Welcome to the next issue of IJO Diamond Jubilee year. The IJO Diamond Jubilee Year was heralded with great éclat. The inaugural session saw a special tribute to the IJO with a portrait of IJO made with a difference. For those of you, who missed it, kindly view it on www.ijo.in.
The special IJO session ‘Publish or Perish,’ in association with the Asia Pacific Journal of Ophthalmology and the British Journal of Ophthalmology at the just concluded APAO - AIOS 2013 in Hyderabad was extremely well received. The sessions were highly interactive with Dr. Arun Singh's talk on Scientific Fraud evoking heated discussions on consequences arising out of such fraud. While Dr. Dua's talk on Plagiarism was an eye opener to all present. Prof Jost Jonas gave a very lucid overview of manuscript structure. Dr. B K Nayak shared his profound knowledge of statistics with customary elan. Dr. V Sangwan and Dr. R Sinha shared the secrets of how to get manuscripts published keeping in mind the stringent peer-review systems. Prof H Taylor crystallized the essence of manuscripts in his talk on “Summary.” I elaborated on the necessary prerequisites required to be an author and the team members to be included in the authorship. The importance of a statistician in the writing of a manuscript was emphasized.
The next AIOC Conference in Agra is scheduled in 6-9 February 2014 and will see the culmination of the IJO Diamond Jubilee celebrations. It has now been named as the AIOC IJO DIAMOND JUBILEE CONFERENCE 2014. I look forward to seeing all of you there.
This issue sees an article by Khodadad Moradian and Ramin Daneshvar evaluating viscocanalostomy for uncontrollable primary open-angle glaucoma in Iran. The high success rate and low complication rate are highly encouraging to suggest popularization of nonpenetrating glaucoma procedures in developing countries. Their findings could inspire other developing countries to look at this as an alternate treatment option.
Two population sub-groups have been evaluated in this issue. Abdul Rauf and Rizwan Malik have followed up Asians from the Indian subcontinent in the United Kingdom. Visual impairment rate among Asians was found to be similar to the Caucasian populations, but the prevalence of cataract and diabetic retinopathy is higher. As in his article, specific population subgroups need to be evaluated so that healthcare accessibility can be channeled in the right direction for the minority communities.
Among patients with bilateral pediatric cataracts, it has been concluded that early detection and surgery, optical rehabilitation, and close follow up are essential for good outcome, especially in those aged less than 1 year, as seen by Rohit C Khanna. Early evaluation is extremely important and should be stressed upon in practice and I always advocate “Prevention is cheaper than cure.”
Raghavendra Rao and Ajita Sasidharan have studied and found iris claw intraocular lens to correct monocular aphakia in eyes without capsular support and have suggested that it may be a better option than a scleral-fixated or an angle-fixated IOL. This article puts forward another treatment option. The results are encouraging. This treatment method needs to be looked at and compared with the standards in management to make it a regular treatment option.
In this issue, Marcella Nebbioso, in his article, has attempted to compare the results of multifocal VEP (mfVEP), traditional pattern-reversal Visual Evoked Potentials (VEP) and frequency-doubling technology (FDT) perimetry, in optic neuritis (ON) patients.
In patients with optic neuritis, any kind of visual field defect, central, ceococentral, paracentral, attitudinal, or peripheral defect can be seen. Confrontation type of field examination must be the part of routine clinical evaluation. Visual field analysis is done with short wavelength automated perimetry (SWAP) using 30-2 or 24-2 program. Frequency double perimetry in which frequency doubling effect phenomenon is utilized have several advantages like rapid test, has low retest variability, having small and portable equipment, and does not require a special room with controlled lighting as compared with conventional automated perimetry, but the main disadvantage is that it is affected by cataract, as are all tests of contrast sensitivity. VEP has a certain role in the diagnosis of optic neuritis, particularly in retrobulbar neuritis. It is simply a gross electric potential of the visual cortex in response to visual stimulation. Typical response comprises of delayed latency and reduced amplitude. Pattern VEP stimulates the ganglion cells of the parvocellular system corresponding to central 10°. Multifocal VEP stimulates both the magnocellular and parvocellular systems corresponding to central 24°. In this study, it is clear that mfVEP can also detect lesions missed on automated perimetry and subclinical demyelination. The potential of mfVEP to detect subclinical demyelination is yet to be tested for its usefulness in eyes of multiple sclerosis (MS) patients that never had a manifest ON. In future, we may be able to answer these pressing questions and be able to relieve or prevent pain and disability in MS patients
The authors have mentioned that even though the mfVEP is an evolving technology and can detect damage missed with the automated perimetry, the opposite may also be true, since the relative advantage of the mfVEP varies with the recording characteristics. It has the advantage of detecting early damage in optic neuritis and for observing disease progression. However, they feel that the difference between VEP and mfVEP is insignificant and further studies may compare the utility of these tests longitudinally.
Newer and more sophisticated techniques and technology are coming up every day. Each of these have advantages that come to the forefront as we utilize and explore their potential. Newer uses of the available resources add further insights to our already large bag of tricks. What is exciting is that the research being done in this evolution and one feels an urgent need for evidence-based evaluation of the questions that we raise so that what seems exciting on paper becomes a reality in practice and can benefit the patient, who needs it the most.
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