Universitätsaugenklinik Magdeburg

We report an iatrogenic corneal ectasia that developed after laser in situ keratomileusis (LASIK) in a case of forme fruste keratoconus. One month postoperatively, corneal topography revealed a central steep area that showed rapid progression. Visual acuity in the eye decreased from 20/20 to 20/80. Corneas with forme fruste keratoconus may have altered biomechanical properties compared with normal corneas. Forme fruste keratoconus may be a contraindication for LASIK.

The treatment of cancer with proton radiation therapy was first suggested in 1946 followed by the first treatments in the 1950s. As of 2020, almost 200 000 patients have been treated with proton beams worldwide and the number of operating proton therapy (PT) facilities will soon reach one hundred. PT has long moved from research institutions into hospital-based facilities that are increasingly being utilized with workflows similar to conventional radiation therapy. While PT has become mainstream and has established itself as a treatment option for many cancers, it is still an area of active research for various reasons: the advanced dose shaping capabilities of PT cause susceptibility to uncertainties, the high degrees of freedom in dose delivery offer room for further improvements, the limited experience and understanding of optimizing pencil beam scanning, and the biological effect difference compared to photon radiation. In addition to these challenges and opportunities currently being investigated, there is an economic aspect because PT treatments are, on average, still more expensive compared to conventional photon based treatment options. This roadmap highlights the current state and future direction in PT categorized into four different themes, 'improving efficiency', 'improving planning and delivery', 'improving imaging', and 'improving patient selection'.

PURPOSE: To review the efficacy of the pattern electroretinogram (PERG) in early diagnosis of glaucoma. METHODS: Stimulation parameters of check size and temporal frequency are considered. Analyses of various peaks (P50, N95, the N95/P50) and Fourier steady-state are considered. The relation to visual field defects is explored. RESULTS: The PERG is markedly alterated in glaucoma. It shows amplitude reductions in (still) normal areas of the visual field. Optical imaging on the retina needs to be optimal. Higher temporal frequency (>10 reversals/s) improves the sensitivity to detect glaucoma compared with transient stimulation. The ratio between the amplitudes to 0.8 degrees checks and to 16 degrees checks, "PERG ratio," exploits a check size-specific reduction in early glaucoma and reduces variability. Longitudinal studies suggest that the PERG can indicate incipient glaucoma damage before evidence from the visual field. CONCLUSIONS: The PERG is a demanding electrophysiological technique that can serve as a sensitive biomarker for retinal ganglion cell function. With appropriate paradigms, PERG assists in identifying those patients with elevated interocular pressure in whom glaucoma damage is incipient before visual field changes occur.

The main objective of this prospective multicentre randomized phase III study was to compare a combined regimen of fotemustine plus whole brain irradiation with fotemustine alone in terms of cerebral response and time to cerebral progression in patients with melanoma cerebral metastases. Seventy-six patients were randomized to receive either fotemustine (arm A, n = 39) or fotemustine plus whole brain irradiation (arm B, n = 37). Fotemustine was administered intravenously at 100 mg/m(2) on days 1, 8 and 15, followed by a 5 week rest period, then every 3 weeks in non-progressive patients. In arm B, concomitant whole brain irradiation was performed at a total dose of 37.5 Gy (2.5 Gy/day on days 1-5 for three consecutive weeks). Although patients who received fotemustine alone had worse prognostic factors, there was no significant difference in cerebral response (arm A, 7.4%, arm B, 10.0%) or control rates (objective responses plus stable disease) after 7 weeks (arm A, 30%; arm B, 47%) or in overall survival (arm A, 86 days; arm B, 105 days). However, there was a significant difference in favour of arm B for the time to cerebral progression (P = 0.028, Wilcoxon test). In conclusion, fotemustine plus whole brain irradiation delayed the time to cerebral progression of melanoma cerebral metastases compared with fotemustine alone but without a significant improvement in terms of objective control or overall survival.

