Archives of Ophthalmology

Beetham, William P.;Aiello, Lloyd M.;Balodimos, Marios C.;Koncz, Lajos

doi: 10.1001/archopht.1970.00990030263001pmid: 5461208

Abstract Between February 1967 and April 1969, 329 patients with various degrees of diabetic proliferating retinopathy have been treated by a circumferential ruby laser photocoagulation technique. Of these, 178 patients represent controls in which both eyes have equal degree of neovascular retinal disease in each eye on the basis of funduscopy, photography, and fluorescein angiography. One eye is treated, the opposite serving as a control. Seventy-two of these control patients had early neovascular retinopathy, have one or more years of follow-up, and are presented herein as a preliminary report of a detailed ongoing control study. Eighty percent of treated eyes have shown a definite improvement to a lesser stage of neovascular retinopathy. Fifty-four percent have had complete disappearance of neovascularization. All untreated controls have remained unchanged or have worsened. References 1. Beetham WP: Visual prognosis of proliferating diabetic retinopathy . Brit J Ophthal 47:611-619, 1963.Crossref 2. Meyer-Schwickerath GRE, Schott K: Diabetic retinopathy and photocoagulation . Amer J Ophthal 66:597-603, 1968. 3. Aiello LM, Beetham WP, Balodimos MC, et al: Ruby laser photocoagulation in treatment of diabetic proliferating retinopathy: preliminary report , in Goldberg MF, Fine SL (eds): Symposium on the Treatment of Diabetic Retinopathy , bulletin 1890. Public Health Service, 1969, pp 437-463. 4. Campbell CJ, Loester CJ, Curtis V, et al: Clinical studies in laser photocoagulation . Arch Ophthal 74:57-65, 1965.Crossref 5. Baum JL, Wise GN: Experimental subretinal neovascularization . Trans Amer Ophthal Soc 63:91-107, 1965. 6. Michaelson IC: Retinal Circulation in Man and Animals . Springfield, Ill, Charles C Thomas Publisher, 1954. 7. Kuwabara T, Aiello LM: Effect of the ruby laser on the monkey retina: An electron microscope study , in Goldberg MF, Fine SL (eds): Symposium on the Treatment of Diabetic Retinopathy , bulletin 1890. Public Health Service, 1969, pp 665-671. 8. Goldberg MF, Fine, SL (eds): Symposium on the Treatment of Diabetic Retinopathy , bulletin 1890. Public Health Service, 1969.

Davidorf, Frederick H.;Newman, Gordon H.;Havener, William H.;Makley, Torrence

doi: 10.1001/archopht.1970.00990030275002pmid: 5415846

Abstract The technique of transscleral diathermy performed under direct visualization is presented and its use discussed in four patients with malignant melanoma of the choroid. This technique is compared to photocoagulation of intraocular tumors. The author's therapeutic classification for the conservative management of malignant melanomas of the choroid has been included. References 1. Weve, H.J.M.: Weber Operative Behandlung von Intraokularen Tumoren Mit Erhaltung des Bulbus , Arch Augenheilk 110:482-497, 1937. 2. Weve, H.J.M.: Diathermy in Ophthalmic Practice , Trans Ophthal Soc UK 59 ( (pt 1) ):61-64, 1939. 3. Melchers, M.J.: Diathermy Treatment of Intraocular Tumors , Utrecht, Netherlands: Schotanusan Jens, 1953. 4. Lauber, H.: Zur Diathermischen Behandlung Beginnender An der Haut Geschwulsts , Ber Deutsch Ophth Ges 52:119, 1938. 5. Savin, L.H., and Pritchard, G.C.: Choroidal Melanoma Treated by Surgical Diathermy , Brit J Ophthal 26:551-555, 1942.Crossref 6. Westerveld, B.E.R., and Zeenan, W.P.: The Prognosis of Melanoblastomata of the Choroid , Ophthalmologica 134:20-29 ( (July) ) 1957.Crossref 7. Pahwa, T.R.: Recurrence Rate of the Enucleation , Brit J Ophthal 25:241-286, 1941.Crossref 8. Reese, A.B.: Tumors of the Eye , New York: Harper & Row, 1963, pp 236, 241, 291-292. 9. Dunphy, E.B.: Management of Intraocular Malignancy , Amer J Ophthal 44:313-322, 1957. 10. Havener, W.H.: Atlas of Retinal Detachment , St. Louis: C. V. Mosby Co., 1967, pp 195-197. 11. Meyer-Schwickerath, G.: Light Coagulation , St. Louis: C. V. Mosby Co., 1960. 12. Dufour, R., et al: Treatment of Intraocular Tumors and Progress in Chorioretinal Surgery , S. Karger, 1968, pp 43-44.

