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Show Literature Abstracts Functional Monocular Temporal Hemianopsia. Gittinger JW Jr. Alii f OphthallllOl 1<)86; 101:226- 31 (Feb). [Reprint requests to J. W. Gittinger, Jr., M.D., Division of Ophthalmology, University of Massachusetts Medical School, 55 Lake Ave. North, Worcester, MA 01605.) To quote Dr. Gittinger, "almost every pattern of visual field loss has been reported in the absence of organic lesions." As the four patients in his article demonstrate, functional monocular temporal hemianopsia may not be uncommon and certainly may occur in the medically unsophisticated. Proof of the functional nature of the defect generally occurs with formal or informal testing of the fields which will show monocular temporal hemianopsia one eye, normal visual field other eye but, with both eyes open, a homonymous hemianopia. An entertaining discussion section reviews the historical thoughts on monocular hemianopsias. Recognition of this nonphysiologic pattern may save the patient unnecessary neurologic and neurosurgical maneuvers. LYII A. Sedll'ick, M.D. Absence of Antibody Production in Patients Treated With Botulinum A Toxin. Biglan AW, Gonnering R, Lockhart LB, Ragin B, Fuerste FH. Am JOpltthalmoI1986;101:232-5 (Feb). [Reprint reguests to A. W. Biglan, M.D., 3518 Fifth Ave., Pittsburgh, PA 15213.] Seventeen patients treated with botulinum toxin for either strabismus, hemifacial spasm, or blepharospasm had one or more serum samples tested for the presence of antibodies to botulinum toxin. In no case were such antibodies detected, even in patients who had multiple botulinum treatments. This study supports Allen Scott's contention that doses of toxin used in these disorders are subthreshold for immunologic recognition; moreover, the phenomenon of increased dose needed for egual effect over time is not mediated immunologically. LYIl A. Sedwick, M.D. 18f. " 1'lH6 Raven Press, New York Metabolic Imaging in Hemianopsia Using Positron Emission Tomography with 18F-DeoxyfIuoroglucose. Kiyosawa M, Mizuno K, Hatazawa J, Fukuda H, Yamada K, Ito M, Matsuzawa T, Watanuki 5, Ido T. Am J Ophthalmol 1986;101:310-9 (Mar). (Reprint reguests to Motohiro Kiyosawa, M.D., Department of Ophthalmology, Tohoku University Medical SchooL Sendai, Miyagi 980, Japan.] Positron emission tomography with 18F-deoxyfluoroglucose gives quantitative information regarding glucose metabolism in the brain. These investigators used this tomography to demonstrate areas of decreased glucose metabolism corresponding to hemianopic visual field defects in eight patients. Only four of these patients had abnormal computerized tomographic scans, and five had abnormal magnetic resonance imaging. Visual field defects were presumed secondary to ischemic events. The authors compare these imaging methods and find that computerized tomography and magnetic resonance imaging give the most detailed morphological demonstration of lesions, ~ut onl~' positron emission tomography can give tunctional evaluation of the occipital cortex. This technigue is an interesting addition to neurodiagnostic imaging and may be sensitive to lesions that are.silent on compute;ized tomography and magnetIC resonance, as this article sho\\'s. LYIl A. Sedwick, M.D. Pupillography of a Relative Afferent Pupillary Defect. Cox TA. Alii J Ophthalmol 1986;101:320-4 (Mar). (Reprint requests to T. A. Cox, M.D., Department of Ophthalmology, University of British Columbia, 2550 Willow St., Vancouver, B.C., Canada V5Z 3N9.] You may want to read this article more than once, ~ecause it contains several pearls about the swmgmg flashlight test that seem obvious at first, but ,take ~n new meaning after reviewing Dr. Cox s p~pJ1lo~raphy. His case report is a young lady, WIth umlateral optic neuritis, in whom he performed pupillography, i.e., alternating stimu- |