Archives of Ophthalmology

Colyear, Bayard H.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010319001

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract As an adjunct in the treatment of retinal detachment, photocoagulation has proven to be, and cryotherapy promises to be, most valuable. They are welcome aids, and there are instances when either one or the other is superior to any former method of treatment. However, the greatly improved results in retinal detachment surgery are not due primarily to the types of instrumentation used, but rather to the development of ophthalmologists who carefully and effectively examine a retina, detect retinal detachments early, and are in a position to give optimum early care. Unhappily, many excellent ophthalmologists do not have access to means of photocoagulation or cryotherapy, and some men have even asked us if they are justified in doing retinal surgery without having both of these techniques at their fingertips. We stand strongly in favor of the ophthalmologist who can and will weigh the individual case, deciding from his own findings and

FOX, SIDNEY A.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010320002pmid: 5946101

Abstract In a counsel of desperation Gerold1 in 1843 suggested treating intractable blepharospasm by "neglecting the spasm and carving a hole in the upper lid opposite the pupil through which the unfortunate patient could peep." Our mastery of this mysterious and dreadful affliction has not improved materially since Gerold's day. Blepharospasm is an involuntary, persistent, and forcible contraction of the orbicularis muscle causing firm closure of the eye and lasting from a fraction of a second to hours. It has been classified in many ways. However, two main categories suffice for clinical purposes: (1) symptomatic, and (2) essential. Symptomatic blepharospasm includes reflex spasm of the orbicularis due to corneal, conjunctival, and lid irritation as well as retinal stimulation due to bright light. A rarer subsidiary type is the tonic spasm of the orbicularis found in postencephalitic parkinsonism and similar affections. Essential blepharospasm has no connection with the eye itself, and References 1. Duke-Elder, S.: Text-Book of Ophthalmology , vol 5, St. Louis: C.V. Mosby Co., 1952, p 5162. 2. Callahan, A.: Intractable Blepharospasm , Amer J Ophthal 60:788, 1965. 3. Duke-Elder, S.: Text-Book of Ophthalmology , vol 5, St. Louis: C.V. Mosby Co., 1952, p 5162. 4. Fumagalli, A.: La Iniezioni Sottocutanee de Alcool nella Cura de Blepharospasmo e del'Entropion Spastico , Ann Ottal 38:163, 1909. 5. Benedict, W.L.: Treatment of Blepharospasm , Trans Amer Ophthal Soc 39:227, 1941. 6. Henderson, J.W.: Essential Blepharospasm , Trans Amer Ophthal Soc 54:453, 1956. 7. Talko, J.: Klinische Krampfe der Augenlider: Neurotomie der Supraorbitalnerven , Klin Mbl Augenheilk 8:129, 1870. 8. Gurdijian, E.S., and Williams, H.W.: The Surgical Treatment of Intractable Cases of Blepharospasm , JAMA 91:2053, 1928.Crossref 9. Dvorak, M., and Nemec, J.: Beitrag zur Neurochirurgischen Therapie der hartnackigen Blepharospasmus , Ophthalmologica 148:130, 1964.Crossref 10. Safar, K., and Spitzmuller, W.: Elektrokoagulation als neues Behandlugfahreh gegen schweren Blepharospasmus , Zschr Augenheilk 76:337, 1932. 11. Pochisov, N.: Operation bei spastichem Lidumschlag , Vestn Oftal 6:131, 1935. 12. Friede, R.: Zur Kasuistik der Operativem Behandlung des Blepharospasmus , Klin Mbl Augenheilk 133:270, 1958. 13. Callahan, A.: Blepharospasm With Resection of Part of Orbicularis Nerve Supply , Arch Ophthal 70:508, 1963.Crossref 14. Yealland, L.R.: Hysterical Disorders of Vision With Special Reference to the Phenomenon of the Contraction of the Antagonists , Brit J Ophthal 2: 545, 1918.Crossref 15. Fox, SA.: Relief of Intractable Blepharospasm , Amer J Ophthal 34:1351, 1951. 16. Urist, M.J.: Bilateral Blepharospasm , Arch Ophthal 58:520, 1957.Crossref 17. Jones, L.T.; Reeh, M.J.; and Tsujimura, J.K.: Senile Entropion , Amer J Ophthal 55:463, 1963.

