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Show 5../ I.IILIU,nlf<L IIHSTRACTS Ih,,/II/,,/100: .II::' .117, Aug, Ir;, I'IKe; 'Rl'prilll rl'qul'sh 10 1', 1\, /i III Illl'l'lll.1I1 , 1\1.1 I, N,'ur"r.ldiol"gv '·...di"n, L;ni\' l'rsitv "' 1\'IlIlSvh'dllid, \'IIIII'i1'1'I11'" 'i11'l'l'1, l'hilddl'lphl'l, 1'1\ 1'Iltl'f I 11,111.. vi ,d '''''d ..,1.1Ild.lrd 111.lglll'l1l rl'S' 111.1 III I' Illldglllg (1\11':1) pldlln'.., "I IIll' "rbih I" "\'dludll' pvdidlri"p.llll'llls \\'llh I,·uk""'rl,l. 1't'rlls.t1 ", 11ll' 1"\1 "I thi" .Irli, I", \\'hi, h ,Ii.."'u",,,,'''' 11ll' l'h.lrddl'ri"li,'" "I MI'l Ihdl '.Ill Iwll' I" di,,lillglll.., h ,llllllllg 11'''1''11'' bd..,,·d 1111 "1,t.;ll,t1 "lr"llglh ", I, "I' I, "\\'l·i,t.;hll-d" illldg,·.." 1ll'1/,,, "Ill' I" illll-r/,rl't Ihl' illl,lgl''', \\'hidl ,Hl' r,lllll'r lTUdl' ill '''lllp,ni''''11 \\'Ith '''IlI/, lIkri/,'d IlllIlllgr,l/,hil' (I..' n illldg,·", I Ill' ,wlh"r" ,1I1Iiclp, ll<' Ihl' lISl' "f surf,l ...· ,'"il" ,llld 1l"ll' Ih,11 11ll' lillll' rvqlllrl'd /'l'r 1\11.:1 slln' is "" l"llg Ih,1l sl"LIlII1l1 \\'dl bl' lll'l,dl'd 1,,1' ,ldl'qUdll' sludll'''' III Pl'dldll'lc f',llll'llls 11ll' ,Hlilil' bv /illlllll'rnldil '-"IlI,lills Sl\ hlgh-lll,lgllill'dll"l1 i\lRI llll,lgl.·" "I thl' "rblls 1,1kl'll b\' ,I "url,lll' ,,,d ,Iltd,'hIllelll used illl.""lIUnlli"ll \\'ilh ,I rl.'gul.n 1\11.:1 Uilit. l"lll/, u!l'ri/ed l'lI11ogr,l/,h\' "11 l'Urrl'll1 "l.lll'-"I-Ihl'-,HI sc,lnnl'r" h,b been /'redidvd I" be I,ll' "upvri"r I" ,urrl'nl lRI 1,,1' ,'rbit,ll illl,lgin,t.;, bul Ihl'''l' \11.:1 pillur,'''', ,11though tlll'\' 1,lkl' .-"n"idl'r,lbh' h'llgl'r I" "I'I,lin lh,lll l I illl,lgl''', ,HI.' rl'Ill,HJ...,lbh· g""d bl''-,lU''l' ", IIll' "url,ll."· ,'"d, As opp"sl'd I" CT, !'v1l.:l 1.',111 di"lillgui"h ,111l"ng l.l'rl,lln "'slon", ,·"pe.-i,llh' Iho"l' Ih,ll ,Hl' bl""d-lilil'd, \\hl(h molkes Ihl' use 01 I'v1RI in 11ll' "rbit l'''/,l'(I,llh' olppl',l11ng 11/11:\ ::. ..du'1<k, .\1 /1, Postoperative Diplopia and Ptosis, R,linin, E :\., ilnd Carls'"l, B, 1'v1. /\,(//. (11'/llhll/Il/"/' 103: 1.1.'17-1,\,\'1, Sept. 141'3. IReprint rl'qm'sh I" H, 1\1. C,Hb,'n, \I.D, Ph,D., Dep<HIllll.'nl "I !\n,ll'"llV, -fh::'::' 1\1.....1 Sci II. l'ni\' l'rsil\' 01 Mi(higoln, Ann Arbo~, 1\11 -iKlll'l,1 To minimiLI.' Ihl' ollll"unt 01 relwbulL',H ,1I1l'slhl·"1,1 used in (iltMold surger\', ,llld Ihus Its S\'"kllll( ,1bsllr/,tion and eill'd, onl' 01 the ,wllll'r" g,I\'(' ,Iddill"n,ll inll'(lions l,l sm,lll anwunh "l bupi\',K'lilll' int" the Ipur redus mu"lil'" bl'f"rl' plTI,'rllling 111l.' "urgl'r\' II i" Iwl c1l'ar ho\\' m,lll\' p,ltil'nls \\'tTl' "0 inl"(kd: ,<,I "i'\ (,ISI.'S arl' pr""l'nl<'d -t\\'" 01 /,I'hi" ,1nd Illur 01 lll"ldil\' dlsl, rders Ir"m rl'llu" Illu"dl' p,Hl'"i", S"llll' "I IIll' /,,1 Ill'nts' disordl'r" rl'""I\'('d bul "l'\'l'r,ll h,ld ("nlinuing dilli( ultil',s, Tlw ,wlh"rs ("I1l'ludl' Ih'll Ihl'sl' (,ISl'" undl'rs( orl' Ihl' m\,,,pollhi, n,llurl' (111",',11 ,1Ilt'sllll'li,'" /1111:\ ::''''',I'lt t ,\ I /1 Radiation Optic Neuropathy. I-.:Iinl', I, B" I-.:im, I. Y, and Cl'["lllos, /.:. ()/'hlhll/III"/"XI/ 92: IIIK II::'h, Aug. IlJH5. I({l'prillt rl'qul'sls 10 I.. B, I-.:Iinl', 1\1 D" Sui'" ",,'e; lhUU 71h I\Vl', South, Birminghdlll, AI 3:;2\.