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Retinal Diseases: Symposium on Differential Diagnostic Problems of Posterior Uveitis
VOL. 62, NO. 3
BOOK REVIEWS
those dealing with ocular disorders as essen tially surgeons, not to be bothered with pharmacology and therapeutics, even though they did discuss the use of agents introduced by ophthalmologists, such as the anticholinesterase agent, Phospholine Iodide, and the antiviral drug, iododeoxyuridine. We do look forward to the 19th edition with great interest. Irving H. Leopold
SYMPOSIUM ON VASCULAR DISEASES OF THE EYE:
BASIC CONSIDERATIONS IN A N A T
OMY AND PHYSIOLOGY.
Sponsored
by
the Visual Sciences Study Section, Divi sion of Research Grants, National Insti tutes of Health, and the Department of Ophthalmology, Presbyterian Medical Center, San Francisco. St. Louis, The C. V. Mosby Company, 1966. Clothbound, 186 pages, 103 figures in black and white, 5 tables, chapter references, author and subject indexes. Price: $12.50. The contents of this 179-page volume were presented as a symposium under the auspices of the Visual Sciences Study Sec tion of National Institute of Neurological Diseases and Blindness in San Francisco in June, 1965. The 17 articles first appeared as the December, 1965, issue of Investigative Ophthalmology. The individual papers are about evenly divided between general background infor mation, which might serve as a point of de parture for someone embarking on a study of ocular circulation, and specific studies on the eye. In the former category one may cite the highly pertinent essay of Zweifach on "Per meability aspects of blood tissue exchange," the Guyton paper on "Pressure-volume rela tionships in the interstititial spaces" and Hanna on "Metabolism of catecholamines." In the latter category are the paper "Esti mation of retinal blood flow in animals" by Friedman and Smith, "The optical study of
591
choroidal blood flow" by Trokel using Evans blue and reflection densitometry, and the discussion of "Intertissue vascular rela tionships in the eye" by Michaelson. The one element not present which one might have wished for would have been an essay bridging the gap between the basic findings in the systemic circulation and those in the eye. The unique effect of intra ocular pressure, the inaccessibility of ocular vessels, particularly the important choroidal and optic nerve circulation, and the large volume of avascular vitreous, lens and cor nea create specific problems and sometimes nullify the pertinence of studies made on tissues elsewhere. Some of these problems are tackled implicitly in the papers dealing specifically with the eye. Some of them are yet to be enunciated. The volume is highly recommended for the student and researcher as well as for the clinician who wants an up-to-date founda tion for his thinking on clinical vascular dis ease of the eye. Albert M. Potts RETINAL DISEASES: SYMPOSIUM ON DIFFER ENTIAL DIAGNOSTIC PROBLEMS OF POS TERIOR UVEITIS. Edited by Samuel J. Kimura, M.D., and Wayne M. Caygill, M.D. Philadelphia, Lea & Febiger, 1966. Clothbound, 395 pages, 134 figures in black and white, 3 tables, chapter refer ences, index. Price: $12.50. This book is a collation of the various pa pers presented at a symposium on retinal diseases held in 1964 at the University of California in San Francisco. The partici pants include the faculty of the University of California and 10 experts on different aspects of retinal disease from elsewhere (Allen, Braley, Brockhurst, Falls, Irvine, Klien, Maumenee, Pischel, Schepens and Straatsma). Although the theme of this symposium is differential diagnostic problems of posterior uveitis, the scope is much broader. The pe-
AMERICAN JOURNAL OF OPHTHALMOLOGY
592
riphery and the equatorial retina receive at tention and the papers are not by any means limited to diseases usually confused with uveitis. Lattice degeneration, retinoschisis, cobblestone degeneration, peripheral detach ment and uveal effusion are some examples of interesting subjects which stray slightly from the theme of this symposium. Some of the material in this book can be found elsewhere and usually in more com plete form; in fact, some sections are so simplified and brief as to be of limited value. This is particularly true of the sec tions on histoanatomy and examination of the fundus. On the other hand, the material in the chapters on retinal disease, inflammatory dis eases and tumors is organized in a most in formative manner. Each of the entities con sidered in these chapters is divided so as to cover clinical features, pathology and mangement independently and then is re viewed in concluding summary and discus sion sections. I found these latter sections to be of considerable value. Points of agree ment are emphasized and no punches are spared in discussing points of disagreement. Sometimes important original information not mentioned in the formal presentations is found in these "off the cuff" discussions. This book is highly recommended for ophthalmologists interested in recent infor mation on a number of difficult retinal prob lems. In general, the material is presented in a simplified, concise and well-organized manner. Alex E. Krill
DIE
CATARACTOPERATION U N D I H R E K O M -
PLIKATIONEN
IN
PATHOLOGISCH-ANA-
By Ernst Landolt. Basel, Switzerland, S. Karger AG, 1966. Paperbound, 94 pages, 121 figures in black and white, bibliography, index. Price: sFr/DM 25.—. This is a most interesting and stimulating monograph. The author discusses the var TOMISCHEN
SICHT.
