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Show LITERATURE ABSTRACTS 71 tion of a variety of tissues with a fibrotic process, including orbital tissue in these patients. Clinically and radiographically, these patients' conditions could easily be confused with thyroid eye disease, orbital pseudotumor, metastatic carcinoma or lymphoma, as the authors point out in their discussion. LYII A. Sedwick, M. D. The Perils of Pauline: Visual Loss in a Tippler. Sedwick LA, with comments by Newman S, Katz B, Hedges TR lll. Suru Ophthalmol 1991; 35: 454-- 62 ( Mar- Apr). [ No reprints available.] This clinical pathologic correlation presents a voung alcoholic woman with bilateral subacute vi~ ual loss. All discussants agree on the diagnosis ( nutritional ambylopia, tobacco- alcohol amblyopia) and the differential diagnosis. The treatment advised varies somewhat among the discussants, however. This is such a nice neuro- ophthalmic disease, as the visual loss can be very significantly reversed with recognition and therapy. Llfll A. Sedwick, M. D. Brown Tumor and Secondary Hyperparathyroidism. Levine MR, Chu A, Abdul- Karim FW. Arch OphthalmoI1991; 109: 847- 9 ( June). [ Reprint requests to Dr. M. R. Levine, 26900 Cedar Road, Beachwood, OH 44122.] A patient with chronic renal failure developed proptosis and diplopia. Computerized tomographic scanning showed a left frontal- ethmOId SInus tumor extending into the superonasal orbit. This Brown tumor, which was a result of secondary hyperparathyroidism in this patient ~ ith renal failure, was totally resected. Five preVIOusly reported cases are reviewed. Lyn A. Sedwick, M. D. Optic Nerve Sheath Decompression for Nonarteritic Ischemic Optic Neuropathy Improves Multiple Visual Function Measurements. Kelman SE, Elman MJ. Arch OphthalmoI1991; 109: 667- 71 ( May). [ Reprint requests to Dr. S. E. Kelman, Neuro- Ophthalmology Service, Department of Ophthalmology, University of Maryland Hospital, 22 S. Greene Street, Baltimore, MD 21201.] Optic Nerve Sheath Decompression for the Treatment of Progressive Nonarteritic Ischemic Optic Neuropathy. Spoor TC, Wilkinson MJ, Ramocki JM. Am I Ophthalmol 1991; 111: 724- 8 ( June). [ Reprint requests to Dr. T. C. Spoor, Kresge Eye Institute, Wayne State University, 4717 Saint Antoine, Detroit, MI 48201.] Two more articles regarding optic nerve sheath decompression for ischemic optic neuropathy, the first involving seven patients, five with progressive non- arteritic ischemic optic neuropathy ( NAION) and two with nonprogressive NAION, and the second article reporting decompression in four patients, five eyes, with progressive NAION. In the first study, all patients had some increase in visual acuity, although it was only slight in one and only one achieved better than 201100, and most had improvement in visual field. In the second study, three eyes improved postoperatively to 20/ 25 ( as well as one fellow eye improving from 20/ 200 to 20/ 25) with improved visual fields. As one reads these articles and reviews Sergott's original article in the December 1989 Archiz'es of Ophthalmology, it becomes apparent that in order to fully evaluate these results, current studies demonstrating that progressive or nonprogressive NAION has a uniformly poor outcome ( an assumption you must make to subject a patient to optic nerve sheath decompression) would be invaluable. Also, the way in which patients are selected for these trials ( i. e., how long from initial onset is " progressive") and outcome is judged ( e. g., visual improvement immediately postoperatively in some versus not until several weeks later in others) confounds interpretation of the data. Optic nerve sheath decompression seems to be a useful therapy for selected patients, but it would be very helpful to see some prospective or retrospective studies of large series of patients with NAION to know what the natural history of this disease is before deciding whether optic nerve sheath decompression is a valid alternative. LYll A. Sedwick, M. D. Transient Cranial Nerve Palsies After Cavernous Sinus Fistula Embolization. Sabates FN Jr., Tsai F, Sabates NR, Blitstein B. Am JOphthalmoI1991; 11l: 771- 3 ( June). [ Inquiries to Dr. F. N. Sabates, Jr., I Cim Neuro- ophtlwlmol. Vol. 12, No. 1, 1992 |