A.M.A. Archives of Ophthalmology

BUCY, PAUL C.;KEPLINGER, JAMES E.

doi: 10.1001/archopht.1959.04220040003001pmid: 13805605

Abstract The invitation received to address the Section on Ophthalmology is an honor indeed. This is doubly true under the chairmanship of your distinguished Dr. Frank B. Walsh, who has contributed so much in the field of neuro-ophthalmology. The past 30 years have seen a great improvement in the diagnosis of tumors of the brain and particularly in their early recognition. Ophthalmologists especially have contributed to this progress. In the late 1920's and early 1930's between 75% and 85% of all patients with tumors of the brain had papilledema by the time they reached the neurological surgeon. Today not more than 30% of the patients who are operated upon for tumors of the brain have such ophthalmoscopic findings. This is obviously the result of the earlier recognition of these tumors and has enabled the neurosurgeon to improve his results and to lower the mortality from his operations. This earlier recognition has References 1. This case was previously reported by Bailey, Buchanan, and Bucy as Case 51. 2. This case was previously reported by Bailey, Buchanan, and Bucy as Case 64. 3. This case was previously reported by Russell and Bucy as Case 2. 4. Alpers, B. J., and Yaskin, J. C.: Gliomas of the Pons , Arch. Neurol. & Psychiat. 41:435-459, 1939. 5. Bailey, P.; Buchanan, D. N., and Bucy, P. C.: Intracranial Tumors of Infancy and Childhood , Chicago, The University of Chicago Press, 1939. 6. Bailey and Eisenhardt, L.: Spongioblastomas of the Brain , J. Comp. Neurol. 56:391-430, 1932. 7. Brain, W. R.: On the Rotated or Cerebellar Posture of the Head , Brain 49:61-76, 1926. 8. Bray, P. F.; Carter, S., and Taveras, J. M.: Brainstem Tumors in Children , Neurology 8:1-7, 1958. 9. Brock, S., and Needles, W.: Tumors of Brain Stem , J. Nerv. & Ment. Dis. 72:521-534, 1930. 10. Buckley, R. C.: Pontile Gliomas: A Pathologic Study and Classification of 25 Cases , Arch. Path. 9:779-819, 1930. 11. Bucy, P. C.; Foerster, O.; Gagel, O., and Mahoney, W.: Die Tumoren der Brücke; ein Fall von Astrocytom der Brücke , Ztschr. f. d. ges. Neurol. u. Psychiat. 157:136-146, 1937. 12. Bucyand Weaver, T. A., Jr.: Paralysis of Conjugate Lateral Movement of the Eyes in Association with Cerebellar Abscess , Arch. Surg. 42:839-849, 1941. 13. Cuneo, H. M., and Rand, C. W.: Brain Tumors of Childhood , Springfield, Ill., Charles C Thomas, Publisher, 1952. 14. Dandy, W. E.: The Brain, in Practice of Surgery , edited by Dean Lewis, Hagerstown, Md., W. F. Prior & Co., 1934, Vol. 12. 15. Hare, C. C., and Wolf, A.: Intramedullary Tumors of the Brain Stem , Arch. Neurol. & Psychiat. 32:1230-1252, 1934. 16. Horrax, G.: Differential Diagnosis of Tumors Primarily Pineal and Primarily Pontile , Arch. Neurol. & Psychiat. 17:179-192, 1927. 17. Pilcher, C.: Spongioblastoma Polare of the Pons , Arch. Neurol. & Psychiat. 32:1210-1230, 1934. 18. Russell, J. R., and Bucy, P. C.: Meningiomas of the Posterior Fossa , Surg. Gynec. & Obst. 96:183-192. 1953.

