Reversible tonic pupils.

A 36-year-old man with a remote history of Hodgkin lymphoma and a recent history of non-Hodgkin lymphoma (NHL) developed tonic pupils and absent deep tendon reflexes in the lower extremities. One year later, pupils were normal except for slight iris segmental contraction to light. Over the next 2 years, the patient remained asymptomatic, and pupils remained unchanged.

Axonal neuropathy with optic atrophy is caused by mutations in mitofusin 2.

Objective: Charcot-Marie-Tooth (CMT) neuropathy with visual impairment due to optic atrophy has been designated as hereditary motor and sensory neuropathy type VI (HMSN VI). Reports of affected families have indicated autosomal dominant and recessive forms, but the genetic cause of this disease has remained elusive.

Methods: Here, we describe six HMSN VI families with a subacute onset of optic atrophy and subsequent slow recovery of visual acuity in 60% of the patients.

Two amino-acid substitutions in the myelin protein zero gene of a case of Charcot-Marie-Tooth disease associated with light-near dissociation.

Charcot-Marie-Tooth disease caused by mutations of the myelin protein zero gene demonstrates considerable phenotypical variability. We describe a 45-year-old female with a peripheral neuropathy with demyelinating and axonal features, pes cavus and pupillary light-near dissociation. She was heterozygous for two mutations in the myelin protein zero gene (His81Tyr and Val113Phe), both present on the same allele.

Design of low cost glaucoma screening.

In 1991 the Netherlands Glaucoma Patient Association organized a glaucoma screening survey. This survey was designed to evaluate the effectiveness of a low cost screening setting. During a screening period of 8 days, 1259 subjects over the age of 49 years were examined by a team of non-ophthalmologically trained students.

Retinal nerve fiber layer assessment by scanning laser polarimetry and standardized photography.

Purpose: To determine whether, in a clinical setting, scanning laser polarimetry and retinal nerve fiber layer photography provide equivalent information on the retinal nerve fiber layer.

Methods: We prospectively studied 60 patients with glaucoma or ocular hypertension and 24 healthy subjects. With scanning laser polarimetry, an estimate of the cross section of the retinal nerve fiber layer was obtained.

Grading of retinal nerve fiber layer with a photographic reference set.

Purpose: We developed a new quantitative approach for the evaluation of diffuse atrophy of the retinal nerve fiber layer.

Methods: A simultaneous, visually supported grading system was designed, which consisted of a set of 25 reference photographs, numbered from 25 (broad, clearly striated nerve fiber bundles) to 1 (no nerve fibers visible). We prospectively evaluated this method by matching 60 retinal nerve fiber layer photographs of patients with glaucoma or ocular hypertension and normal subjects to the reference photographs twice by three observers with varying experience levels in evaluating retinal nerve fiber layer

Results: Intraobserver and interobserver reliability, evaluated by the intraclass correlation coefficient statistics, was excellent (intraclass correlation coefficient > 0.

Treatment of hypotonous maculopathy after trabeculectomy with mitomycin C.

We treated 34 eyes of 32 patients who developed a hypotonous maculopathy after a trabeculectomy with mitomycin C with various treatment strategies. Placement of a Megasoft Bandage Contact Lens in 24 eyes did not result in a notable increase in intraocular pressure or visual acuity. Intrableb injection of autologous blood in 22 eyes resulted in a mean +/- standard deviation (S.

Histopathologic effects of mitomycin C after trabeculectomy in human glaucomatous eyes with persistent hypotony.

We evaluated the histopathologic findings in seven patients who underwent surgical revision of the filtration site after trabeculectomy with mitomycin C because of persistent hypotonous maculopathy. Light microscopic examination of subconjunctival tissue and sclera demonstrated hypocellularity of fibroblasts and disruption of the normal architecture. Tissue fragments at the margin of the bleb wall demonstrated scarring and contained multiple fibroblasts.

Treatment and prognosis of secondary glaucoma in Fuchs' heterochromic iridocyclitis.