The International Consensus Conference on the treatment of primary breast cancer takes place every two years in St. Gallen, Switzerland. The panel in St. Gallen is composed of international experts from different countries. From a German perspective, it seems reasonable to interpret the voting results in the light of AGO-recommendations and S3-guidelines for everyday practice in Germany. Consequently, a team of eight breast cancer experts, of whom two are members of the international St. Gallen panel, commented on the voting results of the St. Gallen Consensus Conference (2013). The main topics at this year's St. Gallen conference were surgical issues of the breast and axilla, radio-therapeutic and systemic treatment options, and the clinical relevance of tumour biology. The clinical utility of multigene assays for supporting individual treatment decisions was also intensively discussed.

ObjectiveEye drops of aganirsen, an antisense oligonucleotide preventing insulin receptor substrate-1 expression, inhibited corneal neovascularization in a previous dose-finding phase II study. We aimed to confirm these results in a phase III study and investigated a potential clinical benefit on visual acuity (VA), quality of life (QoL), and need for transplantation.DesignMulticenter, double-masked, randomized, placebo-controlled phase III study.ParticipantsAnalysis of 69 patients with keratitis-related progressive corneal neovascularization randomized to aganirsen (34 patients) or placebo (35 patients). Patients applied aganirsen eye drops (86 μg/day/eye) or placebo twice daily for 90 days and were followed up to day 180.Main Outcome MeasuresThe primary end point was VA. Secondary end points included area of pathologic corneal neovascularization, need for transplantation, risk of graft rejection, and QoL.ResultsAlthough no significant differences in VA scores between groups were observed, aganirsen significantly reduced the relative corneal neovascularization area after 90 days by 26.20% (P = 0.014). This improvement persisted after 180 days (26.67%, P = 0.012). Aganirsen tended to lower the transplantation need in the intent-to-treat (ITT) population at day 180 (P = 0.087). In patients with viral keratitis and central neovascularization, a significant reduction in transplantation need was achieved (P = 0.048). No significant differences between groups were observed in the risk of graft rejection. However, aganirsen tended to decrease this risk in patients with traumatic/viral keratitis (P = 0.162) at day 90. The QoL analyses revealed a significant improvement with aganirsen in composite and near activity subscores (P = 0.039 and 0.026, respectively) at day 90 in the per protocol population. Ocular and treatment-related treatment-emergent adverse events (TEAEs) were reported in a lower percentage with aganirsen compared with placebo. Only 3 serious TEAEs (2 with aganirsen and 1 with placebo) were considered treatment-related.ConclusionsThis first phase III study on a topical inhibitor of corneal angiogenesis showed that aganirsen eye drops significantly inhibited corneal neovascularization in patients with keratitis. The need for transplantation was significantly reduced in patients with viral keratitis and central neovascularization. Topical application of aganirsen was safe and well tolerated. Eye drops of aganirsen, an antisense oligonucleotide preventing insulin receptor substrate-1 expression, inhibited corneal neovascularization in a previous dose-finding phase II study. We aimed to confirm these results in a phase III study and investigated a potential clinical benefit on visual acuity (VA), quality of life (QoL), and need for transplantation. Multicenter, double-masked, randomized, placebo-controlled phase III study. Analysis of 69 patients with keratitis-related progressive corneal neovascularization randomized to aganirsen (34 patients) or placebo (35 patients). Patients applied aganirsen eye drops (86 μg/day/eye) or placebo twice daily for 90 days and were followed up to day 180. The primary end point was VA. Secondary end points included area of pathologic corneal neovascularization, need for transplantation, risk of graft rejection, and QoL. Although no significant differences in VA scores between groups were observed, aganirsen significantly reduced the relative corneal neovascularization area after 90 days by 26.20% (P = 0.014). This improvement persisted after 180 days (26.67%, P = 0.012). Aganirsen tended to lower the transplantation need in the intent-to-treat (ITT) population at day 180 (P = 0.087). In patients with viral keratitis and central neovascularization, a significant reduction in transplantation need was achieved (P = 0.048). No significant differences between groups were observed in the risk of graft rejection. However, aganirsen tended to decrease this risk in patients with traumatic/viral keratitis (P = 0.162) at day 90. The QoL analyses revealed a significant improvement with aganirsen in composite and near activity subscores (P = 0.039 and 0.026, respectively) at day 90 in the per protocol population. Ocular and treatment-related treatment-emergent adverse events (TEAEs) were reported in a lower percentage with aganirsen compared with placebo. Only 3 serious TEAEs (2 with aganirsen and 1 with placebo) were considered treatment-related. This first phase III study on a topical inhibitor of corneal angiogenesis showed that aganirsen eye drops significantly inhibited corneal neovascularization in patients with keratitis. The need for transplantation was significantly reduced in patients with viral keratitis and central neovascularization. Topical application of aganirsen was safe and well tolerated.

