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Show 298 LITERATURE ABSTRACTS Optic Disk Swelling with Peripheral Neuropathy, Organomegaly, Endocrinopathy, Monoclonal Gammopathy, and Skin Changes ( POEMS Syndrome). Bolling JP, Brazis PW. Am J Ophtha/ mo/ 1990; 109: 503- 10 ( May). [ Reprint requests to Dr. J. P. P. Bolling, Section of Ophthalmology, E- 3B, Mayo Clinic Jacksonville, Jacksonville, FL 32224.] The authors reviewed records from the Mayo Clinic, Rochester and Jacksonville, between 1976 and 1989 to find patients with monoclonal gammopathy and peripheral neuropathy. Of 148, 11 were identified as having the POEMS symdrome ( peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes); and 8 of these had optic disk swelling. Of these 8, 7 presented with weakness/ lethargy or peripheral neuropathy but one initially came to medical attention with headaches and transient obscurations of vision and was found to have papilledema. This diagnosis should be considered if scanning and lumbar puncture do not reveal an etiology for disc edema. Lyn A. Sedwick, M. D. Progressive Visual Field Defects in Patients with Intracranial Arteriovenous Malformations. Kashii S, Solomon SK, Moser FG, et al. Am J Ophtha/ mo/ 1990; 109: 556- 62 ( May). [ Reprint requests to Dr. Ronald M. Burde, Department of Ophthalmology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 E. 210th St., Bronx, NY 10467.] Two men with intracranial arteriovenous malformations and visual loss secondary to chronic papilledema are discussed. In neither was hydrocephalus present on computerized tomographic scanning but, in both, lumbar puncture showed raised cerebrospinal fluid pressure. The authors discuss these interesting cases and recommend shunting procedure or optic nerve sheath decompression. Lyn A. Sedwick, M. D. Visual Function Improvement in Patients with Macroproloactinomas Treated with Bromocriptine. Lesser RL, Zheutlin JD, Boghen 0, et al. Am J Ophtlza/ mo/ 1990; 109: 535--- 43 ( May). [ Reprint requests to Dr. R. Lesser. Yale University School of Medicine, Department of Ophthalmology and Visual Science, 333 Cedar St., New Haven, CT 06510.] The authors report 8 case histories of patients with prolactin- secreting macroadenomas who were treated primarily with bromocriptine and did well. All responded to the medication with reduction in the size of the tumor as well as improvement in visual function. One patient elected to have pituitary surgery as she did not wish to take chronic medication. The authors recommend primary bromocriptine therapy for rapid decompression of pituitary macroadenoma and maintenance therapy with regular neuro- ophthalmic, endocrine, and neuroradiologic follow- up. Lyn A. Sedwick, M. D. Recovery of Spatial Vision Following Shunting for Hydrocephalus. Tytla ME, Buncic JR. Arch Ophtha/ mo/ 1990; 108: 701- 4 ( May). [ Reprint requests to Dr. M. E. Tytla, Department of Ophthalmology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.] Seven patients with shunting for hydrocephalus and good visual acuity, color vision, and visual field preoperatively had testing of contrast sensitivity. In 13 of 14 eyes there was an improvement in low spatial frequency testing by 6 days after the shunt. ( The remaining eye had no detectable edema preoperatively and a normal contrast sensitivity test throughout.) The authors discuss the possible mechanisms for this improvement. Lyn A. Sedwick, M. D. Unilateral Papilledema in Pseudotumor Cerebri. To KW, Warren FA. Arch Ophtha/ mo/ 1990; 108: 6445 ( May). [ Reprint requests to Dr. K. W. To, Department of Ophthalmology, Lenox Hill Hospital, 100 E. 77th St., New York, New York 10021.] A 46- year- old obese woman had unilateral papilledema and elevated cerebrospinal fluid pressure. Optic disc photographs and intravenous fluorescein angiogram are included. Lyn A. Sedwick M. D. TOm |
