Journal of clinical neuro-ophthalmology
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J Clin Neuroophthalmol · Mar 1981
Case ReportsFluorescein angiography of optociliary shunt vessels.
Progressive loss of vision, optic disc pallor, and optociliary shunt vessels (the Hoyt-Spencer sign) constitute the clinical triad of optic nerve sheath meningiomas. However, optociliary shunt vessels may also follow central vein occlusions, and less commonly occur with a few other conditions. This report presents a comparative study of fluorescein angiograms performed on eight patients with optociliary shunt vessels. ⋯ In the optic nerve sheath meningioma group, the shunt vessels fill earlier (in the arteriovenous phase), the flow drains to central venous tributaries, and the late staining is hyperfluorescent to other veins. However, in the central vein occlusion group, the shunts fill later (in the venous phase), show a flow draining to the outer disc margin, and late staining is eufluorescent with other veins. Although optic nerve sheath meningiomas and old vein occlusions are usually rather easily differentiated by a complete examination, the fluorescein angiographic patterns are not only pertinent with regards to the pathogenesis of optociliary vessels, but in certain cases may be clinically helpful in making an important clinical differentiation.
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Stellate ganglion block for relief of pain and prevention of ophthalmic complications in trigeminal herpes zoster has been advised for many years. In a series of 27 patients, control of pain was dramatic after local anesthetic block of the stellate ganglion. ⋯ Because of the retrospective nature of this investigation, the lack of adequate numbers and the absence of controls, no conclusions on efficacy of treatment can be made. However, enough hope of success is presented to justify a controlled series in a large metropolitan area where adequate numbers of patients can be accumulated for a double-blind protocol.