Object. The goal of this study was to examine the potential use of ophthalmodynamometry in the noninvasive assessment of intracranial pressure (ICP). Under normal conditions, pressure within the central retinal vein is equal to or greater than ICP, because the central retinal vein passes through the optic nerve before it drains into the cavernous sinus. The optic nerve sheath is the place where ICP affects retinal venous pressure. Suction ophthalmodynamometry is an established method of investigation in ophthalmology to determine the pressure of the central retinal artery. Although observations of papilledema and lack of venous pulsations are commonly used to provide a vague assessment of ICP, ophthalmodynamometry may be used to determine the pressure of the central retinal vein. This venous pressure has never been compared with ICP. Methods. In this study the pressure of the central retinal vein was recorded in 22 patients who underwent continuous simultaneous registration of ICP for various reasons, mainly for suspected hydrocephalus. A comparison of the two pressures was made. The results indicated a highly significant linear correlation between central retinal vein pressure and ICP. These results are of great practical value because up-to-date reliable ICP monitoring has only been possible by using invasive means, by placing a probe extradurally or subdurally into the brain parenchyma or a ventricle. Conclusions. Ophthalmodynamometry can be relevant for momentary assessment and is not suitable for continuous monitoring. However, this technique can easily be repeated and may be used whenever increased ICP is suspected in a patient suffering from hydrocephalus, brain tumors, or head injury.

PURPOSE: In human albinism a part of the temporal retina projects abnormally to the contralateral hemisphere. An objective VEP procedure to quantify the extent of the abnormality was devised. METHODS: Monocular VEPs were recorded in 16 subjects with albinism and in 16 controls from occipital electrodes to pattern-onset stimulation in 1 of 10 adjacent rectangular apertures along the horizontal meridian covering a total of +/-27 degrees. For each eye interhemispheric difference potentials were calculated and correlated with each other to assess the lateralization of the responses: positive and negative correlations indicate lateralization on same or opposing hemispheres, respectively. Different stimulus conditions were compared to assess the sensitivity and specificity of the procedure for the detection of the misrouting of visual projections in albinism. RESULTS: Locations that were affected by the projection abnormality were detected with a specificity of 100% and an average sensitivity of 97%. In the 16 subjects with albinism tested, the abnormal projection was confined to the central retina and varied in extent between subjects (2 degrees - 15 degrees; median, 8 degrees). The extent did not appear to be correlated with horizontal nystagmus amplitude or visual acuity. CONCLUSIONS: Because of the great interindividual variability of the projection abnormality, studies of the contribution of the abnormally projecting retina to visual perception must be preceded by the localization of the abnormality. This VEP procedure allowed the authors to identify, with high sensitivity and specificity, visual field locations that are affected by the projection abnormality.

Albinism is a genetic condition associated with abnormalities of the visual system. Defects in melanin production cause underdevelopment of the fovea, reduced retinal cell numbers and abnormal routing of ganglion cell nerve fibres at the optic chiasm. We examined 19 subjects with albinism and 26 control subjects to determine whether retinal abnormalities affect the structure of the visual cortex. Whole-brain, high-resolution anatomical magnetic resonance imaging volumes from each subject were obtained on a 1.5-T scanner and segmented into grey and white matter. A voxel-wise statistical comparison of grey and white matter volumes in the occipital lobes between the two groups was performed using voxel-based morphometry. Our analysis revealed a regionally specific decrease in grey matter volume at the occipital poles in albinism. The location of the decrease in grey matter corresponds to the cortical representation of the central visual field. This reduction is likely to be a direct result of decreased ganglion cell numbers in central retina in albinism.

