Archives of Ophthalmology

Nesburn, Anthony B.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020427001pmid: 6022713

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 The symposium appearing in this issue will acquaint the reader with much newly uncovered information about congenital rubella and rubella virus. It also serves as a timely tribute to our recently deceased ophthalmologist colleague Norman McAlister Gregg. Twenty-five years ago Sir Norman astutely incriminated rubella infection for the devastating disease that it is, proposing a relationship between this clinically benign disease in pregnant women and the awesome defects noted in their offspring months later. The first 21 years after the indictment of rubella virus as a cause of congenital disease witnessed meager progress toward indisputably proving its guilt, understanding the mechanism of its action, or preventing its ravages. Research efforts were thwarted by lack of means to identify the virus and were confused by many rubella-like illnesses, now known to be caused by other agents. Viewed against this relatively barren period, the achievements of the last four years have been

Sever, John L.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020429002pmid: 6022714

Abstract THE EPIDEMIC of rubella 25 years ago in Australia resulted in the first recognition of the significance of this infection as a cause of defective children. It was following this epidemic that the ophthalmologist Sir Norman Gregg noted a high frequency of cataracts in children and recognized the association between rubella in the first trimester of pregnancy and damage to the eye.1 Since that time a number of studies have confirmed and extended these observations. The frequency of abnormal pregnancy outcomes is approximately 50% if rubella occurs in the first month of pregnancy, 22% if it occurs in the second month of pregnancy, and 6% if it occurs in the third month of pregnancy.2,3 In addition to the malformations of the eyes, heart, deafness, microcephaly, and mental retardation, in the last few years we have become aware that congenital rubella may also result in hepatosplenomegaly, thrombocytopenia, jaundice, pneumonitis, References 1. Gregg, N.: Congenital Cataract Following German Measles in the Mother , Trans Ophthal Soc Aust 3:35, 1941. 2. Michaels, R.H., and Mellin, G.W.: Prospective Experience With Maternal Rubella and the Associated Congenital Malformations , Pediatrics 26:200, 1960. 3. Lundstrom, R.: Rubella During Pregnancy , Acta Paediat Scand , 51 ( (suppl 133) ): 1-110 (May) 1962.Crossref 4. Rudolph, A.J., et al: Transplacental Rubella Infections in Newly Born Infants , JAMA 191:843-845 (No. (10) ) 1965.Crossref 5. Korones, S.G., et al: Congenital Rubella Syndrome: New Clinical Aspects With Recovery of Virus From Affected Infants , J Pediatrics 67:1966, ( (Aug) ,) 1965. 6. Monif, G.R.; Hardy, J.V.; and Sever, J.L.: Studies in Congenital Rubella, Baltimore, 1964-65: I. Epidemiological and Virological: II. Clinical and Virologic , Bull Hopkins Hosp 118:85, 97, 1966. 7. Ingalls, T.H., et al: Rubella: Its Epidemiology and Teratology , Amer J Med Sci 239:363, 1960.Crossref 8. Epidemiologic Notes , Morbidity Mortality Weekly Rep 14:137-144 ( (April 24) ) 1965. 9. Sever, J.L.; Nelson, K.B.; and Gilkeson, M.R.: Rubella Epidemic, 1964: Effect on 6,000 Pregnancies , Amer J Dis Child 110:395 ( (Oct) ) 1965.Crossref 10. Peczenik, A., and Gauld, J.R.: Rubella at a Military Installation , Arch Environ Health 6:647-663 ( (May) ) 1963.Crossref 11. Sever, J.L., et al: Rubella: Frequency of Antibody Among Children and Adults , Pediatrics 35:996 ( (June) ) 1965. 12. Sever, J.L.; Schiff, G.M.; and Huebner, R.J.: Frequency of Rubella Antibody Among Pregnant Women and Other Human and Animal Populations , Obstet Gynec 23:2, 1964. 13. Sever, J.L., et al: Rubella Antibody Among Pregnant Women in Hawaii , Amer J Obstet Gynec 92:1006-1009 ( (Aug 1) ) 1965. 14. Nagayama, T., et al: Frequency of Rubella Antiobody Among Pregnant Women in the Fukuoka District in Southern Japan , Acta Med (Fukuoka) 57:303-305 ( (April) ) 1966. 15. Sever, J.L. and Brody, J.A.: Rubella Epidemic in the Pribilofs: II. Clinical and Laboratory Findings , JAMA 191:8, 624, 1965.Crossref

Rawls, William E.;Phillips, C. Alan;Melnick, Joseph L.;Desmond, Murdina M.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020432003pmid: 6022715