Toussaint, Daniel;Danis, Pierre

doi: 10.1001/archopht.1970.00990030283003pmid: 5415847

Abstract The coefficients of vascular density in the normal human retina as a function of the distance from the disc have been studied. It appears that the density is higher in the temporal sector than in the nasal sector, which is itself higher than in the superior and inferior sectors. The decrease of the vascular density is equal in the four sectors of the retina. The vascularization is one quarter as dense in the equatorial retina as around the disc. References 1. Snedecor GW, Cochran WG: Statistical Methods , ed 6. Ames, Iowa, Iowa State University Press, 1967.

Tanenbaum, Howard L.;Schepens, Charles L.;Elzeneiny, Ismail;Freeman, H. MacKenzie

doi: 10.1001/archopht.1970.00990030288004pmid: 5415848

Abstract Macular pucker describes minute radiating retinal folds and a preretinal membrane in the macular area. Most often, it follows retinal detachment surgery. A comparison between 105 affected eyes with 3,417 eyes without macular pucker after retina surgery indicates that the following factors probably precipitate macular pucker: vitreous blood, total retinal detachment, detachment of the macula, multiple retina operations, multiple perforations, and most significant, loss of formed vitreous at operation. Diathermy, photocoagulation, or cryoapplication may also be precipitating factors. In affected eyes visual acuity rarely improves as expected particularly if preoperative vision exceeded 20/70. Eyes with 20/400 or better when the diagnosis is made have a 40% chance of later improvement. Eyes with 20/100 or better at the time of diagnosis have a 60% chance of improvement. A possible pathogenesis of preretinal membranes is discussed. References 1. Jaffe, N.S.: Macular Retinopathy After Separation of Vitreoretinal Adherence , Arch Ophthal 78:585-591, 1967.Crossref 2. Meyer-Schwickerath, G.: Eales' Disease: Treatment With Light Coagulation , Bibl Ophthal 70:10-18, 1966. 3. Lincoff, H.A., and McLean, J.M.: Cryosurgical Treatment of Retinal Detachment , Amer J Ophthal 61( (pt 2) ):1227-1234, 1966. 4. Hamburg, A.: Star-Shaped Fold in a Case of Retinal Detachment , Ophthalmologica 141:477-478, 1961.Crossref 5. Jungschaffer, O.H.: Poor Visual Results Following Retinal Reattachment , Trans Pacif Coast Otoophthal Soc 47:165-173, 1966. 6. Grupposo, S.S.: " Visual Results After Scleral Buckling With Silicone Implant ", in Controversial Aspects of the Management of Retinal Detachment , C.L. Schepens, and C.D.J. Regan (eds.), Boston: Little, Brown & Co., 1965, pp 354-363. 7. Cibis, P.A., and Yamashita, T.: Experimental Aspects of Ocular Siderosis and Hemosiderosis , Amer J Ophthal 48:465-480, 1959. 8. Regnault, F.R.: Vitreous Hemorrhages: An Experimental Study: II. Hemoglobin Degradation, Arch Ophthal, to be published. 9. Schepens, C.L.: Clinical Aspects of Pathologic Changes in the Vitreous Body , Amer J Ophthal 38(pt 2):8-21 (No. (1) ) 1954. 10. Cibis, P.A.: Viteoretinal Pathology and Surgery in Retinal Detachment , St. Louis: C. V. Mosby Co., 1965, p 33. 11. Smith, T.R.: " Pathological Findings After Retina Surgery ," in Importance of the Vitreous Body in Retina Surgery , C. L. Schepens (ed.), St. Louis: C. V. Mosby Co., 1960, pp 61-75. 12. Balazs, E.A., et al: Studies on the Structure of the Vitreous Body: XII. Cytological and Histochemical Studies on the Cortical Tissue Layer , Exp Eye Res 3:57-71, 1964.Crossref 13. Freeman, M.I., et al: Lysosomal Enzymes Associated With Vitreous Hyalocyte Granules: I. Intracellular Distribution Patterns of Enzymes , Exp Eye Res 7:113-120, 1968.Crossref 14. Allison, A.: Lysosomes and Disease , Sci Amer 217:62-72, 1967.Crossref 15. Grignolo, A.: Les connaissances actuelles sur la structure de corps vitré , in Progress in Ophthalmology , Basel: S. Karger, 1953, vol 2, pp 1-35.