SEPTEMBER, 1966
ious complications after cataract operations and illustrates their pathologic substrates with numerous photomicrographs. The author first discusses the normal wound healing of the cornea and then the normal and pathologic aspects of the inci sion. He has the impression that epithelial downgrowth is now more frequent than it used to be. Most informative is the chapter on sutures and their influence on the wound. He, correctly, cautions against too many su tures, which may do more harm than good. Original were his first observations on the influence of alpha chymotrypsin on the early stages of wound healing. He could in the meantime examine seven more such globes. He gives good evidence that this enzyme re tards the wound healing for the first few weeks. This study, based on the examination of 70 globes, is an excellent example of clinical and pathologic correlation. It should be of great benefit for every ophthalmic surgeon. Frederick C. Blodi HERITABLE
DISORDERS
OF
CONNECTIVE
By Victor A. McKusick, M.D. St. Louis, The C. V. Mosby Company 1966, edition 3. Clothbound, 499 pages, 190 figures in black and white, 2 figures in color, 12 tables, chapter references, index. Price: $18.50.
TISSUE.
Nature is nowhere accustomed more openly to display her secret mysteries than in cases where she shows traces of her workings apart from the beaten path; nor is there any better way to ad vance the proper practice of medicine than to give our minds to the discovery of the usual law of Nature by careful investigation of cases of rarer forms of disease. For it has been found, in almost all things, that what they contain of useful or applicable nature is hardly perceived unless we are deprived of them, or they become deranged in some way. William Harvey, 1657. A good deal of information about con nective tissue and heritable disorders has been added to our store since the first edi tion of McKusick's book appeared in 1955. I n this edition the author incorporates it into his original, brilliant, painstaking cover-
BOOK REVIEWS
those dealing with ocular disorders as essen tially surgeons, not to be bothered with pharmacology and therapeutics, even though they did discuss the use of agents introduced by ophthalmologists, such as the anticholinesterase agent, Phospholine Iodide, and the antiviral drug, iododeoxyuridine. We do look forward to the 19th edition with great interest. Irving H. Leopold
SYMPOSIUM ON VASCULAR DISEASES OF THE EYE:
BASIC CONSIDERATIONS IN A N A T
OMY AND PHYSIOLOGY.
Sponsored
by
the Visual Sciences Study Section, Divi sion of Research Grants, National Insti tutes of Health, and the Department of Ophthalmology, Presbyterian Medical Center, San Francisco. St. Louis, The C. V. Mosby Company, 1966. Clothbound, 186 pages, 103 figures in black and white, 5 tables, chapter references, author and subject indexes. Price: $12.50. The contents of this 179-page volume were presented as a symposium under the auspices of the Visual Sciences Study Sec tion of National Institute of Neurological Diseases and Blindness in San Francisco in June, 1965. The 17 articles first appeared as the December, 1965, issue of Investigative Ophthalmology. The individual papers are about evenly divided between general background infor mation, which might serve as a point of de parture for someone embarking on a study of ocular circulation, and specific studies on the eye. In the former category one may cite the highly pertinent essay of Zweifach on "Per meability aspects of blood tissue exchange," the Guyton paper on "Pressure-volume rela tionships in the interstititial spaces" and Hanna on "Metabolism of catecholamines." In the latter category are the paper "Esti mation of retinal blood flow in animals" by Friedman and Smith, "The optical study of
591
choroidal blood flow" by Trokel using Evans blue and reflection densitometry, and the discussion of "Intertissue vascular rela tionships in the eye" by Michaelson. The one element not present which one might have wished for would have been an essay bridging the gap between the basic findings in the systemic circulation and those in the eye. The unique effect of intra ocular pressure, the inaccessibility of ocular vessels, particularly the important choroidal and optic nerve circulation, and the large volume of avascular vitreous, lens and cor nea create specific problems and sometimes nullify the pertinence of studies made on tissues elsewhere. Some of these problems are tackled implicitly in the papers dealing specifically with the eye. Some of them are yet to be enunciated. The volume is highly recommended for the student and researcher as well as for the clinician who wants an up-to-date founda tion for his thinking on clinical