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Show LITERATURE ABSTRACTS 131 spot enlargement and multiple evanescent white dot syndrome. Lyn A. Sedwick, M. D. Hydroxychloroquine Retinopathy. Weiner A, Sandberg MA, Gaudio AR, Kini MM, Berson EL. Am J Ophthalmol 1991; 112: 528- 34 ( Nov). [ Reprint requests to Dr. E. L. Berson, Berman- Gund Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114.] Two patients with retinopathy secondary to Plaquenil ( hydroxychloroquine) are discussed. Total cumulative doses were 1,788 and 2,920 g given as 400- 800 mglday for 10 years in one and 400 mgl day for 20 years in the other patient. Although acuity was good ( 20/ 25 in both eyes of both patients), visual fields demonstrated a very dense and broad ring scotoma surrounding a spared 2_ 30 centrally. Evident pigment epithelial changes were centered on the maculae, and electroretinography indicated widespread retinal degeneration. No further visual loss occurred after discontinuing the medication, nor was there improvement in visual function. These remarkable findings underscore the need for ophthalmic surveillance of patients on long- term hydroxychloroquine therapy. Lyn A. Sedwick, M. D. Recurrent Idiopathic Lateral Rectus Muscle Palsy in Adults. Hamilton SR, Lessell S. Am JOphthalmol 1991; 112: 540-- 2 ( Nov). [ Reprint requests to Dr. S. Lessell, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114.] The authors present five very interesting patients with recurrent, isolated lateral rectus palsy, aged 15 to 72 years. Scans, arteriograms, and other neurologic testing were invariably unremarkable, except for one cerebrospinal fluid exam, which found 16 lymphocytes with the second episode in a 28- year- old man. The exact cause of these palsies is elusive, but such patients apparently can be reassured. Lyn A. Sedwick, M. D. Fatal Mucormycosis Therapy Associated With Deferoxamine. Slade MP, McNab AA. Am JOphthalmol 1991; 112: 594-- 5 ( Nov). [ Inquiries to Dr. A. A. McNab, 200 Drummond Street, Carlton 3053, Victoria, Australia.] A 67- year- old man on hemodialysis for chronic renal failure and taking deferoxamine for treatment of iron and aluminum overload developed proptosis in the left eye with a tender superior orbital mass. He was not on immunosuppressive therapy. Computed tomographic scan showed a poorly defined mass in the anterosuperior orbit and mild mucosal thickening in adjacent sinuses. The patient worsened after 24 hours of antibiotic therapy and had an orbital biopsy consistent with mucor. In spite of aggressive surgical and medical management, he died. Although this patient had the complicating feature of chronic renal failure, the authors note that deferoxamine and iron themselves may act as growth factors for fungi, and ophthalmologists should consider mucor in any patient so treated who develops " orbital cellulitis." Lyn A. Sedwick, M. D. Radiation Retinopathy After Standard Radiotherapy for Thyroid- related Ophthalmopathy. Miller ML, Goldberg SH, Bullock JD. Am J Ophthalmol 1991; 112: 600-- 1 ( Nov). [ Inquiries to Dr. S. H. Goldberg, Pennsylvania State University, College of Medicine, Department of Ophthalmology, P. O. Box 850, Hershey, PA 17033.] Three years after completing orbital radiation therapy for compressive optic neuropathy from Graves' disease in presumed safe dosage and administration ( 200 cGy over ten sessions), a 65- yearold woman developed radiation retinopathy in one eye. Reasonable causes of the retinal changes, other than radiation, were excluded. Other studies of radiation retinopathy following radiation therapy for Graves' disease are reviewed. The authors recommend a minimum of 3 years of ophthalmic follow- up for patients who receive even this usually safe radiation dose level. You may wish to share this article with your favorite radiation therapist. Lyn A. Sedwick, M. D. JClin Neuro- ophthalmol, Vol. 12, No. 2, 1992 |