Fonda, Gerald

doi: 10.1001/archopht.1970.00990030296005pmid: 5415849

Abstract Binocular reading additions from + 4.00 D to + 14.00 D were prescribed to 120 patients. Fifty percent of corrections were prescribed for patients with macular degeneration and cataracts, and nearly 25% to patients with heredo-degeneration of the macula. Sixty percent of corrections were prescribed for vision ranging from 20/200 to 20/ 100. Ninety-two percent of corrections were prescribed in the form of bifocals or half-eye glasses. Bifocals make the most inconspicuous optical aid and are indicated when there is a significant distant correction. Half-eye glasses were prescribed for 64%. These are ideal because the lenses can be made small. Bifocal segments must be decentered in 1 mm for each diopter of reading addition for each eye, or 1Δ of base-in prism must be incorporated for each diopter of reading addition for each eye. Eighty-eight percent were judged successful. References 1. Fonda G: Binocular correction for low vision: Rationale for rule of thumb for decentration . Amer J Ophthal 45:23-27, 1957. 2. Lebensohn JE: Practical problems pertaining to presbyopia . Amer J Ophthal 32:22-30, 1949. 3. Tait EF: Textbook of Refraction . Philadelphia, WB Saunders Co, 1951, p 341.

Dawson, Chandler R.;Schachter, Julius;Ostler, Howard B.;Gilbert, Robert M.;Smith, David E.;Engleman, Ephraim P.

