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Show LITERATURE ABSTRACTS 151 to 1988 in patients younger than 17 years of age were located retrospectively. About 50% had sixth palsy, 20% third nerve palsy, 12% fourth nerve palsy, and 11% multiple cranial nerve palsies. Not surprisingly, trauma was the most frequent cause (42.5%), neoplasm next (16.9%), followed by undetermined (14.4%). The Mayo Clinic adult patients from this same time period with ocular motor nerve palsies are compared in etiology to the pediatric patients, and other published series of pediatric cases are also compared to this series. This article nicely highlights the differences between pediatric and adult patients with acquired ocular motor cranial nerve palsy. Lyn A. Sedwick, M.D. Development of Object Vision in Infants with Permanent Cortical Visual Impairment. Chen TC, Weinberg MH, Catalano RA, Simon JW, Wagle WA. Am J Ophthalmol 1992;114:575-8 (Nov). [Reprint requests to Dr. R. A. Catalano, Olean General Hospital, 515 Main St., Olean, NY 14760.] The authors located 30 patients who had profound cortical visual impairment occurring between 6 and 12 months of age from a variety of causes. Half of these infants developed object vision. A history of birth asphyxia or postnatal hypoxia was associated with a poor prognosis for development of object vision. Radiographic studies that were done (mostly computed tomography) were not predictive for whether or not object vision would develop, although the authors postulate that more uniformly obtained magnetic resonance scanning might have added more predictive information. Lyn A. Sedwick, M.D. Optic Neuropathy in Hodgkin's Disease. Siatkowski RM, Lam BL, Schatz NJ, Glaser JS, Byrne SF, Hughes JR. Am J Ophthalmol 1992;114:625-9 (Nov). [Reprint requests to Dr. J. S. Glaser, 900 N.W. 17th St., Miami, FL 33136.] A 21-year-old man treated 3 years previously for Hodgkin's disease presented with visual loss left eye and a swollen optic disc. Magnetic resonance imaging showed diffuse enlargement of the left optic nerve. Lumbar puncture was not diagnostic, but radiation therapy administered to the left orbit, combined with intravenous and oral corticosteroid, resulted in marked improvement in vision and reduction in disc edema. Lymph node biopsy subsequently demonstrated recurrent lymphoma. The authors believe their patient had optic neuropathy as an initial symptom/sign of recurrent Hodgkin's disease, which has not previously been reported. Lyn A. Sedwick, M.D. Nonbacterial Thrombotic Endocarditis and Cortical Blindness. Rush JA. Am JOphthalmoI1992;114: 643-4 (Nov). [Inquiries to Dr. J. A. Rush, 508S Habana Ave., Suite 100, Tampa, FL 33609.] A 73-year-old man had a rapidly progressive course of multiple strokes involving visual cortex bilaterally. Temporal artery biopsy was negative. Autopsy demonstrated a pulmonary adenocarcinoma and nonbacterial thrombotic endocarditis. Although this patient apparently did not have echocardiography, Dr. Rush points out that "conventional echocardiography" may miss these small, fibrin-platelet excrescences on heart valves, which may be a remote effect of carcinoma, but their presence should be diligently sought in any patient with embolic stroke. Lyn A. Sedwick, M.D. Visual Recovery After Radiation Therapy of Orbital Lymphoma. Moshfeghi OM, Finger PT, Cohen RB, Choe W. Smilari T. Am JOphthalmol1992; 114:645-6 (Nov). [Inquiries to Dr. P. T. Finger, Division of Ocular Tumor and Orbital Disease, North Shore University Hospital-Cornell University Medical College, 300 Community Dr., Manhasset, NY 11030.] An 84-year-old with disseminated lymphoma presented 1 month after a normal routine eye examination with left proptosis and no light perception vision left eye. An orbital mass was found to be small-cell malignant lymphoma on fine-needle aspiration. Orbital radiation therapy was started 51 days after documentation of his visual loss, and his vision ultimately improved to 20/40 in this eye. A truly remarkable result! Lyn A. Sedwick, M.D. I Clin Neuro-ophthnlmol, Vol. 13, No.2, 1993 |
