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Immunology of uveitis and ocular tumors
SURVEY OF OPHTHALMOLOGY
VOLUME 24
l
NUMBER 5 l MARCH-APRIL
BOOK REVIEWS
1980
STEVEN M. PODOS, EDITOR
Immunology of Uveitis and Ocular Tumors, by Devron H. Char. New York, Grune & Stratton, 1978, 115 pp., illus. Price: $15.00.
Vitrectomy: A Pars Plana Approach, 2nd ed., by Robert Machemer and Thomas M. Aaberg, New York, Grune & Sfratton, Inc., 1979,262 pp., illus. Price: $23.50.
Dr. Char has provided us with a well written book. The general concepts of immunology are described in such a lucid manner that they become readily understandable. Moreover, although the immune system is discussed very briefly, its critical components are brought to light. The appended references enable the interested reader to expand on the various aspects of humoral and cell mediated immunity and of hypersensitivity, The reviews of experimental studies of uveitis and particularly of human uveitis are concise and up to date. Then follows a chapter on immunologic testing which provides clear descriptions of several methods but which is not complete, as the author himself has noted. There is no general discussion of tests to detect bacterial or viral infections in the pathogenesis of uveitis. Thus, complement fixation and antigen-antibody precipitation tests such as Ouchterlony immunodiffusion are omitted. Immune complex detection, however, is briefly discussed. Dr. Char does describe skin testing for delayed hypersensitivity, as well as assays for cell-mediated and antibody-dependent cellular cytotoxicity in his chapter on ocular tumor immunology. Here appears the methodology for one of the tests for immune complex detection; it is accompanied by a good illustration. Leucocyte migration inhibition however, seems to be synonymous with migration inhibitory factor production. The description of methodology for these in vitro assays of cell-mediated immunity is insufficient. Chapter VII provides an excellent review of tumor immunology and of Dr. Char’s studies. There are also concise, lucid chapters on the use of cytotoxic and steroid drugs in the treatment of uveitis and on the immunotherapy of tumors. Throughout the book there are diagrams and tables that are easily understandable; in fact they illustrate and clarify many aspects of tumor immunology which are difficult to describe. In essence, this brief book is an excellent eyeopener for any interested ophthalmologist and inquisitive house officer. It should be in the collection of every department of ophthalmology.
This is the second edition of this work originated by Dr. Machemer and now written in collaboration with Dr. Aaberg. This edition is more detailed than the first, as expected, and includes a separate section dealing with the risks of pars plana vitrectomy. There are twelve chapters in this volume, and the subject matter ranges from selection of patients and the rationale for treatment of various diseases that would necessitate pars plana vitrectomy surgery to advanced specialized techniques of vitrectomy. The section on ‘Special Surgical Techniques and Applications” and “Intraocular Gas Tamponade” are especially well written. The information in this section is of value to beginners as well as to experts in pars plana vitrectomy. However, the section on “Complications” could be amplified more, since there are well over 120 complications (preoperative, operative and postoperative) that have been documented in the world literature as resulting from pars plana vitrectomy. The illustrations throughout the text are clear and informative. Especially helpful are the sections on “Practice Vitrectomy” and the Appendix on “Instrumentation.” For the beginning vitrectomy surgeon, the guidelines for practicing vitrectomy are useful in developing surgical technique as well as gaining familiarity with the complex instrumentation. This is of paramount importance in order to reduce the chances of a surgical disaster in the operating theater. Also, the “Instrumentation” section in the Appendix is an excellent guide to contacting the various manufacturers of vitrectomy equipment. Vitrectomy is an excellent monograph on the subject and is highly recommended for all those ophthalmic surgeons who are planning to learn this technique. In addition, experienced vitrectomy surgeons will find this volume useful for reviewing the fine points of surgical technique and patient management. Drs. Machemer and Aaberg are to be congratulated in putting together a concise and lucid text on a complex and controversial subject which is at the frontier of modern day ophthalmology. KEITH M. ZINN
WALTER L. HENLEY 329
VOLUME 24
l
NUMBER 5 l MARCH-APRIL
BOOK REVIEWS
1980
STEVEN M. PODOS, EDITOR
Immunology of Uveitis and Ocular Tumors, by Devron H. Char. New York, Grune & Stratton, 1978, 115 pp., illus. Price: $15.00.