doi: 10.1001/archopht.1970.00990030302006pmid: 4190224

Abstract A 21-year-old woman presented with inclusion conjunctivitis followed by iritis. Her husband had developed Reiter's syndrome two years previously. Chlamydia (psittacosis-lymphogranuloma-trachoma or Bedsonia) agent was demonstrated in both husband and wife. This study compares a series of 26 patients with inclusion conjunctivitis and a series of 24 patients with Reiter's syndrome in whom chlamydial infection was demonstrated. In all patients with inclusion conjunctivitis, follicular keratoconjunctivitis was present, and two developed uveitis. Among patients with Reiter's syndrome and Chlamydia infection, one patient had follicular keratoconjunctivitis, two had keratitis, and four had iritis. If some cases of Reiter's syndrome are caused by Chlamydia infections, the disease may be an unusual host response to the agent rather than a direct result of infection as with inclusion conjunctivitis. References 1. Bauer, W., and Engleman, E.P.: A Syndrome of Unknown Etiology Characterized by Urethritis, Conjunctivitis and Arthritis (So-Called Reiter's Disease) , Trans Assoc Amer Physicians 57:307-313, 1942. 2. Weinberger, H.W., et al: Reiter's Syndrome, Clinical and Pathologic Observations: A Long Term Study of 16 Cases , Medicine 41:35-91, 1962.Crossref 3. Csonka, G.W.: Reiter's Syndrome , Ergebn Inn Med Kinderheilk 23:125-189, 1965. 4. Paronen, I.: Reiter's Disease: A Study of 344 Cases Observed in Finland , Acta Med Scand 212-( (suppl) ):7-112, 1948. 5. Noer, H.R.: An "Experimental" Epidemic of Reiter's Syndrome , JAMA 198:693-698, 1966.Crossref 6. Reiter, H.: Ueber eine bisher unerkannte Spirochäten infektion (Spirochaetosis arthrica) , Deutsch Med Wschr 42:1535-1536, 1916.Crossref 7. Schachter, J., et al: Isolation of Bedsoniae From the Joints of Patients With Reiter's Syndrome , Proc Soc Exp Biol Med 122:283-285, 1966.Crossref 8. Schachter, J.: Isolation of Bedsoniae From Human Arthritis and Abortion Tissues , Amer J Ophthal 63( (pt 2) ):1082-1086, 1967. 9. Jones, B.R., et al: Infection by TRIC Agent and Other Members of the Bedsonia Group; With a Note on Reiter's Disease: I. Ocular Disease in the Adult , Trans Ophthal Soc UK 86:291-309, 1966. 10. Dawson, C.R., and Schachter, J.: TRIC Agent Infections of the Eye and Genital Tract , Amer J Ophthal 63( (pt 2) ):1288-1298, 1967. 11. Schachter, J., et al: Comparison of Procedures for the Laboratory Diagnosis of Oculogenital Infections With Inclusion Conjunctivitis Agents , Amer J Epidemiol 85:453-458, 1967. 12. Engleman, E.P., and Weber, H.M.: Reiter's Syndrome , Clin Orthop 57:19-29, 1968. 13. Dawson, G.R., et al: Experimental Inclusion Conjunctivitis in Man: III. Keratitis and Other Complications , Arch Ophthal 78:341-349, 1967.Crossref 14. Gilbert, R.J., et al: Antibiotic Therapy in Experimental Bedsonia Arthritis , abstracted, Arthritis Rheum 12:299 ( (June) ) 1969. 15. Oster, H.B., et al: Animal Studies of a Bedsonia Agent Isolated From the Synovial Membrane of a Patient With Reiter's Syndrome , Arthritis Rheum 12:320-321 ( (June) ) 1969. 16. Meyer, K.F.: The Host Spectrum of Psittacosis-Lymphogranuloma Venereum (PL) Agents , Amer J Ophthal 63( (pt 2) ):1225-1246, 1967. 17. Jawetz, E., et al: Subclinical Infections With TRIC Agents , Amer J Ophthal 63( (pt 2) ):1413-1424, 1967. 18. Dawson, C.R.; Hanna, L.; and Jawetz, E.: Controlled Treatment Trials of Trachoma in American Indian Children , Lancet 2:961-964, 1967.Crossref 19. Dawson, C.R., et al: Controlled Trials With Trisulfapyrimidines in the Treatment of Chronic Trachoma , J Infect Dis 119:581-590, 1969.Crossref 20. Kimura, S.J., et al: Uveitis and Joint Disease: Clinical Findings in 191 Cases , Arch Ophthal 77:309-316, 1967.Crossref

Ellenberger, Carl;Netsky, Martin G.