The key topics of this year's 14th St. Gallen Consensus Conference on the diagnosis and therapy of primary breast cancer were again questions about breast surgery and axillary surgery, radio-oncology and systemic therapy options in consideration of tumor biology, and the clinical application of multigene assays. This year, the consensus conference took place in Vienna. From a German perspective, it makes sense to substantiate the results of the vote of the international panel representing 19 countries in light of the updated national therapy recommendations of the AGO (Arbeitsgemeinschaft Gynäkologische Onkologie). Therefore, 14 German breast cancer experts, 3 of whom are members of the International St. Gallen Panel, have commented on the voting results of the St. Gallen Consensus Conference 2015 in relation to clinical routine in Germany.

In recent years, liposomes have been increasingly explored as novel drug delivery systems, and several liposome-based drug products have been approved in Europe, the USA and Japan. Depending on size, composition and surface characteristics, liposomes interact specifically with biological structures. Liposomal drug products provide a topical activity at the desired locus of action and are deemed more effective and less toxic than conventional drug formulations. The combination of povidone-iodine (PVP-I) and liposomes unites the exceptional microbicidal activity of the antiseptic substance with the excellent tolerability and lack of immunogenicity of liposomes; in addition, liposomes provide a moist molecular film for the wound environment. The multilamellar vesicles act as microreservoirs hence prolonging the release of the active ingredient. Although no commercial product for repeated application on the eye is currently available, PVP-I has been used in ophthalmology not only for pre- and postoperative antisepsis, but also for the treatment of bacterial and viral conjunctivitis and for prophylaxis against ophthalmia neonatorum. For these indications, liposomal formulations with 2.5 and 5.0% PVP-I were developed. These eye drops are isotonic with tear fluid at pH 6. First in vitro tests demonstrated an excellent antimicrobial efficacy, and a placebo-controlled clinical study on volunteers showed a very good local tolerability. A study on rabbits demonstrated positive results of the PVP-I liposome eye drops compared to placebo and the broadspectrum antibiotic Polyspectran in a standardized model of Staphylococcus aureus deep eye infection. The other aim is a well-tolerated liposomal PVP-I hydrogel for improved antiseptic wound treatment with moisturizer. It has been reported that liposomes are enriched at the wound bottom for direct action against infection and support of wound healing. An animal study on the efficacy and tolerability of different formulations of a hydrogel with PVP-I liposomes in deep dermal burn wounds has indicated an outstanding quality of wound healing with smooth granulation tissue, less inflammation, less wound contraction and no hyperkeratotic reactivity, especially with the 3% PVP-I liposome formulation.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron. METHODS: With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment. RESULTS: Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups. CONCLUSIONS: An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.

In albinism a large proportion of nerve fibres originating in temporal retina cross the midline at the chiasm and project to the contralateral hemisphere. Studies in rodents with albinism have suggested that the extent of this misrouting at the chiasm is inversely related to pigmentation levels. Here, we examine whether there is evidence for a similar relationship in humans with albinism. Functional MRI was performed on 18 subjects with albinism, 17 control subjects and six controls with nystagmus as they underwent hemifield visual stimulation of nasal or temporal retina. Functional activation in 16 coronal slices beginning at the posterior occipital lobes were analysed and the extent of hemispheric response lateralization at each slice position was determined. During temporal retina stimulation, the control response was lateralized to the hemisphere ipsilateral to the stimulated eye for all slices. In albinos, the response in posterior slices was predominantly in the contralateral hemisphere, consistent with misrouting of temporal retina fibres. However, as slice location became progressively anterior, response lateralization reverted to the ipsilateral hemisphere. The slice location at which the transition from contra- to ipsilateralization occurred provided an estimate of the extent of fibre misrouting in the individual. The slice transition location correlated negatively with pigmentation level, providing the first evidence for a relationship between pigmentation and the extent of misrouting in humans with albinism.