HARRELL, E. RICHARD;WOLTER, J. REIMER;GUTOW, RICHARD F.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010324003pmid: 5946102

Abstract Isolated aspergillosis infection of the eyelid in an otherwise healthy young man was successfully treated by injections of amphotericin B directly into the lid granuloma. Report of a Case A 27-year-old Negro man first came to the out-patient clinic of the University of Michigan Medical Center on Jan 16, 1963, presenting an ulcerating lesion of the right upper lid (Fig 1), which had been present for about three weeks. He exhibited inactive corneal scars with superficial vascularization in both eyes, which explained his vision of OD: 20/200 and OS: 20/100. These corneal scars were thought to be due to old phlyctenular keratitis. The eyes were otherwise normal. General physical examination of the patient failed to reveal any evidence of other disease. There was no history of any significant previous illness. Results of serologic tests for syphilis were negative and findings of x-ray examination of the chest were normal.A biopsy References 1. Wilson, J.W., and Plunkett, O.A.: The Fungus Diseases of Man , Berkeley, Calif: University of California Press, 1965. 2. Janke, D., and Theune, J.: Zur Kenntnis der Aspergillose mit besonderer Berücksichtigung ihrer granulomatösen Hautmanifestationen , Der Hautarzt 13:145, 1962. 3. Timm, G.: Die Histologie der Lidaspergillose , Ophthalmologica 146:250, 1963.Crossref 4. Fuchs, E.: Keratomycosis aspergillina , Wien Klin Wschr 305, 1894. 5. Grüter, W.: Keratomycosis aspergillina mit Bildung von Konidienträgern , Klin Mbl Augenheilk 52:192, 1914. 6. Saubermann, G., and Scholer, H.J.: Aspergillose der Hornhaut , Basel: S. Karger, 1959. 7. Grüneberg, T., and Theune, J.: Die Behandlung einer dissiminierten knotigen Haut-Aspergillose mit Amphotericin B , Derm Wschr 146:617, 1962. 8. Butler, W.T., et al: Nephrotoxicity of Amphotericin B , Ann Intern Med 61:175, 1964.Crossref

TSCHETTER, RICHARD T.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010327004

Abstract The relationship between arcus senilis (gerontoxon, arcus lipoides, arcus juvenilis) and atherosclerosis has been in question for many years. As far back as 100 years ago, pathologists felt that there was some association between arcus senilis and diseases of the heart and vascular system. White ( 1935),1 on the basis of physical examinations, mental examination, laboratory studies, and postmortem studies of 400 mental patients concluded that there was not an increased incidence of arteriosclerosis or senility in patients with arcus senilis. Forsius2 quotes Rintelen (1942) as finding no increased incidence of arteriosclerosis in patients with arcus senilis during 600 postmortem examinations. On the other hand, Boas (1945)3 concluded after examining 1,000 consecutive patients in office practice that there was a definite correlation between arcus senilis and coronary artery sclerosis. Finley et al (1961)4 found that in 20 young white subjects with arcus sinilis the following characteristics were References 1. White, C.E.: The Relationship of Arcus Senilis to Arteriosclerosis and Senility , New Eng J Med 212:10, 1935.Crossref 2. Forsius, H.: Arcus Senilis Corneae: Its Clinical Development and Relatioship to Serum Lipids, Proteins and Lipoproteins , Acta Ophthal , (suppl 42) , 5-78, 1954. 3. Boas, E.B.: Arcus Senilis and Arteriosclerosis , J Mount Sinai Hosp 12:79, 1945. 4. Finley, K.J.; Berkowitz, D.; and Croel, M.D.: The Physiological Significance of Gerontoxon , Arch Ophthal 66:211-213, 1961.Crossref 5. Cogan, D.G., and Kuwabara, T.: Arcus Senilis: Its Pathology and Histochemistry , Arch Ophthal 61: 553-560, 1959.Crossref 6. Andrews, J.S.: The Lipids of Arcus Senilis , Arch Ophthal 68:264-266, 1962.Crossref 7. Tschetter, R.T.: Lipid Analysis of the Human Cornea With and Without Arcus Senilis , Arch Ophthal this issue , pp 403-405. 8. Valterini, S.; Vergati, A.; and Constantini, G.: L'ipercolisterolemia come fattore di vasculopatia arteriosclerotica e di gerontoxon (Nota seconda) Policlinico (Prat) 58: (49) :1565, 1951. 9. Garn, S.M., and Gertler, M.M.: Arcus Senilis and Serum Cholesterol Levels in the Aleut , New Eng J Med 242:283, 1950.Crossref 10. Scott, L.C.: Arcus Senilis as Accompaniment of Cardiovascular Disease , Southern Med J 24:165, 1931.Crossref 11. Kampmeier, R.H.: Arteriosclerosis and Arcus Senilis in the Young Negro Male , J Trop Med Hyg 39:164, 1936. 12. Connerty, H.V.; Briggs, A.R.; and Eaton, E.H., Jr.: Simplified Determinations of the Lipid Components of Blood Serum , Clin Chem 7:37-53, 1961. 13. Michaels, G.: A Method for the Determination of Plasma Glycerides and Free Fatty Acids , Metabolism 11:833-839, 1962. 14. Bragdon, J.H.: Colorimetric Determination of Blood Lipides , J Biol Chem 190:513-517, 1951.