KORNBLUETH, WALTER;JAMPOLSKY, ARTHUR;TAMLER, EDWARD;MARG, ELWIN

doi: 10.1001/archopht.1959.04220040017002pmid: 14411061

Abstract It is well known that holding a tonometer near the eye or putting it on the cornea causes the patient to squeeze his lids because of a contraction of the orbicularis muscles. This reflex occurs regularly at the sight of an object near the eye and is generally termed a protective or fright reaction. Little attention has been paid to the part played by the oculorotary muscles during the so-called fright reaction.1,2 This study was undertaken to elucidate the reaction of the oculorotary muscles to tonometry and tonography. This seemed important in view of the pronounced influence the oculorotary muscles exercise on the intraocular pressure.3 Changes in the state of contraction of the oculorotary muscles might alter the ocular tension and introduce some inaccuracies in tonometric and tonographic measurements. Materials and Methods The measurements of ocular tension and of electrical activity of the oculorotary and orbicularis muscles were References 1. Lancaster, W. B.: Fifty Years of Experience in Ocular Motility , Am. J. Ophth. 24:485, 1941. 2. Adler, F. H.: Physiology of the Eye: Clinical Application , Ed. 2, St. Louis, The C. V. Mosby Company, 1953, p. 140. 3. Duke-Elder, S.: Text-Book of Ophthalmology , Vol. 1, St. Louis, The C. V. Mosby Company, 1939, p. 508. 4. Marg, E.; Jampolsky, A., and Tamler, E.: Elements of Human Extraocular Electromyography , A. M. A. Arch. Ophth. 61:258, 1959.Crossref 5. Jampolsky, A.,: Tamler, E., and Marg, E.: Arti facts and Normal Variations in Human Ocular Electromyography , A. M. A. Arch. Ophth. 61:402, 1959.Crossref 6. Tamler, E.; Jampolsky, A., and Marg, E.: An Electromyographic Study of Asymmetric Convergence , Am. J. Ophth. 46:174 (Nov., (Pt. 2) ) 1958. 7. Grant, W. M.: Clinical Aspects of the Outflow of the Aqueous Humor , in Glaucoma Symposium , edited by S. Duke-Elder, Springfield, Ill., Charles C Thomas, Publisher, 1955, p. 128. 8. Sadove, M. S., and Unna, K. R.: Ophthalmic Studies of Curare and Curare-like Drugs in Man , Am. J. Ophth. 34:543, 1951. 9. Roche, J. R.: Research in the Use of Curare for Ocular Surgery , Am. J. Ophth. 33:91, 1950. 10. Kirby, D. B.: Use of Curare in Cataract Surgery , Arch. Ophth. 43:678, 1950.Crossref 11. Kornblueth, W.; Aladjemoff, L.; Magora, F., and Gabbay, A.: Influence of General Anesthesia on Intraocular Pressure in Man , A. M. A. Arch. Ophth. 61:84, 1959.Crossref 12. Hippel, A., and Gruenhagen, A.: Über den Einfluss der Nerven auf die Hoehe des intraocularen Druckes , Arch. Ophth. 14:219, 1868. 13. Wessely, K.: Über den Einfluss der Augen bewegungen auf den intraocularen Druck , Arch. Augenh. 81:102, 1916. 14. Hine, M. L.: Some Observations with the Schiøtz Tonometer on the Normal Eye , Ophthalmoscope 14:360, 1916. 15. Greaves, D. P., and Perkins, E. S.: Influence of the Third Cranial Nerve on Intraocular Pressure , Brit. J. Ophth. 37:54, 1953.Crossref 16. Kornblueth, W.; Jampolsky, A.; Tamler, E., and Marg, E.: Contraction of the Oculorotary Muscles and Intraocular Pressure, to be published. 17. Becker, B., and Friedenwald, J. S.: Clinical Aqueous Outflow , A. M. A. Arch. Ophth. 50:557, 1953.Crossref 18. Leydhecker, W.: Ein neues Verfahren der klinischen Tonographie , Klin. Monatsbl. Augenh. 132:77, 1958. 19. Linnér, E.: Changeability Test of Aqueous Outflow Resistance , Brit. J. Ophth. 42:38, 1958.Crossref 20. Stocker, F. W.: On Changes in Intraocular Pressure of the Other Eye While Tonography is Done on One Eye , Trans. Am. Ophth. Soc. 54:63, 1956.