After reviewing the records of 111 patients with Fuchs' heterochromic iridocyclitis, we studied the therapy and prognosis of secondary glaucoma in 30 of these 111 patients (27%) who had glaucoma or could be considered glaucoma suspects. Maximal medical therapy was unsuccessful in 22 of the 30 patients (73%). Surgical intervention (mostly trabeculectomies, half with 5-fluorouracil) successfully controlled intraocular pressure (< or = 21 mm Hg with or without medication) in 13 of the 18 operated-on patients (72%) after a mean follow-up of 26 months.

Effect of peripheral iridectomy on intraocular pressure in chronic primary angle closure glaucoma.

In 67 eyes of 46 patients with chronic primary angle closure glaucoma, the effect of peripheral iridectomy in lowering the intraocular pressure was investigated retrospectively. In the majority of cases the pressure was reduced. For the whole population the mean reduction was 3.

Oculokinetic perimetry compared with standard perimetric threshold testing.

To calibrate oculokinetic perimetry (OKP) as developed by Damato in terms of conventional perimetric threshold values, 33 eyes with either glaucoma or ocular hypertension were tested with a standard Humphrey Field Analyzer using the Central 30-2 test and twice with a 26-point OKP chart. The frequency of seeing of the OKP test spot was plotted against 30-2 thresholds. This showed a weak relation between the two tests.

Discrepancies between single stimulus and multiple stimulus visual field examinations with the Peritest semi-automated perimeter in glaucoma patients.

In a total of 24 randomly selected eyes of glaucoma patients, tested with the automated (single stimulus) and the manual (multiple stimulus) modes of the semi-automated Peritest perimeter, the numbers and depths of defects were compared as estimated with these two different measurement strategies. It was found that with the manual technique considerably less defects were detected than with the automated strategy.

Blue-yellow perimetry in the detection of early glaucomatous damage.

A perimetric method using blue stimuli on a yellow background was compared with perimetry using white stimuli on a white background as a method of detecting glaucomatous damage. Meridian perimetry was used with an adapted Tübinger perimeter. The difference between the blue-on-yellow meridian and the white-on-white meridian was subdivided into two parts: the general blue sensitivity loss (GBSL), probably due to optical factors, and the corrected blue sensitivity loss (CBSL), probably due to glaucoma.

Visual field behavior after intra-ocular surgery in glaucoma patients with advanced defects.

Fifty advanced glaucoma patients with central visual field islands were evaluated before and after intra-ocular surgery with respect to visual acuity and visual field behavior. Thirteen patients underwent a cataract extraction, and 37 a filtering procedure. Visual acuity generally improved to a certain extent after lens extraction, and deteriorated after filtering surgery.

Pupillary membrane after cataract extraction with posterior chamber lens in glaucoma patients.

Deposition of a fibrin-like material leading to a membrane in the pupillary opening is described in glaucoma patients following extracapsular cataract extraction and intraocular lens implantation. The fibrinoid reaction was observed in 4 out of 57 eyes (7%), all operated on within two years by the same surgeon (CTL). The fibrinoid reaction appeared 2 to 15 days postoperatively in glaucoma patients on whom iridoplasty or synechiolysis had been performed during surgery.

Usefulness of the Henson Central Field Screener for the detection of visual field defects, especially in glaucoma.

The Henson Central Field Screener is a recently marketed, relatively inexpensive campimeter with semi-automated registration of responses. The strategy used is suprathreshold, eccentricity-compensated, multiple stimulus static perimetry. The clinical usefulness of this apparatus was tested in a number of glaucoma patients, glaucoma suspects and normals, as well as in subjects with other ocular disorders, for whom stable visual fields as tested with other perimeters were available.

Is there general reduction of sensitivity in glaucoma?

Ten normal controls, ten ocular hypertensive patients, ten high tension, 12 medium tension and nine low tension glaucoma patients were studied prospectively by means of automated static perimetry. Multiple double threshold measurements were obtained during at most three years. A computer algorithm estimated for each visual field the Individual General Sensitivity IGS, in which local defects do not contribute.