Roentgen Diagnosis vs Visual FieldHuber, Alfred
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050003001pmid: 4714793
Abstract This paper is an attempt to establish a relationship between visual field defects, ie, unilateral (orbit), bitemporal (chiasm), homonymous hemianopic (retrochiasmatic visual pathway), and the results of roentgenologic examination consisting of plain methods on the one hand and of the contrast medium techniques on the other. The conclusion is that roentgenologic diagnosis has become an indispensable tool not only for localizing a lesion of the visual pathway but also for determining its nature and extension. References 1. Schinz HR et al: Roentgendiagnosis . New York, Grune & Stratton, Inc, 1969, vol 3. 2. Ziedses des Plantes BG: Subtraktion . Stuttgart, Thieme, 1961. 3. Krayenbühl H, Yasargil G: Die zerebrale Angiographie . Stuttgart, Thieme, 1965. 4. Yasargil G: Die Röntgendiagnostik des Exophthalmus unilateralis . Ophthalmologica, Bibl Ophthalmol , pt (50) , 1957. 5. Krayenbühl H: The value of orbital angiography for diagnosis of unilateral expohthalmos . J Neurosurg 19:289-301, 1962.Crossref 6. Lombardi G: Radiology in Neuro-ophthalmology . Baltimore, Williams & Wilkins Co, 1967. 7. Guillot P, Sarraux H, Sedan R: L'exploration neuroradiologique en ophthalmologie . Paris, Masson, 1966. 8. Rheese H: Die chronische Entzündung der Siebbeinzellen und der Keilbeinhöhle mit besonderer Berücksichtigung ihrer Beziehungen zur allgemeinen Medizin und ihrer Diagnostik durch das Röntengverfaheren . Arch Laryngol Rhin 24:383-448, 1911. 9. Hartmann E, Gilles E: Radiodiagnostic en ophtalmologie . Paris, Masson, 1955. 10. Huber A: Arteriography and phlebography in the diagnosis of orbital affections . Bull NY Acad Med 44:409-430, 1968. 11. Huber A: Eye Symptoms in Brain Tumors . St. Louis, CV Mosby Co, 1971. 12. Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology . Baltimore, Williams & Wilkins Co, 1969. 13. Hoyt WF, Margolis TH: Arterial supply of the striate cortex: Angiographic changes with occlusions of the posterior cerebral artery . Acta XXI Concilium Ophthalmol , 1970, pp 1323-1332.
Monitoring Corneal CryopreservationKeates, Richard H.
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050015002pmid: 4577007
Abstract A cryoindicator system has been developed which detects deleterious temperature changes in the low temperature (—196 C) preservation of human corneas. References 1. Capella JA, Kaufman HE, Robbins JE: Preservation of viable corneal tissue . Arch Ophthalmol 74:669-673, 1965.Crossref 2. Mueller FO, O'Neill P, Trevor-Roper PD: Full-thickness corneal grafts in Addis Ababa, Ethiopia . Br J Ophthalmol 51:227-246, 1967.Crossref 3. Polack FM: Cryopreservation of corneas for penetrating keratoplasty . Am J Ophthalmol 71: 505-516, 1971. 4. O'Neill P, Mueller FO, Trevor-Roper PD: On the preservation of corneae at—196° C for full-thickness homografts in man and dog . Brit J Ophthalmol 51:13-30, 1967.Crossref
Inferior Oblique Weakening Procedures: Effect on Primary Position Horizontal AlignmentStager, David R.;Parks, Marshall M.
