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Show 216 LITERATURE ABSTRACTS Diagnostic Misinterpretation of Fat Suppression Orbital Magnetic Resonance Scanning. Mintz E, Kline LB, Duvall ER. Am J Ophthalmol 1993;115: 262-4 (Feb). [Inquiries to Dr. L. B. Kline, Suite 555, 1600 7th Avenue South, Birmingham, AL 35233.] An 82-year-old man with macular degeneration and worsening visual loss right eye had magnetic resonance orbital scanning, which appeared to show a mass in the right lateral orbit. Further magnetic resonance studies were normal, and the "mass" may have been the result of uneven suppression of the intense signal from orbital fat. Possible reasons for this are presented in the article. Lyn A. Sedwick, M.D. Unilateral Optic Disk Edema and a Contralateral Temporal Fossa Mass. Yohai RA, Bullock JD, Margolis JH. Am JOphthalmoI1993;115:261-2 (Feb). [Inquiries to Dr. J. D. Bullock, Department of Ophthalmology, Wright State University School of Medicine, The Plumwood Building, 5 Plumwood Road, Suite 250, Dayton, OH 45409.] A 40-year-old woman with a I-month history of visual loss right eye to light perception is discussed. Her right disc was swollen, and initial workup included physical examination, chest radiograph, angiotension converting enzyme, computed tomography scans of brain and orbits, sedimentation rate, VORL, and fluorescent treponemal antibody testing, all of which were negative or normal, as was lumbar puncture. High-dose oral prednisone resulted in 20/40 visual acuity by 10 days later, but 4 months later, while off corticosteroids, her vision decreased to 20/200. Magnetic resonance imaging disclosed a left temporal fossa lesion, which was excised and found to be noncaseating granulomata consistent with sarcoidosis. Her vision again improved with corticosteroid therapy. As this case demonstrates, more than one type of "optic neuritis" may respond to corticosteroid therapy, and recrudescence of symptoms is an indication for restudy in such patients, no matter how complete the initial workup. Lyn A. Sedwick, M.D. Velocity of Ophthalmic Arterial Flow Recorded by Doppler Ultrasound in Normal Subjects. Roja- ! Cllll Neuro-ophtltalmol, Vol. 13, No.3. 1993 napongpun P, Drance SM. Am J Ophthalmol1993; 115:174-80 (Feb). [Reprint requests to Dr. S. M. Drance, 2550 Willow Street, Vancouver, Be, Canada V5Z 3N9.] The authors perform transcranial Doppler in 60 normal subjects with mean age early 50s to try to set norms against which disease states can be measured. They also compared flow velocities and spectrograms in their younger versus older patients and found an age-related loss of ophthalmic arterial blood flow. Lyn A. Sedwick, M.D. Baseline Visual Field Profile of Optic Neuritis: The Experience of the Optic Neuritis Treatment Trial. Keltner JL, Johnson CA, Spurr JO, Beck RW, Optic Neuritis Study Group. Arch Ophthalmol1993; 111:231-4 (Feb). [Reprint requests to Dr. J. L. Keltner, Department of Ophthalmology, University of California, Davis, CA 95616.] The Optic Neuritis Treatment Trial will generate many good studies that are tangential to the main intent of the trial, and this paper is a perfect example of one. Characteristics of baseline automated static visual fields done on the Hymphrey Visual Field Analyzer in the patients with optic neuritis are described here. Kinetic Goldmann visual fields were also done on each patient and will be analyzed in a later report. Of 448 visual fields in the affected eye, 48.2% had diffuse visual field loss (minimal 6.3%, moderate 20.1%, and severe 73.7%). Localized defects, i.e., nerve fiber bundle defects, occurred in 20.1 %; central or cecocentral scotomata in 8.3%. Various other defects were present in 23.2. Of great interest, an abnormal visual field was found in the fellow eye in 68.8% of patients, but was judged minimal in 62.0%, moderate in 32.8%, and severe in only 5.2%. Many specifics regarding the actual visual field patterns and location of defects are given in this succinct article, which is required reading for anyone who is involved with diagnosis, workup, or management of patients with optic neuritis. Lyn A. Sedwick, M.D. The Initial Clinical Characteristics of Graves' Orbitopathy Vary with Age and Sex. Kendler DL, |