Abstract ALTHOUGH rubella virus produces a benign self-limiting disease in children and adults, infection in utero may result in congenital anomalies. In addition to the earlier described features of deafness, cardiac defects, and eye defects, the rubella syndrome has recently been shown to include thrombocytopenia, hepatosplenomegaly, central nervous system defects, bone lesions, and growth retardation with failure to thrive.1-6 Affected infants may experience any one of these anomalies or combinations of them. In addition to congenital anomalies, infection by rubella virus in utero has been found to result in viral persistence which occurs despite the presence of circulating antibodies.7-11 Continued shedding of virus following infection is an unusual phenomenon in humans. It has been observed regularly only with one other virus, namely cytomegalovirus.12 Rubella virus persistence in congenital rubella has been demonstrated by isolating the virus from throat swabs, spinal fluid, urine, feces, and other clinical material for References 1. Rudolph, A.J., et al: Transplacental Rubella Infection in Newly Born Infants , JAMA 191:843, 1965.Crossref 2. Korones, S.B., et al: Congenital Rubella Syndrome: New Clinical Aspects With Recovery of Virus From Affected Infants , J Pediat 67:166, 1965.Crossref 3. Banatvala, J.E., et al: Rubella Syndrome and Thrombocytopenic Purpura in Newborn Infants: Clinical and Virologic Observations , New Eng J Med 273:474, 1965.Crossref 4. Cooper, L.Z., and Krugman, S.; Diagnosis and Management: Congenital Rubella , Pediatrics 37:335, 1966. 5. Lindquist, J.M., et al: Congenital Rubella Syndrome as a Systemic Infection: Studies of Affected Infants Born in Philadelphia, USA , Brit Med J 2:1401, 1965.Crossref 6. Hardy, J.B.; Monif, G.R.G.; and Sever, J.L.: Studies in Congenital Rubella, Baltimore 1964-1965: II. Clinical and Virologic , Bull Hopkins Hosp 118:97, 1966. 7. Weller, T.H.; Alford, C.A. Jr.; and Neva, F.A.: Retrospective Diagnosis by Serologic Means of Congenitally Acquired Rubella Infection , New Eng J Med 270:1039, 1964.Crossref 8. Dudgeon, J.A.; Butler, N.R.; and Plotkin, S.A.: Further Serological Studies on the Rubella Syndrome , Brit Med J 2:155, 1964.Crossref 9. Alford, C.A., Jr.: Studies on Antibody in Congenital Rubella Infection: I. Physicochemical and Immunologic Investigations of Rubella Neutralizing Antibody , Amer J Dis Child 110:455, 1965.Crossref 10. Bellanti, J.A., et al: Congenital Rubella: Clinicopathologic, virologic and Immunologic Studies , Amer J Dis Child 110:464, 1965.Crossref 11. Soothill, J.F.; Hayes, K.; and Dudgeon, J.A.: The Immunoglobulins in Congenital Rubella , Lancet 1:1385, 1966.Crossref 12. Medearis, D.N.: Observations Concerning Human Cytomegalovirus Infection and Disease , Bull Hopkins Hosp 114:181, 1964. 13. Phillips, C.A., et al: Persistence of Virus in Infants With Congenital Rubella and in Normal Infants With a History of Maternal Rubella , JAMA 193:1027, 1965.Crossref 14. Monif, G.R.G., et al: Post-mortem Isolation of Rubella Virus From Three Children With Rubella Syndrome Defects , Lancet 1:723, 1965.Crossref 15. Rawls, W.E., et al: Spontaneous Virus Carrier Cultures and Post-mortem Isolation of Virus From Infants With Congenital Rubella , Proc Soc Exp Biol Med 120:623, 1965.Crossref 16. Phillips, C.A., et al: Viral Studies of a Congenital Rubella Epidemic , Health Lab Sci 3:118, 1966. 17. Parkman, P.D., et al: Studies of Rubella: I. Properties of the Virus , J Immun 93:595, 1964. 18. Rawls, W.E., and Melnick, J.L.: Rubella Virus Carrier Cultures Derived From Congenitally Infected Infants , J Exp Med 123:795, 1966.Crossref 19. Sever, J.L.: Limited Persistence of Virus in Congenital Rubella , Amer J Dis Child 110:452, 1965.Crossref 20. Naeye, R.L., and Blanc, W.: Pathogenesis of Congenital Rubella , JAMA 194:1277, 1965.Crossref 21. Woods, W.A., et al: Immunofluorescent Studies in Rubella Infected Tissue Cultures and Human Tissues , J Immun 96:253, 1966.