BACKGROUND: The first 26 patients who underwent photorefractive keratectomy with an excimer laser in our clinic with a 1-year follow up voluntarily answered a questionnaire. METHODS: It was intended to get information about their social status, motivation, expectations, and satisfaction with myopic excimer laser photorefractive keratectomy. RESULTS: All patients wore corrective lenses before surgery; 74% wore no optical correction after the photorefractive keratectomy. "To improve general vision" was the highest ranked motivation while "looking better" was only of minor importance. Seventy-two percent reported that their subjective vision became better; 28% felt that it didn't change, but none reported deterioration of subjective vision. Seventy-five percent of the patients reported improvement of their lifestyle after surgery, whereas 21% reported no change and one patient stated that his lifestyle got worse. On a scale ranging from 1 to 5, early postoperative course was painful with a mean score of 2.25; the treatment itself was considered as professional (1.42 +/- 0.8) and well done (1.54 +/- 0.8). Eighty-four percent of the patients reported that they were satisfied with the overall results. CONCLUSIONS: All patients would decide again to have photorefractive keratectomy for myopic correction.

Complications of photorefractive keratectomy (PRK) for myopia correction are presented based on 615 procedures with a follow-up of up to 2 years. Intraoperative complications with experienced surgeons are extremely rare. The used laser system worked without technical failures for the last 18 months. Gross eccentricities of the ablative zone (1.0 mm to 1.5 mm) occurred in two eyes (0.3%). Also, epithelial disorders are very rare. Recurrent erosions did not occur. Increased intraocular pressure due to the postoperative steroid medication (dexamethasone 0.1% or prednisolone 1%) was manifest in about 30% in patients with a baseline myopia of up to -9.0 D. In myopia over -9.0 D the incidence of steroid glaucoma was about 50%. Steroid responders reveal an increased risk of overcorrection. Subepithelial haze is a common symptom after PRK. Scarring interfering with vision correlates with the amount of attempted correction: up to 6.0 D the incidence of scars is about 0.5% and increases to more than 10% in corrections of more than 10 D. Also, undercorrections of more than 1 D depend strongly on the attempted correction. The most severe complication was a noninfectious corneal ulcer in a patient with systemic lupus erythematosus. Therefore, autoimmune and connective-tissue diseases represent an absolute contraindication for PRK. Corrections of more than 6.0 to 7.0 D should be considered as a relative contraindication for PRK at this time.

BACKGROUND: In human albinism the plasticity of the visual system is challenged, as part of the temporal retina projects abnormally to the contralateral hemisphere. AIM: To investigate whether the sensitivity of the abnormally projecting temporal retina is preserved. METHODS: Light spot detection sensitivities were assessed in the central 20 degrees of the visual field in 15 patients with albinism and electrophysiologically determined extent of the retinal projection abnormality, and in 6 controls. The sensitivities were determined monocularly with static white-on-white perimetry using Octopus 101. RESULTS: In the patients with albinism, the sensitivity of the abnormally projecting part of the temporal retina was not selectively reduced. Apart from the vicinity of the papilla, there was no significant sensitivity difference between nasal and temporal retina in both patients with albinism and controls. CONCLUSIONS: While in the present study the papilla-induced scotoma was detected in those with albinism tested, there was no indication of a selective visual field defect induced by the projection abnormality. This contrasts with the selective visual field defects observed in some animal models of albinism, and indicates that, in humans, mechanisms of cortical self-organisation make the abnormal representation available for visual perception.

<i>Purpose:</i> To analyze a multiflash multifocal electroretinogram in 20 patients with open-angle glaucoma (OAG). <i>Methods:</i> The stimulation sequence consisted of a binary m-sequence (L<sub>max</sub> 200 cd/m<sup>2</sup>, L<sub>min</sub> <1 cd/m<sup>2</sup>). Each m-sequence stimulus was followed by three global flashes (luminance: 400 cd/m<sup>2</sup>) at an interval of 26 ms. <i>Results:</i> The presence of a response to the three global flashes indicated an adaptive effect of the response to the preceding m-sequence stimulus. In the nasal retinal response average the relative amplitude contribution of the response to the second global flash in relation to the other two global flash responses was outside the range of normal (10th–90th percentile) in 10 of 20 OAG patients. <i>Conclusions:</i> The changes in the relative contribution of the response to the second global flash seem indicative of impaired adaptive effects presumably due to inner retinal damage.