doi: 10.1001/archopht.1970.00990030309007pmid: 5415850

Abstract A 58-year-old woman had opsoclonus and signs of cerebellar disease in association with carcinoma of the breast. The case is the first recorded with this abnormal ocular movement and neuroanatomic changes restricted to the cerebellum. Necropsy revealed typical changes of parenchymatous degeneration: absence of Purkinje cells, diffuse and focal gliosis, and neuronal loss in the granular layer and dentate nuclei. Opsoclonus differs clinically from other abnormal, conjugate movements of the eyes because it is spontaneous, irregular, multidirectional, and most severe at the onset of attempts to change fixation. Opsoclonus may occur in patients with encephalitis, polymyoclonia, and neoplastic disease, particularly neuroblastoma. References 1. Orzechowski, C.: De l'ataxie dysmétrique des yeux: Remarques sur l'ataxie des yeux dite myoclonique (opsoclonie, opschorie) , J Psychol Neurol 35 ( (pt 1 and 2) ):1-18, 1927. 2. Ellenberger, C., Jr.; Campa, J.F.; and Netsky, M.G.: Opsoclonus and Parenchymatous Degeneration of the Cerebellum , Neurology 18:1041-1046, 1968.Crossref 3. Brain, W.R.B., and Wilkinson, M.: " Subacute Cerebellar Degeneration in Patients With Carcinoma ," in Brain, W.R.B., and Norris, F., Jr. (eds.): The Remote Effect of Cancer on the Nervous System: The Proceedings of a Symposium (Sponsored by the Division of Neurology, Department of Medicine, University of Rochester School of Medicine and Dentistry) , New York: Grune & Stratton, 1965, pp 17-23. 4. Schou, H.I.: Myoklonus-Epilepsie mit eigentümlichen Gehirnveränderungen , Z Neurol Psychiat 95:12-20, 1925.Crossref 5. Alessi, D.: Lesioni parenchimatose del cervelletto da carcinoma uterino (gliosi carcinotossica?) , Riv Pat Nerv Ment 55:148-174, 1940. 6. Cogan, D.G.: Ocular Dysmetria: Flutter-like Oscillations of the Eyes, and Opsoclonus , Arch Ophthal 51:318-335 ( (March) ) 1954.Crossref 7. Ross, A.T., and Zeman, W.: Opsoclonus, Occult Carcinoma, and Chemical Pathology in Dentate Nuclei , Arch Neurol 17:546-551 ( (Nov) ) 1967.Crossref 8. Brumlik, J., and Means, E.D.: Tremorine—Tremor, Shivering and Acute Cerebellar Ataxia in the Adult and Child—A Comparative Study , Brain 92 ( (pt 1) ):157-190, 1969.Crossref 9. Solomon, G.E., and Chutorian, A.M.: Opsoclonus and Occult Neuroblastoma , New Eng J Med 279:475-477 ( (Aug 29) ) 1968.Crossref 10. Smith, J.L., and Walsh, F.B.: Opsoclonus—Ataxic Conjugate Movements of the Eyes , Arch Ophthal 64:244-250 ( (Aug) ) 1960.Crossref 11. Curnen, E.C., and Chamberlin, H.R.: Acute Cerebellar Ataxia Associated With Poliovirus Infection , Yale J Biol Med 34:219-233, 1961-1962. 12. Kinsbourne, M.: Myoclonic Encephalopathy of Infants , J Neurol Neurosurg Psychiat 25:271-276, 1962.Crossref 13. Cogan, D.G.: Opsoclonus, Body Tremulousness, and Benign Encephalitis , Arch Ophthal 79:545-551 ( (May) ) 1968.Crossref 14. Dyken, P., and Kolář, O.: Dancing Eyes, Dancing Feet , Brain 91( (pt 2) ):305-320, 1968.Crossref 15. Gilbert, G.J.; McEntee III, W.J.; and Glaser, G.H.: Familial Myoclonus and Ataxia , Neurology 13:365-372 ( (May) ) 1963.Crossref 16. Weiss, S., and Carter, S.: Course and Prognosis of Acute Cerebellar Ataxia in Children , Neurology 9:711-721 ( (Nov) ) 1959.Crossref 17. Bray, P.F., et al: The Coincidence of Neuroblastoma and Acute Cerebellar Encephalopathy, Trans Amer Neurol Assoc, to be published. 18. Chutorian, A.M.: in discussion, Bray P.F., et al.17 19. Croft, P.B., and Wilkinson, M.: The Course and Prognosis in Some Types of Carcinomatous Neuromyopathy , Brain 92 ( (pt 1) ):1-8, 1969.Crossref

