Journal Abstracts Succinylcholine-stimulated muscle tensions following botulinum injection in the domestic cat. Dennehy PJ, Lingua RW, Li KF, Hernandez E, Feuer W Exp Eye Res (1991 Apr) 52(4):445-9 ISSN: 0014-4835 Botulinum Toxins Eye Movements Muscle Contraction Animal Cats Muscles Strabismus Succinylcholine Support U.S. Gov't P.H.S.,Time Factors Abstract Succinylcholine (SCh) selectively stimulates, and can therefore selectively assay, the multiple innervated (MI) fiber system of the extraocular muscles. Since botulinum-A toxin has been observed to induce changes in eye position in humans, SCh was used to assess the effect of botulinum-A on the SCh-sensitive MI fibers of extraocular muscles. Intravenous SCh infusion (40 micrograms-1 kg-1 min-1 was performed in the anesthetized domestic cat. Thirty-eight infusions were performed in 19 normal controls, measuring the peak tensions generated in the four horizontal and four vertical rectus muscles. Succinylcholine-stimulated muscle tensions (SSMT) were then repeated in nine animals, 4 weeks and 10 weeks following injection of botulinum-A toxin into both medial rectus muscles. Mean peak SSMTs were unchanged at 4 and 10 weeks following botulinum injection when compared to controls. We propose that botulinum chemo-denervation has no acute or chronic effect on the MI SCh-sensitive muscle fibers of the medial recti of the domestic cat. This lack of effect on the postsynaptic MI fibers indirectly supports light and electron microscopic studies which show changes predominantly in the singly innervated (SI), rather than the MI fibers following botulinum injection. Mean peak SSMTs were also greater for medial and superior rectus muscles compared to lateral and inferior recti respectively, suggesting a greater number or proportion of MI fibers in medial and superior recti. Bascom Palmer Eye Institute Department of Ophthalmology University of Miami School of Medicine FL. -------------------------------------------------------------------------------- A caliper-hook for strabismus surgery. Lingua RW, Lee W Arch Ophthalmol (1989 Sep) 107(9):1387 ISSN: 0003-9950 Strabismus Surgical Instruments Equipment Design Human Abstract An instrument to assist in resection surgery consists of a telescoping hook within a second hook that can be spread a calibrated distance. Its primary purpose is to maintain a constant tension and an accurate measure of tendon length during suture passage. Additionally, the grooved distal hook supports the needle and protects the globe from needle trauma. University of Miami Bascom Palmer Eye Institute, Fla -------------------------------------------------------------------------------- Sequelae of botulinum toxin injection. Lingua RW Am J Ophthalmol (1985 Aug 15) 100(2):305-7 ISSN: 0002-9394 Blepharospasm Botulinum Toxins Entropion Eyelid Diseases Strabismus Adolescence Blepharoptosis Ecchymosis Human Injections, Intramuscular Keratitis, Dendritic Oculomotor MusclesOphthalmoplegiaPrognosisRecurrence Abstract A total of 136 injections was given to 83 patients for strabismus (99 injections), blepharospasm (29 injections), and spastic entropion (eight injections). All four patients with entropion experienced temporary benefits and early recurrence; one injection resulted in temporary paralytic ectropion. Two of 13 patients treated for blepharospasm developed transient bilateral blepharoptosis. Temporary and related sequelae of extraocular muscle injection included one periocular hemorrhage, one total ophthalmoplegia, and a 44% incidence (29 of 66 patients) of blepharoptosis, which in two patients lasted more than six months. Within three days of injection one patient developed homolateral acute herpes simplex keratitis and a second died of an acute myocardial infarction. No causal relationship for these events has been established. -------------------------------------------------------------------------------- Histopathologic and ultrastructural analysis of congenital corneal staphyloma. Schanzlin DJ, Robin JB, Erickson G, Lingua R, Minckler D, Pickford M Am J Ophthalmol (1983 Apr) 95(4):506-14 ISSN: 0002-9394 Cornea Case Report Corneal Stroma Human Infant Microscopy, Electron Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Abstract Although the visual prognosis for eyes with congenital corneal staphyloma has been considered hopeless, we successfully treated a 1- month-old girl with this condition. We performed two penetrating keratoplasties, operating on the left eye first and then, one week later, on the right eye. During each procedure, we totally resected the staphyloma and excised the iris which was adherent