[Round table discussion: Diagnosis and therapy in abducens paralysis].
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Biomedical subjects
Publications and source records attributed to E Mehdorn.
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In three patients, recurrence of a large pituitary adenoma was not detectable by ophthalmological means, because the tumor recurred in an area where the optic nerve fibers had already been destroyed by the primary tumor. These cases demonstrate that unchanged visual fields do not exclude tumor regrowth, and that computer tomography is indispensable in the follow-up surgically treated pituitary adenomas.
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Report on a case of amaurosis fugax during which the wandering of a fibrin platelet embolus through the vessels of the central arteria was photographed.
The essential disturbance in five patients with vertical nystagmus was an inability to generate smooth pursuit eye movements in the direction of the quick phase of their nystagmus. As the cause of this behavior, the authors suggest an asymmetric impairment of the visual input to the pursuit system. This defect causes a 'directional preponderance' of the pursuit system detectable as a continuous drift off target. The drift is interrupted by refoveating saccades, thus resulting in a vertical nystagmus.
If the fixing eye of a squinting patient is covered, a saccade to take up fixation follows which corresponds to the eccentricity of the image on the retina of the squinting eye. However, in some strabismus patients one finds a saccade even though the image on the retina of the squinting eye has already been deflected onto the fovea centrailis with the aid of prisms. This saccade brings the eye into the primary postion and displaces the image of the fixation target to a peripheral retinal point, so that the image must be recentred onto the fovea by a second saccade. We propose to call this movement to and fro a 'rebound-saccade'. This phenomenon indicates that, in patients with alternating strabismus, extraretinal information determined by the angle of squint influences rapid alternation of fixation between the right and left eyes. The rebound-saccade cannot be explained by anomalous retinal correspondence.
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Abnormal innervation hampered the left eye in one twin, while producing the same effect in the right eye of the other twin and in that of his mother.