[Initial experiences with magnetic resonance tomography in processes in the area of the optic chiasm].
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Biomedical subjects
Publications and source records attributed to G Duncker.
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Vision deficiencies are dominant symptoms from digitalis intoxication. Twenty-nine and twenty-eight patients have been examined by the Farnsworth-Munsell-100-Hue-test under common maintenance therapy with digitoxin respectively digoxin or beta-acetyldigoxin. This was done to prove how glycosides may create colour vision disturbances even in "therapeutic" glycoside serum concentrations, and in which degree the lipophile digitoxin differs in its effect from the less lipophile digoxin. To exclude any congenital colour vision deficiencies the study was restricted to females. No definite difference in the total error score has been found among patients treated with digitoxin and digoxin. Our results and further new investigations have pointed out that colour vision in digitalized patients is influenced even under common maintenance therapy. It can also be stated that digitoxin does not influence colour vision other than digoxin.
The use of vitreous surgery instruments in anterior segment surgery is described. The bimanual ocutome technique has been used, in some cases in combination with the special infusion/cutting needle. Three different approaches (limbus, pars plana, limbus and pars plana) are illustrated. The choice of surgical procedure is discussed; it depends mainly on the anterior segment pathology. Personal views and experience (64 eyes) are compared with those of other authors.
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Frequently relapsing acute bilateral uveitis, retinitis and papillitis were observed in a young male smoker. Long-term therapy with azathioprine (150 mg/day), fluocortolone (15 mg every other day) and phenprocumarol proved to be the only means of suppressing the ocular symptoms and achieving a relatively steady condition. Simultaneously relapsing thrombophlebitis of the lower extremities indicated that thrombangiitis obliterans might be the basic disease. The ophthalmic literature on this condition is critically reviewed.
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The influence of three potent lipidosis-inducing agents, i.e. iprindole, triparanol and chloroquine, on the rat adrenal cortex was investigated by determination of the corticosterone excretion in the urine, the responsiveness to ACTH and by determination of the corticosterone content of the adrenals and of the corticosterone concentration in plasma. Administration of iprindole and triparanol left the function of the adrenal cortex unaffected, while under chloroquine treatment an activation with time was observed. Morphologically, similar degrees of lipidosis were found in all experiments. The results demonstrate that the functional capacity of the rat adrenal cortex is not directly correlated to lipidotic alterations.
A 60-year-old woman developed an anterior uveitis of unknown etiology in her right eye. Topical treatment was corticosteroids led to a regression of the inflammation, but three months later a severe relapse occurred, followed by endophthalmitis and blindness. At this time a previously unknown pulmonary tuberculosis was diagnosed. In histologic sections of the enucleated eye numerous acid-fast bacilli were demonstrated. Diagnostic and therapeutic considerations are discussed.
As a chronic, focal, necrotizing granulomatous angiitis Wegener's granulomatosis mainly affects the upper respiratory tract, the lungs and kidneys. Various other organs may be affected including te eyes. Ocular manifestation of Wegener's granulomatosis may result from granulomatous sinusitis that has proceeded into the orbit causing nasolacrimal duct obstruction and proptosis, and affecting eye muscles as well as the optic nerve. Another possible picture is presented by focal vasculitis in the form of conjunctivitis, episcleritis, scleritis, uveitis and granulomatous vasculitis of the retina and optic nerve. In 13 patients out of 26 examined the eyes were found to be involved. The etiology of Wegener's granulomatosis is unknown. The prognosis of this generally lethal disease could definitely be improved by early treatment with cyclophosphamide in combination with glucocorticosteroids.
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In the Federal Republic of Germany nearly 4 million patients receive cardiac glycosides. Intoxication rates of up to 20% have been reported. About 80% of digoxin-intoxicated patients show generalized color vision deficiencies. Ophthalmologists should pay more attention to color vision disturbances due to digitalis.