to the posterior surface of the cornea. We then sutured an 11-mm corneal button into place with 34 interrupted 10-0 nylon sutures. Light and transmission electron microscopy of the Descemet's membrane and endothelium. The left eye had two rejection episodes and underwent a second penetrating keratoplasty. The graft in this eye is now opaque. The child follows objects well with her right eye. -------------------------------------------------------------------------------- Gene for hereditary retinoblastoma assigned to human chromosome 13 by linkage to esterase D. Sparkes RS, Murphree AL, Lingua RW, Sparkes MC, Field LL, Funderburk SJ Benedict WF Science (1983 Feb 25) 219(4587):971-3 ISSN: 0036-8075 Chromosomes, Human, 13-15 Retinoblastoma Chromosome Deletion Chromosome Mapping Esterases Human Linkage (Genetics) Support, U.S. Gov't, P.H.S. Medline Database Cancerlit Database Abstract Evaluation of three families with hereditary retinoblastoma demonstrates close linkage of the gene for this tumor with the genetic locus for esterase D. These results assign the gene for the hereditary form of Top of Abstract retinoblastoma to band q14 on chromosome 13, the same region which is affected in the chromosome deletion form of this eye tumor, and therefore suggest a common underlying mechanism in the pathogenesis of these two forms of retinoblastoma. -------------------------------------------------------------------------------- Splenic epidermoid cysts. Robbins FG, Yellin AE, Lingua RW, Craig JR, Turrill FL, Mikkelsen WP Ann Surg (1978 Mar) 187(3):231-5 ISSN: 0003-4932 CystsSplenectomySplenic DiseasesAdolescenceAdult Case ReportDiagnosis, DifferentialFemaleGastrointestinal SystemHuman MaleUltrasonicsUrography Abstract Four patients with splenic masses were operated upon and found to have epidermoid cysts of the spleen, a rare lesion comprising less than 10% of benign, nonparasitic splenic cysts. The patients were young and had vague, non-specific symptoms which were related to the size of the slowly enlarging splenic mass. Three patients had palpable masses. Contrast gastrointestinal studies and intravenous urography will help exclude mass lesions of the gastrointestinal or genitourinary Top of Abstract tract. Sonar scan may confirm the cystic nature of the lesion and localize it to the spleen. A review of 42,327 autopsy records at the Los Angeles County-- University of Southern California Medical Center revealed 32 benign splenic cysts found incidentally at autopsy. Hemorrhage, infection, rupture, and rarely, malignant change are complications of splenic cysts. Splenectomy is recommended to eliminate the symptoms produced by the cyst and prevent the potential complications. -------------------------------------------------------------------------------- Laser in situ keratomileusis to correct residual myopia and astigmatism after radial keratotomy. Shah SB, Lingua RW, Kim CH, Peters NT J Cataract Refract Surg (2000 Aug) 26(8):1152-7 ISSN: 0886-3350 AstigmatismCorneaKeratomileusis, Laser In SituKeratotomy, RadialMyopiaCircadian RhythmComparative StudyHuman Patient SatisfactionQuestionnairesRefraction, OcularReoperationRetrospective StudiesVisual AcuityHealthstar Database Abstract PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) in selected post-radial-keratotomy (RK) eyes with residual myopia and astigmatism. SETTING: TLC-The Brea Laser Eye Center, Brea, California, USA. METHODS: Nine eyes of 6 patients who had had RK but had residual myopia and/or astigmatism had LASIK. All RK eyes had 8 radial incisions, were more than 1 year post-RK, had no epithelial inclusion cysts or corneal disease, and had had no subsequent ocular surgery. Follow-up was a minimum of 13 months, at which time uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, cycloplegic refraction, keratometry, central and peripheral pachymetries, intraocular pressure, and a subjective assessment of visual function were obtained. RESULTS: At the last follow-up, the mean spherical equivalent (SE) was -0.156 diopter (D) +/- 0.174 (SD). All eyes treated for distance vision had a UCVA of 20/25 or better. No patient lost BCVA. No intraoperative or postoperative complications occurred. Seven eyes had morning and evening measurements. The mean change in manifest SE from morning to evening was -0.143 D. Six of the 7 eyes (86%) had 0 to 1 Snellen line change in UCVA from morning to evening. The subjective questionnaire revealed a high degree of satisfaction with overall vision, minimal glare, and less fluctuation in daily vision than before LASIK. CONCLUSION: Laser in situ keratomileusis is safe and efficacious for