Cooper, Louis Z.;Krugman, Saul

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020436004pmid: 4164540

Abstract RUBELLA was first recognized as a specific clinical entity in the year 1815.1 For more than a century thereafter it was considered a mild and relatively unimportant disease of childhood. The true nature and potential severity of rubella first became apparent in 1941 when Dr. Norman Gregg, an Australian ophthalmologist, reported an "epidemic" of congenital cataracts among 78 infants born following maternal rubella infection acquired during the 1940 epidemic of rubella in Australia.2 More than half of these infants had congenital heart disease. Since 1941, Gregg's observations of the "rubella syndrome" have been amply confirmed. The occurrence of rubella during the first trimester of pregnancy has been associated with a significantly increased incidence of congenital malformations, stillbirths, and abortions. The recent epidemic of rubella in the United States in 1964 was followed by the birth of many thousands of infants with congenital rubella syndrome. The cultivation of rubella References 1. Maton, W.G.: Some Account of a Rash Liable to be Mistaken for Scarlatina , Med Trans Coll of Physicians, London , 5:149-165, 1815. 2. Gregg, N. McA.: Congenital Cataract Following German Measles in the Mother , Trans Ophthal Soc Aust 3:35-46, 1942. 3. Weller, T.H., and Neva, F.A.: Propagation in Tissue Culture of Cytopathogenic Agents From Patients With Rubella-Like Illness , Proc Soc Exper Biol Med 111:215-225, 1962.Crossref 4. Parkman, P.D.; Buescher, E.L.; and Artenstein, M.S.: Recovery of Rubella Virus From Army Recruits , Proc Soc Exper Biol Med 111:225-230, 1962.Crossref 5. Green, R.H., et al: Studies of the Natural History and Prevention of Rubella , Amer J Dis Child 110:348-365, 1965.Crossref 6. Sever, J.L., et al: Rubella Complement Fixation Test , Science 148:385-387, 1965.Crossref 7. Brown, G.C., et al: Rubella Antibody in Human Serum: Detection by Indirect Fluorescent Antibody Technique , Science 145:943-945, 1964.Crossref 8. Rubella Symposium , Amer J Dis Child 110:345-476 ( (Oct) ) 1965. 9. Siegel, M.; Fuerst, H.T.; and Peress, N.S.: Fetal Mortality in Maternal Rubella: Results of a Prospective Study From 1957 to 1964 , Amer J Obstet Gyn 96:247-253, 1966. 10. Manson, M.A.; Logan, W.P.; and Loy, R.: Rubella and Other Virus Infections During Pregnancy , Reports on Public Health No. 101, Ministry of Health, HMSO, London, 1960, 1-101. 11. Lundström, R.: Rubella During Pregnancy: A Follow-up Study of Children Born After an Epidemic of Rubella in Sweden, 1951, With Additional Investigations on Prophylaxis and Treatment of Maternal Rubella , Acta Paediat 51 ( (suppl 133) ):1-110, 1962.Crossref 12. Weiss, D.I.; Cooper, L.Z.; and Green, R.H.: Infantile Glaucoma: A Manifestation of Congenital Rubella , JAMA 195:725-727, 1966.Crossref 13. Cooper, L.Z., et al: Neonatal Thrombocytopenic Purpura and Other Manifestations of Rubella Contracted in Utero , Amer J Dis Child 110:416-427, 1965. 14. Swan, C., et al: Congenital Defects in Infants Following Infectious Diseases During Pregnancy With Special Reference to the Relationship Between German Measles and Cataract, Deaf-Mutism, Heart disease, and Microcephaly and to the Period of Pregnancy Which the Occurrence of Rubella is Followed by Congenital Abnormalities , Med J Aust 2:201-210, 1943. 15. Phillips, C.A., et al: Persistence of Virus in Infants With Congenital Rubella and in Normal Infants With a History of Maternal Rubella , JAMA 193:1027-1029, 1965.Crossref 16. Cooper, L.Z., et al: Rubella in Contacts of Infants With Rubella-Associated Anomalies , Morbidity Mortality Weekly Rep 14:44-45, 1965. 17. Alford, C.A., Jr.,: Studies on Antibody in Congenital Rubella Infections , Amer J Dis Child 110:455-463, 1965.Crossref 18. Bellanti, J.A., et al: Congenital Rubella: Clinicopathologic, Virologic, and Immunologic Studies , Amer J Dis Child 110:464-472, 1965.Crossref 19. Plotkin, S.A.; Klaus, R.M.; and Whitely, J.P.: Hypogammaglobulinemia in an Infant With Congenital Rubella Syndrome: Failure of L-Adamantine to Stop Virus Excretion, J Pediat, to be published. 20. Brody, J.A.; Sever, J.L.; and Schiff, G.M.: Prevention of Rubella by Gamma Globulin During an Epidemic in Barrow, Alaska in 1964 , New Eng J Med 272:127-129, 1965.Crossref 21. Plotkin, S.A.; Cornfield, D.; and Ingalls, T.H.: Studies of Immunization With Living Rubella Virus , Amer J Dis Child 110:381-389, 1965.Crossref 22. Karelitz, S., et al: German Measles Vaccine, read before the 11th International Pediatric Congress, Tokyo, Nov 7-13, 1965. 23. Parkman, P.D., et al: Development of a Live Attenuated Rubella Virus, read before the American Pediatric Society, Atlantic City, NJ, April 27, 1966. 24. Meyer, H.M., Jr.; Parkman, P.D.; and Panos, T.C.: Clinical Trial of an Experimental Live Attenuated Rubella Virus Vaccine, read before the American Pediatric Society, Atlantic City, NJ, April 27, 1966.

