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Abstracts of the French and German Ophthalmic Literature
ABSTRACTS OF THE FRENCH AND GERMAN OPHTHALMIC LITERATURE Compiled by ANTONIA RASICOVICI
BARANOWSKA-GEORGE T, et al: Treatment of alternating squints: Method of localization by prismatic hypercorrection and with penalization. Arch Ophthalmol (Paris) 37:689-696, 1977. A study of 50 cases treated. by penalization associated. with prismatic overcorrection which have been followed. for one year is presented. The authors found that the deviation decreased (surgery could thus be avoided. in some cases) and that a favorable climate for the development of binocular vision is created by this method. BERNARDINI D: Major and labile forms of the blockage syndrome. J Fr Orthopt 10: 35-59, 1978. The major forms present with a relatively stable angle of deviation, while the labile fonns have an extremely variable angle of deviation and may even be intermittent. The author stresses the importance of early treatment especially in the major fonns. She also discusses and amply illustrates the symptomatology of the labile fonns in which the Faden operation is the best surgical approach. CLAVETTE T, CLAVETTE F, BoURRON-MADIGNIER, HUGONNIER R: Diagnosis of the blockage syndrome with special emphasis on the blockage hypertropias. J Fr Orthopt 10:97-103, 1978. The authors describe the clinical tests that confirm the diagnosis of blockage syndrome: the presence of nystagmus, the stop sign described by Corcelle, improvement of the visual acuity in certain positions of gaze, improvement of fixation in adduction, disappearance of the angle of deviation under general anesthesia. Finally they describe a new sign-blockage hypertropia. They noticed this in 13 cases and describe it as a spontaneous spasmodic, monolateral or alternating hypertropia which blocks the nystagmus at onset. The maximum deviation takes place in primary position and decreases or even disappears in the cardinal
directions of gaze, differentiating it from the vertical deviation which is due to overaction of the inferior oblique. CORCELLE L: Pseudo paralytic forms of the blockage syndrome. J Fr Orthopt 10:27-33, 1978. Three main features single out these pseudo paralytic forms: 1. the blockage in convergence; 2. the compensatory hyperactions; 3. the very early onset of the blockage signs. The stop sign proves to be a valuable tool for the diagnosis of these forms. It consists of a sudden stop of the involved eye in conjugate voluntary movements in the field of action of its lateral rectus. The article concludes with a discussion of the possible etiology of these forms. CliPPERS C: History and physiopathology of the "blockage syndrome." J Fr Orthopt 10: 15-26, 1978. The author starts with a review of the various concepts with regard to nystagmus from 1857 to the present and strongly emphasizes that blockage and compensation are by no means synonymous and should not be used interchangeably. He defines blockage as a pure motor innervational phenomenon, characterized by an adducting movement, or a positioning in adduction, which may occur monocularly or bilaterally. This leads to a new classification of nystagmus according to the various compensation mechanisms of which the blockage is by far the most satisfactory. The article ooncludes with three case histories of nystagmus patients in which the surgery consisted of the "Fadenoperation." DELLER M: Technique of the "Fadenoperation." J Fr Orthopt 10:69-96, 1978. The surgical technique of Ciippers Fadenoperation as well as the numerous variations are presented. The author gives a more detailed description of his own variation, which he considers simpler and more reliable. He also advocates a change in the
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name of "Fadenoperation." His choice is retroequatorial myopexy which has the advantage of being precise, explicit, and intelligible, and is also easily translatable in all languages. FOTZSCH R: Ophthalmoplegic polyneuritis. A contribution to Fisher's syndrome. Ophthalmologica 176:6-11, 1978. Ophthalmoplegic neuritis is frequently overlooked in the etiology and pathogenesis of extraocular muscle paralyses. The author thinks it plays an important part and substantiates this with the discussion of six cases. The most striking symptom is the acute ophthalmoplegia which is usually total and bilateral, often with sparing of the pupillary reflexes and the levator. GODDE-JOLLY D: