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Show Literature Abstracts Contralateral Amaurosis After Retrobulbar Injection. Ffl'idLwrg HI., Kline OR. 1\/1/ I Oph'htl/Illo/ 1986;IOI:hS8-h911 Olin). II\eprinl requests to H. L. Frit'dberg, M.D., IO-l W. Red Bank Ave., Woodbury, N] 08096.] Just as Antoszyk and Buckley recently reported (Ophthalmology '1986;93:462- 5, reviewed previously for I Cli/l NClifO Ophtlza/mo/), these authors report two cases of contralateral temporary blindness following retrobulbar anesthetic injection, both of which showed a dilated, nonreactive pupil in the contralateral eye but no notation about ocular motility. The mechanism is felt to be migration of the anesthetic agent in the optic nerve sheath to the chiasm and contralateral optic nerve. Suggestions are given for modifications of the injection technique to avoid this complication. LYIl A. Sedwick, M.D. Sphenoid Sinus Mucocele (Anterior Clinoid Variant) Mimicking Diabetic Ophthalmoplegia and Retrobulbar Neuritis. Johnson LN, Hepler RS, Yee RD, Batzdorf U. Am J Ophtha/mol 1986; 102:111-5 Oul). [Reprint requests to R. S. Hepler, M.D., Jules Stein Eye Institute, 800 Westwood Plaza, Los Angeles, CA 90024.J This intriguing paper gives the case history of two men, aged 56 and 59, who had neuro-ophthalmic problems attributed to sphenoid sinus mucocele-one a partial, pupil-sparing third nerve palsy and later a retrobulbar optic neuropathy; the other episodic visual loss. Surgery in patient 1 disclosed an "extensive mucocele within the left anterior clinoid" with erosion of the roof of the left optic canal and medial wall of the left temporal fossa. Surgery was declined by patient 2; thus, computerized tomographic findings indicating contiguity between the apparent mucocele and optic canal could not be ascertained. Fifteen cases of third nerve palsies in association with sphenoid sinus mucocele, some recurrent and half pupil sparing, are reviewed from the literature. 258 'c,;, 1986 Raven Press, New York Ten cases of visual loss in association with similar mucoceles are also reviewed, only two of which had improvement of vision following surgery. LYIl A. Sedwick, M.D. Cyclophosphamide in the Treatment of Orbital Vasculitis. Garrity JA, Kennerdell JS, Johnson BL, Ellis LD. Am J Ophthalmol 1986;102:97-103 Oul). [Reprint requests to John S. Kennerdell, M.D., Department of Ophthalmology, Allegheny General Hospital, 320 E. North Ave., Pittsburgh, PA 15212.J Three patients are presented with biopsied orbital inflammation, consisting predominantly of vasculitis, whose disease ,vas not controlled by steroids or radiation therapy but did subside on cyclophosphamide therapy. Intravenous doses of 1,000 mg weekly or biweekly were used in all three patients and oral cyclophosphamide (100 mg/day) was used in one patient for 7 months after 5 months of intravenous therapy. The authors seem to believe that orbital inflammation, which is shown to be primarily vasculitic by biopsy, may not be controllable with corticosteroids and will require immunosuppression therapy. LYIl A. Sedwick, M.D. Visual Loss and Intoxication. Frenkel REP, Spoor Te. SlIfi' Ophthl1/lIIoI1986;30:391-6 (Mayl}un). [Reprint requests to T. e. Spoor, M.D., Kresge Eye Institute, 3994 John R., Detroit, MI 48201.] A 51-year-old black man with a history of alcohol abuse, blackout spells, and headaches was found to have very poor vision in both eyes with optic atrophy in the right eye and a swollen optic nerve in the left eye. His computerized tomographic scan showed a large, right frontal meningioma. This case is presented as a true Foster Ken- |