\,1 .. " Klinl' l'1 .11. prl'sl'nt case reports and a literature reo view "I ,In imporlal11 topic that they find "has not been "lllph,lsizl'd in thl' ophthalmologic litl'rature." From Ihl'lr prl'sl'lllalion, with ,1 discussion by Norman Schatz, 'lilt' (,111 leMn l'xadlv wh,lt radiation optic neuropathy is (usuall\' ,I "uddl'n I,,'os "I \'isual acuitv and/or visual fil'ld). when it happl'ns (wilhin 3 years of radiation Ihl'rap\'), to wholll il happens (tolal rads administered I" polti"1l1s \'.lr\' \\'idl'''', induding often "safe" doses, fradi"n,ll ,1I1d 1,,1(1/). Iw\\' to \\'ork it up (good-quality 1I11'lging "f 11ll' sl'II,l and suprasellar space) and what to tI" ,Ib"ut il (In' adlllini"krillg skn>ids and/or hyperbaric "\\'gl'n), fhi" i" a useful <ulide about a distressing dinI.-, ll sit lhlll"n 1.1/11 I\. S"dll>[ck, M,D. The Risk of Cerebrovascular and Cardiovascular Disease in Patients with Anterior Ischemic Optic Neuropathy. em'l'r, D, R" \lilll'r, ,'.:, R" Alll'r, C. 1.., and Fine, S L. :1,<11 (1,'lilhd/lllt'/ 103: 113h-II-i2, Aug 1983. [Reprint rl'qul'sls 10 .'.: R 1\1iJlt-r, \1 D, Thl' Wilmer Eve Inslilutl', Thel"hIb H,'pkin, \1l'dl(al Institutions, 600 \J W"lfl' 51" Ballllllorl'. \10 ::'12l131 Do p,ltlenh \\'llh antl'ril'r Ischemic "pti( neuropathy h,1\'e an in(rl',I ...ed lI1(iden(l' "ll,ther "\'aseular" e\'ents' This Mtide ,Ittempls 1" ,mS\,'l'r thaI questi'lIl. The auIh,' rs' ::'1::' p,ltienl .... ..;een ,'\'1.'1' <1 peril'd ,'I III \'t'ars, \\'ere (,1111.'.1 I"l' 1"II,n,oup and f,'und t" h,1\'e an i~(reased in( iden(e l.ll Ill\'ll(.lrdlal inlardil.>n ,1Ild strl,ke in certain ,Igl' grl'ups ,1nd dassl's ,IS (,'mpared \\'ith eontml paIll'nls Ir,'m l'lher sludies, The aUlhl'rs eL1l1clude that m,'sl poltients \\'llh anll'ri,'r is(hemlc ,'ptie neuropath\' slll'uld ha\'(' "c,'mplell' ph\'sical e'\aminatiLlIl, cardiac l'\',llu,lll,'n, Il'sts "f e<lwlid p,llenC\', and careful medical f"""\\'-up tl.' ,Itlempt It' ~'rl'\'l'nl s~lbsequent (erebroYascul, lr l'r cMdil'\·,lS(ul.lr l.'\·enls." In this age of attempted dl.'-l'S(,ll,llillil 1.,1 medi(,ll C"sts and care, one wonders \\h,11 "Iesls "f (,u,'tid p,llen(\'" are ad\'isable, whether "lllmpit-le ph\'sie,ll e,\,lmin,lt'illn" (an be presumed to lndudl' (,udi"ll'g\' e\',llu,lti,'n, and what e:\a(tly "careful IlllIl'\\"u~'" 111l',lnS (e\<lI11inalillns even' 6 ~onths, -l 111\'nlhs, I::' Illl.'nths'). Certainh' (ases sh~luld be individu, lliled, ,md pl.'rh,lps patient 'education is more mean. IIlglul f,'r Ihl'sl' p,ltients than fLlr others (i.e., what a II',lib Il'llt ischemic att,lck would be, what cardiac '\'Inpt"llls m,I\' bl'l. but it Sl'l'ms irresponsible to imply lh,ll p,llll.'llls with ,1Illerillr ischemic optic neuropathY need [)\'ppkr digit,ll subtraction angiographY and/or lull ,Hkril'gr,lph\' llf the camtid arteries, elect~ocardiogr, llll, ,'dll1c.Hdiogram, Holter monitoring, treadmill Il'st, and general phvsical examination every 6 months if tl1l'\' ,Hl' asymptomatic. Nevertheless, this ~rticle undersellres the predictive aspect of anterior ischemic optic Ileuropath\' tor other vascular events in certain patient |