THIS ISSUE OF ACTA (2006)

This issue of Acta has more pages than normal. We have more than 150 pages of scientific material, which is 32 pages more than the average issue. Submissions to Acta are at an all time high and were between 700 and 800 in 2005. We are only able to publish 150–200 of the submitted manuscripts each year and are therefore forced to reject many good manuscripts. The extra 32 pages in this issue of Acta allow us to print a few more good articles. The cover illustration shows a colour fundus photograph and fluorescein angiography of a giant traumatic tear in the retinal pigment epithelium. The case is described in a letter to the editor by Amiel et al. in this issue. Jan Ulrik Prause discusses the upcoming Nordic Congress of Ophthalmology in Copenhagen in June 2006. Algvere, Marshall and Seregard present an outstanding review article on the pathogenesis of age-related maculopathy. They discuss photochemical retinal light damage, age-related alterations of the retina, inflammatory response in age-related maculopathy, light toxicity and free radicals and prophylactic treatment with antioxidants. The article will update the reader on the latest developments in the pathophysiology of age-related macular disease. Bek and Erlandsen in Aarhus studied the visual prognosis after pan-retinal photocoagulation for proliferative diabetic retinopathy and found that the visual acuity prior to treatment, age and number of treatment sessions with laser or surgery influence the visual prognosis. Not surprisingly, older patients with worse vision who need more extensive treatment for stabilization of their disease have worse visual prognosis. Laser photocoagulation is also used for retinopathy of prematurity and Kieselbach et al. from Innsbruck found that most eyes with retinopathy of prematurity respond well to photocoagulation. Complications of treatment included hemorrhages that resorb spontaneously and an occasional cataract. Most of the eyes had considerable hypermetropia. Transpupillary thermotherapy has been debated as a treatment in age-related macular degeneration. Pirozzi et al. in Rome used focal electroretinography to study the short-term changes in macular function following transpupillary thermotherapy. They did not find significant changes in macular function with this treatment and were able correlate changes in focal electroretinography to those in visual function. Plantinga and a group of Dutch and Finnish researchers report on visual impairment in Usher syndrome in Finland and Holland. They find a progressive deterioration in visual function in the Finnish Usher syndrome type 3 patients and this is similar to the rates seen in Dutch Usher syndrome patients. Kiilgaard, Nissen and la Cour from Copenhagen study the effect of indocyanine green dye on retinal pigment epithelial cells in culture. They found that hyperconfluent retinal pigment epithelial cell cultures tolerated the indocyanine green dye well, unlike what has been previously been reported for more immature retinal pigment epithelial cell cultures. The implications of this for the clinical use of indocyanine green dye in vitreoretinal surgery are interesting and important and warrant further clinical studies. Saeed et al. from London propose a combination of pneumatic retinopexi, cryotherapy and scleral buckling to avoid subretinal fluid drainage in selected cases of primary rhegmatogenous retinal detachments. This is an interesting alternative to conventional subretinal fluid drainage with cryotherapy and scleral buckling. Kükner et al. in Turkey study leptin expression in experimental uveitis. The leptin expression seems to be closely related to ocular inflammation and is inhibited by vitamin E, melatonin and protinin. The letter to the editor section contains correspondence regarding a previous article in Acta on duration of face down positioning after macular holes surgery as well as the presence of propionibacterium in the vitreous fluid in patients with sarcoidosis. The medical literature tends to emphasize data over ideas. The article by Grieshaber, Terhorst and Flammer from Basel is an exception. The authors propose a hypothesis on the pathophysiology of optic disc hemorrhages and propose that these are due to disturbed blood retinal barrier. While further study is needed to further test this hypothesis, it provides an interesting approach to a well known phenomenon. Lam et al. from Philadelphia studied glaucoma patients with peripapillary focal arteriolar narrowing and found this feature to have no significant relationship to a cardiovascular risk factors. Lindblom and a large group of researchers from Sweden, France, Germany, the United Kingdom and the United States looked at resource utilization and costs associated with glaucoma management in France and Sweden. The annual cost per patient is almost 400 Euros in France and more than 500 Euros in Sweden and half of the cost is medications. Hoevenaars et al. in Maastricht used a questionnaire to study glaucoma patients' knowledge of their disease and not surprisingly found this to be positively related to socioeconomic status. Buller and Hercules in Manchester write a letter to the editor where they asked glaucoma patients about the preference for eye drop regiments and suggest that ophthalmologists should consult their patients before they decide on the glaucoma treatment regiment. Vuori and Mäntyjärvi in Turku found that the blue light filtering intraocular lens did not affect color vision tests nor did it influence the evaluation of retinal nerve fiber layer photographs. Similarly Leibovitch et al. in Australia found that a yellow intraocular lens had postoperative visual performance comparable to a clear intraocular lens and both color vision and contrast sensitivity were not affected by the intraocular lens color. Bäckström and Behndig in Sweden found that intracameral mydriatics are effective in redilating the pupil during phacoemulsification surgery and also confirmed the benefit of epinephrine in the irrigation solution in cataract surgery. Cagini et al. in Italy compared limbal anesthesia with topical anesthesia in cataract surgery. 92–95% of the patients tolerated the procedure well and no patients required supplemental anesthesia during the cataract procedure. Jonas et al. in Mannheim write a letter to the editor and found that inexperienced surgeons, low preoperative visual acuity and patients fasting were associated with intraoperative lens capsule problems in cataract surgery. Grueb et al. in Tübingen demonstrated the presence of several monoamine receptors in the human cornea. These include alpha and beta-adrenergic receptors and the authors suggest that they may play a role in the regulation of fluid transport in the cornea. Jonsson, Markström and Behndig in Umeå found that within increasing age the aqueous humor volume is decreased and the cornea becomes thinner. They also found significant differences between the genders in this regard. The authors suggest that these normal differences may be important in refractive surgery. Kamis et al. in Turkey report in a letter to the editor a comparison of the efficacy of olopatadine eye drops to artificial tears in seasonal allergic conjunctivitis and indeed find the olopatadine to be effective. Seider and an American-Israeli group report the use of commercially available fascia lata allografts in frontalis suspension and find this to be useful in the treatment of adult myogenic blepharoptosis. Siepmann et al. in Tübingen use the scanning laser ophthalmoscope to study fixation behavior in patients with strabismic amblyopia. The patients with the worst visual acuity tended to have eccentric fixation. They discuss the relationship between the sensory and motor adaptation of visual function in patients with strabismus. Østergaard, Prause and Heegaard in Copenhagen reported 574 caruncular lesions studied in Denmark over a 25-year period. 96% of the caruncular lesions were benign and nevi and papillomata were most common. Basal cell carcinoma and lymphoma were the most common malignant lesions. In the diagnosis/therapy in ophthalmology section Zhou and an American-Chinese group of researchers present a 7-year-old boy with a cystic intraocular medulloepithelioma in the anterior chamber of the eye. Pomeranz, Agadzy and Ekesten from Minneapolis and Uppsala present the case of an 18-year-old boy with achiasmia and unilateral optic nerve hypoplasia. Claes and associates in Brussels and Paris report a case of retrobulbar optic neuropathy due to rupture of an anterior communicating artery aneurysm in a 29-year-old woman. I hope that this issue of Acta contains something of interest for all our readers and contributes to the science of ophthalmology and the well being of our patients.