CAMBON, EILEEN N.;POLLARD, MORRIS

doi: 10.1001/archopht.1959.04220040024003pmid: 13807099

Abstract The medical literature has reflected an increasing interest in viral diseases of the eye.1,2 While many of the reports concern the clinically diseased eye, little attention has been directed to the viral flora of the normal conjunctival sac. The bacterial flora of the human eye has been studied extensively, and such information is important in evaluating microbial disease of the eye.3,4 It is equally significant to ascertain a base line of the normal viral flora of the human eye. This report concerns such a study on 200 eyes. Materials and Methods The clinically normal eyes of 100 persons were investigated for the presence of virus in the conjunctival sac. Patients coming to the Outpatient Eye Clinic of the University of Texas-Medical Branch Hospitals were chosen. The eye patients were chosen because the specimens could be taken as routine on the new patients with a minimum of time and References 1. Microbiological Associates, Bethesda, Md. 2. The Symposium on Viral Keratocontivitis , Am. J. Ophth. 43:3-166 (April, (Pt. 2) ) 1957. 3. Syverton, J. T.: Lennette, E. H., and Thygeson, P.: Symposium: Viruses and Viral Diseases , Tr. Am. Acad. Ophth. 62:394-431, 1958. 4. Berens, C., Editor: The Eye and Its Diseases , Ed. 2, Philadelphia, W. B. Saunders Company, 1949. 5. Duke-Elder, S., Editor: Parsons' Diseases of the Eye , Ed. 12, London, J. & A. Churchill, Ltd., 1953. 6. Zitcer, E. M.; Fogh, J., and Dunnebacke, T. H.: Human Amnion Cells for Large-Scale Production of Polio Virus , Science 122:30, 1955.Crossref 7. Weinstein, H. J.; Alexander, C.; Yoshihara, G. M., and Kirby, M. M.: Preparation of Human Amnion Tissue Cultures , Proc. Soc. Exper. Biol. & Med. 92:535-538, 1956. 8. Deinhardt, E., and Henle, G.: Studies on the Viral Spectra of Human Cell , J. Immunology 79: 60-67, 1957. 9. Morgan, J. F.: Tissue Culture Nutrition , Bact. Rev. 22:20-45, 1958. 10. Rappaport, C.: Monolayer of Trypsinized Monkey Kidney Cells in Synthetic Medium , Proc. Soc. Exper. Biol. & Med. 91:464-470, 1956. 11. Enders, J. F.: Cytopathology of Virus Infections , Ann. Rev. Microbiol. 8:473-502, 1954. 12. Rustigan, R.; Johnston, P., and Reihart, H.: Infection of Monkey Kidney Tissue Culture with Virus-like Agents , Proc. Soc. Exper. Biol. & Med. 88:8-16, 1955. 13. Kaufman, H. E., and Kaufman, E.: Human Amonion-Cell Tissue Culture , A. M. A. Arch. Ophth. 59:342-349, 1958. 14. Hanna, L.; Jawetz, E., and Coleman, V. R.: Studies on Herpes Simplex: VII. The Signifi cance of Isolating Herpes-Simplex Virus from the Eye , Am. J. Ophth. 43:126-131 (April, (Pt. 2) ) 1957. 15. Rowe, W. P.; Huebner, R. J.; Gilmore, L. K.; Parrott, R. H., and Ward, T. G.: Isolation of a Cytopathogenic Agent from Human Adenoids Undergoing Spontaneous Degeneration in Tissue Culture , Proc. Soc. Exper. Biol. & Med. 84:570-573, 1953. 16. Jawetz, E.; Kimura, S.; Nicholas, A. N.; Thygeson, P., and Hanna, L.: New Type of APC Virus from Epidemic Keratoconjunctivitis , Science 122:1190-1191, 1955.

MEADOWS, S. P.

doi: 10.1001/archopht.1959.04220040028004pmid: N/A

Abstract In 1872, Roberts Bartholow, of Cincinnati, wrote a description of the clinical features of intracranial aneurysms arising from the internal carotid artery, which showed evidence of acute clinical observation. Jonathan Hutchinson, a London surgeon, described a case in 1875, and even considered carotid ligation. More recently, McKinney, Acree, and Soltz (1936) reported the clinical and radiological features of eight cases and called attention to the erosion of the optic foramen and widening of the superior orbital (sphenoidal) fissure which occurred in several of them. Jefferson (1938) made a detailed study of the clinical features of a series of 17 cases, which forms the basis of our present knowledge. At this period arteriography was in its infancy. Since then, relatively safe percutaneous angiography has become available and was undertaken in the majority of the present series of 15 patients which form the basis of the present contribution. Aneurysms arising from the References 1. Bartholow, R.: Am. J. M. Sc. 64:373-386, 1872.Crossref 2. Hutchinson, J.: Tr. Clin. Soc. London 8:127-131, 1875. 3. Jefferson, G.: Brit. J. Surg. 26:267-302, 1938.Crossref 4. McKinney, J. M.; Acree, T., and Soltz, S. E.: Bull. Neurol. lust. New York 5:247-277, 1936. 5. Rischbieth, R. H., and Bull, J. W.: Brit. J. Radiol. 31:125-135, 1958.Crossref