HILGERS, J. H. C.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010331005

Abstract Beta-irradiation is generally accepted as a specific cure for recurrent pterygium.1 Of the five sources of β-irradiation now available for clinical use (x-rays produced by certain x-ray machines, radium, radon, radium D, and strontium 90), the 90Sr radioactive applicator was used in this study. The indication for its use was to combat the high incidence of pterygium recurrence after surgery, viz, 23 %.2 Whatever the indication for treatment with 90Sr β-irradiation may be, there is always the urgent question: what is a safe noncataractogenic dose? The 90Sr applicator was introduced for ophthalmological use in 1950.3 In the ensuing 15 years many experimental studies have been published, reporting the complications of 90Sr β-irradiation. In contrast to this, relatively few clinical reports were written describing the late complications, such as cataractogenicity, of the human eye. The long observation time (several years being required to evaluate the References 1. Leahey, B.D.: Beta Radiation in Ophthalmology , Amer J Ophthal 49:7, 1960. 2. Hilgers, J.H.C.: Prevention of Recurrent Pterygium by Beta Radiation , Ophthalmologica 140:369, 1960.Crossref 3. Friedell, H.L.; Thomas, C.I.; and Krohmer, M.S.: Beta Ray Application to the Eye , Amer J Ophthal 33:525, 1950. 4. Hughes, W.F.: Beta Radiation Therapy With Strontium 90 Applicator , Amer J Ophthal 39:413, 1955. 5. Gostin, S.B.: Prevention of Recurrent Pterygium by Prophylactic Beta Radiation , Amer J Ophthal 44:417, 1957 6. Oglesby, R.B., et al: Cataracts in Rheumatoid Arthritis Patients Treated With Corticosteroids , Arch Ophthal 66:519, 1961.Crossref 7. McDonald, J.F.; Hughes, W.F.; and Peiffer, V.G.: Beta Radiation Cataracts , Arch Ophthal 53: 248, 1955.Crossref 8. Schiff, F.S.: The Effects of Beta Radiation on Aqueous Secretion in Rabbits , Amer J Ophthal 47: 553, 1959. 9. Cogan, D.G., et al: Experimental Radiation Cataract: III. Further Experimental Studies on X-Ray and Neutron Irradiation of the Lens , Arch Ophthal 50:597, 1953.Crossref 10. Ham, W.T.: Radiation Cataract , Arch Ophthal 50:618, 1953.Crossref 11. Cogan, D.G.: in discussion of Dr. W. F. Hughes, Amer J Ophthal 39:416, 1955. 12. Haik, G.M.; Ellis, G.S.; and Nowell, J.F.: The Management of Pterygiam With Special Reference to Surgery Combined With Irradiation , Trans Amer Acad Ophthal 66:776, 1962. 13. Hughes, W.F.: Beta Radiation Sources, Uses, and Dangers in Treatment of the Eye , JAMA 170: 2101, 1959. 14. Merriam, G.R.: Late Effects of Beta Radiation on the Eye , Arch Ophthal 53:708, 1955.Crossref 15. McDonald, J.E.; Wilson, F.M.; and Hughes, W.F.: Ocular Therapy With Beta Particles , Trans Amer Acad Ophthal 63:468-485, 1959. 16. Bernstein, M., and Unger, S.M.: Experiences With Surgery and Sr90 in the Treatment of Pterygium , Amer J Ophthal 49:1024, 1960. 17. Walter, W.L.: Pterygium Surgery , Amer J Ophthal 51:441, 1961. 18. Fulgosi, A., and Frank, D.: Die Behandlung des Pterygiums mit radioaktivem Strontium , Ophthalmologica 134:410, 1957.Crossref 19. Darrell, R.W., and Bachrach, C.A.: Pterygium Among Veterans , Arch Ophthal 70:158, 1963.Crossref 20. Hilgers, J.H.C.: Pterygium: Its Incidence, Heredity and Etiology , Amer J Ophthal 50:635, 1960.

