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Show LITERATURE ABSTRACTS 215 seen in three patients with giant-cell arteritis who did not have visual loss but underwent fluorescein angiography. Thus, fluorescein angiography may be a useful diagnostic adjunct in patients with anterior ischemic optic neuropathy who might have giant-cell arteritis. Lyn A. Sedwick, M.D. Optic Nerve Hypoplasia: Clinical Significance of Associated Central Nervous System Abnormalities on Magnetic Resonance Imaging. Brodsky MC, Glasier CM. Arch Ophthalmol 1993;111:6&-74 Oan}. [Reprint requests to Dr. M. C. Brodsky, Arkansas Children's Hospital, 800 Marshall, Little Rock, AR 72202.] Forty children with moderate to severe unilateral or bilateral optic nerve hypoplasia were seen in a 3-year period at Arkansas Children's Hospital. In 30, magnetic resonance imaging demonstrated one or more associated neuroradiologic abnormalities with absent septum pellucidum most common (21 of 40 patients). The authors grouped their 30 patients into two groups based on magnetic resonance abnormalities, one having a more favorable neurodevelopmental prognosis than the other. A very straightforward "flow chart" to categorize patients is included on page 72. A thoughtful study with useful clinical information. Lyn A. Sedwick, M.D. Optic Nerve Sheath Fenestration for Treatment of Progressive Ischemic Optic Neuropathy: Results in 26 Patients. Jablons MM, Glaser JS, Schatz NJ, Siatkowski RM, Tse DT, Kronish JW. Arch Ophthalmol 1993;111:84-87 Oan}. [Reprint requests to Dr. J. S. Glaser, Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136.] The authors report their experience with 26 patients age 52 to 91 years with progressive anteri~r ischemic optic neuropathy who underwen! optic nerve sheath decompression by two expenenced orbital surgeons, who did not participate in p~tient selection. Improvement in visual funchondefined as two lines improvement by Snellen or two levels improvement on gros~ ~cui.ty suc~ as LP to CF or visual field isopter pOSItion mcreasmg by 20° or scotomata resolved on Goldmann visual fields or increase in 5 db in mean deviation or scotoma resolved on Humphrey 30-2 programoccurred in 7 of 26 patients but only to "functional levels" in 5 defined as 20/50 through 20/80. The authors conclude that this visual outcome is probably no better than that in untreated eyes. Lyn A. Sedwick, M.D. Optic Disc Pallor: A False Localizing Sign. Newman NJ. Comments by Slavin M, Newman SA. Surv Ophthalmol1993;37:273-82 Oan-Feb}. [Reprint address: Dr. N. Newman, 1327 Clifton Road N.E., Atlanta, GA 30322.] A 20-year-old woman with a 2-year history of bilateral visual loss is discussed. She demonstrated profound color vision loss, 20/50 best-corrected acuity, visual fields with generalized reduction in sensitivity as well as optic atrophy but normal maculae. To compound the diagnostic problem, she was pregnant and had no health insurance. The discussants both highlight the important clinical features, and both favor a hereditary disorder. Dr. Steven Newman also addresses the "cost/ benefit" ratio of diagnostic testing and decides on electroretinography as the single first test that might obviate further testing. In fact, the patient does turn out to have a cone dystrophy which was diagnosed by ERG (normal rod function but cone dysfunction). Sometimes in neuro-ophthalmology, "less is more" as this case reminds us. Lyn A. Sedwick, M.D. The Role of Abnormalities in the Anticoagulant and Fibrinolytic Systems in Retinal Vascular Occlusions. Vine AK, Samama MM. Surv Ophthalmol 1993;37:283-92 Oan-Feb}. [Reprint requests to Dr. A. K. Vine, Retina Service, W. K. Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI48105.] The authors review the clotting sequence and known pathological conditions of clotting factors or cofactors that have been reported to cause retinal vascular occlusions. They give suggestions for the use of laboratory screening tests. Lyn A. Sedwick, M.D. J Clin Neuro-ophlhalmol. Vol. 13, No.3, 1993 |