HATCH, JOSEPH L.

doi: 10.1001/archopht.1959.04220040037005pmid: 13852021

Abstract Ochronosis is a rare condition in which eye findings are almost always present.1 This disease has not been stressed in ophthalmological literature, but its detection is a matter of considerable importance. Skinsnes2 reported a tragic case where a man's only eye (the other one was lost after an injury) was needlessly removed because of suspected melanoma of the uvea. This eye had medial and lateral pigmentations of the globe such as are found in ochronosis. No tumor was found. The patient died one year later of bronchopneumonia, and the diagnosis of ochronosis was proved at autopsy. Hereditary alkaptonuria is characterized by the excretion of homogentisic acid in the urine because of a block in the metabolic breakdown of tyrosine to carbon dioxide and water. There may be no symptoms, but about one-half of the cases have deposition of Considerable amounts of pigment in the tissues, called ochronosis. References 1. Smith, J. W.: Ochronosis of the Sclera and Cornea Complicating Alkaptonuria: Review of the Literature and Report of 4 Cases , J. A.M. A. 120:1282-1288, 1942.Crossref 2. Skinsnes, O. K.: Generalized Ochronosis: Report of an Instance in Which it Was Misdiagnosed as Melanosarcoma with Resultant Enucleation of an Eye , Arch. Path. 45:552-558, 1948. 3. Pomeranz, M. M.; Friedman, L. J., and Tunick, J. S.: Roentgen Findings in Alkaptonuria Ochronosis , Radiology 37:295-302, 1941.Crossref 4. Fishberg, E. H.: The Instantaneous Diagnosis of Alkaptonuria on a Single Drop of Urine , J.A.M.A. 119:882, 1942.Crossref 5. Osler, W.: Ochronosis, the Pigmentation of Cartilages, Sclerotics and Skin in Alkaptonuria , Lancet 1:10, 1904.Crossref 6. Stern, C.: Principles of Human Genetics , San Francisco, W. H. Freeman & Company, 1949, pp. 39-40, 161, 353-354. 7. Nelson, W. E.: Textbook of Pediatrics , Ed. 6, Philadelphia, W. B. Saunders Company, 1954, pp. 218-219. 8. Martin, W. J.; Underdahl, L. O., and Mathieson, D. R.: Alkaptonuria: Report of 3 Cases , Proc. Staff Meet. Mayo Clin. 27:193-200, 1952. 9. Young, H. H.: Calculi of the Prostate Associated with Ochronosis and Alkaptonuria , J. Urol. 51:48-58, 1944. 10. Lichtenstein, L., and Kaplan, L.: Hereditary Ochronosis: Pathological Changes Observed in 2 Necropsied Cases , Am. J. Path. 30:1, 99-125, 1954. 11. Berliner, M. L.: Biomicroscopy of the Eye , New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1949, pp. 169-173.

SCHEIE, HAROLD G.;McLELLAN, THOMAS G.