ELLIOTT, JAMES H.;LEIBOWITZ, HOWARD M.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010336006pmid: 5946103

Abstract Azathioprine is the S-imidazolyl derivative of 6-mercaptopurine. Both of these purine analogues have proven antineoplastic and immunosuppressive properties.1-10 While their precise mechanism of action in producing these effects is unknown, it is likely that separate modalities are involved. The immunosuppressive effects of purine analogues are presumed to be exerted by interference with adaptive metabolic processes occurring during the inductive phase of the immune response5,6,8,10; the antineoplastic effects are generally attributed to their cytostatic or cytotoxic potential.10 The demonstrated efficacy of azathioprine in suppression of experimental corneal graft reactions11,12 will naturally lead to its evaluation at the clinical level. However, the cytostatic or biosynthetic alterations, or both, induced by the drug on rapidly proliferating cells may be detrimental to corneal wound healing. Consequently, assessment of the effect of systemic azathioprine on corneal reparative processes was deemed mandatory. The studies reported herein indicate that systemic azathioprine is capable References 1. Elion, G.B., et al: A Summary of Investigations With 6[(1-methyl-4-nitro-5-imidazolyl)thio] Purine (B.W. 57-322) , Cancer Chemother Rep 14:93-98 ( (Oct) ) 1961. 2. Nathan, H.C., et al: Detection of Agents Which Interfere With the Immune Response , Proc Soc Exp Biol Med 107:796-799 ( (Aug-Sept) ) 1961.Crossref 3. Schwartz, R.S.; Stack, J.; and Dameshek, W.: Effect of 6-MP on Antibody Production , Proc Soc Exp Biol Med 99:164-167 ( (Oct) ) 1958.Crossref 4. Rundles, R.W., et al: Clinical and Hematological Study of 6[(1-methyl-4-nitro-5-imidazolyl) thio] Purine (B.W. 57-322) and Related Compounds , Cancer Chemother Rep 14:99-115 ( (Oct) ) 1961. 5. Hitchings, G.H., and Elion, G.B.: Chemical Suppression of the Immune Response , Pharmacol Rev 15:365-405 ( (June) ) 1963. 6. Schwartz, R.S., and André, J.: " The Chemical Suppression of Immunity ," in Mechanism of Cell and Tissue Damage Produced by Immune Reaction , Basel: Second International Symposium on Immunopathology, Benno Schwabe Co., 1962, pp 385-409. 7. Hitchings, G.H.; Nathan, H.C.; and Elion, G.B.: Comparative Antitumor and Anti-immune Effects , Blood 20:116 ( (July) ) 1962. 8. Sterzl, J.: Effect of Some Metabolic Inhibitors on Antibody Formation , Nature 189:1022-1023 ( (March 25) ) 1961.Crossref 9. Berenbaum, M.C.: Effect of Cytotoxic Agents on Antibody Production , Nature 185:167-168 ( (Jan 16) ) 1960.Crossref 10. Hitchings, G.H., and Elion, G.B.: " Purine Analogues ," in Hochster, R. M., and Quastel, J. H. (eds.): Metabolic Inhibitors , New York: Academic Press, 1963, vol 1, pp 215-237. 11. Leibowitz, H.M., and Elliott, J.H.: Chemotherapeutic Immunosuppression of the Corneal Graft Reaction: I. Systemic Antimetabolites , Arch Ophthal 75:826-835 ( (June) ) 1966.Crossref 12. Polack, F.M.: Inhibition of Immune Corneal Graft Rejection by Azathioprine (Imuran) , Arch Ophthal 74:683-689 ( (Nov) ) 1965.Crossref 13. Payrau, P., and Dohlman, C.H.: IDU in Corneal Wound Healing , Amer J Ophthal 57:999-1002 ( (June) ) 1964. 14. Aquavella, J.V.; Gasset, A.R.; and Dohlman, C.H.: Corticosteroids in Corneal Wound Healing , Amer J Ophthal 58:621-626 ( (Oct) ) 1964. 15. Gasset, A.R., and Dohlman, C.H.: The Tensile Strength of Corneal Wounds, in preparation. 16. Palmerton, E.S.: The Effect of Local Cortisone on Wound Healing in Rabbit Corneas , Amer J Ophthal 40:344-353 ( (Sept) ) 1955. 17. Polack, F.M., and Rose, T.: The Effect of 5-Iodo-Deoxyuridine (IDU) in Corneal Healing , Arch Ophthal 71:520-527 ( (April) ) 1964.Crossref 18. André, J.A., et al: Morphologic Responses of Lymphoid System to Homografts: II. Effects of Antimetabolites , Blood 19:334-347 ( (March) ) 1962. 19. Zukoski, C.F.; Lee, H.M.; and Hume, D.M.: The Effects of Antimetabolites on Prolonging Functional Survival of Canine Renal Homografts: 6-mercaptopurine, 8-azaguanine , Fed Proc 20:34, 1961. 20. Harris, J.E.: " Corneal Wound Healing ," in King, J. H. and McTigue, J. W. (eds.): The Cornea-World Congress , Washington: Butterworths, 1965, pp 73-79. 21. Dohlman, C.H., and Boruchoff, S.A.: Personal communication to author, April 3, 1966. 22. Elliott, J.H., and Leibowitz, H.M.: Personal observation. 23. Monaco, A.P., and Russell, P.S.: Personal communication to author, March 27, 1966. 24. Urrets-Zavalía, A., Jr.: " Panel Nine ," in King, J. H., and McTigue, J. W. (eds.): The Cornea-World Congress , Washington: Butterworths, 1965, p 723. 25. Leibowitz, H.M.; Elliott, J.H.; and Boruchoff, S.A.: Unpublished observations.