Scheie, Harold G.;Schaffer, David B.;Plotkin, Stanley A.;Kertesz, Elsa D.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020442005pmid: 4960634

Abstract THIS PAPER presents (1) the results from operating upon 49 eyes with congenital rubella cataracts; (2) the outcome of attempts to recover the rubella virus from intraocular specimens from some of these eyes; and (3), a suggestion that the poor surgical outlook for congenital rubella cataracts may be partially explained by the persistence of the virus within the eye. A total of 19 cultures was taken from 16 different eyes; 17 of which were obtained at the time of surgery, and two immediately following enucleation. The oldest child from whose eyes; 17 of which were obtained at the time of age. The diagnosis of congenital rubella cataract was made clinically in nine patients (Table 1; patients 1 through 9) who were born prior to the development of techniques for rubella virus isolation. The validity of the diagnosis was determined by the presence of at least two thirds of the classical References 1. Gregg, N.M.: Congenital Cataracts Following German Measles in Mother , Trans Ophthal Soc Aust 3:35-46, 1941. 2. Plotkin, S.A.; Dudgeon, J.A.; and Ramsay, A.M.: Laboratory Studies on Rubella and the Rubella Syndrome , Brit Med J 2:1296-1299, 1963.Crossref 3. Dudgeon, J.A., Butler, N.R. and Plotkin, S.A.: Further Serological Studies on the Rubella Syndrome , Brit Med J 2:155-160 ( (July 18) ) 1964.Crossref 4. Scheie, H.G.: Aspiration of Congenital or Soft Cataracts: A New Technique , Amer J Ophthal 50:1048-1056, 1960. 5. Scheie, H.G.; Rubenstein, R.A.; and Kent, R.B.: Aspiration of Congenital or Soft Cataracts: Further Experience , Amer J Ophthal 63:3-8 ( (Jan) ) 1967. 6. Parkman, P.D.; Buescher, E.L.; and Artenstein, N.S.: Recovery of Rubella Virus From Army Recruits , Proc Soc Exp Biol Med 111:225-230, 1962.Crossref 7. Plotkin, S.A.: Virologic Assistance in the Management of German Measles in Pregnancy , JAMA 190:265-268 ( (Oct 26) ) 1964.Crossref 8. Reid, R.R., et al: Isolation of Rubella Virus From Congenital Cataracts Removed at Operation , Med J Aust 1:540-542 ( (March 26) ) 1966. 9. Zimmerman, L.E.: Pathogenesis of Rubella Cataract , Arch Ophthal 73:761, 1965.Crossref 10. Alfano, J.E.: Ocular Aspects of the Maternal Rubella Syndrome , Trans Amer Acad Ophthal Otolaryng 70:235-266 ( (March-April) ) 1966. 11. Krause, A.: Congenital Cataracts Following Rubella in Pregnancy , Ann Surg 122:1049-1055, 1945.Crossref 12. Wolter, J.R., et al: Eye Pathology Following Maternal Rubella: A Study of Four Children Pediat Ophthal 3:29-39 ( (May) ) 1966.

Krill, Alex E.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020447006pmid: 6022716