reducing residual myopia and astigmatism in properly selected RK patients. Department of Ophthalmology University of California, Irvine 92697 -------------------------------------------------------------------------------- Topical intrastromal steroid during laser in situ keratomileusis to retard interface keratitis. Peters NT, Lingua RW, Kim CH J Cataract Refract Surg (1999 Nov) 25(11):1437-40 ISSN: 0886-3350 Corneal StromaGlucocorticoids, SyntheticKeratitisKeratomileusis, Laser In SituPostoperative ComplicationsPrednisoloneAdministration, TopicalAdultAstigmatismComparative StudyFollow-Up StudiesHuman IncidenceIntraoperative PeriodMyopiaProspective StudiesSafetySeverity of Illness IndexTreatment OutcomeVisual AcuityClinical TrialMedline DatabaseHealthstar Database Abstract PURPOSE: To evaluate the effect of an intraoperative topical intrastromal steroid on the incidence and severity of nonspecific diffuse intralamellar keratitis (NSDIK). SETTING: T.L.C. The Laser Center, Brea, California, USA. METHODS: This prospective study included 2 cohort groups, each consisting of 105 consecutive eyes treated with laser in situ keratomileusis (LASIK) for myopia and astigmatism. Group A received the standard LASIK medication protocol and Group B, an additional drop of prednisolone sodium phosphate 1% solution on the undersurface of the cap immediately after it was reflected, prior to initiating the laser treatment. After the laser treatment was completed, the flap was repositioned; 1 minute after the steroid application, the interface was irrigated. All patients were examined postoperatively and placed in 1 of 4 categories: no interface keratitis, grade 1 (mild), grade 2 (moderate with decreased vision), or grade 3 (severe with decreased vision). RESULTS: The incidence of NSDIK in Group A was 17.1% (18 eyes); 14 eyes (78.0%) were grade 1 and 4 (22.0%), grade 2. The incidence in Group B was 6.7% (7 eyes); all eyes were grade 1. Topical intrastromal steroid application significantly reduced the incidence and severity of NSDIK (P < .01). CONCLUSION: We propose that intraoperative intrastromal steroid application is a safe and effective way to reduce the incidence and severity of NSDIK. The Laser Center, Brea, California -------------------------------------------------------------------------------- Contrast sensitivity in dyslexia. Gross-Glenn K, Skottun BC, Glenn W, Kushch A, Lingua R, Dunbar M, Jallad B Lubs HA, Levin B, Rabin M, et al Vis Neurosci (1995 Jan-Feb) 12(1):153-63 ISSN: 0952-5238 Contrast SensitivityDyslexiaAdolescenceAdultFemaleHumanMale Middle AgeReadingSpace PerceptionSupport, U.S. Gov't, P.H.S.Time PerceptionVision Tests Abstract Contrast sensitivity was determined for dyslexic and normal readers. When testing with temporally ramped (i.e. stimuli with gradual temporal onsets and offsets) gratings of 0.6, 4.0, and 12.0 cycles/deg, we found no difference in contrast sensitivity between dyslexic readers and controls. Using 12.0 cycles/deg gratings with transient (i.e. abrupt) onsets and offsets, we found that dyslexic individuals had, compared to controls, markedly inferior contrast sensitivity at the shortest stimulus durations (i.e. 17, 34, and 102 ms). This deficit may reflect more sluggish temporal summation. There was no difference in sensitivity to 0.6 cycles/deg gratings with transient onsets and offsets. Under these conditions, the two groups showed a consistent and equal increase in sensitivity Top of Abstract relative to the ramped baseline condition at 0.6 cycles/deg at the longer stimulus durations. This demonstrates that dyslexic readers have no deficit in their ability to detect stimulus transients, a finding which appears to be inconsistent with a transient system deficit. That detection of the low-frequency stimuli was mediated by the transient system is further indicated by the fact that these stimuli were more susceptible to forward masking than were the high-frequency stimuli. The effects of masking of both high and low spatial-frequency stimuli were about equal for dyslexic readers and controls. This is not in agreement with the transient system deficit theory, according to which one would expect there to be less masking of high spatial- frequency stimuli in the case of dyslexic readers. Department of Pediatrics University of Miami School of Medicine, FL 3310 -------------------------------------------------------------------------------- Cataract extraction and intraocular lens implantation in an infant with a monocular congenital cataract. Sinskey RM, Amin PA, Lingua R J Cataract Refract Surg (1994 Nov) 20(6):647-51 ISSN: 0886-3350 CataractCataract