LEIBOWITZ, HOWARD M.;ELLIOTT, JAMES H.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010340007pmid: 5329645

Abstract Several studies have independently demonstrated that systemically administered purine analogues (eg, 6-mercaptopurine, azathioprine) are capable of suppressing immunogenic rejection of corneal grafts.1-4 However, each of these studies has also emphasized that when these drugs are given for extended periods in doses adequate to maintain the cornea in a transparent state, prohibitively toxic side effects are encountered. On the other hand, short-term administration of optimal doses of the purine analogue, azathioprine, causes no significant toxic side effects.1 Thus, it is possible temporarily to inhibit immune reactions in the cornea with antimetabolites without the occurrence of significant drug-related morbidity or mortality. Unfortunately, termination of antimetabolite therapy in this situation generally results in the occurrence of a corneal immune response soon thereafter. The present communication reports our experience with the use of a combined therapeutic regimen in the suppression of the corneal xenograft (heterograft) reaction in rabbits. Systemic azathioprine was administered References 1. Leibowitz, H.M., and Elliott, J.H.: Chemotherapeutic Immunosuppression of the Corneal Graft Reaction: I. Systemic Antimetabolites , Arch Ophthal 75:826-835 ( (June) ) 1966.Crossref 2. Pollack, F.M.: Inhibition of Immune Corneal Graft Rejection by Azathioprine (Imuran) , Arch Ophthal 74:683-689 ( (Nov) ) 1965.Crossref 3. Cleasby, G.W., and Byland, S.S.: Modification of the Homograft Reaction in Corneal Transplantation: A Preliminary Report , Ann N Y Acad Sci 120: 802-805 ( (Nov) ) 1964.Crossref 4. Cobb, G.M., and Basu, P.K.: Effect of 6-Mercaptopurine on the Immune Response in Interlamellar Corneal Heterografts , Transplantation 1:232-234 ( (April) ) 1963.Crossref 5. Elliott, J.H., and Leibowitz, H.M.: Corneal Immune Rings Associated With Heterograft Rejection , Arch Ophthal 73:519-527 ( (Feb) ) 1965.Crossref 6. Leibowitz, H.M., and Elliott, J.H.: Immune Responses in the Cornea and Their Suppression With Purine Analogues, Survey Ophthal: to be published. 