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Show 62 LITERATURE ABSTRACTS mane Medical University, Izumo, Shimane 693, Japan.] Four patients with Moyamoya disease are described. In spite of the underlying pathology, bilateral carotid occlusion at the level of the siphon, most findings were attributable to posterior circulation difficulties ( homonymous hemianopia, visual agnosia) although one patient had poor visual acuity that was not explained (" relative central scotomata" on visual fields with apparently normal retinal and optic nerve examination). The fourth patient supposedly had a left homonymous hemianopia, which was not very respectful of the vertical midline in the fields in the article, and also had bilateral temporal optic nerve pallor with normal visual acuity. Perhaps this article is important not for what ophthalmologic findings the patients did have but rather for what they did notcentral retinal vein occlusion, venous stasis retinopathy, neovascular glaucoma, ischemic oculopathy, arterial occlusions- in the face of bilateral carotid artery occlusion. LYII A. Sedwick, M. D. Amaurosis Fugax at Downward Gaze. Manor RS, Sira 18, with comments by Odel JG, ewman SA, Sedwick LA. Sur". OphthallllOl 1987; 31: 411- 6 ( May- Jun). [ Reprint requests to Dr. R. S. Manor, Neuro- ophthalmological Unit, Department of Ophthalmology, Beilinson Hospital, Petah Tiqva 49100, Israel.] A 54- year- old man with amaurosis fugax 00 in down- gaze only was found to have a visual field defect, afferent pupillary defect, and disk edema 00. Discussion by Drs. Odel, Newman, and Sedwick enumerates the multitude of causes of unilateral amaurosis fugax and the likely diagnosis in this patient who appeared to have an orbital hemangioma on computerized tomography. LYII A. Sedwick, M. D. Orbital Lymphoid Tumors Located Predominantly Within Extraocular Muscles. Hornblass A, Jakobiec FA, Reifler OM, Mines J. Ophthalmology 1987; 94: 688- 97 Oun). [ Reprint requests to Dr. F ,/ I 1" k, , hive. Dt'p< 1l'tmt'nt of Ophthalmology, Manhattan Eye, Ear & Throat Hospital, 210 East 64th Street, New York, NY 10021.] Seven cases of lymphoid tumors in extraocular muscle ( six in superior rectus- levator, one in medial rectus) are presented in detail. Symptoms were present from months to years and usually were ptosis, diplopia, proptosis, but generally little or no pain. All were treated after biopsy with orbital radiation therapy, 1,500- 3,200 rads. Two patients had cytologically malignant lesions and one of these patients eventually died from systemic lymphoma. The authors note that this involvement of lymphoid tumor localized to an extraocular muscle is probably not as uncommon as review of the literature would suggest. This is a complete reference that details history, clinical course, radiologic studies ( computerized tomography), pathology, response to treatment, and follow- up data for patients with these tumors. LYII A. Sedwick, M. D. The Incidence of Extraocular Muscle and Cranial Nerve Palsy in Orbital Floor Blow- out Fractures. Wojno TH. Ophtlw11lology 1987; 94: 682- 7 Oun). [ Reprint requests to Dr. T. H. Wojno, Emory Eye Center, 1327 Clifton Road, N. E, Atlanta, GA 30322. J Forty consecutive patients with unilateral isolated blow- out fracture of the orbital floor were studied prospectively. Motility examination revealed seven patients in whom an isolated extraocular muscle was palsied without evidence of restriction or entrapment by either computerized tomography or forced ductions. All but one patient resolved or improved without surgery. Dr. Wojno argues that local cranial nerve or extraocular muscle damage occurred to cause the motility problem in these patients. Dr. Putterman discusses this article and points out that local bleeding or embedded fracture spicules into extraocular muscle could cause the same findings and might yield negative forced ductions. He also recommended forced generation testing to distinguish between weak muscles and those with any amount of entrapment. LYIl A. Sedwick, M. D. |