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050017003pmid: 4714791
Abstract Fifty patients who only had bilateral inferior oblique weakening procedures were retrospectively analyzed to determine the third month postoperative horizontal alignment change produced in the primary position. No significant horizontal change occurred in 84% of the patients and, in those who manifested a change, it was never greater than 8Δ. Six percent manifested an esophoria shift of more than 3Δ and 10% had an exophoria shift of more than 3Δ. It was concluded that the surgeon should not fear producing a postoperative esotropia by weakening the inferior oblique muscles in patients who preoperatively have straight eyes in the primary position. References 1. Duane A: A new classification of the motor anomalies of the eye . Ann Ophthalmol 5:969-1008, 1896. 2. Duane A: The basic principles of diagnosis in motor anomalies of the eye . Arch Ophthalmol 48:1-18, 1919. 3. Duane A: Anomalies of the ocular muscles: Symptoms and diagnosis, evidences of paralysis and spasm . Arch Ophthalmol 11:394-422, 1934.Crossref 4. Jampolsky A: The A and V syndromes , in Strabismus Symposium of the New Orleans Academy of Ophthalmology . St. Louis, CV Mosby Co, 1962, pp 157-177. 5. Jampolsky A: Oblique muscle surgery of the A-V patterns . J Pediatr Ophthalmol 2:31, 1965. 6. Jampolsky A: Vertical strabismus surgery , in Strabismus symposium: Transactions of the New Orleans Academy of Ophthalmology . St. Louis, CV Mosby Co, 1971, 366-385. 7. Bietti GF, Bagolini B: Problems related to surgical overcorrection in strabismus surgery . J Pediatr Ophthalmol 2:11-14, 1965. 8. Parks MM: Concomitant exodeviations in children. Strabismus Symposium of the New Orleans Academy of Ophthalmology . St. Louis, CV Mosby Co, 1962, pp 45-55. 9. Khawam E, Scott AB, Jampolsky A: Acquired superior oblique palsy: Diagnosis and management . Arch Ophthalmol 77:761-768, 1967.Crossref 10. Costenbader F: Surgery of strabismus . Int Ophthalmol Clin 2:939-1028, 1962.Crossref 11. Costenbader F: The role of the oblique muscles in the A and V syndrome . J Pediatr Ophthalmol 2:25-30, 1965. 12. Dyer JA: Should I operate on one eye or both eyes , in Strabismus symposium: Transactions of the New Orleans Academy of Ophthalmology . St. Louis, CV Mosby Co, 1971, pp 160-193. 13. Nolon J: Surgical aspects of combined horizontal and vertical strabismus , in Strabismus . St. Louis, CV Mosby Co, 1969. 14. Parks MM: A study of the weakening surgical procedures for eliminating overaction of the inferior oblique . Trans Am Ophthalmol Soc 69:163-187, 1971. 15. Jampel RS: The fundamental principle of the action of the oblique ocular muscles . Am J Ophthalmol 69:623-638, 1970. 16. Knapp P: Surgical treatment of strabismus , Allen JH (ed): Strabismus Symposium 11 . St. Louis, CV Mosby Co, 1958, pp 377-390. 17. Fink WH: Surgery of the Oblique Muscles of the Eye . St. Louis, CV Mosby Co, 1951, p 293. 18. White J, Brown HW: Occurrence of vertical anomalies with convergent and divergent anomalies: A clinical study . Arch Ophthalmol 21:999-1009, 1939.Crossref
Radioactive Phosphorus for the Detection of Ocular Melanomas: A Critical EvaluationPacker, Samuel;Lange, Robert
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050019004pmid: 4714792