7. Berenbaum, M.C.: Effect of Cytotoxic Agents on Antibody Production , Nature 185:167-168 ( (Jan 16) ) 1960.Crossref 8. Sterzl, J.: Study of Antibody Formation by the Use of Metabolic Inhibitors: I. The Effect of 6-Mercaptopurine on Specific Immune Reactions , Folia Microbiol 5:364-373 ( (Sept) ) 1960.Crossref 9. Sterzl, J.: Inhibition of the Inductive Phase of Antibody Formation by 6-Mercaptopurine Examined by the Transfer of Isolated Cells , Nature 185:256-257 ( (Jan 23) ) 1960.Crossref 10. Spain, D.M.: " Steroid Alterations in the Histopathology of Chemically Induced Inflammation " in Mills, L. C., and Moyer, J. W. (eds.): Inflammation and Disease of Connective Tissue , Philadelphia: W. B. Saunders Co., 1961, pp 514-517. 11. Bjorneboe, M.; Fischel, E.E.; and Stoerck, H.C.: The Effect of Cortisone and Adrenocorticotrophic Hormone on the Concentration of Circulating Antibody , J Exp Med 93:37-48 ( (Jan) ) 1951.Crossref 12. Berglund, K.: Studies on Factors Which Condition the Effect of Cortisone on Antibody Production: I. The Significance of Time of Hormone Administration in Primary Hemolysin Response , Acta Path Microbiol Scand 38:311-328 ( (April) ) 1956.Crossref 13. Harris, S., and Harris, T.N.: Effect of Cortisone on Some Reactions of Hypersensitivity in Laboratory Animals , Proc Soc Exp Biol Med 74:186-189 ( (May) ) 1950.Crossref 14. Long, J.B., and Favour, C.B.: The Ability of ACTH and Cortisone to Alter Delayed Type Bacterial Hypersensitivity , Bull Hopkins Hosp 87:186-202 ( (Sept) ) 1950. 15. Aquavella, J.V.; Gasset, A.R.; and Dohlman, C.H.: Corticosteroids in Corneal Wound Healing , Amer J Ophthal 58:621-626 ( (Oct) ) 1964. 16. Palmerton, E.S.: The Effect of Local Cortisone on Wound Healing in Rabbit Corneas , Amer J Ophthal 40:344-353 ( (Sept) ) 1955. 17. Dohlman, C.H., and Boruchuff, S.A.: Personal communication to the authors, 1966. 18. Leibowitz, H.M., and Elliott, J.H.: Unpublished observations. 19. Maumenee, A.E.: Clinical Aspects of the Homograft Reaction , Invest Ophthal 1:244-252 ( (April) ) 1962. 20. Billingham, R.E.; Brent, L.; and Medawar, P.B.: Enhancement in Normal Homografts With a Note on Its Possible Mechanism , Transplantation Bull 3:84-88 ( (July) ) 1956. 21. Billingham, R.E.; Krohn, P.L.; and Medawar, P.B.: Effect of Locally Applied Cortisone Acetate on Survival of Skin Homografts in Rabbits , Brit Med J 2:1049-1053 ( (Nov) ) 1951.Crossref 22. Scothorne, R.J.: The Effect of Cortisone on the Cellular Changes in the Regional Lymph Node Draining a Skin Homograft , Transplantation Bull 3:13-14 ( (Jan) ) 1956. 23. Moran, T.J.: Weight Loss in Cortisone Treated Rabbits , Arch Path 76:330-332 ( (Sept) ) 1963. 24. Kaufman, H.E.: Personal communication to the authors, 1965. 25. Nursoll, J.F.: Systemic Effects of the Topical Use of Ophthalmic Corticosteroid Preparations , Amer J Ophthal 59:29-30 ( (Jan) ) 1965.