ExtractionLenses, IntraocularAmblyopiaCase ReportFollow-Up StudiesHuman Infant, NewbornLens Capsule, CrystallineMalePrognosisSensory DeprivationVision, Monocular Abstract A cataract extraction and primary capsulotomy with intraocular lens (IOL) implantation was performed on a 17-day-old infant with a monocular mature congenital cataract. The IOL power, calculated at the time of surgery, was undercorrected to Top of Abstract compensate for the growth of the eyeball. Two additional surgical procedures were required to resolve visual axis obstruction caused by lens epithelial cell proliferation. Follow-up was 18 months, during which amblyopia prevention therapy was instituted. Sinskey Ophthalmic Center Santa Monica, California 90411. -------------------------------------------------------------------------------- Intraoperative succinylcholine and the postoperative eye alignment [published erratum appears in J Pediatr Ophthalmol Strabismus 1994 Jan-Feb;31(1):56] Lingua RW, Feuer W J Pediatr Ophthalmol Strabismus (1992 May-Jun) 29(3):167-70 ISSN: 0191-3913 EyeStrabismusSuccinylcholineHumanInjections, IntravenousIntraoperative Complications Muscle ContractionOculomotor MusclesPostoperative ComplicationsRegression AnalysisSupport, U.S. Gov't, P.H.S. Abstract In 99 patients undergoing strabismus surgery, an intravenous bolus of succinylcholine (Sch) was given after completion of the strabismus procedure. Reliable data were obtained in 53 patients. The interlimbal distance measured at 60 seconds after injection (VR60) was compared to the interlimbal distance at 1 and 6 weeks postoperatively, to evaluate the correlation between the drug-induced eye position under anesthesia and the awake-eye alignment postoperatively. Correlations were highest in patients undergoing symmetric recessions of the medial or lateral recti in primary horizontal Top of Abstract strabismus. Confidence intervals of 0.8 to 1.2 were noted for both the esotropia and exotropia groups. Two patients experienced Sch-related complications of masseter spasm and prolonged apnea. Although infrequent, the potential gravity of the complications from Sch use and the currently enjoyed high rate of success in primary strabismus surgery suggest that these formulas not be used clinically. Nonetheless, the high correlations between the drug- induced and awake ocular position provide further support to the premise that the Sch sensitive fibers provide an important motor component to the awake eye position. Department of Ophthalmology Bascom Palmer Eye Institute University of Miami School of Medicine, Fla. -------------------------------------------------------------------------------- Synergistic divergence: saccadic velocity analysis and surgical results. Hamed LM, Lingua RW, Fanous MM, Saunders TG, Lusby FW J Pediatr Ophthalmol Strabismus (1992 Jan-Feb) 29(1):30-7 ISSN: 0191-3913 Ocular Motility DisordersSaccadesAdolescenceAdultCase ReportChild, PreschoolElectromyography ExotropiaFemaleHumanInfantMaleSupport, Non-U.S. Gov'tTreatment Outcome Abstract The clinical findings are described in four patients with synergistic divergence (SD), an ocular motility disorder which is considered to be a variant of Duane retraction syndrome (DRS). Saccadic velocity studies in three patients demonstrated preserved abducting saccades in the affected eye with equally reduced amplitudes on both attempted abduction and adduction. The preserved saccades on attempted abduction of the affected eye, coupled with electromyographic evidence that shows maintenance of normal reciprocal innervation with respect to gaze on attempted abduction as dictated by Sherrington's law, Top of Abstract strongly suggest that the abducens nerve is not necessarily absent or severely hypoplastic in this condition. One patient showed typical DRS in the contralateral eye and had a son with bilateral DRS, attesting to a possible genetic and etiologic relationship between SD and DRS. Three patients underwent strabismus surgery. Review of our surgical results and an analysis of the literature indicate that a crippling procedure to the ipsilateral lateral rectus muscle, such as extirpation, may be necessary to eliminate simultaneous abduction. Overcorrection did not occur following lateral rectus extirpation. University of Florida Department of Ophthalmology Gainesville. -------------------------------------------------------------------------------- Synergistic divergence and jaw-winking phenomenon. Hamed LM, Dennehy PJ, Lingua RW J Pediatr Ophthalmol Strabismus (1990 Mar-Apr) 27(2):88-90 ISSN: 0191-3913 Ocular Motility DisordersOculomotor NerveTrigeminal