Abstract The concentration of radioactive phosphorus (32P) in several malignant melanomas of the choroid, as well as in adjacent normal ocular tissues in the same eyes, was determined. A polymerized methyl methacrylate phantom was designed so as to determine the minimum tumor size that could be detected with an ocular probe. Finally, the importance of tissue penetration was defined. The concentration of radioactive phosphorus in choroidal melanoma averaged 0.020 microcurie/gm. With the detecting probe 2 mm away from the tumor, the minimum detectable tumor size had a 10 mm diameter and a 5 mm thickness. This was at the concentration actually found in choroidal melanomas. The use of radioactive phosphorus in ophthalmology has been very limited and used only if the detecting device can be placed within 2 mm of the suspected tumor. References 1. Erf LA, Lawrence JH: Phosphorus metabolism in neoplastic tissue . Proc Soc Exp Biol Med 46:694-695, 1941.Crossref 2. Kenny JM, Marinelli LD, Woodard HQ: Tracer studies with radioactive phosphorus in malignant neoplastic disease . Radiology 37:683-687, 1941.Crossref 3. Dunphy EB, Selverstone B: Distribution of radioactive phosphorus in ocular tissues . Am J Ophthalmol 34:1603, 1951. 4. Thomas CI, Krohmer JS, Storaasli JP: Detection of intraocular tumors with radioactive phosphorus: A preliminary report with special reference to differentiation of the cause of retinal separation . Arch Ophthalmol 47:276-286, 1952.Crossref 5. Beierwaltes WH, Knorpp CT: Lack of selective uptake of radioactive iodine, phosphorus and copper by melanomas in mouse and man . J Lab Clin Med 38:786-787, 1951. 6. Snodgrass MB, Lenihan J, Primrose DA: Radioactive phosphorus as an aid to the diagnosis of malignant melanoma of the eye . Br J Ophthalmol 38:553-559, 1954.Crossref 7. Bettman JW, Fellows V: Radioactive phosphorus as a diagnostic aid in ophthalmology . Arch Ophthalmol 51:171-179, 1954.Crossref 8. Dunphy EB, Dowling JR, Scott A: Experience with radioactive phosphorus in tumor detection . Trans Am Ophthalmol Soc 54:289-305, 1956. 9. O'Rourke JF, Patton H, Bradley R: Fundamental limitations of radiophosphorus counting methods used for detection of intraocular neoplasm . Arch Ophthalmol 57:730-738, 1957.Crossref 10. Terner IS, Leopold IH, Eisenberg IJ: The radioactive phosphorus (P32) uptake test in ophthalmology: A review of the literature and analysis of results in 262 cases . Arch Ophthalmol 55:52-83, 1956.Crossref 11. Newell FW, et al: The use of iodine-125 as a diagnostic agent in ophthalmology . Trans Am Acad Ophthalmol Otolaryngol 67:177-184, 1963. 12. Hagler WS, Jarrett WH, Humphrey WT: Radioactive phosphorus uptake test in diagnosis of uveal melanoma . Arch Ophthalmol 83:548-557, 1970.Crossref 13. Larose JH: Semiconductor detectors for eye-tumor diagnosis , in Hoffer PB, Beck RN, Gottschalk A (eds): The Role of Semiconductor Detectors in The Future of Nuclear Medicine . New York, Society of Nuclear Medicine Inc, 1971. 14. Marinelli LD, Goldschmidt B: Concentration of 32P in some superficial tissues of living patients . Radiology 39:454-463, 1942.Crossref 15. Marcus R, Rotblat J: The application of radioactive isotopes in a case of multiple melanomata . Br J Radiol 23:541-549, 1950.Crossref 16. Walsh TJ, Packer S: Radioisotope detection of ocular melanomas . N Engl J Med 284: 317-318, 1971.Crossref 17. Mackley TA, Teed RW: Unsuspected intraocular malignant melanomas . Arch Ophthalmol 60:475-478, 1958.Crossref
Unilateral Retinitis PigmentosaCarr, Ronald E.;Siegel, Irwin M.