Abstract AN AUSTRALIAN physician, Aileen Mitchell, was the first to note fundus changes in a child born with rubella.1 In his initial report before the Ophthalmological Society of Australia in 1941, Gregg did not mention this observation.2 Several years later, however, while reviewing his notes of case reports collected for this original paper,1 he cites the following fundus description by Dr. Mitchell from a child with a left-sided monocular cataract: "The fundus of the right eye appeared pale, and some scattered irregular spots of pigment were observed." Rubella retinitis is now recognized as one of the three most frequent ocular abnormalities in a child with congenital rubella. The exact incidence is uncertain since eyegrounds are sometimes not visualized because of dense congenital cataracts. Reported frequencies are: 16 out of 120 cases,3 17 out of 38 cases,4 15 out of 29 cases,5 50 out of 82 References 1. Gregg, N.M., in discussion, Marks, E.O.: Pigmentary Abnormality in Children Congenitally Deaf Following German Measles , Trans Ophthal Soc Aust 6:122, 1946. 2. Gregg, N.M.: Congenital Cataract Following German Measles in the Mother , Trans Ophthal Soc Aust 3:35, 1941. 3. Gregg, N.M.: Further Observations on Congenital Defects in Infants Following Maternal Rubella , Trans Ophthal Soc Aust 119:131, 1946. 4. Marks, E.O.: Pigmentary Abnormalities in Children Congenitally Deaf Following Maternal German Measles , Brit J Ophthal 31:119, 1947. 5. Hamilton, J.B., et al: Rubella Retinitis in Tasmania , Trans Ophthal Soc Aust 8:114, 1948. 6. Morlet, C.: Rubella Retinitis in Western Australia , Trans Ophthal Soc Aust 9:212, 1949. 7. Alfano, J.E.: Ocular Aspects of the Maternal Rubella Syndrome , Trans Amer Acad Ophthal Otolaryng 70:235, 1966. 8. Roy, F.H., et al: Ocular Manifestations of Congenital Rubella Syndrome , Arch Ophthal 75:601, 1966.Crossref 9. Franceschetti, A.; Francois, J.; and Babel, J.: Les Heredo-degenerescences (Degenerescences Tapeto-retiniennes) Paris: Masson et Cie, 1963, vol 1. 10. Cordes, F.C.: in discussion, Goar, E.L., and Potts, G.R.: The Relationship of Rubella in the Mother to Congenital Cataracts in the Child , Trans Amer Ophthal Soc 43:135, 1945. 11. Blankstein, S., and Feiman, L.H.: Macular Pigmentation Following Maternal Rubella , Amer J Ophthal 35:408, 1952. 12. Francois, J., and Verriest, G.: Les effets malformatifs chez l'enfant des infections virales de la mere , Ann Oculist 189:269, 1956. 13. Franceschetti, A., and Bourquin, J.: Rubeole pendant la grossesse et malformations congenitales de l'enfant , Ann Oculist 179:623, 1946. 14. Babel, J., and Dieterle, P.: Cataract apparemment heredetaire d'origine embryopathique , Confin Neurol 20:122, 1960.Crossref 15. Franceschetti, A.; Dieterle, P.; and Schwarz, A.: Retinite pigmentaire a virus: relation entre tableau clinique et electroretinogramme (ERG) , Ophthalmologica 135:545, 1958.Crossref 16. Francois, J.: Congenital Cataracts , Springfield, Ill: Charles C. Thomas, 1963. 17. Emerson, E.: Retinitis: Pigmentosa or Rubella? Amer J Ophthal 45:93, 1958. 18. Long, J.C., and Danielson, R.W.: Cataract and Other Congenital Defects in Infants Following Rubella in the Mother , Arch Ophthal 34:24, 1945.Crossref 19. Ferdinando, R., Di: Malformazioni congenite da embriopatica rubeolica e parotitica , Boll Oculist 31:427, 1952. 20. Barham-Black, G.H.: in discussion of paperby Marks, E.O.: Pigmentary Abnormality in Children Congenitally Deaf Following German Measles , Trans Ophthal Soc Aust 6:122, 1946. 21. Francois, J.: Congenital Cataracts , Springfield, Ill: Charles C Thomas, 1963. 22. Zetterstrom, B.: The ERG in Congenital Rubella-Retinitis , Acta XVIII Concil Ophthal Belgica 1:661, 1958. 23. Gregg, N.M.: Congenital Cataract in Relation to Rubella , Trans Canad Ophthal Soc 7:131, 1955. 24. Krill, A.E.: The Electroretinographic and Electrooculographic Findings in Patients With Macular Lesions , Trans Amer Acad Ophthal Otolaryng , 70:1063, 1966. 25. Burian, H., and Lawwill, T.: Electroretinographic Studies in Strabismic Amblyopia , Amer J Ophthal 61:422, 1966. 26. Jacobson, J.H.: Clinical Electroretinography , Springfield, Ill: Charles C Thomas, 1961. 27. Bourquin, J.B.: Les malformations du neuveaune causees par les viroses de la grossesse et plus particulierement par la rubeole (embryopathie rubeoleuse) , Paris: Le Francois, 1948. 28. Blum, J.D., and Babel, J.: Diagnostic differential des retinites et des pseudo-retinites pigmentaires au point de vue histologique , Ann Oculist 181:468, 1948. 29. Pendergast, J.J.: Congenital Cataract and Other Anomalies Following Rubella in Mother During Pregnancy: A California Survey , Arch Ophthal 35:39, 1946.Crossref 30. Tondury, G., and Smith, D.W.: Fetal Rubella Pathology , J Pediat 68:867, 1966.Crossref 31. Leber, T.: Ueber Retinitis Pigmentosa und angeboren amaurose , Graefe Arch Ophthal 15:1, 1867.Crossref 32. Alstrom, C.H., and Olson, O.: Heredo-retinopathia congenitalis monohydridia recessiva autosomalis , Hereditas 43:1, 1957. 33. Waardenburg, P.J.: Does Agenesis or Dysgenesis Neuro-Epithelilalis Retinae, Whether or not Related to Keratoglobus, Exist? , Ophthalmologica 133:454, 1957.Crossref 34. Sorsby, A., and Williams, C.E.: Retinal Aplasia as a Clinical Entity , Brit Med J 1:293, 1960.Crossref 35. Babel, J.: Histological findings in Leber's Infantile Amaurosis and in Different Forms of Hemeralopia , Ophthalmologica 145:399, 1963.Crossref 36. Henkes, H.E., and Verduin, P.C.: Dysgenesis or abiotrophy? A differentiation With the Help of the Electroretinogram (ERG) and Electrooculogram (EOG) in Leber's Congenital Amaurosis , Ophthalmologica 145:144, 1963.Crossref 37. Sidler-Huguenin: Die hereditaer-syphilitischen Augenhintergrundverauderungen, nebst einigen Allgemeinen Bemerkungen ueber Augenerkrankungen bei angeboren Lues , Beitr Augenheilk 6( (51) ):1, 1902. 38. Guzzinati, G.C.: Sulla possibilita di lesioni oculari congente da morbillo e da epatite epidemica , Boll Oculist 33:833, 1954. 39. LaPlane, R.; Bregeat, P.; and Ossoporski, B.: Un cas d'embryopathie probablement consecutif a une vericelle maternelle , Arch Franc Pediat 7:530, 1950. 40. LaForet, E.G., and Lynch, C.L.: Multiple Congenital Defects Following Maternal Varicella , New Eng J Med 236:534, 1947.Crossref 41. Mann, I.: Developmental Abnormalities of the Eye , ed 2, London: J. B. Lippincott Co., 1957. 42. Francois, J., et al: Embryopathie par radiations ionisantes , Ophthalmologica 143:163, 1962.Crossref 43. Duke-Elder, S. (ed.): System of Ophthalmolgy: Embryology , St. Louis: C. V. Mosby Co., 1963, vol 3, pt 1. 44. Gouras, P., and Carr, E.: Light Induced DC Responses of Monkey Retina Before and After Central Retinal Artery Interruption , Invest Ophthal 4:310, 1965. 45. Pasik, P.; Pasik, T.; and Bender, M.B.: Re covery of the Electrooculogram After Total Ablation of the Retina in Monkey , Electroenceph Clin Neurophysiol 19:291, 1965.Crossref 46. Elenius, V., and Lehtonen, J.: Spectral Sensitivity of the Standing Potential of the Human Eye , Acta Ophthal 40:559, 1962.Crossref 47. Arden, G., and Kelsey, J.H.: Some Observations on the Relationship Between the Standing Potential of the Human Eye and the Bleaching and Regeneration of Visual Purple , J Physiol 161:205, 1962. 48. Noell, W.K.: The Origin of the Electroretinogram , Amer J Ophthal 38:78, 1954.

