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Show Literature Abstracts Ophthalmology), which reveals not only a handful of retrobulbar hematomas caused by orbital fine-needle biopsy but also blindness and three deaths caused by penetration into the brain of the biopsy needle. One's impression from reading other reports from D~. Kennerdell is that this technique can be successful In very careful hands with appropriate case selection, meticulous technique, and the availability of a competent cytologist. The experience of Dr. Krohel et al. has been slightly different. Krohel and colleagues repo~t on fine-needle aspiration biopsy of 34 orbital leSIOns. These biopsies were obtained under direct visualization at the time of definitive surgery. They compared the results using fine-needle biopsy with the final histopathology obtained conventionally and found a 47% correlation, which they contrasted with Kennerdell et al.'s previously reported accuracy of 92% (in 1980). Discussion by Kennerdell following this paper critiques the selection of cases chosen for fine-needle aspiration biopsy and stresses the necessity of a cytologist well versed in orbital disease processes. Lyn A. Sedwick, M.D. • • • Fine Needle Aspiration Biopsy in Ophthalmology. Midena, E., Segato, T., Piermarocchi, S., and Boccato, P. Surv. Ophtha/mol. 29: 410-422, 1985. [Reprint requests to Edoardo Midena, M.D., Institute of Ophthalmology, University of Padova, 35100 Padova, Italy.] For those who would like to get "back to basics" and review the history of needle aspiration biopsy in general as well as how it applies to ophthalmology, this article from several ophthalmologists in Italy can be recommended. Their technique seems not appreciably different from that of Kennerdell et al. or Krohel et al. and they elaborate certain fine points of execution that will be helpful to those using or contemplating fine-needle aspiration biopsy for orbitallesions. Moreover, they discuss their use of this technique in ocular tumors as well as orbital lesions. This paper suffers from an overuse of text where tables might be more revealing; numbers of actual cases and their diagnoses would help the reader assess the strength of the authors' pronouncements. Nevertheless, this paper offers a slightly different and interesting perspective on what is becoming a hot topic. Lyn A. Sedwick, M.D. • • • Central Retinal Artery Occlusion During Cardiac Catheterization. Stefansson, E., Coin, J. T., Lewis, W. R. III, Belkin, R. N., Behar, V. S., Morris, J. J., Jr., and Anderson, W. B. Jr. Am. J. Ophthalmol. 99: 586-589, 1985. [Reprint requests to Einar Stefansson, M.D., Room lON116, Bldg. 10, National Eye Institute, National Institutes of Health, Bethesda, MD 20205.] Ischemic Optic Neuropathy Associated with Retinal Embolism. Tomsak, R. L. Am. J. Ophtha/mol. 99: 590-592, 1985. [Reprint requests to Robert L. 278 Tomsak, M.D., Desk T-ll, 9500 Euclid Ave., Cleveland, OH 44106.) These two articles in the May, 1985 American Journal of Ophthalmology are contiguous and se~m related. One describes a patient with central retinal artery occlusion during cor.onary angiogr~phy, and the other discusses two patients whose VIsual loss followed coronary artery bypass grafting and one whose loss followed cardiac catheterization. Emboli were seen in the fundi of all the patients. The embolic artery occlusion is easily explained; however, as Dr. Tomsak notes, "although highly unusual, ischemic optic neuropathy may be associated ~ith and po~: sibly caused by a shower of emboh to the eye. Ophthalmologists and car~io~ogists shoul~ be aw~re of these potential comphcatlons of certam cardiaC procedures. Lyn A. Sedwick, M.D. • • • Thymectomy in Myasthenia with Pure Ocular Symptoms. Schumm, F., WiethoIter, H., FatehMoghadam, A., and Dichgams, J. J. Neural. Neurosurg. Psychiatry 48: 332-337, 1985. [Reprint requests to Dr. F. Schumm, Neurologische Klinic, Liebermeisterst, 18-20, D-7400 Tubingen, FRG.] Eighteen patients with pure ocular myasthenia gravis were thymectomized without morbidity or mortality. All patients had histologically abnormal thymuses (thymoma [1], thymic hyperplasia [13], persistent thymus [1]). Ocular signs and symptoms significantly improved in 80% of patients. Three patients enjoyed total remission of symptoms. No patient developed generalized myasthenia. The authors suggest considering thymectomy for patients with ocular myasthenia unresponsive to therapy with cholinesterase inhibitors or as an alternative to long-term therapy with prednisone and azathioprine. Thomas C. Spoor, M.D., F.A.C.S. • • • Radiation Therapy for Incompletely Resected Meningiomas. Petty, A. M., Kun, L. E., and Meyer, G. A. J. Neurosurg. 62: 502-507, 1985. [Reprint requests to Larry E. Kun, M.D., Dept. of Radiation Oncology, St. Jude Children's Research Hospital, 332 North Lauderdale, Memphis, TN 38101.] The authors document the efficacy of irradiation (4,800-6,080 rads) in treating incompletely resected meningiomas (many spheno-orbital) in 12 patients. Tumor activity was monitored by serial computed tomographic scanning. Follow-up was between 20 and 112 months (median 54.5 months). Nine patients had no evidence for recurrent disease after radiation treatment. Three patients had recurrent tumors, two outside the irradiated field. Three patients who were irradiated after prior recurrences ~ad prolonged progression-free intervals in comparIson to the intervals prior to irradiation. It appears that irradiation has a significant effect in both pro- Journal of Clinical Neuro-ophthalmology |