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050023005pmid: 4714794
Abstract Seven cases of unilateral retinal pigmentary degeneration are presented including five of unknown cause and two which developed following ophthalmic artery occlusion. Ophthalmoscopic and functional findings were similar in all of these patients, strongly suggesting a vascular cause for this disease. References 1. Biro I: Symmetrical development of pigmentation as a specific feature of fundus pattern in retinitis pigmentosa . Am J Ophthalmol 55: 1176-1179, 1963. 2. Pedraglia: Retinitis pigmentosa . Klin Monatsbl Augenheilkd 3:114-117, 1865. 3. Deutschmann R: Einsetige typische retinitis pigmentosa mit pathologisch anatomischen befund . Beitr Augenheilkd 1:69, 1891. 4. François J, Verriest G: Retinopathie pigmentaire unilaterale . Ophthalmologica 124:65-87, 1952.Crossref 5. Gunkel RD, Bornschein H: Automatic intensity control in testing dark adaptation . Arch Ophthalmol 57:681-686, 1957.Crossref 6. Gouras P, Carr RE: Electrophysiological studies in early retinitis pigmentosa . Arch Ophthalmol 72:104-110, 1964.Crossref 7. François J: Heredity in Ophthalmology , St. Louis, CV Mosby Co, 1961, p 455. 8. Landolt E: Zur einseitigen retinitis pigmentosa . Ophthalmologica 137:155-159, 1959.Crossref 9. Kolb H, Galloway N: Three cases of unilateral pigmentary degeneration . Br J Ophthalmol 48:471-479, 1964.Crossref 10. Henkes H: Does unilateral retinitis pigmentosa really exist? in Burian HM, Jacobson JH (eds): Clinical Electroretinography Proceedings of the Third International Symposium . New York, Pergamon Press Inc, 1966, pp 327-350. 11. Auerbach E, Rowe H: The "good" eye in unilateral retinitis pigmentosa . Ophthalmologica 115:98-116, 1968.Crossref 12. Sverak J, Peregrin J, Velicky J: Unilateral pigmentary degeneration . Acta Ophthalmol 46:1256-1262, 1968.Crossref 13. Arden GB, Fojas MR: Electrophysiological abnormalities in pigmentary degeneration of the retina: Assessment of value and basis . Arch Ophthalmol 68:369-389, 1962.Crossref 14. Dieterle P, Avanza C: Studio clinico electroretinografico e genetico della retinite pigmentosa unilaterle . Soc Optal Ital. Atti del XLIV Cong 18:267-276, 1960. 15. Duke-Elder S: Textbook of Ophthalmology. St. Louis, CV Mosby Co, 1967, vol 10, pp 530-532. 16. Smith JL, et al: Seronegative ocular and neurosyphilis . Am J Ophthalmol 59:753-762, 1965. 17. Bjork A, Karpe G: The clinical electroretinogram: The electroretinogram in retinitis pigmentosa . Acta Ophthalmol 29:361-371, 1951.Crossref 18. Weiss JF, Nicholl RJ: Nonsyphilitic unilateral retinitis pigmentosa . Am J Ophthalmol 65:573-574, 1968. 19. Lauring L: Chromosomal mosaicism and unilateral retinitis pigmentosa . J Ped Ophthalmol 7:33-36, 1970. 20. Shoji Y: Retinite pigmentaire congenitale unilaterale non syphilitique . Arch Ophtalmol 43:402-407, 1926. 21. Wagenmann A: Experimentell Untersuchungen ueber den Einfluss der Circulation in den Netzhaut und Aderhautgefassen auf die Ernahring des Auges, insbesondere der Retina, und ueber die Folgen der Sehnervendurchschneidung . Arch Ophthalmol 36:1-30, 1890. 22. Nicholls J: The effect of section of the posterior ciliary arteries in the rabbit . Br J Ophthalmol 22:672-687, 1938.Crossref 23. Hollenhorst RW, Svien HJ, Benoit CF: Unilateral blindness occurring during anesthesia for neurosurgical operations . Arch Ophthalmol 52:819-830, 1954.Crossref 24. Moro F, Crepaldi A: Retinopatia pigmentosa monolaterale . Ann Ottalmol Clin Ocul 91: 798-814, 1965. 25. Maeder G, Muller P: La Retinite pigmentaire unilaterale . Ann Ocul 183:771-777, 1950. 26. Kandori F, et al: Unilateral pigmentary degeneration of the retina . Am J Ophthalmol 66: 1091-1101, 1968. 27. Cogan D: Primary chorioretinal aberrations with nightblindness . Trans Am Ophthalmol Otol 54:629-661, 1950. 28. Carr R, Siegel I: Electrophysiologic aspects of several retinal diseases . Am J Ophthalmol 58:95-107, 1964. 29. Gouras P, Carr RE: Light induced DC responses on monkey retina before and after central retinal artery interruption . Invest Ophthalmol 4:310-317, 1965.