Treister, Giora;Mannor, Shlomo

doi: 10.1001/archopht.1970.00990030313008pmid: 4906253

Abstract Continuous treatment with mestranol, 0.1 mg/ day, in normal women, caused a small gradually growing intraocular pressure decrease of 2.0 ± 0.45 mm Hg and an outflow facility increase of 0.085μl ± 0.015μl (min mm Hg)-1 at six months. Treatment of another group of 15 normal women with mestranol + ethynodiol diacetate in doses of 0.1 mg and 1.0 mg per day, respectively, gave similar results. The decrease in intraocular pressure was 1.8 ± 0.38 mm Hg at six months, and the increase in outflow facility was 0.056μl ± 0.01μl (min mm Hg)-1 at six months. In both groups, the effect of the drugs on intraocular pressure and outflow facility was highly significant (P < 0.001). However, the differences between the two groups were not significant. Reasons are presented for the belief that the drugs act on the trabecular meshwork. References 1. Paterson, G.D., and Miller, S.J.H.: Hormonal Influence in Simple Glaucoma , Brit J Ophthal 47:129-137, 1963.Crossref 2. Becker, B., and Friedenwald, J.S.: Clinical Aqueous Outflow , Arch Ophthal 50:557-571, 1953.Crossref 3. Lieb, W.A., and Stärk, N.: Interrelationship of Ascorbic Acid and Facility of Outflow: Steroid Hormone as Possible Regulating Mechanism of Intraocular Pressure, Drug Mechanism in Glaucoma , London: J. & A. Churchill, Ltd., pp 105-136, 1966. 4. Obal, A.: Die hormonale Steuerung des Augendruckes , Ber Deutsch Ophth Ges 56:136, 1950. 5. Sano, Sh.: Der Einfluss von weibl: Hormonen auf das Verhalten des I.O. Druckes , Acta Soc Ophthal Jap 65:775, 1961. 6. Medgyaszay, A.: Increase in the Intraocular Pressure Caused by the Follicular Hormone , Szemészet 99:58-60, 1962. 7. Treumer, K.: Glaukombehandlung durch Gelbkörperhormon , Klin Mbl Augenheilk 120:523-534. 1952. 8. Meyer, E.J., et al: Influence of Norethynodrel With Mestranol on Intraocular Pressure in Glaucoma: II. A Controlled Double-Blind Study , Arch Ophthal 75:771-773, 1966.Crossref 9. Meyer, E.J., et al: Influence of Norethynodrel With Mestranol on Intraocular Pressure in Glaucoma , Arch Ophthal 75:157-161, 1966.Crossref 10. Caramazza, R.; Anselmi, P.; and Meduri, R.: Le modificazione indotte da una associazione estrogeno-progestinica sulla dinamica dell'umor acqueonel glaucoma semplice , Ann Ottal 94:299-321, 1968. 11. Jones, R.F., and Maurice, D.M.: New Methods of Measuring the Rate of Aqueous Flow in Man With Fluorescein , Exp Eye Res 5:208-220, 1966.Crossref 12. Goldmann, H.: Abflussdruck, Minutenvolumen und Widerstand der Kammerwasserströmung des Menschen , Docum Ophthal 5-6:278-356, 1951.Crossref 13. Goldmann, H., and Schmidt, Th.: Studien mittels Applanationstonographie , Docum Ophthal 20:184-213, 1966. 14. Goldmann, H.: On Pseudofacility , Bibl Ophthal 76:1-14, 1968. 15. Armaly, F.M.: On the Distribution of Applanation Pressure , Arch Ophthal 73:11-18, 1965.Crossref 16. Dalton, K.: Influence of Menstruation on Glaucoma , Brit J Ophthal 51:692-695, 1967.Crossref 17. Bárány, E., and Christensen, R.E.: Cycloplegia and Outflow Resistance , Arch Ophthal 77:757-760, 1967.Crossref 18. Bárány, E.H.: " Relative Importance of Autonomic Nervous Tone and Structure as Determinants of Outflow Resistance in Normal Monkey Eyes (Cercopithecus ethiops and Macaca irus) ," in Rohen, J.W. (ed.): Eye Structure: II. Symposium , Stuttgart, Germany: Schattauer-Verlag, 1965, pp 223-236. 19. Grant, W.M.: Further Studies on Facility of Flow Through the Trabecular Meshwork , Arch Ophthal 60:523-533, 1958.Crossref 20. Grant, W.M.: Experimental Aqueous Perfusion in Enucleated Human Eyes , Arch Ophthal 69:783-801,1963.Crossref 21. Henneman, D.H.: Effect of Estrogen on in Vivo and in Vitro Collagen Biosynthesis and Maturation in Old and Young Female Guinea Pigs , Endocrinology 83:678-690, 1968.Crossref 22. Dziewiatkowski, D.D.: Effect of Hormones on the Turnover of Polysaccharides in Connective Tissues , Biophys J 4( (suppl) ):215-238, 1964.Crossref 23. Priest, R.E., and Koplitz, R.M.: Inhibition of Synthesis of Sulfated Mucopolysaccharides by Estradiol , J Exp Med 116:565-574, 1962.Crossref 24. Kvarstein, B., et al: An Effect of Estrogen on Chondroitin Sulphate of Rat Skin Tissue , Acta Endocr 44:209-215, 1963. 25. Kowalewski, K.: Effect of Oestradiol Cyclopentylpropionate on Serum and Liver Lipids and Aortic35 S-Sulphated Mucopolysaccharides in Cockerels Fed Normal and Atherogenic Diet , Acta Endocr 36:126-130, 1961. 26. Asboe-Hansen, G.: Hormone Control of Connective Tissue , Fed Proc 25:1136-1140, 1966.

