This Issue of Acta (2002)

The review article in this issue deals with loss of vision, and corticosteroid therapy in giant cell arteritis. This paper, by Hayreh, Zimmerman and Kardon, is both an original article reporting important data gathered over a very long time period in a large number of patients, and a comprehensive literature review. The results should be highly interesting to all ophthalmologists, and shows that in spite of prompt high-dose corticosteroid therapy only 4% (5 out of 114) of patients with sudden visual loss caused by giant cell arteritis showed genuine improvement in both visual acuity and central visual field. Higher improvement rates reported previously may represent patient learning rather than true improvement of neuronal function. Age-related macular degeneration (ARMD) represents one of the largest challenges for ophthalmologists today. Surely photodynamic therapy has given us a new therapeutic tool, but as clinicians we know that this tool is no panacea. Research on transplantation of pigment epithelial cells and of neuronal tissue are both pursued in many centres today. A report from Crafoord and co-workers in this issue showed that in rabbits autologous iris pigment epithelial cells transplanted to the subretinal space did not disturb the normal appearance of the area of the transplant, and damage to the adjacent photoreceptors occurred only in circumscribed locations where transplanted cells were multilayered. The cover of this issue shows a histologic section from this study. Antioxidants are one of many types of compounds that have been supposed to be of potential value in ARMD. Snellen and co-workers present a study in this issue showing that 72 patients with ARMD had considerably lower dietary antioxidant intake than 66 control patients. This study can motivate a prospective trial studying the influence of nutritional or supplementary factors in the prevention of ARMD. Advanced diabetic retinopathy is another dreaded retinal disease. Screening for signs of vision-threatening retinopathy is of course an essential early step necessary to institute laser treatment to prevent serious visual damage. Von Wendt, Heikkilä and Summanen compared 45 and 60 degree fundus photography in the screening for such disease. Important proliferative retinopathy may remain undiagnosed in a rather large percentage of patients if the fundus appearance is judged from only two 45 degree photographs, centered on the fovea and on the disc, respectively. Thus, the results of von Wendt and co-workers indicate that in photographic screening for diabetic retinopathy, it is important to use as wide photographic fields as possible, or a combination of several photographic fields from each eye. Retinal ischaemia may play an important role in the development of ocular damage, e.g. in diabetic retinopathy and glaucoma, and agents with protective properties are intensively searched for and studied. Celiker and co-workers have studied octreotide in a guinea pig model, and show that this substance have positive effects in ischaemia-reperfusion. Thus octreotide-treated animals were protected from increases in retinal thickness and retinal malondialdehyde levels induced by the pressure-induced ischaemia. Because of the development and success of corneal refractive surgery, the interest in corneal anatomy and refraction is higher than ever. Dubbelman and co-workers have used time-honoured Scheimpflug photography to study the radius and asphericity of the posterior corneal surface in 83 normal subjects. Their results show that Scheimpflug photography is an appropriate technique for such measurements, and also that the asphericity decreased with age. A case report by Keratli and Bilgiç describes a new and unusual side-effect following transpupillary thermotherapy, subretinal pigment dispersion. Abstracts of presentations at the upcoming XXXVth Nordic Ophthalmological Congress constitute the major part of this issue, – abstracts mirroring almost everything that is happening on ophthalmology today. I hope that you will have the opportunity to attend the meeting, the most important ophthalmic meeting in the Nordic Countries this year. You can find more information at http://www.nok2002.com