Neodymium Laser CyclocoagulationBeckman, Hugh;Sugar, H. Saul
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050029006pmid: 4736646
Abstract Nineteen neodymium laser cyclocoagulations were performed on 18 glaucomatous eyes. Thirteen eyes can be considered successfully treated if a criterion of an intraocular pressure of 30 mm Hg or less is used. All 18 eyes are now pain-free. Neodymium cyclocoagulation seems as effective as ruby cyclocoagulation in blue and brown eyes, and may possibly be more effective in dark-brown eyes. The intraocular pressure lowering effect of neodymium cyclocoagulation may be slightly greater than that of ruby cyclocoagulation. To date, no serious complications of this procedure have been found. References 1. Beckman H et al: Transscleral ruby laser irradiation of the ciliary body in the treatment of intractable glaucoma . Trans Am Acad Ophthalmol Otolaryngol 76:423-436, 1972. 2. Beckman H et al: Laser iridectomies . Am J Ophthalmol 72:393-402, 1971. 3. Bietti G: Recent experimental, clinical and therapeutic research on the problems of intraocular pressure and glaucoma . Am J Ophthalmol 73:475-500, 1972.
B-Scan Ultrasonography in Diagnosis and Management of Retinal DetachmentsColeman, D. Jackson;Jack, Robert L.
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050031007pmid: 4740332
Abstract B-scan ultrasonography in eyes with clouding or opacity of the ocular media uniquely indicates the presence of retinal and vitreous disease, and in eyes with clear media provides supplemental information to that obtained by optical methods. The present ultrasonographic study is based on evaluation of 160 patients with retinal detachments of all types. Forty detachments in this group were nonrhegmatogenous, including 25 detachments secondary to ocular tumors. B-scan ultrasonography graphically indicates the location and extent of retinal detachments, and reliably differentiates rhegmatogenous retinal detachments from detachments secondary to solid tumors. The uses of B-scan ultrasonography in the diagnosis and the preoperative and postoperative management of retinal detachments are outlined. References 1. Oksala A, Lehtinen A: Diagnostics of detachment of the retina by means of ultrasound . Acta Ophthalmol 35:461-467, 1957.Crossref 2. Goldberg RE, Sarin LK: Experiences in ultrasonography: I. The posterior segment . Am J Ophthalmol 61:1497-1502, 1966. 3. Offret G, Rousselie F: Diagnosis and surveillance of retinal detachment by means of time-amplitude ultrasonography , in Gitter K, et al (eds): Ophthalmic Ultrasound . St Louis, CV Mosby Co, 1969, pp 260-268. 4. Baum G, Greenwood I: A critique of time amplitude ultrasonography . Arch Ophthalmol 65:353-365, 1961.Crossref 5. Baum G: Problems in ultrasonographic diagnosis of retinal disease . Am J Ophthalmol 71:723-739, 1971. 6. Purnell E: Intensity-modulated (B-scan) ultrasonography , in Goldberg R, Sarin LK (eds): Ultrasonics in Ophthalmology . Philadelphia, WB Saunders, 1967, pp 102-123. 7. Coleman DJ, Konig WF, Katz L: A hand-operated ultrasound scan system for ophthalmic evaluation . Am J Ophthalmol 68 ( (pt 2) ):256-263, 1969. 8. Coleman DJ: Reliability of ocular and orbital diagnosis with B-scan ultrasound: I. Ocular diagnosis . Am J Ophthalmol 73:501-516, 1972. 9. Coleman DJ: Ultrasound in vitreous surgery . Trans Am Acad Ophthalmol Otolaryngol 76:467-479, 1972. 10. Coleman DJ, Carrol FD: Evaluation of optic neuropathy with B-scan ultrasonography . Am J Ophthalmol 74:915-920, 1972. 11. Coleman DJ, et al: High resolution B-scan ultrasonography of the orbit: VI. Pseudotumors of the orbit . Arch Ophthalmol 88:472-480, 1972.Crossref
Argon Laser Photocoagulation of Proliferative Sickle RetinopathyGoldberg, Morton F.;Acacio, Irineo
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050037008pmid: 4736647
