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Show 216 LITERATURE ABSTRACTS or unilateral amblyopia who had bilateral paradoxical pupillary responses ( constriction to darkness). They also found 13 such patients with retinal or optic nerve abnormalities, previously thought to be the only abnormalities resulting in this pupillary phenomenon. No explanations are offered for the responses of this unusual group of patients. Lyn A. Sedwick, M. D. Stroke: An Overview. Patterson RH Jr. Ophthalmology 1988; 95: 1473- 7 ( Oct). [ Reprint requests to Dr. R. H. Patterson Jr., Cornell University Medical Center, 1300 York Ave., New York, NY 10021.] This article is from the talk given by neurosurgeon Russel Patterson at the American Academy of Ophthalmology meeting in 1987. He is remarkably conservative in his approach to patients with transient ischemic attacks and completed stroke in terms of further therapy, surgical versus medical, and presents supporting literature. Dr. Trobe's discussion includes information regarding the North American Symptomatic Carotid Endarterectomy Trial, a prospective study that will use randomly chosen patients with transient ischemic attacks in a study of endarterectomy versus aspirin therapy. Lyn A. Sedwick, M. D. Treatment of Acquired Nystagmus With Botulinum A Toxin. Helveston EM, Pogrebniak AE. Am J Ophthalmol 1988; 106: 584- 6 ( Nov). [ Reprint requests to Dr. E. M. Helveston, 702 Rotary Circle, Indianapolis, IN 46223.] Two patients with subnormal VISIOn due to nystagmus presumed secondary to a brainstem infarction were treated with retrobulbar botulinum A toxin. A subjective and objective improvement in vision was achieved that was not forthcoming with injection of all four rectus muscles directly with botulinum. Unfortunately, the effect was transient ( 4- 20 weeks). It seems unwise to perform up to 12 retrobulbar injections a year for such patients to effect continued relief; nevertheless, this is another interesting use of botulinum A toxin. ..; .~\ Sedwick, M. D. I elm Neuru- vphthalmnl. Vol. Y, r"; o. J, 1' 4~': 1 Optic Nerve Sheath Decompression: How Does It Work? Has Its Time Come? Keltner JL. Arch OphthalmoI1988; 106: 1365- 9 ( Oct). [ No reprint information given.] Optic Nerve Sheath Decompression for Pseudotumor Cerebri. Brourman NO, Spoor TC, Ramocki JM. Arch Ophthalmol 1988; 106: 1378- 83 ( Oct). [ Reprint requests to Dr. T. C. Spoor, Kresge Eye Institute, 3994 John R, Detroit, MI 48201.] Modified Optic Nerve Sheath Decompression Provides Long- Term Visual Improvement for Pseudotumor Cerebri. Sergott RC, Savino PI, Bosley TM. Arch Ophthalmol 1988; 106: 1384- 90 ( Oct). [ Reprint requests to Dr. R. C. Sergott, NeuraOphthalmology Service, Wills Eye Hospital, 9th and Walnut Streets, Philadelphia, PA 19107.] Results of Optic Nerve Sheath Fenesqation for Pseudotumor Cerebri: The Lateral Orbitotomy Approach. Corbett JJ, Nerad JA, Tse DT, Anderson RL. Arch Ophthalmol 1988; 106: 1391- 7 ( Oct). [ Reprint requests to Dr. J. J. Corbett, Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242.] Optic Nerve Sheath Fenestration in Pseudotumor Cerebri: A Lateral Orbitotomy Approach. Tse DT, Nerad JA, Anderson RL, Corbett JJ. Arch Ophthalmol 1988; 106: 1458- 62 ( Oct). [ Reprint requests to Dr. D. T. Tse, Bascom Palmer Eye Institute, P. O. Box 016880, Miami, FL 33101.] You can immerse yourself and read all five of these articles regarding pseudotumor cerebri and optic nerve sheath decompression or save some time and read Dr. Keltner's excellent editorial, which summarizes the next three articles of clinical series of three different sets of authors. In brief, no matter whether performed medially or laterally with an orbitotomy, optic nerve sheath decompression appears to work in most cases to resolve papilledema and halt visual loss ( or even, rarely, improve vision). Sometimes one procedure will decompress both optic nerves- the why and why not of this phenomenon are well explained by Dr. Keltner. The risk to the patient is low, and longterm follow- up observation, albeit limited to date, suggests that the results remain good. The last article describes a surgical technique for lateral orbitotomy. Read Dr. Keltner's editorial, and you |