Gass, J. Donald M.

doi: 10.1001/archopht.1970.00990030321009pmid: 5415851

Abstract MAJOR complications developing after vitreous loss during cataract extraction are usually due to failure of the surgeon to keep calm and to take appropriate measures to remove all vitreous from the anterior chamber prior to closing the surgical wound. Maumenee1 described a technique of aspiration of fluid vitreous through the pupil as a means of repositing formed vitreous that has entered the anterior chamber. For this purpose he used a 2 cc syringe connected to a blunt-tipped, open-ended 18-gauge needle marked 15 mm from the tip. Following aspiration, he recommended closure of the wound followed by air injection into the anterior chamber and sweeping the wound area with a cyclodialysis spatula. Recently, Kasner2 reported a technique referred to as "radical anterior vitrectomy" in which he advocates use of scissors, forceps, and cellulose sponges to remove all vitreous from the anterior and posterior chamber prior to closure of the References 1. Maumenee, A.E.: Epithelial Invasion of the Anterior Chamber, Retinal Detachment, Corneal Edema, Anterior Chamber Hemorrhages, Changes in the Macula , Trans Amer Acad Ophthal Otolaryng 61:51-68 ( (Jan-Feb) ) 1957. 2. Kasner, D.: Vitrectomy: A New Approach to the Management of Vitreous , Highlights Ophthal 11:304-309 (No. (4) ) 1968 series (published in July 1969). 3. Boyd, B.F.; Maumenee, A.E.; and McLean, J.M.: Advances in Cataract Surgery: Management of Vitreous Prolapse , Highlights Ophthal 3:272-277 (No. (4) ) 1959. 4. Castroviejo, R.: Handling of Eye With Vitreous Prolapse , Amer J Ophthal 48:397-399 ( (July) ) 1959. 5. Sanders, N.: New Treatment for Bullous Keratopathy: Penetrating Grafts and Radical Anterior Vitrectomy , Highlights Ophthal 11:296-303, 1968 series (published in July 1969).

Anderson, Douglas R.;Spencer, William H.