Abstract Retinal neovascular proliferations in 21 eyes of patients with sickling disorders were treated by argon laser photocoagulation. Nineteen eyes (90.5%) were free of perfused neovascular tissue at the time of follow-up, and 73 of 75 discrete neovascular patches (97%) were obliterated or non-perfused. The most effective technique of photocoagulation involved closure of feeder arterioles as they entered the neovascular patches. Vitreous hemorrhage occurred immediately or within the first week after photocoagulation in 14% of treatment sessions. All hemorrhages were minimal in amount and apparently inconsequential. Only one eye had a late, spontaneous vitreous hemorrhage. Induced field defects were clinically insignificant. Evidence suggests that argon laser photocoagulation is an effective treatment for proliferative sickle retinopathy. Whether or not it is more effective and less dangerous than xenon arc photocoagulation requires further evaluation. References 1. L'Esperance FA Jr: An ophthalmic argon laser photocoagulation system: Design, construction, and laboratory investigations . Trans Am Ophthalmol Soc 66:827-904, 1968. 2. L'Esperance FA Jr: The treatment of ophthalmic vascular disease by argon laser photocoagulation . Trans Am Acad Ophthalmol Otolaryngol 73:1077-1096, 1969. 3. Peabody RR, Zweng HC, Little HL: Treatment of retinal vascular disease with argon laser slit lamp photocoagulation . Trans Pac Coast OtoOphthalmol Soc 51:307 -326, 1970. 4. Little HL, Zweng HC, Peabody RR: Argon laser slit-lamp retinal photocoagulation . Trans Am Acad Ophthalmol Otolaryngol 74:85-97, 1970. 5. Patz A: A guide to argon laser photocoagulation . Survey Ophthalmol 16:249-257, 1972. 6. Patz A, Maumenee AE, Ryan SJ: Argon laser photocoagulation: Advantages and limitations . Trans Am Acad Ophthalmol Otolaryngol 75:569-579, 1971. 7. Pomerantzeff O et al: Clinical importance of wavelengths in photocoagulation . Trans Am Acad Ophthalmol Otolaryngol 75:557-568, 1971. 8. Goldberg MF: Classification and pathogenesis of proliferative sickle retinopathy . Am J Ophthalmol 71:649-665, 1971. 9. Goldberg MF: Natural history of untreated proliferative sickle retinopathy . Arch Ophthalmol 85:428-437, 1971.Crossref 10. Goldberg MF: Treatment of proliferative sickle retinopathy . Trans Am Acad Ophthalmol Otolaryngol 75:532-556, 1971. 11. Goldberg MF, Charache S, Acacio I: Ophthalmologic manifestations of sickle cell thalassemia . Arch Intern Med 128:33-39, 1971.Crossref 12. Okun E: Development of sickle cell retinopathy . Doc Ophthalmol 26:574-587, 1969.Crossref 13. Welch RB, Goldberg MF: Sickle-cell hemoglobin and its relation to fundus abnormality . Arch Ophthalmol 75:353-362, 1966.Crossref 14. Goldberg MF: Retinal detachment associated with proliferative retinopathies . Ophthalmol Surg 2:222-231, 1971. 15. Ryan SJ, Goldberg MF: Anterior segment ischemia following scleral buckling in sickle cell hemoglobinopathy . Am J Ophthalmol 72:35-50, 1971. 16. Archer D, Krill AE, Newell FW: Fluorescein angiographic evaluation of the effects of photocoagulation in three retinal vascular diseases . Trans Ophthalmol Soc UK 90:677-699, 1970. 17. Goldberg MF, Herbst RW: Acute complications of argon laser photocoagulation: Epipapillary and peripapillary neovascularization . Arch Ophthalmol 89:311-318, 1973.Crossref 18. Fankhauser F: Optischer Zusatz zum Lichtkoagulator von Zeiss-Oberkochen fur das Arbeiten mit dem Spiegelkontaktglas von Goldmann . Klin Monatsbl Augenheilkd 160:218-220, 1972. 19. Marshall J et al: Pathology of short pulse retinal photocoagulations using the Goldmann contact lens . Graefe Arch Ophthalmol 182:154-169, 1971.Crossref 20. Apple D, Goldberg MF, Wyhinny G: Histopathology and ultrastructure of the argon laser lesion in human retinal and choroidal vasculature. Read before the Wilmer Residents' Meeting, Baltimore, 1972; and the Association for Research in Vision and Ophthalmology Meeting, Sarasota, Fla, 1972.