O'Neill, John F.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020452007pmid: 6022717

Abstract IDEAL goals in the treatment of strabismus include the attainment of single binocular vision with good stereopsis and secure ocular alignment. These aims must often be significantly modified in the presence of organic brain damage, particularly in cases of congenital rubella where the central nervous system involvement is but part of a generalized process of fetal injury which often includes major ocular defects. The frequency of strabismus in these infants is directly related to the severity of those characteristic rubella defects which primarily reduce vision, and only secondarily to the brain damage. Since the restoration of good vision in each eye is necessary to maintain ocular alignment, strabismus management in such children must include early efforts to obtain a clear visual axis and the subsequent institution of an appropriate aphakic corrective lens soon thereafter. The present discussion will be limited to the early management of strabismus in congenital rubella, that References 1. O'Neill, J.F.; Monif, G.R.G.; and Sever, J.L.: The Ocular Defects of Congenital Rubella Confirmed by Virus Isolation, read before the Washington Hospital Center Ophthalmology Society Annual Alumni Meeting, May 7, 1966. 2. Roy, F.H., et al: Ocular Manifestations of Congenital Rubella Syndrome , Arch Ophthal 75:601-607, 1966.Crossref 3. Schrire, L.: An Ophthalmological Survey of a Series of Cerebral Palsy Cases , S Afr Med J 30:405, 1956. 4. Guibor, G.P.: Some Eye Defects Seen in Cerebral Palsy, With Some Statistics , Amer J Phys Med 32:342, 1953. 5. Altman, H.E.; Hiatt, R.L.; and DeWeese, M.W.: Ocular Findings in Cerebral Palsy , Southern Med J 59:1015-1018, 1966.Crossref 6. Byron, H.M.: Ophthalmic Survey of 162 Mentally Retarded Children , NY J Med 62:3102-3104, 1962. 7. Maumenee, A.E., et al: Ocular Manifestations of Congenital Rubella, read before the Wilmer Residents Meeting, Baltimore, April 1965. 8. Sever, J.L.; Nelson, K.B.; and Gilkeson, M.R.: Rubella Epidemic, 1964: Effect on 6,000 Pregnancies , Amer J Dis Child 110:395, 1965.Crossref 9. Adler, F.H.: Physiology of the Eye , ed 3, St. Louis: the C. V. Mosby Co., 1959, p 421. 10. Rudolph, A.J., et al: Transplacental Rubella Infection in Newly Born Infants , JAMA 191:843-845, 1965.Crossref 11. Boniuk, M., and Zimmerman, L.E.: Ocular Pathology of the Rubella Syndrome in the Newborn , Arch Ophthal , this issue pp 455-473. 12. Scheie, H.G.: Aspiration of Congenital or Soft Cataracts: A New Technique , Amer J Ophthal 50:1048, 1960. 13. Parks, M.M., and Hiles, D.A.: Management of Infantile Cataracts , Amer J Ophthal 63:10-19, 1967. 14. Cotlier, E.; Fox, J.; and Smith, M.: Rubella Virus in the Cataractous Lens of Congenital Rubella Syndrome , Amer J Ophthal 62:233-235, 1966.

