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Show LITU\/\ILl/\/ /IHS1RACrS 55 groups. As its re\'il'II' in tl1l' /0111'11111 llf the .. I/IIl'l/(,11I '\1<',/Il'lll ASSI'Clllt/('/1 implies, this inturm,ltiun m,l\' bl' mUH' \"lluable ,1I1d surprising tll intl'rnisls ,1Ild Ill'uHlluglsls th,1I1 tll llphth,llnllllllgisls. I 1111 .. \ .";e'/i('ll~. ,\ I I) Voluntary Alteration of P.lllern Visu.ll Evoked Responses, tl.hl rg,lIl, 1\. ", \;ug"IlL H, 1l,1ITI~Un, I tl.l, ,111d O'L'llnl1l1L I' ~ lll'I/II/dlll/"/I'."11 <}2( III) U'ih Uhl, Ocl. lq~:;. Il\epnnt rl''1ul'Sls III I tl.1. ILnri,,'n, I'h I), Dep.utllll'llt III l)phth,111l1ll1'1g\', L'1l1\'l'r~It\' ul Il''\,'~ He,llth ~Clell(l' l'l'nll'r ,11 ~,1Il :\ntl1nill, 770.\ !'Iul'd Curl Dr. S,1I1 ..\nt,lnill. 1\ :-s~s-t I \'Isu,ll-e\lll-.l'd rl'spllnsl' (\'1-1\) I,lns ,1Ild I"l'S ,llil-.e sl1l1uld ~'enlse thiS ,lrtICil', IIhlch des(l'ib,'~ p,ltll'rn ,1I1d 11.1Sh \'ER ll'stin~ In -t2 nllrm,ll subll'ds wh'l werl' ,1sl-.ed tll l'ither ",ltll'nd" l'r "I~nllre" the stimulus. An llbsel'\'l'r (lluld dell'(t n,' chan~e In ii'\,ltilln with tl1l' dilkrent requests. \1,111\' subll'Cls Wl'rl' ,lble tll mMh'dll' reduce thl' ,1mplitude III their p,ltll'rn \'1:-:1\ ,1I1d ~O', cuuld e'\tin~ uish it cllmplell'iI". \;ll subJed cuuld reduce the Il.lsh \ER b\' I~nlll'ln~ the sllmulus Ihe cUl11mentarl' b\' Rl1l1ald Burde IS ncdlenl. The entire ,1I'tide cZln be taulted l)nil" Illr Its presentatwn in ,1 stridll' uphthall11lc !llurnal. as it sure'" hZls interest tllr neurlllll~ists ,md l)ther phl'sioans \\hll 1I'lsh tll use e\'ul-.ed respllnses dlagnostical'" . Treatment Protocol for Orbital Inflammatory Disease, leone, C R, Jr., and lllll'd, W. C, III. 1I1'1/thll/llll1logll 92(10) 132:;-1331, Ocl. 1'is:; [Rl'print requests tll C R leone, Jr., \10, Suite 70:;, MedicZlI Center Tllwer, 79:;0 FlOI'd Curl Dr, San Antunlo, TX 7822'i.) leone and 11l1\'d propo~l' a rl',l~on,lble flo\\' chart for the diagnosis a nd carl' ot orbllal 111 f1a 11111101 torI' d iSl',l'" based on their experience with -t'i pati,'nls ~uspedl'd ul harboring such disease. By their ~chel11a, unll' p,ltienls unresponsive to oral andor II1travl'nous ~ll'rllld trlab would merit bIOpSY. RecummenJations Ml' given lor specific. long-ll'rm managl'ml'nt, including ro1diZltion therapy and CYclophosphamide U~l' in rl'~i~t,1I11 l-'lSl'~. Their very practical approach IS dl~cu~sed bl'lon,lth,ln Trobe, who presents ,1 fl'W suggl'stions for ils improvement. II/II /1 :;e'/il'll k, !vi f) Visual Function in Prolactinoma Patients Treated with Bromocriptine, Moster, M. L., Savino, P. J, Scllo1t/, N. J" Snyder, P. J., Sergoll, R. C. 