Microvascular Changes In Retina Research Articles

This issue of Acta Sept 2018

The cover illustration shows a macular haemorrhage, as described by Schargus from Dusseldorf in the electronic part of this issue. Vaes et al in the Netherlands and Belgium point to microvascular changes in retina of patients with chronic obstructive pulmonary disease. Ramdas in Maastricht reviews the literature on dietary influences in glaucoma. Iron and selenium may increase risk, and leafy vegetables decrease risk of glaucoma. However, the data are limited. Bengtsson et al and Lindén et al in Sweden describe the ongoing GLAUCOMA INTENSIVE TREATMENT STUDY and show that intensive treatment lowers IOP more than monotherapy. The study will determine the effect of intensive glaucoma therapy on visual field progression and predict vision loss at life's end. Willekens et al in Belgium and Portugal found that some glaucoma patients have posterior vitreous detachment at an older age than healthy controls. Farhoudi et al in Sweden demonstrate that patients benefit from new spectacle following cataract surgery. Stolk-Vos et al in the Netherlands emphasize the advantage of recording patient-reported visual function and recommend the Catquest-9SF questionnaire. Grimfors et al in Sweden use the Swedish National Cataract Register to demonstrate a correlation between patient-reported improvement and visual function on the one hand and surgical complications, comorbidities, age, gender and visual acuity on the other. Næser et al in Denmark and Italy show that corneal astigmatism is stable until age 50 and changes by 0.25 dioptres every 10 years thereafter. Frimmel et al in the Netherlands and Switzerland report significant eye trauma from fireworks on new Year′s Eve. Sahraravand et al in Helsinki found falls at home to cause most eye injuries in elderly Finns. Bro and Lindblom in Sweden point out that visual requirement for driving are variable in Nordic countries. Mourits et al in the Netherlands looked at cosmetic outcomes following enucleation or radiation for retinoblastoma. Orbital implant complications were manageable, whereas external beam radiation gave less favourable cosmetic outcomes. Scheerlink et al in the Netherlands found better foveal sensitivity on microperimetry with gas compared with silicone oil tamponade for retinal detachment. Leinonen et al in Helsinki used intravitreal steroid implants to treat uveitis-related macular oedema. Pérez-Trullén et al in Spain propose that Goya had age-related cataract and this influenced his late paintings. The following articles are published electronically and are accessible on www.actaophthalmologica.com, as are all articles in Acta for the last century. Leal et al in Portugal and UK conclude that intravitreal injection of anti-TNF antibodies is a possible but not proven treatment for noninfectious uveitis. Zhu et al in China provide a comprehensive review on exercise and glaucoma, including the possible effect on IOP, blood flow and neuroprotection. Kang et al in United States and Australia found that total flavonoid intake does not influence glaucoma risk. Mataki et al in Japan correlated beta peripapillary atrophy with age, lower IOP and disc-fovea distance. Rabensteiner et al in Austria found Meibomian gland dysfunction to play a major role in dry eye, often in combination with reduces aqueous tear secretion. Klingensteiner et al in Munchen recommend PET scanning for orbital adnexal lymphomas. Liu et al in China influence angiotensin pathways in retina with microRNA. This affects proliferation and apoptosis in retinal endothelial cells in diabetic rats. Rose et al in Canada and Australia measure changes in retinal perfusion and oxygen metabolism in radiation retinopathy. Hanhart et al in Israel suggest that bevacizumab intravitreal injections may increase mortality in patients who have recently suffered TIA or stroke. Blixt et al in Denmark and Sweden found that endothelin-1 induced vasoconstriction in retina can be suppressed and this may offer treatment possibilities in retinal ischaemia. Subhi and Sörensen in Denmark view pigment epithelial detachment in 3D and measure volume. They suggest that such analysis may be superior to current practice. Shargus in Dusseldorf supplied the cover illustration of a picturesque retinal haemorrhage. Ferreira et al in Portugal used infrared pupillometry to demonstrate transient pupil changes following laser iridotomy. Diederen et al in the Netherlands recommend Baerveldt implants in uveitis glaucoma in young patients. Vohra et al in Denmark found vision loss in a patient with cerebral amyloid angiopathy. Grzybowski and Nowak in Poland found similar rate of myopia in Polish children as in other Caucasian cohorts. Schrader et al in Germany present a plastic compressed collagen device, which they transplanted onto the corneal surface of a patient with corneal ulcer. Krohn et al in Norway describe a slowly progressive RPE dysgenesis with severe visual loss. I hope this issue of Acta provides pleasant and informative reading in the cool and dark evenings ahead.

Disturbance of Inorganic Phosphate Metabolism in Diabetes Mellitus: Its Impact on the Development of Diabetic Late Complications

The pathogenesis of diabetic late complications (DLC) is multifactorial. Studies of mechanisms leading to early functional microvascular changes in retina and kidneys point towards a disturbance in the metabolism of inorganic phosphate (Pi) in diabetes. Since tissue hypoxia and reduced high energy phosphates may be important factors in the development of DLC, the influence of Pi concentration on the metabolism and function of the erythrocytes and renal tubular cells, as well as the relationship of the concentration of Pi to total oxygen consumption, have been reviewed. While extensive research data in non-diabetic conditions support the suggestion, that the Pi concentration is a determining factor in regulation of metabolism and rate of oxygen consumption, diabetes shows the opposite behavior. In diabetes, the highest oxygen consumption is associated with the lowest concentration of Pi. Many conventionally-treated juvenile diabetic patients respond as if their tissues were in a state of chronic hypoxia. A disturbance in phosphate handling occurs in the kidney tubules, where the excessive sodium-dependent glucose entry in diabetics depolarizes the electrochemical sodium gradient and consequently impairs inorganic phosphate reabsorption. Similar changes may occur in other cells and tissues in which glucose entry is not controlled by insulin, and particularly in poorly-regulated diabetic patients in whom long-term vascular complications are more likely.