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Show LITERATURE ABSTRACTS 63 Magnetic Resonance Imaging in the Evaluation of Optic Nerve Gliomas. Haik BG, Saint Louis L, Bierly J, Smith ME, Abramson DA, Ellsworth RM, Wall M. Ophtilamology 1987; 94: 709- 17 Uun). [ Reprint requests to Dr. B. G. Haik, 1430 Tulane Avenue, New Orleans, LA 70112.] Magnetic resonance was used to examine five patients with presumed optic nerve glioma based on clinical and computerized tomographic impression. Many magnetic resonance pictures using a variety of techniques are presented but, curiously, no computerized tomographic scans for comparison. Magnetic resonance, especially T2- weighted images, is exceptional at delineating chiasmal and tract involvement with these lesions but does not seem to surpass high quality computerized tomography in the orbit. In only two cases did magnetic resonance reportedly show further extension than computerized tomography had demonstrated ( into the optic tract in one and into the occipital lobe in the other). The authors contend that magnetic resonance is a superior way to study these patients. Although this may be true, it is puzzling that no side- by- side comparison of magnetic resonance and computerized tomographic pictures are presented in this article to demonstrate graphically such superiority. LYIl A. Sedwick, M. D. Carotid Endarterectomy: Who Needs It? Trobe JD. Ophthalmology 1987; 94: 725- 30 Uun). [ Reprint requests to Dr. J. D. Trobe, W. K. Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI 48105. Dr. Trobe presents data gleaned from many previous reports to support his contention that carotid endarterectomy, the third most common operative procedure in the U. S. A., may not be justified in several subgroups of patients who are receiving the procedure, namely those with asymptomatic bruits or retinal transient ischemic events only. Moreover, he stresses the increased likelihood of demise from cardiac disease of all patients currently thought candidates for endarterectomy and the relative safety and efficacy of aspirin therapy. A clinical trial soon underway he feels may help better define who truly is a good candidate for such surgery. This article is succinct, weIlargued, well- researched, and compelling, as one would expect considering its author. Read it and send it to your local neuro- and vascular surgeons. LYIl A. Sedwick, M. D. The Prevalence of Simple Anisocoria. Lam BL, Thompson HS, Corbett JJ. Am J OpiltlwlIlol 1987; 104: 69- 73 Uul). [ Reprint requests to C. S. O'Brien Library, Department of Ophthamology, University of Iowa Hospitals, Iowa City, IA 52242.) Photographs of the pupils of 128 normal volunteers done in the morning and afternoon on 5 separate days were examined. At any given examination, 190/[ showed anisocoria of at least 0.4 mm. Only 3% had unequal pupils of 0.4 or more in all 10 photographic records but 41 ' 7c had 0.4 mm or more at least one time on photographs. This article looks at the data in several ways and attempts to show the varying number of presumed normals who would be labeled as having anisocoria if the definition were altered, e. g., the number is quite changed if a difference in pupil area of 15% or more is used rather than 0.4 mm difference in pupil diameter. The table " Effect of changing the definition of anisocoria" is not easily grasped by the casual reader. Some useful baseline information is here if you want to devote some time to detailed reading of this article. LYIl A. Sedwick, M. D. Magnetic Resonance Imaging of Optic Tract Involvement in Multiple Sclerosis. Rosenblatt MA, Behrens MM, Zweifach PH, Forman S, Odel JG, Duncan CM, Gross SA. Am J Oplztlzamol 1987; 104: 74- 9 Uul). [ Reprint requests to Dr. M. M. Behrens, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, 635 West 165th Street, New York, NY 10032.) Two cases with optic tract involvement from multiple sclerosis are presented with magnetic resonance scans demonstrating these lesions. The scans are fairly striking and provide exquisite clinical- radiologic correlation of this rare complication of demyelinating disease. LYIl A. Sedwick, M. D. , Oill NellrO- OI'Jrtltallllol. Vol. 8. No. J. 1988 |