doi: 10.1001/archopht.1959.04220040041006pmid: 14442569

Abstract This paper presents further observations on the treatment of herpes zoster ophthalmicus with corticotropin and corticosteroids. In a previous paper Scheie and Alper1 reported the results obtained by the use of corticotropin and cortisone in 11 patients, 10 of whom showed complete recovery. The present report summarizes the treatment and course of 25 more patients with herpes zoster ophthalmicus who have been treated with hormones given systemically. All of the patients had typical cutaneous changes accompanied by ocular involvement and severe pain. Further experience has strengthened our initial conclusion that hormones exert a favorable influence when used therapeutically for herpes zoster ophthalmicus. Relief of pain usually is achieved in one or two days, and the ocular lesions show prompt improvement. The course of the skin lesions seems shortened. Several reports on the use of corticotropin and corticosteroids have appeared since the review of the literature in our previous paper. References 1. Scheic, H. G., and Alper, M. C.: Treatment of Herpes Zoster Ophthalmicus with Cortisone or Corticotropin , A. M. A. Arch. Ophth. 53:38-44 ( (Jan.) ) 1955.Crossref 2. Doenges, J. P.: Treatment of Herpes Zoster with Cortisone , Illinois M. J. 106:131-133 ( (Aug.) ) 1954. 3. Hogan, M. J.; Thygeson, P., and Kimura, S.: Uses and Abuses of Adrenal Steroids and Corticotropin , A.M.A. Arch. Ophth. 53:165-176 ( (Feb.) ) 1955.Crossref 4. Marshall, F. A.: Treatment of Herpes Zoster with Topical Application of Hydrocortisone , J. M. Soc. New Jersey 52:474-475 ( (Sept.) ) 1955. 5. Appelman, D. H.: Treatment of Herpes Zoster with ACTH , New England J. Med. 253:693-695 ( (Oct.) ) 1955.Crossref 6. Benedict, W. H.: Herpes Zoster Ophthalmicus and Its Treatment , Guildcraft 30:24-28 ( (Dec.) ) 1956. 7. Carter, A. B.: Treatment of Ophthalmic Zoster with Prednisone , Brit. M. J. 2:746-748 ( (Sept.) ) 1957.Crossref 8. Epstein, E., and Allington, H. V.: The Treatment of Herpes Zoster , A. M. A. Arch. Dermat. 76:408-414 ( (Oct.) ) 1957.Crossref 9. Sheard, C., and Felder, E. A.: Herpes Zoster of Face and Neck with Earache, Dizziness and Nausea , Connecticut M. J. 19:103-105 ( (Feb.) ) 1955. 10. Stokes, J., Jr.: in Rivers, T. M.: Viral and Rickettsial Infections of Man , Ed. 2, Philadelphia, J. B. Lippincott Company, 1952, pp. 506-513. 11. Gundersen, T.: Convalescent Blood for Treatment of Herpes Zoster Ophthalmicus , Arch. Ophth. 24:132-141 ( (July) ) 1940.Crossref 12. Shelley, W. B.: Personal communication to the authors.

LOVEKIN, LOUISE G.;CHANDLER, MARGARET R.

doi: 10.1001/archopht.1959.04220040050007pmid: 14418492

Abstract Flicker fusion frequency may be measured in terms of either increasing or decreasing rates at which successive visual stimuli are presented to the subject. In this work, a decreasing rate was used and flicker fusion frequency is defined as the rate at which the subject noted a change from a continuous to an interrupted sensation. It is expressed in cycles per second. Although flicker fusion was known to be a sensitive method of examining the retina and optic pathways, it was not until 1933 that Phillips11 demonstrated its utility for examination of visual fields of several neurological patients and three normal subjects. His work was carried on and extended by Riddell,12 working with the same equipment but with modified technique. He tested 15 normal subjects at 16 points in the visual field. Hylkema3,4 tested 33 light-adapted normal subjects at four points on the horizontal meridian, reaching 25 References 1. These frequencles based on additional studies described in the text. 2. We wish to call attention to the large bibliography on flicker fusion compiled under the direction of Carney Landis and published by the Armed Forces National Research Council, Vision Committee Secretariat, University of Michigan, Ann Arbor, Mich., June, 1953 (An Annotated Bibliography of Flicker Fusion Phenomena Covering the Period 1740-1952). 3. Landis, C.: Something About Flicker Fusion , Scient. Month. 73: 1951. 4. Havener, W. H., and Henderson, J. W.: Comparison of Flicker Perimetry with Standard Perimetric Methods , A. M. A. Arch. Ophth. 52:91-105, 1954.Crossref 5. Hylkema, B. S.: Fusion Frequency with Intermittent Light Under Various Circumstances , Acta ophth. 20:159-180, 1942.Crossref 6. Hylkema, B. S.: Examination of the Visual Field by Determining the Fusion Frequency , Acta ophth. 20:180-193, 1942. 7. Krasno, L. R., and Ivy, A. C.: Response of the Flicker Fusion Threshold to Nitroglycerine and Its Potential Value in the Diagnosis, Prognosis, and Therapy of Subclinical and Clinical Cardiovascular Disease , Circulation 1:1267-1276, 1950.Crossref 8. Ivy, A. C.; Krasno, L. R., and Roback, G. S.: Effect of Analeptic Drugs on the Somnifiacient Effect of Seconal and Antihistaminics as Measured by Flicker Fusion Threshold, Chicago, University of Illinois, Department of Clinical Science. 9. Marty, J. P., and Hardy, J. A.: Flicker Fusion Thresholds in Pregnancy , Am. J. Obst. & Gynec. 64:1149-1153, 1952. 10. Mayer, L. L., and Sherman, I. C.: A Method of Flicker Perimetry , Am. J. Ophth. 21:390-395, 1938. 11. Miles, P. W.: Flicker Fusion Frequency in Amblyopia ex Anopsia , Am. J. Ophth. 32:225-231, 1949. 12. Miles, P. W.: Flicker Fusion Fields: Technique and Interpretation , Am. J. Ophth. 33:1069-1077, 1950. 13. Phillips, G.: Perception of Flicker in Lesions of the Visual Pathways , Brain 56:464-478, 1933. 14. Riddell, L. A.: The Use of the Flicker Phenomenon in the Investigation of the Field of Vision , Brit. J. Ophth. 20:385-410, 1936. 15. Teräskeli, H.: Untersuchungen über die Amblyopie ohne Spiegelbefund bei schielenden und nichschielenden Augen mittelst der Flimmermethode , Acta Soc. med. fenn. duodecim (Ser. B , fasc. 3, art. 5) 19:1-84, 1934. 16. Weekers, R., and Roussel, F.: La Mesure de la frequence de fusion en clinique , Docum. ophth. 2:130-192, 1948. 17. Kennelly, A. E., and Whiting, S. E.: The Frequencies of Flicker at Which Variations in Illumination Vanish , Nat. Elect. Light A. Conv., Proc. 30:327-340, 1957. 18. Erlick, D., and Landis, C.: The Effect of Intensity, Light-Dark Ratio, and Age on Flicker-Fusion Threshold , Am. J. Psychol. 65:375-388, 1952.