Penalization in convergent strabismus therapy. J Fr Ophtalmoll:607614, 1978. The author describes and discusses various methods for the treatment of amblyopia due to convergent strabismus: full occlusion, atropine penalization, optic penalization, graded filters, and partial occlusion of the glasses (sectors). Indications and results are presented according to age groups and the degree of amblyopia. Each method has its advantages and disadvantages; none of the methods can succeed without full cooperation between ophthalmologist, parent, and patient. HUBER A: Diagnosis and treatment of eye muscle palsies. Klin Monatsbl Augenheilkd 172:138-140, 1978. The author discusses the importance of electromyography for the differential diagnosis of myopathy, myasthenia and peripheral neurogenic palsies, as well as the symptomatology of these differing afflictions. Therapeutic guidelines conclude the paper. HUBER A: Neurinoma of the oculomotor nerve. Klin Monatsbl Augenheilkd 172: 627-635, 1978. Three cases of neurinomas of the third nerve, all diagnosed as sphenoid ridge meningiomas, are reported. The diagnoses were not made preoperatively. The author lists the signs of ocular neurinomas in the order of their appearance in time. He then discusses the differential diagnosis of the
OPHTH AAO
sphenoid ridge meningioma, the trigeminal neurinoma, and the numerous tumors within the cavernous sinus. JUNGINGER-CROZON, MOUILLONI M, RoMANET JP: Penalization with high convex lenses. A preliminary study. J Fr Orthopt 10:147-150, 1978. The authors recommend a +11.00 D overcorrection of the dominant eye in order to obtain a change of dominance. This is done after a preliminary period of three weeks of full occlusion of the dominant eye and daily treatment on the pleoptophore and coordinator. QUERE MA, CLERGEAU G, PECHEREAU A: Motor and sensory signs associated with the blockage syndrome. J Fr Orthopt 10: 69-75, 1978. The authors state that there is no relationship between the blockage syndrome and associated vertical deviations (study based on 70 cases); that out of 125 cases of nystagmus it was present only in 57; that out of 125 cases it appeared as frequently in the right eye as it did in the left. Finally they found that in 51 cases of blockage with amblyopia there was no significant difference in the amblyopia present in minor or major forms of the blockage syndrome, but that quite frequently the blockage was present in the fixing eye. SPIELMANN A: Nystagmus surgery. Arch Ophtalmol (Paris) 37:751-765, 1977. Nystagmus surgery is still dominated by Kestenbaum's idea of transferring the neutral point to the primary position and thereby eliminating the torticollis. The author suggests that Clippers' Fadenoperation and the surgery of the obliques should be added to the Kestenbaum-Anderson procedure and discusses which surgical techniques are the most successful in cases of nystagmus with strong binocularity, with partial binocularity, and without binocularity. VUKOV B, JOJIC J: Surgical aspect of esotropia of the blockage syndrome type (spasmodic strabismus). J Fr Orthopt 10:105115, 1978. The authors describe a new technique for the dynamic part of esotropias of the blockage syndrome type: thermocauterization of
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the motor end-plate of the medial rectus. They discuss the result obtained in 25 cases operated on with this procedure.
degree of involvement of the cerebellum. They base their discussion on three clinical cases.
QUERE MA, CLERGEAU G, PECHEREAU A, FONTENAILLE N, BRASSEUR G: The retroequatorial muscular strapping. A technical adaptation of Clippers Fadenoperation. A preliminary report. Arch Ophtalmol (Paris) 37:531-538, 1977.
STANGLER-ZUSCHROTT E: Disturbances' of fusion after extensive retinal hemorrhages in new-born infants. Klin Monatsbl Augenheilkd 172:209-212, 1978.
An analysis of 300 cases of Fadenoperations leads the authors to recommend a retro-equatorial strapping on the sclera rather than a muscular fastening, in order to avoid sclerosis of the formerly operated muscle and its neighboring capsule. The steps of the technique are described.
QUERE MA, CLERGEAU G, PECHEREAU A: Complimentary tests in esotropia with blockage signs. J Fr Orthop 10:61-68, 1978. The authors describe and discuss three very useful indicators for the diagnosis of the blockage syndrome: 1. electro-oculography; 2. the positions of the eyes in stage III of anesthesia; 3. the preoperative sign of muscular traction.