NerveAdolescenceCase ReportConvergence, OcularCranial Nerve Diseases EyelidsFemaleHumanOculomotor MusclesSupport, Non-U.S. Gov'tSyndrome Abstract Synergistic divergence is a congenital syndrome of monocular adduction deficit, with simultaneous abduction of both eyes on attempted gaze into the field of action of the paretic medial rectus muscle. Based on electromyographic data, it has been speculated that it is a neural miswiring disorder related to Top of Abstract Duane's retraction syndrome. The association between Duane's retraction syndrome and the Marcus Gunn jaw-winking phenomenon, another neural miswiring disorder, has been previously reported. The authors describe a patient with both bilateral synergistic divergence and Marcus Gunn jaw-winking phenomenon. Bascom Palmer Eye Institute University of Miami School of Medicine, Fla. -------------------------------------------------------------------------------- Thyroid eye disease presenting after cataract surgery. Hamed LM, Lingua RW J Pediatr Ophthalmol Strabismus (1990 Jan-Feb) 27(1):10-5 ISSN: 0191-3913 Cataract ExtractionStrabismusThyroid DiseasesAgedAged, 80 and over Case ReportDiplopiaFemaleHumanMale Oculomotor MusclesSupport, Non-U.S. Gov'tTomography, X-Ray ComputedUltrasonographyVisual Acuity Abstract Strabismus presenting after cataract surgery has been attributed to a variety of disorders, some of which are unrelated to the surgery. When thorough ophthalmologic and neurologic examinations fail to elucidate a definitive etiology, the motility disturbance is often ascribed to operative trauma to the orbital soft tissues. In a series of 58 patients with strabismus presenting after cataract surgery, eight (14%) were found to have previously unsuspected thyroid eye disease. Three of the eight patients had past histories of systemic dysthyroidism, but none reported diplopia prior to cataract extraction. Three of the Top of Abstract remaining five patients showed normal thyroid function tests. Absence of diplopia prior to cataract extraction in these patients may be due to: 1) poor vision precluding diplopia until surgical restoration of sight; 2) intraoperative aggravation of the inflammatory process in otherwise subclinical thyroid eye disease; or 3) onset of clinical thyroid eye disease that was temporally associated with cataract surgery by chance. Thyroid eye disease should be included in the differential diagnosis of all patients presenting with binocular diplopia following cataract surgery. Suitable neuroimaging studies may be needed to confirm the diagnosis. Bascom Palmer Eye Institute University of Miami School of Medicine, Fla. -------------------------------------------------------------------------------- Reliability and variability in the measurement of interlimbal distance with a semiautomated video replay analysis system (SAVRAS. Lingua RW, Azen SP, Doiron D, Egge A, Levin L, Emry JK, Baker S J Pediatr Ophthalmol Strabismus (1986 Mar-Apr) 23(2):74-9 ISSN: 0191-3913 EsotropiaExotropiaEyeOphthalmologyStrabismusVideotape RecordingChild, Preschool Comparative StudyEvaluation StudiesHumanInfantPostoperative PeriodSupport, U.S. Gov't, P.H.S.Wakefulness Abstract This paper reports on the reliability and variability of a semi- automated, video replay and analysis system (SAVRAS) in determining interlimbal distance in patients with strabismus. Factors under investigation were: choice of observer, choice of video frame, patient age and patient Top of Abstract state (awake or anesthetized). It was demonstrated that SAVRAS was a highly reliable and reproducible system. This system is currently in use to evaluate the relationship between the succinylcholine induced ocular position, under anesthesia, and the postoperative awake alignment. -------------------------------------------------------------------------------- A comparison of the succinylcholine induced ocular position and the postoperative alignment in strabismus. Lingua RW, Azen SP, Walonker F, Levin L, Baker S J Pediatr Ophthalmol Strabismus (1986 Mar-Apr) 23(2):69-73 ISSN: 0191-3913 Oculomotor MusclesStrabismusSuccinylcholineAdolescenceAdultChildChild, PreschoolComparative Study HumanInfantMethodsPostoperative PeriodRegression AnalysisSupport, U.S. Gov't, P.H.S.Videotape Recording Abstract Succinylcholine was injected intraoperatively in 41 strabismus patients with congenital esotropia or intermittent or constant exotropia. Regression analyses were performed to investigate the predictive relationships between the one-, six-, and 26-week postoperative alignment and the intraoperative, succinylcholine- induced ocular position. Ocular position, determined by the