JACOBSON, JERRY HART;GESTRING, GIDON F.

doi: 10.1001/archopht.1959.04220040061008pmid: 13853066

Abstract Recent interest in psychopharmacology has led to extensive investigation of a number of types of drugs. The derivative of ergot known as d-lysergic diethylamide, or LSD-25, is one of the most thoroughly studied. This substance has been known to have pronounced effects upon the uterus, vagina, and bronchi and to cause mydriasis, tachycardia, rise in temperature, and other autonomic effects.1 Hoffman,2 in 1943, was the first to report psychic effects of the drug, after he had accidentally ingested a small quantity of it. These have been found to include mood changes, schizoid states, and, most important from the ophthalmological standpoint, visual hallucinations. The doses required for production of hallucinations in man are extremely minute, as little as 0.5μg. to 1.0μg. per kilogram of body weight being effective.3 Larger doses are required in schizophrenic patients.4 Recently Apter and Pfeiffer5 reported their observation that upon administration References 1. Rothlin, E.: Lysergic Acid Diethylamide and Related Substances , Ann. New York Acad. Sc. 66:668, 1957.Crossref 2. Hoffman, cited by Rothlin.1 3. Mayer-Gross, W.; McAdam, W., and Walker, T.: Psychological and Biochemical Effects of LSD , Nature, Lond. 168:827, 1951.Crossref 4. Mayer-Gross, W.; McAdam, W., and Walker, T.: Further Observations on the Effects of LSD , J. Mental Sc. 99:804, 1953. 5. Apter, J. T., and Pfeiffer, C. C.: The Effect of the Hallucinogenic Drugs LSD-25 and Mescaline on the Electroretinogram , Ann. New York Acad. Sc. 66:508, 1957.Crossref 6. Jacobson, J. H.; Stephens, G.; Basar, D., and Gestring, G.: Electrical Response of Human Excised Retina , A. M. A. Arch. Ophth. 60:23, 1958.Crossref 7. Wohlzogen, F. X.: Beeinflussung des Sauger-ERG durch Zentral Nervos Wirksame Substanzen , Ztschr. Biolog. 108:217, 1956. 8. Noell, W. K.: Differentiation of Visual Cell , A. M. A. Arch. Ophth. 60:702, 1958.Crossref 9. Jacobson, J. H., and Gestring, G.: Centn trifugal Influence upon the Electroretinogram , A. M. A. Arch. Ophth. 60:295, 1958.Crossref 10. Noell, W. K.: The Effects of Iodoacetate on the Vertebrate Retina , J. Cell. & Comp. Physiol. 37:283, 1951. 11. Noell, W. K., and Petersen, P. N.: Retinal Effects of Trichloroethylene , Am. J. Physiol. 187: 619, 1956. 12. Granit, R.: Sensory Mechanism of the Retina , London, Oxford University Press, 1947. 13. Noell,8 p. 722. 14. Purpura, D.: Experimental Analysis of the Inhibitory Action of Lysergic Acid Diethylamide on Cortical Dendritic Activity , Ann. New York Acad. Sc. 66:515, 1957. 15. Urist, M. J.: Afterimages and Ocular Muscle Proprioception , A. M. A. Arch. Ophth. 61:230, 1959. 16. Brock, F. W., and Givner, I.: Fixation Anomalies in Amblyopia , Arch. Ophth. 47:775, 1952. 17. Evarts, E. V.: A Review of the Neurophysiological Effects of Lysergic Acid Diethylamide (LSD) and Other Psychotomimetic Agents , Ann. New York Acad. Sc. 66:479, 1957. 18. Apter and Pfeiffer,5 p. 512.