PIGASSOU-ALBOUY R: Strabismus and pseudo-strabismus. Arch Ophtalmol (Paris) 37: 641-648, 1977. A study done on 18 Siamese cats and 56 alley cats proved that the former do not have strabismus and have good fusional amplitudes, while the latter show intermittent exotropia with poor binocularity. Objective tests such as the corneal reflex test, the cover-uncover test, and the prism-bar used in children prior to 3 years of age were used for the study of the cats.
SAFRAN AB, BABEL J, GAUTHIER G, WERNER A: Oculomotor symptomatology in cases of cerebellar pathology. J Fr Ophthalmol 1:275-282, 1978. The authors review the literature with regard to the cerebellar control of ocular motility. The oculomotor symptomatology is extremely helpful for the assessment of the
A follow-up on 21 children without strabismus at 6 years of age revealed that most children who had had extensive bilateral postpartum retinal hemorrhages had a significantly higher incidence of impaired range of fusion than the control cases. Orthoptic treatment was unsuccessful. The author assumes that the disorder is due to a discrete perinatal impairment of the cerebral optomotor centers.
TRAPPE A, WEIDENBACH W: Unilateral exophthalmos and temporary ipsilateral oculomotor paresis: The only symptoms of an extensive chordoma of the base of the skull. Klin Monatsbl Augenheilkd 171:953958, 1977. The author describes and discusses a case of histologically proven chordoma in an 18year-old girl. An oculomotor paresis of sudden onset a year prior to the diagnosis of the tumor was the first sign. This subsided in six months, but a right exophthalmos appeared two months later, despite the fact that the tumor extended from the clivus into the nasopharynx. High-dose radiotherapy stopped the process. WUTZ W, BARTl G, RoDLER H, BRUNNER H: Electrooph thalmological investigations in amblyopia. Klin Monatsbl Augenheilkd 172:277-280, 1978. Electroophthalmological studies were done on eight amblyopic patients. The tests performed were ERG, the brightness VECP, as well as the TV.pattern reversal with stimulation of the whole field, the lower, and the upper halves. The ERG and the brightness VECP did not show significant differences between amblyopic and control eyes. However, the amblyopic eye showed a significant reduction in the amplitude of the pattern reversal VECP in the whole field and the lower half field.
BARANOWSKA-GEORGE T, et al: Treatment of alternating squints: Method of localization by prismatic hypercorrection and with penalization. Arch Ophthalmol (Paris) 37:689-696, 1977. A study of 50 cases treated. by penalization associated. with prismatic overcorrection which have been followed. for one year is presented. The authors found that the deviation decreased (surgery could thus be avoided. in some cases) and that a favorable climate for the development of binocular vision is created by this method. BERNARDINI D: Major and labile forms of the blockage syndrome. J Fr Orthopt 10: 35-59, 1978. The major forms present with a relatively stable angle of deviation, while the labile fonns have an extremely variable angle of deviation and may even be intermittent. The author stresses the importance of early treatment especially in the major fonns. She also discusses and amply illustrates the symptomatology of the labile fonns in which the Faden operation is the best surgical approach. CLAVETTE T, CLAVETTE F, BoURRON-MADIGNIER, HUGONNIER R: Diagnosis of the blockage syndrome with special emphasis on the blockage hypertropias. J Fr Orthopt 10:97-103, 1978. The authors describe the clinical tests that confirm the diagnosis of blockage syndrome: the presence of nystagmus, the stop sign described by Corcelle, improvement of the visual acuity in certain positions of gaze, improvement of fixation in adduction, disappearance of the angle of deviation under general anesthesia. Finally they describe a new sign-blockage hypertropia. They noticed this in 13 cases and describe it as a spontaneous spasmodic, monolateral or alternating hypertropia which blocks the nystagmus at onset. The maximum deviation takes place in primary position and decreases or even disappears in the cardinal
directions of gaze, differentiating it from the vertical deviation which is due to overaction of the inferior oblique. CORCELLE L: Pseudo paralytic forms of the blockage syndrome. J Fr Orthopt 10:27-33, 1978. Three main features single out these pseudo paralytic forms: 1. the blockage in convergence; 2. the compensatory hyperactions; 3. the very early onset of the blockage signs. The stop sign proves to be a valuable tool for the diagnosis of these forms. It consists of a sudden stop of the involved eye in conjugate voluntary movements in the field of action of its lateral rectus. The article concludes with a discussion of the possible etiology of these forms. CliPPERS C: History and physiopathology of the "blockage syndrome." J Fr Orthopt 10: 15-26, 1978. The author starts with a review of the various concepts with regard to nystagmus from 1857 to the present