interlimbal distance in millimeters, was calculated using a semi- automated, video replay analysis system. Large, statistically significant correlation coefficients were obtained for patients undergoing bimedial recessions of 4.0 to 5.5 mm and bilateral Top of Abstract lateral rectus recessions of 5.0 to 7.0 mm. Small correlations were obtained for esotropes undergoing the recession/resection procedure and those with bimedial recessions of 6.0 mm or greater. These data support the theory that the succinylcholine-sensitive subgroup of the extraocular muscle fibers are those whose tonic contracture provide the motor component to ocular alignment. Sample sizes at present are insufficient to suggest clinical use of these data. In future research, these relationships will be tested for their ability to predict postoperative alignment and thereby, improve success rates in strabismus surgery. -------------------------------------------------------------------------------- GENE FOR HEREDITARY RETINOBLASTOMA ASSIGNED TO HUMAN CHROMOSOME 13 BY LINKAGE TO ESTERASE D Sparkes RS, Murphree AL, Lingua RW, Sparkes MC, Field LL, Funderburk SJ Benedict WF Science (1983) 219(4587):971-983 1983 ISSN: 0036-8075 Cancerlit Database Abstract In a previous study, the locus for esterase D (ESD) was assigned to chromosomal region 13q14 by deletion mapping. Evaluation of three families with hereditary retinoblastoma (HR) is presented which demonstrates close linkage of the gene for HR with the genetic locus for ESD. The results assign the gene for the hereditary form of retinoblastoma to band q14 on chromosome 13. ESD enzyme activity and electrophoretic types were evaluated in 35 families in which the inherited form of retinoblastoma occurs. Three families were informative for linkage analysis; that is, the affected parent carried both ESD Types 1 and 2 so that transmission of the disease gene and ESD Top of Abstract type to the children could be followed. Genetic linkage analysis was performed with the use of program LIPED, which calculates for each pedigree the odds of linkage vs no linkage at specified values of recombination fraction theta (a measure of the distance between two loci). The new gene map made on the basis of the study indicates that the ESD locus is close to the genetic locus for the inherited nondeletion form of retinoblastoma. It is thus possible in informative families to use the ESD electrophoretic type to predict who may be at risk to develop retinoblastoma before the disease has become manifest in the individual, allowing early institution of therapy. (8 Refs) Div. Medical Genetics Dept. Medicine UCLA Center for the Health Sciences Los Angeles, CA 90024 -------------------------------------------------------------------------------- PRECLINICAL EVALUATION OF HEMATOPORPHYRIN DERIVATIVE FOR THE TREATMENT OF INTRAOCULAR TUMORS: A PRELIMINARY REPORT Gomer CJ, Szirth BC, Doiron DR, Jester JV, Lingua RW, Mark C, Benedict WF Murphree AL Adv Exp Med Biol (1983) 160:109-114 1983 Meeting Paper Cancerlit Database Abstract Preclinical studies designed to evaluate the efficacy of hematoporphyrin derivative (HPD) photoradiation therapy (PRT) as a primary clinical modality for treating ocular tumors were performed. Areas under investigation included (1) development of relevant animal ocular tumor models, (2) quantifying HPD concentrations in normal and tumor tissue of the eye, (3) documentation of normal ocular tissue toxicity induced by HPD PRT, and (4) examining the effectiveness of HPD PRT to selectively treat ocular tumors. Two experimental ocular tumor models were utilized, human retinoblastoma heterotransplanted to the anterior chamber of athymic (nude) mice and the amelanotic hamster melanoma. Studies with the amelanotic melanoma transplanted in the rabbit anterior chamber indicated that at 24 and 48 hr after iv administration of [3H]-HPD (5.0 mg/kg) the tumor tissue Top of Abstract retained 3.4 and 1.5 mg [3H]-HPD/g, respectively. These levels were higher than in any other ocular structure. An acute toxicity study utilizing 41 pigmented rabbit eyes was performed. Fundus examinations demonstrated that toxicity in the forms of retinal edema, detachment, and hemorrhage could be observed as early as 2 days following a single PRT treatment (5.0 mg HPD/kg, 100 milliwatt/square cm). A chronic toxicity study has been started. The effectiveness of HPD PRT in treating single nodule tumors (4.0-8.0 mm in diameter) growing in the anterior chamber of pigmented rabbit eyes was examined. Preliminary results obtained from 14 treated eyes indicated that the HPD PRT dose response for tumor treatment