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Show 50 LITERATURE ABSTRACTS requests to Thomas J. Smith, M.D., Department of Ophthalmology, University of Kentucky, Lexington, KY 40536.] These authors tested 22 patients with pseudotumor cerebri by using automated static threshold perimetry (Digilab 350 or Octopus 2000R). They found significant visual field defects in 17 of 22 patients. Presumably, these visual fields were the first ones performed after diagnosis of pseudotumor cerebri, but many patients had symptoms for months to several years. Commentary by Dr. Roy Beck underscores the weakness of this study: "Although the conclusion that visual field defects are common in pseudotumor cerebri appears valid, the conclusion that automated threshold perimetry is more sensitive than standard kinetic perimetry in this disorder, although probably true, really cannot be made from the data collected in this study. The authors base their contention on the fact that a greater percentage of eyes in this study had visual field defects with automated perimetry than has been previously reported with manual perimetry. However, it is not possible to determine whether the patient population in the current study is similar enough to populations described in previous studies to make a comparison." Lyn A. Sedwick, M.D. The Nasal Junction Scotoma in Giant Aneurysms. Farris BK, Smith JL, David NJ. Ophthalmology 1986;93:895-905 (July). [Reprint requests to Bradley Kent Farris, M.D., Department of Ophthalmology, University of Oklahoma, Dean A. McGee Eye Institute, 608 Stanton L. Young Blvd., Oklahoma City, OK 73104.] Ten patients with 13 giant internal carotid artery aneurysms were reviewed retrospectively, with each case presented in detail. Six of seven patients with one aneurysm had decreased vision in the ipsilateral eye; six patients with a total of seven aneurysms had ipsilateral nasal visual field defects (five of these defects were discrete and two were central scotomas that broke out nasally); and the remaining patients had a variety of visual field de~ feets. Only one patient had an ipsilateral central scotoma with contralateral superotemporal visual field loss. Other reports describing giantlU'l.~ eurysms are reviewed and confirm the ptedil'eC" tion for ipsilateral nasal defects, although manyo'f these cases also showed temporal defects in the contralateral eye. These authors conclude that "ipsilateral nasal scotomas, in the absence of the common ocular causes for nasal field defects, should suggest the diagnostic possibility of giant internal carotid artery aneurysms." They also favor high-resolution computerized tomography over magnetic resonance imaging to detect such lesions, but no representative scans are presented to substantiate this contention. Lyn A. Sedwick, M.D. Neuroophthalmologic Abnormalities and Intravascular Therapy of Traumatic Carotid Cavernous Fistulas. Kupersmith MJ, Berenstein A, Flamm E, Ransohoff J. Ophthalmology 1986;93:906-12 (July). [Reprint requests to Mark J. Kupersmith, M.D., 530 First Ave., 3B, New York, NY 10016.] Thirty-three patients with 34 traumatic carotid cavernous fistulas were treated between 1979 and 1982. Treatment was achieved with embolization with either detachable balloons (28 cases) or isobutyl- 2-cyanoacrylate (by itself in two cases and with a balloon in two cases). The carotid was sacrificed intentionally in four cases and unintentionally in three. A variety of neuro-ophthalmic findings was present preoperatively (cranial neuropathies, orbital congestion, visual loss, bruit, etc.), with all patients experiencing improvement postoperatively and only two patients suffering transient cerebral dysfunction. Although this article suffers from poor presentation of data (more tables and less text would have allowed the casual reader quick grasp of the salient points), the authors convincingly show that these patients can be helped safely. "Versatility in methods, with the use of tissue adhesives in fistulas through external carotid artery collaterals or rigid catheters and detachable balloons, which use the hemodynamic aspects of the fistula for placement, is essential in treating these cases." Lyn A. Sedwick, M.D. Sixth Nerve Palsy and Unilateral Horner's Syndrome. Gutman I, Levartovski S, Goldhammer Y, Tadmor R, Findler G. Ophthalmology 1986;93:9136 (July). [Reprint requests to I. Gutman, M.D., |