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Show LITERATURE ABSTRACTS 117 Ophthalmology 1986;93:1373-82 (Nov). [Reprint requests to Dr. G. C. Brown, 910 E. Willow Grove Ave., Wyndmoor, PA 19118.] These authors selected eight patients with acute combined obstruction of retinal and choroidal circulation, the equivalent of an ophthalmic artery obstruction, from a larger group of 150 patients with "a fundus picture compatible with acute central retinal artery occlusion" seen at Wills Eye Hospital between 1972 and 1985. The patients all had acute, total visual loss and retinal opacification in the posterior pole and one or more of other fundus characteristics suggestive of choroidal infarction either observable directly, by fluorescein angiogram, or by electroretinography. Most patients had identifiable embolic sources, and two patients had bilateral, simultaneous visual loss. This paper nicely outlines what one expects to see in such obstructions but offers no treatment options for these patients, whose visual prognosis is "generally grim." Lyn A. Sedwick, M.D. Superior Oblique Paralysis. von Noorden GK, Murray E, Wong SY. Arch Ophthalmol 1986;104: 1771-6 (Dec). [Reprint requests to Dr. von Noorden, Ophthalmology Service, Texas Children's Hospital, Box 20269, Houston, TX 77225.] Two hundred seventy consecutive patients with superior oblique palsy were examined by the authors between 1973 and 1984. Congenital palsies made up 39% of the total but were rarely bilateral, whereas traumatic palsies made up 30% of the total and were bilateral 20% of the time. Idiopathic (23%) and other (3%) causes completed the spectrum. No patients with "pure cyclotropia" without associated hypertropia were included, although three cases were seen and believed to be secondary to superior oblique palsy. Some of the idiopathic cases were probably congenital, but for inclusion in the congenital group, a history of, or photographic documentation of, head tilt was required. The authors found that diplopia was more frequently seen in patients with acquired palsies (57 vs. 21 %), and image tilt was exclusively a complaint of those with acquired palsies (23%). Tests that are helpful in detecting bilateral superior oblique palsy are discussed, but none are believed to be 100% accurate. Details of the selection of ap-propriate surgical treatment are discussed. The authors' patients experienced excellent surgical results, with an average of 1.45 surgerical procedures per operated patient. This review study has no surprises, just well-presented information regarding the causes of, signs and symptoms of, and surgical correction of unilateral and bilateral superior oblique palsy. Lyn A. Sedwick, M.D. Ocular Adnexal Monoclonal Lymphoid Tumors with a Favorable Prognosis. Jakobiec FA, Iwamoto T, Patell M, Knowles OM II. Ophthalmology 1986;93:1547-57 (Dec). [Reprint requests to Frederick A. Jakobiec, M.D., Manhattan Eye, Ear & Throat Hospital, 210 East 64th Street, New York, NY 10021.] Over a 5-year period (1977-1982), 14 patients with monoclonal B-Iymphocytic tumors of the orbit or conjunctiva were identified from a larger group of 51 patients with all types of ocular and adnexal lymphoid tumors. Following local radiation therapy to the orbit (2,000-3,000 rads total), long-term follow-up (average 7.5 years) disclosed only two patients with nonocular recurrent lymphoid tumors. There is lengthy histopathologic discussion of these tumors, and in summary, they are moderately to well differentiated. The authors recommend minimal radiation therapy for these lesions (1,800-2,000 rads), which will need light and electron microscopy for identification, and predict that these patients have little chance of developing nonocular lymphoid tumors on followup. Lyn A. Sedwick, M.D. Ptosis Associated with Botulinum Toxin Treatment of Strabismus and Blepharospasm. Burns eL, Gammon JA, Gemmill Me. Ophthalmology 1986;93:1621-7 (Dec). [Reprint requests to J. Allen Gammon, M.D., King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, Saudi Arabia 11462.] In a group of 44 patients treated with botulinum injections, 39 for strabismus and five for blepharospasm, some degree of ptosis was encountered in 53% of injections, with 21% resulting in visually J Clin Neuro-ophthalmol, Vol. 7, No.2, 1987 |