Vitrectomy: A Pars Plana Approach, 2nd ed., by Robert Machemer and Thomas M. Aaberg, New York, Grune & Sfratton, Inc., 1979,262 pp., illus. Price: $23.50.
Dr. Char has provided us with a well written book. The general concepts of immunology are described in such a lucid manner that they become readily understandable. Moreover, although the immune system is discussed very briefly, its critical components are brought to light. The appended references enable the interested reader to expand on the various aspects of humoral and cell mediated immunity and of hypersensitivity, The reviews of experimental studies of uveitis and particularly of human uveitis are concise and up to date. Then follows a chapter on immunologic testing which provides clear descriptions of several methods but which is not complete, as the author himself has noted. There is no general discussion of tests to detect bacterial or viral infections in the pathogenesis of uveitis. Thus, complement fixation and antigen-antibody precipitation tests such as Ouchterlony immunodiffusion are omitted. Immune complex detection, however, is briefly discussed. Dr. Char does describe skin testing for delayed hypersensitivity, as well as assays for cell-mediated and antibody-dependent cellular cytotoxicity in his chapter on ocular tumor immunology. Here appears the methodology for one of the tests for immune complex detection; it is accompanied by a good illustration. Leucocyte migration inhibition however, seems to be synonymous with migration inhibitory factor production. The description of methodology for these in vitro assays of cell-mediated immunity is insufficient. Chapter VII provides an excellent review of tumor immunology and of Dr. Char’s studies. There are also concise, lucid chapters on the use of cytotoxic and steroid drugs in the treatment of uveitis and on the immunotherapy of tumors. Throughout the book there are diagrams and tables that are easily understandable; in fact they illustrate and clarify many aspects of tumor immunology which are difficult to describe. In essence, this brief book is an excellent eyeopener for any interested ophthalmologist and inquisitive house officer. It should be in the collection of every department of ophthalmology.
This is the second edition of this work originated by Dr. Machemer and now written in collaboration with Dr. Aaberg. This edition is more detailed than the first, as expected, and includes a separate section dealing with the risks of pars plana vitrectomy. There are twelve chapters in this volume, and the subject matter ranges from selection of patients and the rationale for treatment of various diseases that would necessitate pars plana vitrectomy surgery to advanced specialized techniques of vitrectomy. The section on ‘Special Surgical Techniques and Applications” and “Intraocular Gas Tamponade” are especially well written. The information in this section is of value to beginners as well as to experts in pars plana vitrectomy. However, the section on “Complications” could be amplified more, since there are well over 120 complications (preoperative, operative and postoperative) that have been documented in the world literature as resulting from pars plana vitrectomy. The illustrations throughout the text are clear and informative. Especially helpful are the sections on “Practice Vitrectomy” and the Appendix on “Instrumentation.” For the beginning vitrectomy surgeon, the guidelines for practicing vitrectomy are useful in developing surgical technique as well as gaining familiarity with the complex instrumentation. This is of paramount importance in order to reduce the chances of a surgical disaster in the operating theater. Also, the “Instrumentation” section in the Appendix is an excellent guide to contacting the various manufacturers of vitrectomy equipment. Vitrectomy is an excellent monograph on the subject and is highly recommended for all those ophthalmic surgeons who are planning to learn this technique. In addition, experienced vitrectomy surgeons will find this volume useful for reviewing the fine points of surgical technique and patient management. Drs. Machemer and Aaberg are to be congratulated in putting together a concise and lucid text on a complex and controversial subject which is at the frontier of modern day ophthalmology. KEITH M. ZINN
WALTER L. HENLEY 329