KITANO, SHUSAKU;GOLDMAN, JEROME N.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010347008pmid: 5946104

Abstract There is general agreement that the keratocytes undergo morphologic changes after the cornea has been wounded, but the question of whether they actually become the fibroblasts which collect at the edge of the wound and subsequently produce the scar has been disputed. Weimar1 acknowledged that some keratocytes became fibroblasts following wounding, but calculated that their rate of movement was not rapid enough to account for the large numbers of fibroblasts which appeared at the wound edge. She observed numerous monocytes migrating from the limbus in wounded rat corneas and identified transitional forms which led her to conclude that 65% of these fibroblasts were derived from monocytes within 60 hours after wounding. Wolter2 described the steps by which keratocytes became fibroblast-like cells following an incision in rabbits, but thought that he could distinguish these transformed cells from the fibroblast which invaded from the limbus. He believed that the latter References 1. A method of selectively blocking Alcian blue staining with magnesium chloride was modified for corneal tissue after consultation with J.E. Scott. Six-micron paraffin sections of cetylpyridinium chloride-formalin fixed corneas were mounted on albumin-treated slides. After drying overnight at 37° C the sections were deparaffinized in two five-minute xylol baths. After air drying, the slides were placed in freshly prepared solutions of 0.1% Alcian blue 8GX (Fisher Scientific Co., Medford, Mass) in 0.05 molar citrate buffer adjusted to pH 5.7 into which magnesium chloride was added so that the final concentration of magnesium chloride was 0.7 molar, 0.9 molar, and 1.0 molar. A control solution contained no magnesium chloride. Slides were left in these solutions overnight (14 to 18 hours), and rinsed by dipping twice in citrate buffer with magnesium chloride of the same molarity as the Alcian blue solution in which the slides had been left overnight. After gently dipping in distilled water two times and then bathing the slides for one minute each in 90% and 100% ethanol, the slides were placed in two five-minute changes of xylol, and coverslips were mounted with Permount. 2. The details of the histochemical interpretations may be found in references 4 and 6. In summary, it may be stated that keratan sulfate shows hyaluronidase-resistant metachromasia to toluidine blue at pH 2.5 and Alcian blue affinity in 1.0 molar magnesium chloride solutions, whereas the other principal acid mucopolysaccharide of cornea—chondroitin sulfate—has hyaluronidase-digestible toluidine blue metachromasia at pH 2.5 and it loses its Alcian blue affinity when the magnesium chloride concentration of the staining solution exceeds 0.7 molar. 3. Since this work was completed, the authors have been informed by Dr. Toichiro Kuwabara of Harvard University Medical School that he has performed experiments in which nonpenetrating wounds were made from either the endothelial or the epithelial surface. In the latter, there is no fibrin plug, while in the former, the epithelium does not appear to play a role. The degree of interrelationship of the factors involving the two is unknown, but most of the observations made in this manuscript are related to an epithelial presence. 4. Weimar, V.L.: The Sources of Fibroblasts in Corneal Wound Repair , Arch Ophthal 60:93, 1958.Crossref 5. Wolter, J.R.: Reactions of the Cellular Elements of the Corneal Stroma , Arch Ophthal 59:873, 1958.Crossref 6. Robb, R.M., and Kuwabara, T.: Corneal Wound Healing: II. An Autoradiographic Study of the Cellular Components , Arch Ophthal 72:401, 1964.Crossref 7. Kitano, S.: Cytoplasmic Granules of the Corneal Stroma Cell , Invest Ophthal 5:277, 1966. 8. Anseth, A.: Glycosaminoglycans in Corneal Regeneration , Exp Eye Res 1:122, 1961.Crossref 9. Scott, J.E.; Darling, J.; and Quintarelli, G.: Differential Staining of Acid Glycosaminoglycans by Alcian Blue in Salt Solutions , Proc Biochem Soc 91:4P, 1964. 10. Epstein, W.L., and Sullivan, D.J.: " Epidermal Mitotic Activity in Wounded Human Skin " in Advances in Biology of Skin , Wound Healing, W. Montagna and R. E. Billingham (eds.), New York: Pergamon Press, 1964, vol 5, p 68. 11. Grillo, H.C.: Origin of Fibroblasts in Wound Healing , Ann Surg 157:453, 1963.Crossref 12. Glucksmann, A.: " Cell Turnover in the Dermis ," in Advances in Biology of Skin , Wound Healing, W. Montagna and R. E. Billingham (eds.), New York: Pergamon Press, 1964, vol 5, p 68. 13. Weimar, V.L., and Haraguchi, K.H.: The Development of Enzyme Activities in Corneal Connective Tissue Cells During the Lag Phase of Wound Repair: I. 5-Nucleotidase and Succinic Dehydrogenase , Invest Ophthal 4:853, 1965. 14. Bunting, H.: The Distribution of Acid Mucopolysaccharides in Mammalian Tissues as Revealed by Histochemical Methods , Ann NY Acad Sci 52: 977, 1950.Crossref 15. Godman, G.C., and Lane, N.: On the Site of Sulfation in the Chondrocyte , J Cell Biol 21:353, 1964.Crossref

