This Issue of Acta (2003)

We continuously strive to increase the variation of the contents of Acta Ophthalmologica. Thus Acta now has several sections that did not exist several years ago: our image section, Diagnosis and Therapy in Ophthalmology; Clinical Questions with Answers; more review articles, editorials and guest editorials. We are continuing this development and in this issue you can find two new types of contributions. The Artist's Eye is a new section, where Dr Werner Polland will publish a series of lavishly illustrated short articles on possible ophthalmic conditions of famous historical artists. The first one in this issue is about Albrecht Dürer. I thoroughly enjoyed Polland's text and the accompanying works of art and I hope that you will also find these contributions stimulating. This section will not stay forever, but Acta will strive to provide similar lighter, yet educational material in the future. This month's Review Article is the second new concept in the current issue. Here Stefánsson and coworkers have used the program of the 2002 Nordic Ophthalmologic Congress in Tampere as a platform to provide a broad overview of current ophthalmic research in the Nordic countries. This makes interesting reading, and a similar article should be written after the upcoming NOK36 in Malmö, next year. The Guest Editorial by Shaarawy deals with glaucoma surgery and is inspired by three papers in the current issue. Results from large controlled glaucoma trials that have been published during the last one or two years, have demonstrated that IOP reduction clearly influences the course of the disease, and some of the results indicate that for some patients target pressures need to be low. We certainly have access to a much broader armamentarium for medical treatment of glaucoma than 10 years ago, but as Shaarawy points out, we all wish that surgical treatment had improved as much as medical treatment and diagnostics. Non-penetrating surgery has met with a lot of interest and been subjected to much development in the last decade. Drolsum reports results from deep sclerectomy. Particularly interesting in the Nordic countries is that success rate was higher in exfoliation than in primary glaucoma. An article in this issue by Vuori describes serious complications that may follow goniopuncture after deep sclerectomy. Three patients had spontaneous iris prolapse with high IOP, and the author discusses how this complication might be avoided. In a retrospective study Fagerli and coworkers describe the results of needling revision of failed blebs after glaucoma filtering surgery. The results are encouraging, and may inspire us to closer postoperative follow-up of patients after trabeculectomy, and possibly earlier needling when we notice early but definite signs of bleb failure. The variety of the other papers in this issue is large. We have all got used to messages of how smoking negatively influences our health. In a controlled study Satici and coworkers demonstrate negative ocular surface changes of many different parameters in smokers; one more reason not to smoke. Stone et al. have studied refraction and ambient lighting in Finnish conscripts. Sauder and Jonas compared topical and peribulbar anaesthesia for cataract surgery in a randomised, large, prospective study. Acta's readers should feel comfortable with the results; the authors suggest topical anaesthesia as the first choice. Jonas' group has another interesting paper in this issue. They describe and test a computer-based medical work station for simulated pars plana victrectomy. Maybe approaches such as this could take the tension out of the first step of young, learning posterior segment surgeons; patients might in fact be the most grateful. Refracting children always poses a challenge, particularly for the clinician who does not feel entirely comfortable with a retinoscope in his hand. The results of Abrahamsson, Ohlsson et al. provide some comfort. They tested the new Power-refractor and conclude that this instrument can be a helpful tool in large-scale screening examinations of children. Levofloxacin and ciprofloxacin eye drops were compared by Colin and coworkers. Levofloxacin gave higher aqueous humour levels indicating that it may be preferable for prophylaxis. This issue will now be further evaluated in an ESCRS trial. O'Keefe et al. report outcomes of feared Zone 1 ROP and discuss the importance of their observations for screening and disease management. Toker et al. have studied ocular blood flow in pre- and postmenopausal women. There are three biochemical/experimental papers in this issue. Alyahya and coworkers studied biochemical changes in melanoma-associated spongiform sclerophaty (MASS). Mitsuhiro et al. show that transforming growth factor-β can influence RPE cell migration, and demonstrate mechanisms of action. Effects of ageing on the insulin signalling system have been studied in rats by Rocha et al. The Diagnosis and Therapy in Ophthalmology section shows a beautifully illustrated case of subretinal haemorrhages with increasing lacquer cracks. There is an increasing interest of intravitreal steroid treatment for a variety of conditions. Karacorlu and coworkers in this issue present a case series where six pseudophakic patients with chronic resistant to medical treatment (CME) were treated with intravitreal triamcinolone. All patients improved dramatically. There is also an interesting review of patients with cat scratch disease from Japan. And there are also many interesting letters to the editor in the current issue.