COGAN, DAVID G.;KUWABARA, TOICHIRO

doi: 10.1001/archopht.1959.04220040066009pmid: 13810883

Abstract The occurrence of discrete gray areas, often called plaques, in the sclera just in front of the medial and lateral recti is a common finding in old age. If these areas are excised together with a rim of normal sclera and held before a light, they show increased translucency. They are not pigmented and are not plaques in the usual sense of the word. Their gray color is due to enhanced visibility of the uveal pigment, but occasionally they do contain calcific plaques. Since these focal spots are not known to have clinical significance, they have not attracted much attention and are poorly described in current textbooks and most reviews. The scanty literature up to 1945 was collected by Roper1 in an article which incidentally presents the best clinical illustrations of the entity in the literature. That article emphasizes the association of the spots with age and points up References 1. For the crystallography and interpretation we are indebted to Prof. Cornelius Hurlbut, Department of Mineralogy, Harvard University. 2. Roper, K. L.: Senile Hyaline Scleral Plaques , Arch. Ophth. 34:283, 1945.Crossref 3. Urrels Zavalia, A.; Maldonado Allende, 1., and Obregón Oliva, R.: Scleromalacia Observed During the Course of Chronic Porphyrinuria , Arch. oftal. Buenos Aires 12:115, 1937. 4. Culler, A. M.: The Pathology of Scleral Plaques , Brit. J. Ophth. 23:44, 1939.Crossref 5. Kyrieleis, W.: Über unschriebenen Lederhautschwund (Skleromalazie) in höherem Lebensalter , Klin. Monatsbl. Augenh. 103:441, 1939. 6. Pur, S.: Senile Hyaline Degeneration of the Sclera , Českoslov. oftal. 11:284, 1955 7. abstracted Zentralbl. ges. Ophth. 67:79, 1956. 8. Cogan, D. G.; Hurbut, C. S., and Kuwabara, T.: Crystalline Calcium Sulphate (Gypsum) in Scleral Plaques of a Human Eye , J. Histochem. 6:142, 1958. 9. Swan, K.: Some Contemporary Concepts of Scleral Disease , A. M. A. Arch. Ophth. 45:630, 1951.Crossref 10. Boschoff, P. H.: Hyaline Scleral Plaques , Arch. Ophth. 28:503, 1942.Crossref 11. Krekeler, F.: Die Struktur der Sclera in den verschiedenen Lebensaltern , Arch. Augenh. 93: 144, 1923. 12. Fischer, F. P.: Experimentelle Untersuchungen an der Lederhaut , Arch. Augenh. 97: 467, 1926. 13. Gasteiger, H.: Über senile Entartung der Lederhaut an den Ansatzstellen der Augenmuskeln , Klin. Monatsbl. Augenh. 98:767, 1937. 14. Pagenstecher, A.: Beiträge zur pathologischen Anatomie des Auges , Arch. Ophth. 7: 118, 1860. 15. Katz, D.: A Localized Area of Calcareous Degeneration in the Sclera , Arch. Ophth. 2:30, 1929.Crossref 16. Lewi, M.: Über umschriebene Kalkherde und Nekrosen in der Lederhaut , Ztschr. Augenh. 79:180, 1932. 17. Klien-Moncrieff, B.: Isolated Foci of Calcification in the Sclera: Anatomical and Clinical Aspects , Arch. Ophth. 7:757, 1932.Crossref 18. Friedenwald, J. S., et al.: Ophthalmie Pathology, An Atlas and Textbook , Philadelphia, W. B. Saunders Company, 1952.

