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Show LITERATURE ABSTRACTS 217 Lippa J, Rootman J. Arch OphthalmoI1993;111:197201 (Feb). [Reprint requests to Dr. D. L. Kendler, Thyroid Orbitopathy Clinic, The University of British Columbia, Department of Ophthalmology, Eye Care Center, 2550 Willow Street, Vancouver, BC, Canada V5Z 3N9.] This interesting study looks at clinical characteristics of 557 consecutive patients referred for Graves' orbitopathy. The authors compared signs and symptoms, objectively measured or classified (i.e., corneal staining judged 0 to 4 in intensity) in men versus women and older versus younger patients. In all age groups, the male to female ratio was 0.29. In general, older patients had insidious onset of symptoms and worse disease, as did men compared to women. Many other observations and comparisons are discussed in this study, but a major recommendation is for careful monitoring and "perhaps earlier definitive intervention" in older patients. Lyn A. Sedwick, M.D. Paralysis of Downgaze in Two Patients With Clinical- Radiologic Correlation. Green JP, Newman NI, Winterkorn JS. Arch Ophthalmol 1993;111:21922 (Feb). [Reprint requests to Dr. N. J. Newman, Neuro-Ophthalmology Unit, Emory Eye Center, 1327 Clifton Rd NE, Atlanta, GA 30322.] Two patients with downgaze palsy were found to have small bilateral lesions at the junction of the midbrain and the thalamus on magnetic resonance imaging. This clinical-imaging correlation supplies convincing confirmation for the location of the supranuclear control of downgaze in humans. Lyn A. Sedwick, M.D. Alternating Skew on Lateral Gaze. Neuroanatomic Pathway and Relationship to Superior Oblique Overaction. Hamid LM, Maria BL, Quisling RG, Mickle JP. Ophthalmology 1993;100:281-6 (Feb). [Reprint requests to Dr. L. M. Hamed, Section of Pediatric Ophthalmology, Department of Ophthalmology, University of Florida College of Medicine, Box 100284, JHMHSC, Gainesville, FL 32610-0284.] Because previous studies have indicated that "alternating skew" (right hypertropia in rightward gazes, left hypertropia in leftward gazes) may be localized to the level of brainstem tegmentum or the cervicomedullary junction, the authors looked at their series of 50 children with brain tumors, 39 with neuro-ophthalmic findings, and found 7 with alternating skew. All seven had pathology at the cervicomedullary junction and/or cerebellum on neuroimaging. The authors conclude that these areas are the "neuroanatomic substrate" for alternating skew. Lyn A. Sedwick, M.D. , Clin Neuro-ophthalmol, Vol. 13, No.3, 1993 |