and strongly emphasizes that blockage and compensation are by no means synonymous and should not be used interchangeably. He defines blockage as a pure motor innervational phenomenon, characterized by an adducting movement, or a positioning in adduction, which may occur monocularly or bilaterally. This leads to a new classification of nystagmus according to the various compensation mechanisms of which the blockage is by far the most satisfactory. The article ooncludes with three case histories of nystagmus patients in which the surgery consisted of the "Fadenoperation." DELLER M: Technique of the "Fadenoperation." J Fr Orthopt 10:69-96, 1978. The surgical technique of Ciippers Fadenoperation as well as the numerous variations are presented. The author gives a more detailed description of his own variation, which he considers simpler and more reliable. He also advocates a change in the
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name of "Fadenoperation." His choice is retroequatorial myopexy which has the advantage of being precise, explicit, and intelligible, and is also easily translatable in all languages. FOTZSCH R: Ophthalmoplegic polyneuritis. A contribution to Fisher's syndrome. Ophthalmologica 176:6-11, 1978. Ophthalmoplegic neuritis is frequently overlooked in the etiology and pathogenesis of extraocular muscle paralyses. The author thinks it plays an important part and substantiates this with the discussion of six cases. The most striking symptom is the acute ophthalmoplegia which is usually total and bilateral, often with sparing of the pupillary reflexes and the levator. GODDE-JOLLY D: Penalization in convergent strabismus therapy. J Fr Ophtalmoll:607614, 1978. The author describes and discusses various methods for the treatment of amblyopia due to convergent strabismus: full occlusion, atropine penalization, optic penalization, graded filters, and partial occlusion of the glasses (sectors). Indications and results are presented according to age groups and the degree of amblyopia. Each method has its advantages and disadvantages; none of the methods can succeed without full cooperation between ophthalmologist, parent, and patient. HUBER A: Diagnosis and treatment of eye muscle palsies. Klin Monatsbl Augenheilkd 172:138-140, 1978. The author discusses the importance of electromyography for the differential diagnosis of myopathy, myasthenia and peripheral neurogenic palsies, as well as the symptomatology of these differing afflictions. Therapeutic guidelines conclude the paper. HUBER A: Neurinoma of the oculomotor nerve. Klin Monatsbl Augenheilkd 172: 627-635, 1978. Three cases of neurinomas of the third nerve, all diagnosed as sphenoid ridge meningiomas, are reported. The diagnoses were not made preoperatively. The author lists the signs of ocular neurinomas in the order of their appearance in time. He then discusses the differential diagnosis of the
OPHTH AAO
sphenoid ridge meningioma, the trigeminal neurinoma, and the numerous tumors within the cavernous sinus. JUNGINGER-CROZON, MOUILLONI M, RoMANET JP: Penalization with high convex lenses. A preliminary study. J Fr Orthopt 10:147-150, 1978. The authors recommend a +11.00 D overcorrection of the dominant eye in order to obtain a change of dominance. This is done after a preliminary period of three weeks of full occlusion of the dominant eye and daily treatment on the pleoptophore and coordinator. QUERE MA, CLERGEAU G, PECHEREAU A: Motor and sensory signs associated with the blockage syndrome. J Fr Orthopt 10: 69-75, 1978. The authors state that there is no relationship between the blockage syndrome and associated vertical deviations (study based on 70 cases); that out of 125 cases of nystagmus it was present only in 57; that out of 125 cases it appeared as frequently in the right eye as it did in the left. Finally they found that in 51 cases of blockage with amblyopia there was no significant difference in the amblyopia present in minor or major forms of the blockage syndrome, but that quite frequently the blockage was present in the fixing eye. SPIELMANN A: Nystagmus surgery. Arch Ophtalmol (Paris) 37:751-765, 1977. Nystagmus surgery is still dominated by Kestenbaum's idea of transferring the neutral point to the primary position and thereby eliminating the torticollis. The author suggests that Clippers' Fadenoperation and the surgery of the obliques should be added to the Kestenbaum-Anderson procedure and discusses which surgical techniques are the most successful in cases of nystagmus with strong binocularity, with partial binocularity, and without binocularity. VUKOV B, JOJIC J: Surgical aspect of esotropia of the blockage syndrome type (spasmodic strabismus). J Fr Orthopt 10:105115, 1978. The authors describe a new technique for the dynamic part of esotropias of the blockage syndrome type: thermocauterization of
VOLUME 86 DECEMBER 1979
FRENCH AND GERMAN ABSTRACTS
2191
the motor end-plate of the medial rectus. They discuss the result obtained in 25 cases operated on with this procedure.