Boniuk, Milton;Zimmerman, Lorenz E.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020457008pmid: 6022718

Abstract THE RELATIONSHIP between congenital cataracts, deafness, cardiovascular malformations, and other abnormalities in infants born to mothers who have had rubella in the first trimester of pregnancy has been widely recognized since Gregg1 first described this association in 1941. Recent interest in the rubella syndrome has been due to the development of virologic techniques for the growth of rubella virus in tissue culture2,3 and to the widespread epidemic in the United States during the winter and spring of 1963 to 1964. There have been many older and several recent reports4,5 describing the ocular manifestations of the rubella syndrome. In the past, very few eyes have been examined pathologically, and little has been written regarding the pathologic changes in the eyes in the rubella syndrome. As a result of the recent epidemic, a fairly large number of eyes have become available for pathologic examination; the purpose of the present References 1. Gregg, N.M.: Congenital Cataract Following German Measles in Mother , Trans Ophthal Soc Aust 3:35-46, 1941. 2. Weller, T.H., and Neva, F.A.: Propagation in Tissue Culture of Cytopathic Agents From Patients With Rubella-Like Illness , Proc Soc Exp Biol Med 111:215-225, 1962.Crossref 3. Parkman, P.D., Buescher, E.L., and Artenstein, M.S.: Recovery of Rubella Virus from Army Recruits , Proc Soc Exp Biol Med 111:225-230, 1962.Crossref 4. Alfano, J.E.: Ocular Aspects of the Maternal Rubella Syndrome , Trans Amer Acad Ophthal Otolaryng 70:235-266, 1966. 5. Roy, F.H., et al: Ocular Manifestations of Congenital Rubella Syndrome , Arch Ophthal 75:601-607, 1966.Crossref 6. Drualt, A., and Drualt, S.: Eye of the Newborn , Ann Oculist 179:375-388, 1946. 7. Last, R.J.: Wolff's Anatomy of the Eye and Orbit , ed 5, Philadelphia and London: W. B. Saunders Co., 1961. 8. Sorsby, A., and Sheridan, M.: The Eye at Birth: Measurements of the Principal Diameters in Forty-Eight Cadavers , J Anat 94:192-197, 1960. 9. Duke-Elder, S., and Cook, C.: " Normal and Abnormal Development ," in System of Ophthalmology , St. Louis: C. V. Mosby Co., 1963, vol 3, p 311. 10. Swan, C.: Study of Three Infants Dying From Congenital Defects Following Maternal Rubella in Early Stages of Pregnancy , J Path Bact 56:289-295, 1944.Crossref 11. Cordes, F.C., and Barber, A.: Changes in Lens of Embryo After Rubella , Arch Ophthal 36:135-140, 1946.Crossref 12. Roy, F.H., et al: The Congenital Rubella Syndrome With Virus Recovery , Amer J Ophthal 62:222-232, 1966. 13. Wolter, J.R., et al: Eye Pathology Following Maternal Rubella , J Pediat Ophthal 3:29-35, 1966. 14. Töndury, G., and Smith, D.W.: Fetal Rubella Pathology , J Pediat 68:867-879, 1966.Crossref 15. Zimmerman, L.E., and Font, R.L.: Congenital Malformations of the Eye; Some Recent Advances in Knowledge of the Pathogenesis and Histopathological Characteristics , JAMA 196:684-692, 1966.Crossref 16. Cotlier, E., et al: Rubella Virus in the Cataractous Lens of Congenital Rubella Syndrome , Amer J Ophthal 62:233-235, 1966. 17. Bellanti, J.A., et al: Congenital Rubella: Clinicopathologic, Virologic, and Immunologic Studies , Amer J Dis Child 110:464-472, 1965.Crossref 18. Weiss, D.I., et al: Infantile Glaucoma: A Manifestation of Congenital Rubella , JAMA 195:725-727, 1966.Crossref

Smith, J. Lawton;Israel, Charles W.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020476009pmid: 5336940

Abstract A young woman with a gradual onset of blurred vision was found to have a bitemporal hemianopia. It was possible that these symptoms represented an early optochiasmatic arachnoiditis. Inflammatory eye changes with bilateral neuroretinitis and anterior uveitis were then noted. A protracted course of exacerbations and remissions occurred during a one-year course of systemic steroid therapy. After a reactive fluorescent treponemal antibody absorption test was found, spirochetes were demonstrated in the aqueous humor. The patient was then given more than nine million units of long-acting penicillin. One month later, at a second paracentesis, spirochetes were again found. These organisms were motile on darkfield examination, and stained with fluorescein tagged anti-Treponema pallidum globulin. References 1. Yobs, A.R.; Brown, L.; and Hunter, E.F.: Fluorescent Antibody Techniques in Early Syphilis , Arch Path 77:220-225, 1964. 2. Smith, J.L., et al: Experimental Ocular Syphilis and Neurosyphilis , Brit J Vener Dis 41:15-23 ( (March) ) 1965. 3. Smith, J.L.: Neuro-Ophthalmology: Symposium of the University of Miami and the Bascom Palmer Eye Institute , St. Louis: C. V. Mosby Co., 1965, vol 2, pp 1-43. 4. Taylor, W.H.; Smith, J.L.; and Singer, J.A.: Experimental Seronegative Syphilis , Amer J Ophthal 60:1093-1098 ( (Dec) ) 1965. 5. Wells, J.A., and Smith, J.L.: Neuro-Ophthalmology: Symposium of the University of Miami and the Bascom Palmer Eye Institute , St. Louis: C. V. Mosby Co., 1967, vol 3, pp 262-293. 6. Smith, J.L., and Israel, C.W.: The Presence of Spirochetes in Late Seronegative Syphilis, JAMA, to be published. 7. Smith, J.L., and Taylor, W.H.: The FTA-ABS Test in Ocular and Neurosyphilis , Amer J Ophthal 60:653-658 ( (Oct) ) 1965. 8. Deacon, W.E.; Lucas, J.B.; and Price, E.V.: Fluorescent Treponemal Antibody Absorption (FTA-ABS) Test for Syphilis , JAMA 198:624-628 ( (Nov 7) ) 1966.Crossref 9. Collart, P.: "Persistence of Treponema Pallidum in Late Syphilis in Rabbits and Humans, Notwithstanding Treatment," Proceedings of World Forum on Syphilis and Other Treponematoses, publication No. 997, US Public Health Service, 1964, pp 285-291.