'lnd Bosley, T M. Ophthalmology 92(10): 1332-1341, Oct. I'iH:; lI{eprint rl'- quests to 1'. J. Savino, M.D., Nl'uro-ophthalmology Service, Wills he Hospital, 9th and Walnut Sts., Philadelphia, 1'/\ I'Jlm.] This thought-provol-.ing articIL' from Wills Eye Hospit, ll desLTibl's 10 mel1 with prolactin-secrding pituitary ,1dl'l1om,ls tl'l'ated prim.Hily with bromocriptine (ParIOlh'I). Mo.~t had ,1 dramatic rl'sponse, with improve1lll'llt of vi~ual fields ,lnd visual acuity; o Ill' patient had all illl''\plil,'bll' wor~l'nll1g of visual fields; one patient W,lS lo~t to follow-up; one had pr,'sumably irreversible loss of visu,ll function that did not changl' with normali100tion of serum proladin while on brol11ocriptinl' therap\'. Sl'\'l'ral c,lution~ must be e'\ercised in interprding thesl' data fir~t, bromocnptine is not curati\'e but must be continul'd indefinitL-ly; sl'cond, not all patil'nts can to1l'ratL' or attllrd such therap\' (thl' cost per \'l'ar for thl' "averagl' dOSl'" reported in this article would be approximatL-ly 5900); third, no one knows the 111ng-term side effects of such meJication. Bromocriptine is an exciting breal-.through in the treatment of pituitarv adenomas that secrete prolactin, but, as the authl1rs acknowledge, "the exact place it will e\'entualll' l1CCUpy in the treatment plan llf pituitaI'\' adenomas IS speculative. " Lilli A Scdil'llk, .\1.0. Eccentric Visual Acuity in Patients with Macular Disease, Harris, M. J., RllblllS, 0, Dietl-I', J \1 Ir., Fine, S L, and Gu\'tl1n, D. L. l)"hth,71l11l'/,'.\I/ 92( 111 1550~ 15:;3, N,H'. 19S:; [Reprint requests tll D. l. Guvton, M.D., Wilmer BI-3:;, Jl)hns H,)pkins Hl)spital. Baltimore, MD 2120:;] This is an astl1nishing'" lOgical and easy method ni assessing plllL'nti,ll \'isu,ll ,Kuil\' in patients \\'Ith macular disease; It uses h,1I1d-lwld C,1rds. LKh card IS iilled With I:-:'s, all the same size, and c,1I1 be I'llt,ltl'd tll test repl',ltl'dlv luI' p,ltients' ,lbilit\, tll ,l(cur,ltell' dL'll'd the W,l\' lhe ['s pl1int. With such lL'sting lln 37e\'l'S, the ,1Uthors tllund th,lt 70'; h,1Li plltenti,ll \'iSU,ll ,Kuitl' ,1t least two timl's betll'r than th,lt indic,llL'd by ((l[1\'l'n til1l1a I n1l',lsures llf visu,ll ,Kuit\', and 20'; h,ld inur times better ViSU,ll ,Kuit\' Clll1tHlls Wl'rl' "!tlggl'd" [wrm,ll subjects, I1l11H' 01 Wh'llll showed imprl1\'l'd \'isual acuit\' using these cards ,1S COlllp,Hl'd with linl'ar E ll'sting. 1\I,1I1V patiellts with ,Kquired m,Klil.u dise,lse dn I1llt spl1ntaneousl\' use p,1r,lll1\'l',ll fi'\,ltIOI1 tll impl'l1\'e their visual acuit\' even it tlwir m,lcular dlse,lsl' is bilalL'ral. This ll'sting h,ls llb\'ious 'lpplic'ltil1l1 in Chlll1sing patients Whll would dll wdl with IllW vision ,lids. These easv E cards "lso will be gl'ldl\' ,1ccepll'd intl1 the armamentarium of ,1Illlphth,1InHlILlgists whl1evaluate patients for ViSU,ll loss. 1.11/1 A. Sedwick, M.D. I OJ/{ NCliro-ol'/{I/{"llIlol, Vol. b, No. 1, 1986 |