Granulomatous Choroiditis in a Case of Disseminated Histoplasmosis: Histologic Demonstration of Histoplasma capsulatum in Choroidal LesionsKlintworth, Gordon K.;Hollingsworth, Albert S.;Lusman, Paul A.;Bradford, William D.
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050047009pmid: 4714795
Abstract The identification of Histoplasma capsulatum in choroidal lesions of a fatal human case of disseminated histoplasmosis is described. Aside from granulomatous chorioretinitis, this patient had Addison's disease with bilateral adrenal calcification secondary to histoplasmosis of the adrenal glands and a cell-mediated immune deficiency. The fungus was isolated from bone marrow, skin, lymph nodes, and the cerebrospinal fluid during life and from the brain postmortem. The organisms observed within the choroid were identical to those in other tissues from which H capsulatum was isolated. The presence of H capsulatum in a granulomatous choroiditis fills a void in our knowledge about ocular histoplasmosis. References 1. Ajello L, Chick EW, Furcolow ML (eds): Histoplasmosis: Proceedings of the Second National Conference . Springfield, Ill, Charles C Thomas Publisher, 1971. 2. Fetter BF, Klintworth GK, Hendry WS: Mycoses of the Central Nervous System . Baltimore, Williams & Wilkins Co, 1967. 3. Schwartz J: Histoplasmosis , in Baker RD, et al: Human Infectious With Fungi, Actinomycetes and Algae . New York, Springer-Verlag, 1971, chap 4. 4. Reid JD, et al: Systemic histoplasmosis diagnosed before death and produced experimentally in guinea pigs . J Lab Clin Med 27:419-434, 1942. 5. Spaeth GL: Absence of so-called Histoplasma uveitis in 134 cases of proven histoplasmosis . Arch Ophthalmol 77:41-44, 1967.Crossref 6. Hoefnagels KLJ, Pijers PM: Histoplasma capsulatum in a human eye . Am J Ophthalmol 63:715-723, 1967. 7. Day R: Experimental ocular histoplasmosis . Am J Ophthalmol 32:1317-1330, 1949. 8. Woods AC, Wahlen HE: The probable role of benign histoplasmosis in the etiology of granulomatous uveitis . Am J Ophthalmol 49:205-220, 1960. 9. Krause AC, Hopkins WG: Ocular manifestations of histoplasmosis . Am J Ophthalmol 34:564-566, 1951 10. Gass JDM, Wilkinson CP: Follow-up study of presumed ocular histoplasmosis . Trans Am Acad Ophthalmol Otolaryngol 76:672-693, 1972. 11. Krill AE, et al: Multifocal inner choroiditis . Trans Am Acad Ophthalmol Otolaryngol 73:222-245, 1969. 12. Giles CL, Falls HF: Further evaluation of amphotericin-B therapy in presumptive histoplasmosis chorioretinitis . Am J Ophthalmol 51:588-598, 1961. 13. Schlaegel TF Jr, Weber JC: Follow-up study of presumed histoplasmic choroiditis . Am J Ophthalmol 71:1192-1195, 1971. 14. Van Metre TE Jr, Maumenee AE: Specific ocular lesions in patients with evidence of histoplasmosis . Arch Ophthalmol 71:314-324, 1964.Crossref 15. Cooper RA Jr, Goldstein E: Histoplasmosis of the central nervous system . Am J Med 35:45-57, 1963.Crossref 16. Rubin H, et al: The course and prognosis of histoplasmosis . Am J Med 27:278-288, 1959.Crossref
Atheromatous Plaques of the Retinal Blood Vessels: Histologic Confirmation of Ophthalmoscopically Visible LesionsBrownstein, Seymour;Font, Ramon L.;Alper, Melvin G.