Taylor, Daniel M.

1967 Archives of Ophthalmology

doi: 10.1001/archopht.1967.00980020480010pmid: 6022719

Abstract Results of a series of 216 patients with congenital strabismus operated on at various age levels were analyzed and bear out the following conclusions. Congenital strabismus is a common disorder. Its incidence in the overall strabismus population is at least 50% and may be higher. The first few years of life appear to be critical in the development of normal binocular single vision. Potentiation of the latent binocular reflexes is brought about by bifoveal stimulation during infancy. Early case detection and adequate surgery are mandatory if functional results are to be obtained. It is recommended that surgery be done between 6 to 12 months of age. The functional goal should be to convert a constant tropia to a phoria. This is the most useful yardstick in evaluating results. Surgery done after the second birthday almost always resulted in functional failure. References 1. Duane, A.: Fuchs' Text Book of Ophthalmology , Philadelphia and London: J. B. Lippincott Company, 1917. 2. Chavasse, F.B.: Worth's Squint , Philadelphia: P. Blakiston Sons and Company, 1939. 3. Worth, C.: Squint: Its Causes, Pathology, and Treatment , Philadelphia: P. Blakiston Sons and Company, 1929. 4. Lyle, T.K.: Worth and Chavasse Squint , London: Bailliére, Tindall, and Cox, 1950. 5. Lyle, T.K.: Treatment of Concomitant Convergent Esotropia , Trans Ophthal Soc UK , 1952. 6. Lyle, T.K., and Jackson, S.: Practical Orthoptics in the Treatment of Squint , Philadelphia: P. Blakiston Sons and Company, 1953. 7. Lyle, T.K., and Foley, J.: Prognosis in Cases of Strabismus With Special Reference to Orthoptic Treatment , Brit J Ophthal 41:129-152, 1957.Crossref 8. Lyle, T.K.: Non-Paralytic Convergent Strabismus , Amer Orthop J 14:60-64, 1963. 9. Bridgeton, G.J.O.: Convergent Squint of Early Onset: Results of Treatment , Brit Orthop J 20:45-53, 1963. 10. Taylor, D.M.: How Early is Early Surgery in the Management of Strabismus? , Arch Ophthal 70:54-58, 1963. 11. Hubel, D.H.: The Visual Cortex of the Brain , Sci Amer 209:54-62 ( (Nov) ) 1963.Crossref 12. Cogan, D.G.: Researches into Vision , Arch Ophthal 75:155-156 ( (Feb) ) 1966.Crossref 13. Wiesel, T.N., and Hubel, D.H.: Comparison of the Effects of Unilateral and Bilateral Eye Closure on Cortical Unit Responses in Kittens , J Neurophysiol 28:1029-1040, 1965. 14. Hubel, D.H. and Wiesel, T.N.: Binocular Interaction in Striate Cortex of Kittens Reared With Artificial Squint , J Neurophysiol 28:1041-1059, 1965. 15. Wiesel, T.N., and Hubel, D.H.: Extent of Recovery From the Effects of Visual Deprivation in Kittens , J Neurophysiol 28:1060-1072, 1965. 16. Costenbader, F.D.: Infantile Esotropia , Trans Amer Ophthal Soc 59:397-429, 1961. 17. Costenbader, F.D.: " Clinical Course and Management of Esotropia ," in Allen, J.H. (ed.): Strabismus Ophthalmic Symposium II , St. Louis: C. V. Mosby Company, 1958, pp 325-353. 18. Parks, M.M.: " Comitant Esodeviation in Children ," in Haik: G.M. (ed.): Strabismus: Symposium of the New Orleans Academy of Ophthalmology , St. Louis: C. V. Mosby Company, 1962, pp 31-44. 19. Parks, M.M.: Monofixational Phoria , Amer Orthop J 11:38-45, 1961. 20. Ing, M., et al: Surgery for Congenital Esotropia , Amer J Ophthal 61:1419-1427 ( (June) ) 1966.