| OCR Text |
Show 188 UIL/~ATUln ABS1RACTS tllll/lI/ol 1986;104:410-3 (M.u). IRl'print relJuests to Dr. R. L. Font, Ophthalmic Pathology Labor,ltory, Cullen Eve Insti tute, B,l\' lor College of Medici ne, 1 Bavlor Plaza, Houston, TX 77()JO·1 An interesting patient with progressive unilateral, tlll'n bilateral, visual loss is prl'sl'nted vvho ultimatelv was found to have meningeal carcinom, ltosis. 'The diagnosis was l'lusive, and a total of four lumbar punrlures were Ix'rfornll'd to identilv malignant signet-ring cells, which were detected only upon review of reportedly normal cvtology on the third lumbar puncture. Further workup led to the primary gastric carcinoma. This patient underwent extensive workup before and after her positive spinal tap, including roentgenograms of most of her body, two cranial computerized tomographic scans, abdominal and pelvic computerized tomography, mammography, bone scan, whole lung tomograms, barium enema, cerebral angiography, and numerous blood and urine tests. As the authors note, one needs "a high index of suspicion ... to make an early clinical diagnosis," and repeat cerebrospinal fluid examinations are often necessary to confirm this clinical impression. Llfll A. Sedwick, M.D. Threshold Amsler Grid Testing: Cross-Polarizing Lenses Enhance Yield. Wall M, Sadun AA. Arch Ophthall/w/, 1986;104:520-3 (Apr). [Reprint requests to Dr. M. Wall, Department of Neurology and Psychiatry, Tulane Medical Center, 1415 Tulane Ave., New Orleans, LA 70112.] In order to enhance detection of scotomata bv Amsler grid, Drs. Wall and Sadun used rotating cross-polarized filters first to extinguish the grid and then to bring the grid back to bare perception. They demonstrate a number of shallow scotomata with this technique which usually were identified on tangent screen or threshold automated perimetry. This seems a fast, reliable technique for detection of relative paracentral scotomata and may find a place not only in office examination, but also for hospital consultations on patients with suspected optic neuropathy. Llfll A. Sedwick. M.D. Optic Neuropathy in Systemic Lupus Erythematosus. Jabs DA, Miller NR, Newman SA, Johnson ,elm ;"'v'cur(l-oplltJIIlJ"'t,l, \'01 tJ, No. J, 1980 MA, Stevens MB. Arch Ophtha/mo/, 1986;104:564-8 (Apr). [Reprint requests to Dr. D. A. Jabs, Uveitis and Clinical Immunology Service, The Wilmer Ophthalmological Institute, Wilmer 300, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21205.] Seven cases of retrobulbar optic neuropathy in patients with lUpus erythematosus are presented; the cases were drawn from the Department of Rheumatology records at Johns Hopkins and the Department of Ophthalmology at Hopkins and The University of Virginia. All patients met American Rheumat~)logic Association criteria for classification as systemic lUpus erythematosus. Most were treated with steroids for their optic neuropathy (apparently five of seven); details of steroid therapy are given for the four cases which were presented in detail, two of which involved oral steroid and two high-dose, pulsed intravenous steroid. Some visual improvement occurred in most patients. The authors make a distinction between retrobulbar optic neuropathy and retrobulbar ischemic optic neuropathy which seems unsupported clinically, but may correlate with visual evoked response data (mislabeled by case numbers on page 568, which adds to the confusion). The mechanism for the optic nerve lesions is vascular occlusion, according to the authors who review all other reported cases of lupus optic neuropathy. LI/1/ A. SedlL'ick. M.D. Restoration of Vision After Optic Canal Decompression. Spoor TC. 1\1athog RH. Arcll Ophtha/mo/ 1986;104:804-6 (June). [No reprints available.] This is a case report and a letter to the editor of a 28-year-old man who sustained a stab wound through the right nostril and had immediate, total loss of \'ision in his right e~'e and a right third, tl)urth, and sixth nerve palsy. Treatment with intravenous meth~'lprednisolone250 mg every 6 h tor 5 da~'s gave no return of vision; he then underwent transethmoid-sphenoidotomv with removal of the medial wall of the right optic canal. Vision slowly improved to 20/50 with return of approximately one-third to one-half of a normal visual field. It is almost incredible that visual recovery could occur after "no light perception" vision for 5 days, and it seems unlikely that such recovery would have occurred without surgery. Patients |