vascular dis ease of the eye. Albert M. Potts RETINAL DISEASES: SYMPOSIUM ON DIFFER ENTIAL DIAGNOSTIC PROBLEMS OF POS TERIOR UVEITIS. Edited by Samuel J. Kimura, M.D., and Wayne M. Caygill, M.D. Philadelphia, Lea & Febiger, 1966. Clothbound, 395 pages, 134 figures in black and white, 3 tables, chapter refer ences, index. Price: $12.50. This book is a collation of the various pa pers presented at a symposium on retinal diseases held in 1964 at the University of California in San Francisco. The partici pants include the faculty of the University of California and 10 experts on different aspects of retinal disease from elsewhere (Allen, Braley, Brockhurst, Falls, Irvine, Klien, Maumenee, Pischel, Schepens and Straatsma). Although the theme of this symposium is differential diagnostic problems of posterior uveitis, the scope is much broader. The pe-
AMERICAN JOURNAL OF OPHTHALMOLOGY
592
riphery and the equatorial retina receive at tention and the papers are not by any means limited to diseases usually confused with uveitis. Lattice degeneration, retinoschisis, cobblestone degeneration, peripheral detach ment and uveal effusion are some examples of interesting subjects which stray slightly from the theme of this symposium. Some of the material in this book can be found elsewhere and usually in more com plete form; in fact, some sections are so simplified and brief as to be of limited value. This is particularly true of the sec tions on histoanatomy and examination of the fundus. On the other hand, the material in the chapters on retinal disease, inflammatory dis eases and tumors is organized in a most in formative manner. Each of the entities con sidered in these chapters is divided so as to cover clinical features, pathology and mangement independently and then is re viewed in concluding summary and discus sion sections. I found these latter sections to be of considerable value. Points of agree ment are emphasized and no punches are spared in discussing points of disagreement. Sometimes important original information not mentioned in the formal presentations is found in these "off the cuff" discussions. This book is highly recommended for ophthalmologists interested in recent infor mation on a number of difficult retinal prob lems. In general, the material is presented in a simplified, concise and well-organized manner. Alex E. Krill
DIE
CATARACTOPERATION U N D I H R E K O M -
PLIKATIONEN
IN
PATHOLOGISCH-ANA-
By Ernst Landolt. Basel, Switzerland, S. Karger AG, 1966. Paperbound, 94 pages, 121 figures in black and white, bibliography, index. Price: sFr/DM 25.—. This is a most interesting and stimulating monograph. The author discusses the var TOMISCHEN
SICHT.
SEPTEMBER, 1966
ious complications after cataract operations and illustrates their pathologic substrates with numerous photomicrographs. The author first discusses the normal wound healing of the cornea and then the normal and pathologic aspects of the inci sion. He has the impression that epithelial downgrowth is now more frequent than it used to be. Most informative is the chapter on sutures and their influence on the wound. He, correctly, cautions against too many su tures, which may do more harm than good. Original were his first observations on the influence of alpha chymotrypsin on the early stages of wound healing. He could in the meantime examine seven more such globes. He gives good evidence that this enzyme re tards the wound healing for the first few weeks. This study, based on the examination of 70 globes, is an excellent example of clinical and pathologic correlation. It should be of great benefit for every ophthalmic surgeon. Frederick C. Blodi HERITABLE
DISORDERS
OF
CONNECTIVE
By Victor A. McKusick, M.D. St. Louis, The C. V. Mosby Company 1966, edition 3. Clothbound, 499 pages, 190 figures in black and white, 2 figures in color, 12 tables, chapter references, index. Price: $18.50.
TISSUE.
Nature is nowhere accustomed more openly to display her secret mysteries than in cases where she shows traces of her workings apart from the beaten path; nor is there any better way to ad vance the proper practice of medicine than to give our minds to the discovery of the usual law of Nature by careful investigation of cases of rarer forms of disease. For it has been found, in almost all things, that what they contain of useful or applicable nature is hardly perceived unless we are deprived of them, or they become deranged in some way. William Harvey, 1657. A good deal of information about con nective tissue and heritable disorders has been added to our store since the first edi tion of McKusick's book appeared in 1955. I n this edition the author incorporates it into his original, brilliant, painstaking cover-