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Show 'oumal of Clinical Neuro-ophlhalmology 8(3): 203-207, 1988. Literature Abstracts Effect of Visual Blur on Contrast Sensitivity. Marmor MF, Gawande A, Ophthalmology 1988;95:139-43 (Jan). [Reprint requests to Dr. M. F, Marmor, Department of Ophthalmology, Stanford University Medical Center, Stanford, CA 94305.] The authors degraded visual acuity in normal volunteers with spherical plus lenses and then tested contrast sensitivity at distance (Vistech chart) and near (Arden gratings) with a pinhole to control pupil size. They also simulated corneal or lens pathology with a haze filter and tested contrast sensitivity. They found that "even modest refractive degradation of acuity in normal subjects results in a broad loss of contrast sensitivity" even for spatial frequencies below the level corresponding to the degraded visual acuity. The authors conclude that optimal optical correction is necessary during testing, even if it does not result in improved visual acuity, and that "contrast sensitivity data should be interpreted with knowledge of the observed association between contrast sensitivity and visual acuity," Lyn A. Sedwick, M.D. Treatment of Optic Neuritis with Intravenous Megadose Corticosteroids. A Consecutive Series. Spoor TC, Rockwell DL. Ophthalmology 1988;95:131-4 (Jan). [Reprint requests to Dr. T. C. Spoor, Kresge Eye Institute, 3994 John R., Detroit, MI48201.] Twelve patients extracted from 19 consecutive patients with optic neuritis initially of uncertain etiology were treated with high-dose (250-500 mg) methylprednisolone every 6 h for 2-7 days. Workups on the 19 patients revealed a specific etiology for the optic neuritis in seven of the 19 who did not receive steroid therapy. Also, one of the 12 treated with steroid had a positive fluorescent treponemal antibody absorption test and cerebrospinal fluid lymphocytic pleocytosis; her vision "normalized after 2 days of intravenous corticosteriods before any treatment for her reactive FTA-ABS test." One patient treated with steroids 203 <9 1988 Raven Press, Ltd., New York had an exacerbation of a previous psychosis, one had oral candidiasis, and several had "unstable blood glucose levels," Heaven forbid that the lay press gets wind of this study and concludes that intravenous steroids are indicated for every patient with optic neuritis; even the authors of this dubiously conceived study reflect that "a randomized treatment trial is necessary to determine whether visual outcome is better [with megadose intravenous steriods] than with pharmacologic doses or oral steroids or no treatment." Fortunately, this is exactly what the Optic Neuritis Treatment Trial, to be underway in mid-1988 according to Roy Beck, M.D., hopes to discover. Lyn A. Sedwick, M.D. Management of Nontraumatic Vascular Shunts Involving the Cavernous Sinus. Kupersmith MJ, Berenstein A, Choi IS, Warren F, Flamm E. Ophthalmology 1988;95:121-30 (Jan). [Reprint requests to Dr. M. J. Kupersmith, 530 First Avenue, Suite 3B, New York, NY 10016.] The authors report their experience with 38 patients who had spontaneous, nontraumatic carotid cavernous fistulae or dural arteriovenous shunt. Their indications for neuroradiologic therapeutic intervention were rather liberal (progressive proptosis, increasing intraocular pressure, "debilitating" diplopia) and there are no data given regarding time from onset to consideration for interventional treatment. Detachable balloons were used in carotid cavernous fistulae and particulate embolization for dural arteriovenous shunts. Results were in general good, with few complications, and the detailed description of the actual technique is of interest. I am impressed that such an aggressive approach is urged for these often spontaneously resolving lesions. LYll A. Sedwick, M.D. Orbital T-cell Lymphoma in Human T-cell Leukemia Virus-l Infection. Lauer SA, Fischer J, Jones J, Gartner 5, Dutcher J, Hoxie JA. Oplztlzalmology 1988;95:110-5 (Jan). [Reprint requests to |
