ABSTRACT
The treatment of small cell lung cancer (SCLC) is a challenge for all specialists involved. New treatments have been added to the therapeutic armamentarium in recent months, but efforts must continue to improve both survival and quality of life. Advances in surgery and radiotherapy have resulted in prolonged survival times and fewer complications, while more careful patient selection has led to increased staging accuracy. Developments in the field of systemic therapy have resulted in changes to clinical guidelines and the management of patients with advanced disease, mainly with the introduction of immunotherapy. In this article, we describe recent improvements in the management of patients with SCLC, review current treatments, and discuss future lines of research.
ABSTRACT
PURPOSE: To report the findings of unilateral cystoid macular edema (CME) associated with bilateral sub-foveal hyperreflectivity in a patient previously diagnosed with breast cancer and treated with docetaxel and cyclophosphamide. OBSERVATIONS: A 69-year-old female on docetaxel and cyclophosphamide chemotherapy treatment for breast cancer developed blurry vision 20 days after initiation of therapy. Ophthalmic examination revealed reduced visual acuity with bilateral retinal pigment epithelium mottling and annular sub-foveal thickening in the left eye. Optical coherence tomography (OCT) showed cystoid macular changes in the right eye and central sub-macular hyperreflectivity of outer layers in both eyes. Six-months after discontinuation of therapy, OCT findings remained unchanged and visual acuity did not improve. CONCLUSIONSAND IMPORTANCE: CME may occur in patients taking taxanes, but this finding associated with sub-macular hyperreflectivity of the outer layers in diagnostic testing has never been reported before. Sub-macular deposits found in this patient may be responsible for decreased vision and did not respond to cessation of therapy.
ABSTRACT
We report the case of a 9-year-old girl with chiasmal glioma and longstanding monocular nystagmus, in whom video-oculography showed a disconjugate binocular nystagmus indistinguishable from spasmus nutans. The "acquired monocular nystagmus" associated with chiasmal glioma is actually a binocular nystagmus that is indistinguishable from spasmus nutans, except that it lacks the associated head nodding and torticollis. Superimposed visual loss in one eye predisposes to acquired monocular nystagmus and explains the absence of the other components of the spasmus nutans triad.
Subject(s)
Diagnostic Techniques, Ophthalmological , Eye Movements/physiology , Glioma/complications , Nystagmus, Pathologic/etiology , Optic Chiasm , Optic Nerve Neoplasms/complications , Child , Diagnosis, Differential , Female , Glioma/diagnosis , Humans , Magnetic Resonance Imaging , Nystagmus, Pathologic/diagnosis , Nystagmus, Pathologic/physiopathology , Optic Nerve Neoplasms/diagnosisABSTRACT
PURPOSE: To evaluate the effects of isolated inferior oblique (IO) muscle recession in patients with superior oblique palsy (SOP) and persistent hypertropia in abduction. METHODS: Retrospective review of patients with unilateral SOP who were treated with isolated IO recession by a single surgeon (MCB) between January 2008 and December 2017. We included patients with congenital and acquired fourth nerve palsies, with a hyperdeviation of less than 20 prism diopters in primary position and at least 4 prism diopters in abduction by prism and alternate cover test (PACT) during distance fixation. A minimum follow-up of 4-6 weeks was required. Age at surgery, etiology, presence of head tilt, motor alignment in primary and secondary gaze positions at distance and near using PACT, versions, ductions, and torsion were recorded from the patients' chart. RESULTS: Seven patients with SOP were included in this study. Four (57.14%) males, with a mean age at presentation of 41.86 years (range: 6-66 years). Mean follow-up was 13.25 months (range: 1.3-52.2 months). A decrease in mean central gaze hypertropia from 11.4 to 1.71 PD was found. A mean contralateral gaze hypertropia that decreased from 22.28 to 5.71 PD and an ipsilateral gaze hypertropia that improved from 5.86 to 1.14 PD were also noted. Torsion had a mean change of 3.4° of incyclodeviation at the final examination. CONCLUSIONS: This study confirms the efficacy of isolated maximal IO recession for the treatment of unilateral SOP that is accompanied by a modest hypertropia of the paretic eye in abduction.
Subject(s)
Oculomotor Muscles/surgery , Ophthalmologic Surgical Procedures , Strabismus/surgery , Trochlear Nerve Diseases/surgery , Adolescent , Adult , Aged , Child , Diplopia/diagnosis , Eye Movements/physiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Oculomotor Muscles/innervation , Retrospective Studies , Strabismus/diagnosis , Strabismus/physiopathology , Treatment Outcome , Trochlear Nerve Diseases/diagnosis , Trochlear Nerve Diseases/physiopathology , Vision, Binocular/physiologyABSTRACT
A 4-year-old girl with maxillary hypoplasia, intermittent exotropia, and high myopia displayed congenital oculonasal synkinesis. We examine the implications for pathogenesis of these disparate craniofacial findings.