KAUFMAN, HERBERT E.;REMINGTON, JACK;MELTON, MARJORIE L.;JACOBS, LEON

doi: 10.1001/archopht.1959.04220040073010pmid: 14404853

Abstract Both Eyles1 and Summers,2 working independently, discovered that pyrimethamine (Daraprim) cured acute experimental toxoplasmosis in mice. A subsequent study of the action of pyrimethamine and sulfadiazine3 revealed that in mice infected with moderate inocula of RH-strain organisms (less than 20,000 parasites) the drugs acted synergistically and were toxoplasmicidal, when given early enough in the course of infection. When larger inocula were used, however, the same combination of pyrimethamine and sulfadiazine, at the highest doses tolerated, did not kill all the parasites, although the mice survived. Similarly, Cook and Jacobs4 noted that, while pyrimethamine was generally toxoplasmicidal at a concentration of 0.3 mg. % when tested against RH-strain organisms in monkey-kidney tissue cultures, occasionally some organisms remained alive. They reported also that nonproliferating parasites, suspended in tissue culture medium without cells, were apparently unaffected by the drug. Cook then developed a strain of RH toxoplasmas resistant to pyrimethamine References 1. Eyles, D. E., and Coleman, M.: Tests of 2-,4-Diammino Pyrimidine on Toxoplasmosis , Pub. Health Rep. 67:249-252, 1952.Crossref 2. Summers, W. A.: The Chemotherapeutic Effect of 2-,4-Diammino-5-pChlorophenyl-6-Ethylpyrimidine (Daraprim) in Experimental Toxoplasmosis , Am. J. Trop. Med. 2:1037-1044, 1953. 3. Eyles, D. E., and Coleman, M.: An Evaluation of the Curative Effects of Pyrimethamine and Sulfadiazine, Alone and in Combination, on Experimental Mouse Toxoplasmosis , Antibiotics & Chemother. 5:529-539, 1955. 4. Cook, M. K., and Jacobs, L.: In Vitro Investigations on the Mode of Action of Pyrimethamine Against Toxoplasma Gondii , J. Parasitol. 44:280-288, 1958. 5. Cook, M. K.: The Development of a Pyrimethamine-Resistant Line of Toxoplasma Underin Vitro Conditions , Am. J. Trop. Med. 7:400-402, 1958. 6. Kaufman, H. E.; Remington, J. S., and Jacobs, L.: Toxoplasmosis: The Nature of Virulence , Am. J. Ophth. 46:255-260 (Nov. (Pt. 2) ) 1958. 7. Kaufman, H. E.; Melton, M. L.; Remington, J. S., and Jacobs, L.: Strain Differences of Toxoplasma Gondii, to be published. 8. Jacobs, L., and Melton, M. L.: Modifications in Virulence of a Strain of Toxoplasma Gondii by Passage in Various Hosts , Am. J. Trop. Med. 3:447-452, 1954. 9. Goodman, L. S., and Gilman, A.: The Pharmacological Basis of Therapeutics , Ed. 2, New York, 1955, pp. 1331-1414. 10. Hitchings, G. H.: Daraprim as an Antagonist of Folic and Folinic Acids , Tr. Roy. Soc. Trop. Med. & Hyg. 46:467-473, 1952. 11. Armstrong, C., and MacMurray, F. G.: Toxoplasmosis Found by Recovery of Toxoplasma Gondii from Excised Axillary Gland , J. A. M. A. 151:1 103-1104, 1953. 12. Beverley, J. K., and Beattie, C. P.: Glandular Toxoplasmosis , Lancet 2:379-383, 1958. 13. Siim, J. C.: Toxoplasmosis Acquisita Lymphonodosa: Clinical and Pathological Aspects , Ann. New York Acad. Sc. 64:185-206, 1956. 14. Fair, J. R.: Congenital Toxoplasmosis , Am. J. Ophth. 46:135-154, 1958. 15. Hogan, M. J.; Zweigart, P. A., and Lewis, A.: Recovery of Toxoplasma from a Human Eye , A. M. A. Arch. Ophth. 60:548-554, 1958. 16. Kaufman, 11. E., and Caldwell, L.: Pharmacological Studies of Pyrimethamine (Daraprim) in Man, A. M. A. Arch. Ophth., to be published.