CLARKE, W. B.;KNOLL, H. A.;NELSON, C.

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010357009pmid: 5946105

Abstract Pupillography, as the name suggests, is the measurement and recording of the diameter of the pupil. Prior to 1958 photographic methods were used almost exclusively. In that year, Lowenstein and Loewenfeld described their electronic pupillograph.1 This facilitated recording much more data than was previously considered practical. With the advent of electronic pupillography, pupillary reflex responses could be obtained from a wide variety of stimuli. The pupillograph has been used both for studies in vision research and for clinical investigations. The instrument we have developed is a binocular infrared pupillograph intended primarily for use in research. Description The instrument consists of three assemblies: the head support (A), the optical scanning system (B), and the electronic system (C) (Fig 1). The optical axis of the scanning system is 20° below the horizontal. This makes it possible for the subject to fixate on a target by looking straight ahead and leaves adequate References 1. Lowenstein, O., and Loewenfeld, I.D.: Electronic Pupillography , Arch Ophthal 59:352-363, 1958.Crossref

KNOX, DAVID L.;PALMER, C. A. L.;ENGLISH, FRANK

1966 Archives of Ophthalmology

doi: 10.1001/archopht.1966.03850010361010pmid: 5946106

Abstract The ocular manifestations of a toxic reaction to systemic quinine therapy have been recorded in over 230 articles in the world's medical literature.1 These ocular complications occur primarily in the posterior eye,1,2 yet anterior complications have been observed on one occasion.3 This report describes the details of two additional cases of severe iris pigment atrophy with pupil abnormalities following quinine amblyopia. Stölting in 1903 reported for the first time the findings in a patient who developed iris atrophy after quinine amblyopia.3 The patient, a 17-year-old boy who had had a lung infection for five weeks, was thought to have taken 3 gm of quinine for several days of his illness. Soon thereafter he lost all vision. Five days later, when first seen by Stölting, bare light perception had returned, the optic nerve head was pale, and the retinal arteries narrow. The vision slowly returned, visual fields References 1. Grant, W.M.: Toxicology of the Eye , Springfield, Ill: Charles C Thomas, 1962. 2. Walsh, F.B.: Clinical Neuro-Ophthalmology , Baltimore: Williams and Wilkins, 1957. 3. Stölting: Folgen einer Chininvergiftung am Auge , Arch für Ophthal 55:85-93, 1903. 4. Hart, J.L.: Quinine Amblyopia With Spontaneous Detachment , Brit J Ophthal 29:375-376, 1945.Crossref 5. Wunderlich, G.: Die Chininintoxikation und ihre Pathogenese mit Bericht über eine Eigene Beobachtung , Klin Mbl Augenheilk 64:270, 1920. 6. Gruening, E.: On Quinine Amaurosis, With a Case , Arch Ophthal 10:81, 1881. 7. de Schweinitz, G.: Toxic Amblyopia , Philadelphia: Lea Brothers and Co., 1896. 8. de Schweinitz, G.: Additional Experiments to Determine the Lesion in Quinine Blindness , Trans Amer Ophthal Soc 6:23, 1891. 9. de Schweinitz, G.: Concerning Quinine Blindness, With the Report of a Case , Arch Ophthal 39: 101, 1893. 10. Holden, De Ward A.: Die Pathologie der Experimentellen Chinin Amblyopie , Arch Augenheilk 39:139, 1899. 11. Parker, F.J.: Quinine Amaurosis With Report of a Case , Arch Ophthal 35:420, 1906.