%) than in the iStent inject® W group (13%), though the difference was not statistically significant (p = 0.102). No device-related complications were observed in either group. Conclusions: The Hydrus® Microstent demonstrated superior IOP reduction and a more significant reduction in the need for antiglaucoma medications compared to the iStent inject® W in a real-world setting. These findings support the use of the Hydrus implant as an effective and safe micro-invasive glaucoma surgery (MIGS) option for patients with mild to moderate POAG. Further studies with larger patient populations and long-term follow-up are warranted to confirm the efficacy in patients with PEX and advanced glaucoma.

Treatment decisions for neovascular age-related macular degeneration (nAMD) in the setting of individualised treatment regimens are adapted to disease activity. The main marker of disease activity and trigger for re-treatment with anti-vascular endothelial growth factor (anti-VEGF) agents is the presence of retinal fluid on optical coherence tomography (OCT). Recently, attention has focused on the impact of residual retinal fluid on nAMD management. Based on a literature review and the combined clinical experience of an international group of retinal specialists, this manuscript provides expert guidance on the treatment of nAMD according to fluid status and proposes an algorithm for determining when to administer anti-VEGF treatment according to residual fluid status. We explore the role of residual fluid in treatment decisions and outcomes in nAMD, taking into consideration fluid evaluation and, in particular, distinguishing between fluid in different anatomic compartments and at different stages during the treatment course. Current limitations to identifying and interpreting fluid on OCT, and the assumption that any residual retinal fluid reflects ongoing VEGF activity, are discussed.

OBJECTIVE:Employing optical coherence tomography angiography (OCTA), recent research has uncovered retinal vascular changes in pregnant women compared to nonpregnant controls. Yet, longitudinal data on retinal OCTA metrics until childbirth are lacking in the current literature, and an understanding of a possible reversibility of these changes remains limited. This prospective study aims to quantify retinal capillary metrics in healthy pregnant women prenatally and postnatally, describing the natural evolution of OCTA metrics during and after pregnancy. METHODS:OCTA measurements were performed repeatedly on 52 eyes of 26 healthy, pregnant women, assessing the superficial (SCP), deep (DCP), choriocapillary (CC), and radial peripapillary (RPC) capillary plexus at various intervals during pregnancy and after childbirth. Flow density (FD) within these layers and parameters of the foveal avascular zone (FAZ) were compared throughout pregnancy and in the postpartum period using linear mixed models. RESULTS:52 eyes of 26 pregnant women were included in the study. Although layer-specific variations in FD throughout the prepartum phase were noted, these changes were statistically insignificant for all investigated capillary plexus and the FAZ (p > 0.05). FD of the DCP, CC and RPC capillary plexus was significantly lower after childbirth in comparison to the prepartum phase (p ≤ 0.04). CONCLUSIONS:The microvascular structure remains stable throughout healthy pregnancies; however, postpartum changes hint toward late vasculo-structural adaptations after childbirth. OCTA can be used to noninvasively to assess microvascular changes associated with pregnancy.

The retinal pigment epithelium (RPE) plays an important role in the pathogenesis of age-related macular degeneration (AMD) and other retinal degenerative diseases. The introduction of healthy RPE cell cultures into the subretinal space offers a potential treatment strategy. The aim of this study was the long-term culture and characterisation of RPE cells on nanofiber scaffolds. Nanofiber scaffolds consisting of polycaprolactone (PCL) and collagen were prepared by electrospinning. Porcine RPE cell cultures were maintained on PCL scaffolds, PCL-collagen scaffolds, and controls at the bottom of 24-well plates. Cell culture analysis was performed by immunohistochemistry, while the release of inflammatory cytokines IL-6, IL-8, TNF-α, and PDGF-β was measured by ELISA and multiplex assays. Ultrastructural features were examined by transmission electron microscopy. The observation period averaged 42.7 weeks for controls, 38.7 weeks for PCL scaffold cultures, and 36.1 weeks for PCL-collagen scaffold cultures, with cell number and morphology remaining stable. TNF-α levels in the supernatants were minimal, IL-6 levels were consistently low, and IL-8 levels decreased from initially high to lower levels over time. RPE cells were stably cultured on nanofiber scaffolds for extended periods of time. The long-term physiological properties of RPE cells, including phagocytic ability and visual cycle enzyme activity, need to be further investigated before clinical application. In addition, controlling the expression of inflammatory mediators is a major challenge. Despite these hurdles, overcoming them is critical given the increasing prevalence of retinal degenerative diseases.

Introduction The oregis registry operated by the German Ophthalmological Society (DOG) serves as a central digital platform for collecting and analysing ophthalmological healthcare data in Germany. The aim of oregis is to provide a comprehensive picture of the current healthcare situation and promote healthcare research using real-world-data from inpatient and outpatient facilities. Since its launch in 2020, oregis has continuously expanded its database to enable scientific analyses on a wide range of topics. This paper presents the new dashboard feature allowing participating centres to compare their own patient data with aggregated data in real time while also covering privacy aspects of the system. Materials and Methods The oregis steering committee opted to implement the oregis dashboard based on existing medical registries. First, forty-nine national and international registries were analysed to identify common features such as benchmarking functionality. This was followed by technical realisation and implementation. Results Each centre connected to oregis has secure access to the oregis dashboard, which displays key indicators for patients, diagnoses, and treatments. Dynamic filtering options allow targeted data analysis, comparing each centre's results anonymously with aggregated data from other centres. The dashboard uses Apache Superset data visualisation software [! etwas informativer]. Data is synchronised using an integrated oregis Konnektor module to anonymise patient data according to defined standards. Extensive security and privacy measures ensure data security, including server-side encryption, transport encryption, and two-factor authentication. The dashboard is part of a comprehensive privacy policy developed and validated for oregis by privacy experts. Conclusion The number of centres connected to oregis is still growing. The new web-based dashboard allows flexible analysis of data and comparison with other centres without allowing conclusions to be drawn about any individual care centre; this ensures data privacy and independence in each centre. More features can be added to provide a more thorough overview of eye care in Germany as oregis grows.

Background The number of female ophthalmologists has risen steadily in recent years. The aim of this study is to investigate the gender ratios, subspecialties, and academic degrees of ophthalmologists at German university hospitals. Additionally, the study analyzes the proportion of women in science programs such as the Clinician Scientist Program. Methods Data collection was performed in August 2023 based on the official websites of university eye clinics and the German Ophthalmological Society (DOG). The numbers of male and female residents, specialists, senior physicians, and chief physicians as well as subspecialties and academic degrees were determined. Information on the Clinician Scientist Program was collected in a 2022 survey by the Medical Faculty Council. Results In August 2023 there were two female chief physicians at the university eye clinics (5%), both specialized in retinal surgery. There were more male senior physicians than female senior physicians (59.9% vs. 40.1%). There was no significant difference between the genders in terms of the number of habilitations (p = 0.554). There were more female specialists than male specialists at the university clinics (58.6% vs. 41.4%) as well as more female residents (56.9% vs. 43.1%). Female specialists were significantly more likely to hold a doctorate than their male colleagues (p = 0.037). The percentage of female applicants for the Clinician Scientist Program nationwide in 2022 was 46.6%, with 41.8% female program starters in 2021 and 39.7% female program graduates in 2021. Conclusion Senior and chief physician roles at university eye clinics remain predominantly occupied by men. Additionally, support programs for young researchers are still predominantly awarded to men.