was similar to that which was observed in normal ocular tissue toxicity studies. Additional experiments are needed in order to determine the definitive dose- response for tumor kill. (8 Refs) Clayton Center for Ocular Oncology Children's Hosp. Los Angeles 4650 Sunset Blvd., Los Angeles, CA 90027 -------------------------------------------------------------------------------- Succinylcholine as a predictor in strabismus surgery. Lingua RW, Azen S, Szirth B, Edelman P, Walonker F J Pediatr Ophthalmol Strabismus (1983 Jul-Aug) 20(4):145-8 ISSN: 0191-3913 EsotropiaOculomotor MusclesStrabismusSuccinylcholineAnesthesia, General ChildFollow-Up StudiesHumanPrognosisSupport, U.S. Gov't, P.H.S. Abstract Succinylcholine was injected intraoperatively in 20 patients with congenital esotropia, before and after the surgical procedure. Regression analysis was performed to investigate the relationship between the awake pre- and postoperative alignment and the drug- induced ocular positions, under Top of Abstract anesthesia. The postoperative succinylcholine-induced ocular position was found to be a highly significant predictor of the one week postoperative alignment (r = 0.98, p less than 0.0001). Further investigation may lead to an ability to predict the postoperative alignment intraoperatively. -------------------------------------------------------------------------------- TUMOR REGRESSION OF HUMAN RETINOBLASTOMA IN THE NUDE MOUSE FOLLOWING PHOTORADIATION THERAPY: A PRELIMINARY REPORT Benedict WF, Lingua RW, Doiron DR, Dawson JA, Murphree AL Med Pediatr Oncol (1980) 8(4):397-401 1980 Cancerlit Database Abstract Retinoblastoma is the most common malignant intraocular neoplasm of childhood. Enucleation of both eyes is necessary in some advanced cases where radiotherapy and other modalities of treatment have failed. We present in this paper our initial observation Top of Abstract that photoradiation therapy (the combination of the photosensitizing drug, hematoporphyrin derivative, and red light) produces marked tumor cytotoxicity in human retinoblastoma heterotransplanted into the anterior chamber of the nude mouse eye. (Author abstract) (9 Refs) Childrens Hosp. Los Angeles Clayton Ocular Oncology Center 4650 Sunset Blvd., Los Angeles, CA 90027 -------------------------------------------------------------------------------- Tumor regression of human retinoblastoma in the nude mouse following photoradiation therapy: a preliminary report. Benedict WF, Lingua RW, Doiron DR, Dawson JA, Murphree AL Med Pediatr Oncol (1980) 8(4):397-401 ISSN: 0098-1532 Eye NeoplasmsMice, NudePhotochemotherapyRetinoblastomaAnimalCell LineCorneaHematoporphyrins Infrared RaysMiceNecrosisNeoplasm TransplantationTransplantation, HeterologousMedline DatabaseCancerlit Database Abstract Retinoblastoma is the most common malignant intraocular neoplasm of childhood. Enucleation of both eyes is necessary in some advanced cases where radiotherpy and other modalities of treatment have failed. We present in this paper our initial Top of Abstract -------------------------------------------------------------------------------- Abberrant muscular insertions in Crouzon's disease. Captuo AR, Lingua RW J Pediatr Ophthalmol Strabismus (1980 Jul-Aug) 17(4):239-41 ISSN: 0191-3913 Craniofacial DysostosisStrabismusAdult Case ReportHumanMale Oculomotor MusclesSupport, Non-U.S. Gov't Abstract Herein we present a case of Crouzon's disease with anomalous medial rectus formation and horizontal recti insertions. This adds a feature of the disease to the literature and reminds us to approach Top of Abstract strabismus in orbital anomalies cautiously via a limbal peritomy. As the overall prognosis for these patients continues to improve we anticipate that more of these patients will seek strabismus surgery. -------------------------------------------------------------------------------- The problem of cycloplegia in the pediatric age group: a combination formula for refraction. Caputo AR, Lingua RW J Pediatr Ophthalmol Strabismus (1980 Mar-Apr) 17(2):119-28 ISSN: 0191-3913 MydriaticsRefractive ErrorsAge Factors ChildCyclopentolateDrug Combinations HumanPhenylephrineTropicamide Abstract Cycloplegic refraction and indirect ophthalmoscopy are essential to evaluation of the pediatric patient. Unfortunately, along with this practice occur the attendant risks of toxicity and the unpleasantness of instillation. The literature that documents the development of cycloplegic agents is often contradictory regarding efficacy and side effects. It is presented for perspective. We have found that efficacy and discomfort are inseparable; however, as