AIM: To analyze the epidemiology of open eye globe injuries and their treatment outcomes in patients treated at two university eye clinics in Germany in the past two decades. METHODS: Retrospective analysis was performed of medical records of 1,026 patients with open globe injuries primarily treated at the Universities of Freiburg and Wurzburg between January 1981 and December 1999. Final visual function was determined as a parameter of age, extent of injury, sex, cause of injury, and activity at the time of injury. Relative risk was calculated. RESULTS: After correction for the demographic distribution, the risk for open globe injury was 1.7 times the average for young adults and 0.6 for seniors. In the recent years, the risk for severe eye injury has been more equally distributed and is increasing for old people. The proportion of injuries at work decreased over the studied period from 42% to 32% for all open globe injuries, and the proportion of injuries in traffic accidents decreased from 30% to 4%. The number of eye injuries related to hobby activities increased. The proportion of enucleations and blindness decreased. Social life and income was moderately or severely impaired in 27% of patients after severe unilateral eye trauma. The median follow up of patients was 7 months. CONCLUSION: The prevalence and types of open globe injuries changed over the years, especially in relation to the law requiring seat belt use in traffic. The progress in surgical techniques led to a significant reduction in the number of blind eyes after injury. The proportion of enucleations and blindness decreased partly due to better surgical techniques, but mostly due to the decrease in injuries with usually poor outcome, such as gunshots, ruptures, and windscreen injuries.

OBJECTIVE/AIM: One of the factors limiting the long-term success of glaucoma drainage devices and traditional filtering surgery is the tendency of bleb encapsulation. Glaucoma shunts present an opportunity of introducing drug-eluting mechanisms for a lasting exposure of the bleb to anti-proliferative substances. The aim of this in vitro study was to investigate the effects of short- and long-term exposure of primary cultures of human Tenon's fibroblasts to different concentrations of paclitaxel on cell proliferation, migration, collagen production and cytotoxicity, in order to evaluate the suitability of the drug for the use in such a device. MATERIALS/METHODS: Seven individual primary cultures of human Tenon's fibroblasts were observed over the course of 1 week after administering paclitaxel concentrations varying from 10(-9) mol/l to 10(-6) mol/l for either 1 hour or continuously. Relative cell count and migration across a cell-free area introduced by scratching through a confluent cell layer were determined every 24 hours, using photomicrographs of the cells for each concentration and exposure time. Soluble collagen concentration in the cell culture medium was determined using a Sircol collagen assay 72 hours after paclitaxel exposure. Cytotoxicity of the compound was assessed by flow cytometry using dual staining with annexin V-FITC and propidium iodide. RESULTS: Paclitaxel dose-dependently inhibited both proliferation and migration of the cells. Cell count was reduced at all concentrations and both exposure times (p = 0.001); similarly, all but two concentrations of paclitaxel caused a significant reduction of cell migration (p < 0.001). This may be explained in part by the dose- and time-dependent induction of apoptosis in up to 23.7% of the cells (maximal effect at 10(-6) mol/l, 7 days after exposure). Collagen production was significantly reduced at all concentrations and at both exposure times. However, no statistically significant difference was observed between any of the concentrations, indicating that this inhibition may be an indirect effect. CONCLUSION: Paclitaxel may be a useful addition to the repertoire of anti-proliferative substances currently in use in glaucoma filtering surgery and shunt implantation. Further studies of the compound and its effects on Tenon's fibroblasts as well as other ocular tissues are warranted.

Zusammenfassung. Aufgrund einer ausführlichen Besprechung eigener Fälle und mit Berücksichtigung von Angaben aus der Literatur wurde die Meinung ausgesprochen, dass die Uveo‐Parotitis (Heerfordt) als Teilsyndrom der Besnier‐Boeck‐Schaumannschen Krankheit aufzufassen ist. Es wurde weiter dargetan, dass höchst wahrscheinlich die Tuberkulose als Ursache der Besnier‐Boeck‐Schaumannschen Krankheit zu betrachten ist, wobei der häufig negative Ausfall der Tuberkulinreaktionen einer näheren Analyse unterzogen wurde.