This issue of <i>Acta</i>

This issue of Acta emphasizes pseudoexfoliation syndrome, as demonstrated by Fridbert Jonasson’s cover illustration. Jonasson has also written the editorial, in which he discusses the recent Icelandic discovery of the genetic basis of exfoliation glaucoma. Drolsum, Ringvold and Nicolaissen, based in Oslo, review cataract and glaucoma surgery in pseudoexfoliation syndrome. Pseudoexfoliation syndrome is a risk factor in cataract surgery because of weak zonules and reduced pupillary dilatation. Glaucoma is frequent in eyes with pseudoexfoliation syndrome. Compared with primary open-angle glaucoma, exfoliation glaucoma is frequently worse at the time of diagnosis, and responds poorly to medical therapy, but better to argon laser trabeculoplasty. Arnarsson et al., writing from Reykjavik, Canada and Japan, found pseudoexfoliation syndrome to be an age-related phenomenon, associated with elevated intraocular pressure (IOP) and more commonly seen in women than in men. Swedish authors Åström and Lindén, in Umeå, found pseudoexfoliation syndrome to affect about a quarter of individuals over the age of 66 years in northern Sweden and to be more common in women. Elevated IOP is six times more frequent in eyes with pseudoexfoliation syndrome than in those without and the prevalence of open-angle glaucoma is 2.1% in this group. Åström et al. followed up on their study of pseudoexfoliation and found that the prevalence of pseudoexfoliation syndrome increases with age. The risk of glaucoma is four times higher in patients with pseudoexfoliation than in those without. Ankara-based Koz et al. compared three prostaglandin analogues and found all of them to reduce IOP and ocular perfusion pressure in patients with glaucoma and ocular hypertension. Travoprost and latanoprost also reduced the resistance indices of the central retinal and ophthalmic arteries. Borazan et al., also writing from Ankara, compared different mixtures of local anaesthetics for peribulbar anaesthesia in cataract surgery. They found no clinically significant difference between the various mixtures. Japanese researchers Oshika et al. report the incidence of endophthalmitis after cataract surgery in Japan to be about 0.05% and to be similar in clear corneal incisions and scleral incisions in phacoemulsification surgery. Ness et al., based in Freiburg, found Candida and Aspergillus in eyes with endogenous endophthalmitis. Their patient group was immunocompromised and one-third were intravenous drug abusers. Visual prognosis depends on the micro-organisms and is particularly poor in case of infections with gram positive bacteria or Aspergillus. Monteiro et al., writing from Portugal, used topical and subconjunctival anaesthesia for secondary intraocular lens (IOL) implantation in eyes without capsule support. They report that this technique works well with foldable IOLs. Jonasson and associates, collaborating between Iceland, Denmark and the USA, used optical coherence tomography to study early morphological changes in Sveinsson’s chorioretinal atrophy. They found early damage in the photoreceptor/retinal pigment epithelium junction and suggest that other changes in the retinal pigment epithelium choriocapillaris and inner part of the photoreceptors may be secondary. Linköping authors Frennesson and Nilsson studied eccentric viewing in patients with central scotoma and found that reading performance is better when subjects use the superior rather than the inferior retina. Goncalves et al., of Brazil, found increased levels of the CXCL8 chemokine in acute toxoplasmic retinochoroiditis and suggest this may be a useful marker in patient follow-up. Nguyen et al., based in Germany, used low-vision aids to improve vision-related quality of life after macular translocation surgery. Although best corrected visual acuity did not significantly improve with macular translocation surgery, 53% of patients reported a subjective improvement in visual function and reading ability. Nagai and associates, in Japan, compared the surgical outcomes of macular hole surgery performed with and without indocyanine green. Mean visual acuity was similar between the two groups. Vienna-based Kiss et al. report two cases of retinal pigment epithelium tears following intravitreal ranibizumab therapy. Also writing from Vienna, Prager et al. describe the treatment of choroidal neovascularization in Sorsby’s fundus dystrophy with systemic bevacizumab. Århus authors Nielsen and associates estimate the prevalence of keratoconus in Denmark to be 86 patients per 100 000 residents and the incidence to be 1.3 per 100 000 per year. New Delhi researchers Gupta et al. used neodymium:YAG laser or surgical excision for post-traumatic iris cysts, but found the surgical outcome to be generally poor, with a high rate of recurrence. Grzybowski and Kaufman, writing from Poland and the UK, review the contributions to neuro-ophthalmology of Charles Bell a 19th century Scottish scientist. I hope that this issue of Acta provides good Christmas reading for all. May I send my best wishes for a Merry Christmas and a Happy New Year to all readers and contributors, and thank you for your ongoing support of Acta.

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