with efficacy and toxicity they are directly Top of Abstract related to the concentration used. The case is therefore made to use each agent in its minimal effective concentration and thereby minimize both discomfort and toxicity. Our combination of 1.3% cyclogyl, .167% mydriacil, and 1.6% phenylephrine accomplishes effective cycloplegia for refraction and indirect ophthalmoscopy, has a rapid onset and short duration, works reliably in dark irides, is accomplished in a single encounter with the patient, and exhibits none of the side effects of the individual agents in our series. -------------------------------------------------------------------------------- SPLENIC EPIDERMOID CYSTS Robbins FG, Yellin AE, Lingua RW, Craig JR, Turill FL, Mikkelsen WP Ann Surg (1978) 187(3):231-235 1978 ISSN: 0003-4932 Cancerlit Database Abstract Four patients with splenic masses were operated upon and found to have epidermoid cysts of the spleen, a rare lesion comprising less than 10% of benign, nonparasitic splenic cysts. The patients were young and had vague, nonspecific symptoms which were related to the size of the slowly enlarging splenic mass. Three patients had palpable masses. Contrast gastrointestinal studies and iv urography will help exclude mass lesions of the gastrointestinal Top of Abstract or genitourinary tract. Sonar scan may confirm the cystic nature of the lesion and localize it to the spleen. A review of 42,327 autopsy records revealed 32 benign splenic cysts found incidentally at autopsy. Hemorrhage, infection, rupture, and rarely, malignant change are complications of splenic cysts. Splenectomy is recommended to eliminate the symptoms produced by the cyst and prevent the potential complications. (Author abstract) (15 Refs) Dept. Surgery Univ. Southern California Medical Center Los Angeles, CA -------------------------------------------------------------------------------- Surgical management of Duane retraction syndrome [letter; comment] Lingua RW J Pediatr Ophthalmol Strabismus (1995 Jan-Feb) 32(1):67-8 ISSN: 0191-3913 Duane's SyndromeOculomotor MusclesAdult Eye MovementsFemaleHuman CommentLetter Comment on: J Pediatr Ophthalmol Strabismus 1994 May-Jun;31(3):162-9; discussion 170-1 -------------------------------------------------------------------------------- Photodynamic therapy for ocular tumors. Lingua RW J Photochem Photobiol B (1991 Apr) 9(1):119-22 ISSN: 1011-1344 Eye NeoplasmsPhotochemotherapyChoroid NeoplasmsHuman MelanomaRetinoblastomaReviewReview, Tutorial Medline DatabaseCancerlit Database Loma Linda University Eye Medical Group, CA 92354. -------------------------------------------------------------------------------- Pressure patch treatment for congenital upper eyelid eversion [letter] Kronish JW, Lingua R Arch Ophthalmol (1991 Jun) 109(6):767-8 ISSN: 0003-9950 BandagesEctropion HumanMethods Letter -------------------------------------------------------------------------------- Protein C deficiency associated with vitreous hemorrhage in a neonate. Pulido JS, Lingua RW, Cristol S, Byrne SF Am J Ophthalmol (1987 Nov 15) 104(5):546-7 ISSN: 0002-9394 Protein CVitreous Hemorrhage Case ReportHuman Infant, NewbornMale Department of Ophthalmology Bascom Palmer Eye Institute University of Miami School of Medicine, FL 33101. -------------------------------------------------------------------------------- Comparison of the succinylcholine induced ocular position and the postoperative alignment in strabismus. Lingua RW, Levin L, Azen SP, Baker S, Walonker F J Ophthalmic Nurs Technol (1987 Jan-Feb) 6(1):7-13 ISSN: 0744-7132 StrabismusSuccinylcholineAdolescenceAdultChildChild, PreschoolComparative Study EsotropiaExotropiaHumanInfantMiddle AgeOculomotor MusclesSupport, U.S. Gov't, P.H.S. -------------------------------------------------------------------------------- Succinyldicholine and the basic ocular deviation [letter] Lingua RW, Azen S Am J Ophthalmol (1983 Jul) 96(1):120-2 ISSN: 0002-9394 Fixation, OcularSuccinylcholine HumanPostoperative Period StrabismusLetter -------------------------------------------------------------------------------- Preclinical evaluation of hematoporphyrin derivative for the treatment of intraocular tumors: a preliminary report. Gomer CJ, Szirth BC, Doiron DR, Jester JV, Lingua RW, Mark C, Benedict WF Murphree AL Adv Exp Med Biol (1983) 160:109-14 ISSN: 0065-2598 Eye NeoplasmsHematoporphyrinsMelanomaPhotochemotherapyDrug EvaluationEye HumanSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Medline DatabaseHealthstar DatabaseCancerlit Database Check back often for updates!

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