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Show 138 LITERATURE ABSTRACTS mentation rates had higher hematocrits. They conclude that in patients with a normal hematocrit, clinical symptoms may be more accurate in predicting the presence of giant cell arteritis than Westergren erythrocyte sedimentation rate. The authors also note that (a) a perspective study would help to determine whether Zeta or Wintrobe erythrocyte sedimentation rates would be preferable and that (b) their sample size is small and biased, which may affect their conclusions. Lyn A. Sedwick, M.D. Hydroxychloroquine Therapy in Massive Total Doses without Retinal Toxicity. Johnson MW, Vine AK. Am J Ophthalmol 1987;104:139-44 (August) [Reprint requests to Dr. Andrew K. Vine, Retina Service, W. K. Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI48105-1994.) Nine patients were selected historically who were known to have exceeded a total dose 1,000 g chloroquine for treatment of rheumatoid arthritis or systemic lupus erythematosus. Only one patient showed evidence of "preretinopathy" in one eye, which the authors attribute to a daily dose of 600 mg in this patient, as opposed to 400 mg/day or less in the other patients. They feel the total dose, which ranged from 1,054 to 3,923 g in their patients, is not the determining factor for retinopathy, but rather the daily dose. It is interesting that 2 of their nonmaculopathy patients had exceeded 500 mg for years, but were on lower doses at the time of the study, which tends to refute their claims, unless it is possible to "improve" when the daily dose is lowered. Lyn A. Sedwick, M.D. Assessment of Visual Impairment in Patients with Alzheimer's Disease. Sadun AA, Borchert MM, DeVita E, Hinton DR, Bassi q. Am J Ophthalmol 1987;104:113-20 (August). [Reprint requests to Dr. A. A. Sadun, 1355 San Pablo S1., Los Angeles, CA 90033.) These authors examined 12 patients with Alzheimer's disease and present 5 cases in detail. These patients were solicited from the Alzheimer's Consortium of Southern California; thus, there was no bias for vi<;ual complaints (i.e., "no clinical or self-referrals"). All 12 patients had visual co~plaints perceived by themselves or by f.aml1y members and most often had difficulty ~e~dmg. A variety of neuro-ophthalmic abn?r~al~tIes were found, including dysmetna, poor. mitiatIOn of saccades, abnormal flash pattern VIsual evoke~ response, abnormal color t~s.ti~g, abnormal VIsual fields, poor contrast senSItI~lty, a~d, rarely, decreased visual acuity with mIld optic atrophy. The authors discuss the pathology they feel accounts for their findings and stress that a~terior vis~al pathway degeneration, includi~g retm~l .ganghon cells, may have a larger role m explammg complaints of these patients than previ~usly thought. Several strategies to help these patIents read are discussed. Dr. Cogan reviews this paper in an editorial on the same issue on page 183. Lyn A. Sedwick, M.D. Optic Nerve Hypoplasia. Lambert SR, Hoyt CS, Narahara MH. Surv Ophtlzalmol 1987;32:1-9 UulAug). [Reprint requests to Dr. C. S. Hoyt, Room A704, UCSF, 400 Parnassus Ave., San Francisco, CA 94143.) A review of this disorder is presented with black and white optic nerve photographs, one magnetic resonance and one computerized tomographic picture. The authors postulate that the causative abnormality in this disorder is a greater than normal regression of optic nerve axons (normally, a peak of 3.7 million, which declines to 1.1 million nerve fibers by gestational week 31). LYIl A. Sedwick, M.D. Visual Recovery in Combined Central Retinal Artery and Central Retinal Vein Occlusion. Jorizzo PA, Klein ML, Shults WT, Linn ML. Am J OphthalmoI1987; 104:358-63 (Oct). [Reprint requests to Dr. M. L. Klein, Department of Ophthalmology, Oregon Health Sciences University, Portland, OR 97201.) Two patients with presumed combined central retinal vein and central retinal artery occlusion are presented. Both patients recovered good vision and had a transient central retinal vein occlusion picture in the contralateral eye. Carotid disease |