doi: 10.1001/archopht.1970.00990030326010pmid: 4244460

Abstract Colloidal iron stains showed that many optic nerve gliomas contain mucoid material. This material is extracellular, as demonstrated especially by electron microscopy of two gliomas. In one glioma it was particularly abundant and it apparently contributed to a sudden increase of proptosis due to rapid enlargement of the tumor. There was no evidence of necrosis or degeneration in these tumors, by light or by electron microscopy, and the accumulation of mucosubstance is not considered to be a degenerative change. The tumor cells were mainly astrocytes. These had certain embryonic ultrastructural features, but did not exhibit malignant alteration. References 1. Reynolds EW: The use of lead citrate at high pH as an electron-opaque stain in electron microscopy . J Cell Biol 17:208-212, 1963.Crossref 2. Anderson DR, Hoyt WF, Hogan MJ: The fine structure of the astroglia in the human optic nerve and optic nerve head . Trans Amer Ophthal Soc 65:275-305, 1967. 3. Anderson DR, Hoyt WF: Ultrastructure of intraorbital portion of human and monkey optic nerve . Arch Ophthal 82:506-530, 1969.Crossref 4. Vaughn JE, Peters A: Electron microscopy of the early postnatal development of fibrous astrocytes . Amer J Anat 121:131-151, 1967.Crossref 5. Peters A, Vaughn JE: Microtubules and filaments in the axons and astrocytes of early postnatal rat optic nerves . J Cell Biol 32:113-119, 1967.Crossref 6. Smith KR Jr, Schwartz HG, Luse SA, et al: Nasal gliomas: A report of five cases with electron microscopy of one . J Neurosurg 20:968-982, 1963.Crossref 7. Anderson DR: Ultrastructure of xanthelasma . Arch Ophthal 81:692-694, 1969.Crossref 8. Saunders AM, Rosan RC: Histochemical nomenclature of carbohydrate-rich components . J Histochem Cytochem 14:869, 1966.Crossref 9. Kuhn C III: Cytochemistry of pulmonary alveolar epithelial cells . Amer J Path 53:809-833, 1968. 10. White A, Handler P, Smith EL: Principles of Biochemistry , ed 4. New York, McGraw-Hill Co, 1968. 11. Spicer SS, Leppi TJ, Stoward PJ: Suggestions for a histochemical terminology of carbohydrate-rich tissue components . J Histochem Cytochem 13:599-603, 1965.Crossref 12. Verhoeff FH: Primary intraneural tumors (gliomas) of the optic nerve . Arch Ophthal 51( (pt 2) ):120-140 13. (pt 3)239-254, 1922. 14. Russell DS, Rubinstein LJ: Pathology of Tumors of the Nervous System. London, Edward Arnold, 1959, p 318. 15. Hudson AC: Primary tumors of the optic nerve . Roy London Ophthal Hosp Rev 18:317-439, 1912. 16. Hogan MJ, Zimmerman LE: Ophthalmic Pathology . Philadelphia, WB Saunders Co, 1962. 17. Arseni C, Carp N, Mestes E, et al: Histochemistry of mucopolysaccharides in brain tumors . Acta Neuropath 7:275-284, 1967.Crossref 18. Duffell D, Farber L, Chou S, et al: Electron microscopic observations on astrocytomas . Amer J Path 43:539-554, 1963. 19. Luse SA: An electron microscopic study of normal optic nerve and of optic nerve glioma . J Neurosurg 18:466-478, 1961.Crossref 20. Luse SA: Electron microscopic studies of brain tumors . Neurology 10:881-905, 1960.Crossref 21. Raimondi AJ, Mullan S, Evans, JP: Human brain tumors: An electron microscopic study . J Neurosurg 19:731-753, 1962.Crossref 22. Raimondi AJ: Correlation of structure and function in selected tumors of the human nervous system . Acta Neuropath 8:149-162, 1967.Crossref 23. Sawada T: Fine structure of gliomas . Acta Med 37:47-76, 1967. 24. Wetzel MG, Wetzel BK, Spicer SS: Ultrastructural localization of acid mucosubstances in the mouse colon with iron-containing stains . J Cell Biol 30:299-315, 1966.Crossref 25. Berlin JD: The localization of acid mucopolysaccharides in the Golgi complex of intestinal goblet cells . J Cell Biol 32:760-766, 1967.Crossref 26. Torack RM: Ultrastructure of capillary reaction to brain tumors . Arch Neurol 5:416-428, 1961.Crossref 27. Schlote W: Beitrag zum Vorkommen und zu Veränderungen an intracytoplasmatischen Filamenten in Gliomen . Acta Neuropath 8:108-112, 1967.Crossref 28. Grinker RR: Tumors of the optic nerve . Arch Ophthal 4:497-508, 1930.Crossref 29. Wolter JR, McKenney MJ: Collateral hyperplasia and cyst formation of orbital leptomeninx secondary to optic nerve glioma . Amer J Ophthal 57:1037-1042, 1964. 30. Duke-Elder WS: Textbook of Ophthalmology . St. Louis, CV Mosby Co, 1941, p 3085. 31. Davis FA: Primary tumors of the optic nerve (a phenomenon of Recklinghausen's disease): A clinical and pathological study with a report of five cases and a review of the literature . Arch Ophthal 23( (pt4) ):735-821Crossref 32. (pt 5)957-1022, 1940. 33. Marshall D: Glioma of the optic nerve as a manifestation of von Recklinghausen's disease . Trans Amer Ophthal Soc 51:117-155, 1953. 34. Verhoeff FH: Tumors of the optic nerve , in Penfield W (ed): Cytology and Cellular Pathology of the Nervous System . New York, Paul B Hoeber Inc, 1932, vol 3, pp 1029-1039. 35. Tym R: Piloid gliomas of the anterior optic pathways . Brit J Surg 49(No. (215) ):322-331, 1961.Crossref