1973 Archives of Ophthalmology
doi: 10.1001/archopht.1973.01000050051010pmid: 4714796
Abstract Ophthalmoscopic examination of the left eye revealed numerous yellowish-white plaques involving the major branches of the central retinal artery in a 55-year-old man. Significant laboratory examinations demonstrated hyperlipidemia with hypercholesterolemia. A diagnosis of occlusive vascular disease of the left retina caused by atherosclerotic plaques was made. The patient was treated with heparin and clofibrate, with no significant change in ophthalmoscopic appearance of the plaques or in the lipid values in his blood. After sudden death 15 months later, both eyes were obtained. Gross examination of the left eye disclosed numerous yellowishwhite plaques in retinal arteries, corresponding exactly to those previously observed ophthalmoscopically. Two plaques demonstrated that they represented multiple atheromas of retinal vessels. References 1. Duke-Elder S, Dobree JH: System of Ophthalmology . St. Louis, CV Mosby Co Publishers, 1967, vol 10, pp 304-313. 2. Bloodworth JMB Jr: Diabetic retinopathy . Diabetes 11:1-22, 1962. 3. Bloom W, Fawcett DW: A Textbook of Histology . Philadelphia, WB Saunders Co, 1968, pp 366-368. 4. Hogan MJ, Feeney L: The ultrastructure of retinal blood vessels . J Ultrastruct Res 9:10-46, 1963.Crossref 5. Boyd W: A Textbook of Pathology . Philadelphia, Lea & Febiger, 1970, pp 575-591. 6. Hogan MJ, Zimmerman LE: Ophthalmic Pathology: An Atlas and Textbook , ed 2. Philadelphia, WB Saunders Co, 1962, pp 64-70. 7. Physicians' Desk Reference . Oradell, NJ, Medical Economics Inc, 1968, p 551. 8. Rabinowicz IM, Litman S, Michaelson IC: Branch venous thrombosis: A pathological report . Trans Ophthalmol Soc UK 88:171-210, 1969. 9. Friedenwald JS: Disease processes versus disease pictures in the interpretation of retinal vascular lesions . Arch Ophthalmol 37:403-427, 1947.Crossref 10. Penner R, Font RL: Retinal embolism from calcified vegetations of aortic valve . Arch Ophthalmol 81:565-568, 1969.Crossref 11. Zimmerman LE: Embolism of central retinal artery . Arch Ophthalmol 73:822-826, 1965.Crossref 12. Galin MA, Harris L: The ocular pulse in carotid cavernous sinus fistula . Am J Ophthalmol 61:1472-1479, 1966. 13. Knox DL: Ocular aspects of cervical vascular disease . Survey Ophthalmol 13:245-262, 1969. 14. Hollenhorst RW: Significance of bright plaques in the retinal arterioles . Trans Am Ophthalmol Soc 59:252-273, 1961. 15. Ball CJ: Atheromatous embolism to the brain, retina, and choroid . Arch Ophthalmol 76: 690-695, 1966.Crossref 16. Cogan DG, Kuwabara T, Moser H: Fat emboli in the retina following angiography . Arch Ophthalmol 71:308-313, 1964.Crossref 17. David NJ, et al: Fatal atheromatous cerebral embolism associated with bright plaques in the retinal arterioles . Neurology 13:708-713, 1963.Crossref 18. Dark AJ, Rizk SN: Progressive focal sclerosis of retinal arteries: A sequel to impaction of cholesterol emboli . Br Med J 1:270-273, 1967.Crossref