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A new colour vision test for clinical use
determine the value of CSF changes in optic neuritis, especially regarding diagnostic utility, immunologie changes, correlations with magnetic resonance imag ing (MRI), and progression to clinically definite multiple sclerosis. CSF determinations included immunoglobulin G (IgG) synthesis, IgG ratio, myelin basic protein, IgG kappa light chains, and oligoclonal banding. The diagnosis or management was not altered in any patient as a result of the CSF findings. With the exception of oligoclonal bands, only a few of the CSF tests were abnormal and none correlated with the twO'year development of multiple sclerosis. Although oligoclonal banding predicted progression to multiple sclerosis, it was not independent of MRI abnormalities. The authors concluded that CSF anal ysis may not be necessary in the routine evaluation of patients with the typical clinical characteristics of multiple sclerosis who seek medical attention and that most CSF tests add minimal supplementary infor mation to MRI results for predicting progression to multiple sclerosis. Determining the precise role of oligoclonal banding requires longer follow-up. —George B. Bartley *Mukiple Sclerosis Center, The Marshfield Clinic, 1000 N. Oak Ave., Marshfield, Wl 54449.
• A new colour vision test for clinical use. Kon CH*, De Alwis D. Eye 1996;10:65-74.
T
test's effectiveness in screening subjects with congeni tal red-green defects and in monitoring color vision status in patients with acquired disorders.—George B. Bartley *44A Courtfield Gardens, London SWS 0LZ, United Kingdom.
• Retinal toxicity in long-term hydroxychloroquine treatment. Mavrikakis M*, Papazoglou S, Sfikakis PP, Vaiopoulos G, Rougas K. A n n Rheum Dis 1996;55:187-9.
T
HE AUTHORS CONDUCTED A PROSPECTIVE STUDY
involving 360 patients with rheumatoid arthritis or systemic lupus erythematosus who were treated with hydroxychloroquine. Ophthalmic examinations, which were performed every six months, included electroretinography, automated perimetry, and tests for color vision and dark adaptation. Among the 58 patients who received hydroxychloroquine for more than six years, two women, ages 39 and 58 years, developed the characteristic retinal lesions of hy droxychloroquine toxicity after cumulative doses of 700 g (6.5 years) and 730 g (8 years), respectively. Visual acuity was 20/20 and 20/25, respectively, and color vision testing in both patients was normal. Despite discontinuation of hydroxychloroquine, both women had permanent paracentral visual field defects and one patient demonstrated persistent abnormali ties on fluorescein angiography.—George B. Bartley
HE ISHIHARA COLOR VISION TEST ORIGINALLY WAS
designed to detect red-green defects in individuals applying for employment as railway workers. Al though effective in identifying unambiguous congeni tal red-green defects, the Ishihara test may not detect subtle red-green defects and is inappropriate for evaluating abnormalities of the blue-yellow axis, such as may occur in optic neuritis, retinitis pigmentosa, chorioretinitis, or diabetic retinopathy. The authors developed a new color vision test based on pseudoisochromatic principles that examines both the redgreen and blue-yellow axes. The test uses 17 plates, has four levels of difficulty for each axis, is graded with an error score, and takes about six minutes to complete. Results from a pilot study demonstrate the
VOL.122, No. I
* Department of Therapeutics, Alexandra Hospital, 80 Vas Sofias Ave., 115 28 Athens, Greece.
• Tamoxifen-associated eye disease: a review. Nayfield SG*, Gorin MB. J Clin Oncol 1996; 14: 1018-26.
T
AMOXIFEN IS AN ORAL ANTIESTROGEN THAT IS
used in the treatment of breast cancer. This paper reviews published case reports, clinical series, and clinical trial data on ocular toxicity attributed to the drug. Although ophthalmic sequelae are relatively uncommon, the most frequent and visually important
ABSTRACTS
145
• A new colour vision test for clinical use. Kon CH*, De Alwis D. Eye 1996;10:65-74.
T
test's effectiveness in screening subjects with congeni tal red-green defects and in monitoring color vision status in patients with acquired disorders.—George B. Bartley *44A Courtfield Gardens, London SWS 0LZ, United Kingdom.
• Retinal toxicity in long-term hydroxychloroquine treatment. Mavrikakis M*, Papazoglou S, Sfikakis PP, Vaiopoulos G, Rougas K. A n n Rheum Dis 1996;55:187-9.
T
HE AUTHORS CONDUCTED A PROSPECTIVE STUDY
involving 360 patients with rheumatoid arthritis or systemic lupus erythematosus who were treated with hydroxychloroquine. Ophthalmic examinations, which were performed every six months, included electroretinography, automated perimetry, and tests for color vision and dark adaptation. Among the 58 patients who received hydroxychloroquine for more than six years, two women, ages 39 and 58 years, developed the characteristic retinal lesions of hy droxychloroquine toxicity after cumulative doses of 700 g (6.5 years) and 730 g (8 years), respectively. Visual acuity was 20/20 and 20/25, respectively, and color vision testing in both patients was normal. Despite discontinuation of hydroxychloroquine, both women had permanent paracentral visual field defects and one patient demonstrated persistent abnormali ties on fluorescein angiography.—George B. Bartley
HE ISHIHARA COLOR VISION TEST ORIGINALLY WAS
designed to detect red-green defects in individuals applying for employment as railway workers. Al though effective in identifying unambiguous congeni tal red-green defects, the Ishihara test may not detect subtle red-green defects and is inappropriate for evaluating abnormalities of the blue-yellow axis, such as may occur in optic neuritis, retinitis pigmentosa, chorioretinitis, or diabetic retinopathy. The authors developed a new color vision test based on pseudoisochromatic principles that examines both the redgreen and blue-yellow axes. The test uses 17 plates, has four levels of difficulty for each axis, is graded with an error score, and takes about six minutes to complete. Results from a pilot study demonstrate the
VOL.122, No. I
* Department of Therapeutics, Alexandra Hospital, 80 Vas Sofias Ave., 115 28 Athens, Greece.
• Tamoxifen-associated eye disease: a review. Nayfield SG*, Gorin MB. J Clin Oncol 1996; 14: 1018-26.
T
AMOXIFEN IS AN ORAL ANTIESTROGEN THAT IS
used in the treatment of breast cancer. This paper reviews published case reports, clinical series, and clinical trial data on ocular toxicity attributed to the drug. Although ophthalmic sequelae are relatively uncommon, the most frequent and visually important
ABSTRACTS
145