degree of involvement of the cerebellum. They base their discussion on three clinical cases.
QUERE MA, CLERGEAU G, PECHEREAU A, FONTENAILLE N, BRASSEUR G: The retroequatorial muscular strapping. A technical adaptation of Clippers Fadenoperation. A preliminary report. Arch Ophtalmol (Paris) 37:531-538, 1977.
STANGLER-ZUSCHROTT E: Disturbances' of fusion after extensive retinal hemorrhages in new-born infants. Klin Monatsbl Augenheilkd 172:209-212, 1978.
An analysis of 300 cases of Fadenoperations leads the authors to recommend a retro-equatorial strapping on the sclera rather than a muscular fastening, in order to avoid sclerosis of the formerly operated muscle and its neighboring capsule. The steps of the technique are described.
QUERE MA, CLERGEAU G, PECHEREAU A: Complimentary tests in esotropia with blockage signs. J Fr Orthop 10:61-68, 1978. The authors describe and discuss three very useful indicators for the diagnosis of the blockage syndrome: 1. electro-oculography; 2. the positions of the eyes in stage III of anesthesia; 3. the preoperative sign of muscular traction.
PIGASSOU-ALBOUY R: Strabismus and pseudo-strabismus. Arch Ophtalmol (Paris) 37: 641-648, 1977. A study done on 18 Siamese cats and 56 alley cats proved that the former do not have strabismus and have good fusional amplitudes, while the latter show intermittent exotropia with poor binocularity. Objective tests such as the corneal reflex test, the cover-uncover test, and the prism-bar used in children prior to 3 years of age were used for the study of the cats.
SAFRAN AB, BABEL J, GAUTHIER G, WERNER A: Oculomotor symptomatology in cases of cerebellar pathology. J Fr Ophthalmol 1:275-282, 1978. The authors review the literature with regard to the cerebellar control of ocular motility. The oculomotor symptomatology is extremely helpful for the assessment of the
A follow-up on 21 children without strabismus at 6 years of age revealed that most children who had had extensive bilateral postpartum retinal hemorrhages had a significantly higher incidence of impaired range of fusion than the control cases. Orthoptic treatment was unsuccessful. The author assumes that the disorder is due to a discrete perinatal impairment of the cerebral optomotor centers.
TRAPPE A, WEIDENBACH W: Unilateral exophthalmos and temporary ipsilateral oculomotor paresis: The only symptoms of an extensive chordoma of the base of the skull. Klin Monatsbl Augenheilkd 171:953958, 1977. The author describes and discusses a case of histologically proven chordoma in an 18year-old girl. An oculomotor paresis of sudden onset a year prior to the diagnosis of the tumor was the first sign. This subsided in six months, but a right exophthalmos appeared two months later, despite the fact that the tumor extended from the clivus into the nasopharynx. High-dose radiotherapy stopped the process. WUTZ W, BARTl G, RoDLER H, BRUNNER H: Electrooph thalmological investigations in amblyopia. Klin Monatsbl Augenheilkd 172:277-280, 1978. Electroophthalmological studies were done on eight amblyopic patients. The tests performed were ERG, the brightness VECP, as well as the TV.pattern reversal with stimulation of the whole field, the lower, and the upper halves. The ERG and the brightness VECP did not show significant differences between amblyopic and control eyes. However, the amblyopic eye showed a significant reduction in the amplitude of the pattern reversal VECP in the whole field and the lower half field.