No abstract

The long-acting somatostatin analogue SMS 201-995 has been shown to be efficient in the treatment of somatotropic and thyrotropic adenomas. In some cases, it can suppress adenoma secretion and lead to tumor shrinkage. Pituitary macroadenomas are often associated with a vision-threatening chiasmal syndrome. In this series, SMS 201-995 was administered subcutaneously to eight patients with pituitary macroadenomas of various types responsible for severe long-lasting visual defects. An obvious improvement of both visual fields and acuity occurred in six patients, in two of these during the first 4 to 6 hours of treatment; in two patients, gonadotropic adenomas were unresponsive. Maximal improvement (normalization of visual fields in three cases) occurred within 6 to 45 days and was sustained during the 1- to 12-month follow-up period. This effect seems independent of the type of adenoma since the adenomas secreting growth hormone (GH) and thyroid-stimulating hormone and silent corticotropic-secreting adenomas responded as well as did two of the non-functioning adenomas. In one acromegalic patient visual improvement was obtained while the abnormal GH secretion remained unaltered. In all cases but one, no tumor shrinkage could be demonstrated. These data demonstrate that SMS 201-995 can rapidly improve the chiasmal syndrome due to pituitary macroadenoma, and suggest that this effect might be independent of a reduction in tumor volume.

No abstract

In normal subjects, saccade amplitude inequality can be induced almost immediately when the image is made larger for one eye. This disconjugacy allows binocular fusion at the point of regard despite the image size inequality. It persists under subsequent monocular viewing which suggests a fast adaptive mechanism. This study tests whether such disconjugacy can be induced in subjects with microstrabismus who do not have foveal fusion. Three microstrabismic subjects viewed a random dot pattern the size of which was 10% larger in one eye. Within 40 sec horizontal saccades became larger in the eye viewing the larger image by 4-10%; the induced disconjugacy persisted under subsequent monocular viewing. Thus, fast disconjugate adaptation is possible in microstrabismus demonstrating that foveal fusion is not necessary to achieve it.

Memory-guided saccades to disparate targets (i.e., more eccentric for one eye) flashed 1 s earlier become disconjugate (i.e., of different amplitude for the two eyes) after only about 30 trials. After about 225 trials the disconjugacy persists even when the target to remember is no longer disparate. This suggests fast learning based on short-term memorization of disparity. Learning, however, fails to occur if during the training the memory delay for each trial is increased to 2 s. The purpose of the present study was to test the importance of the frequency of stimulus presentation and thereby the rate of saccades. The same memory-guided saccade paradigm was used as in the prior study and a short training period of 225 trials was applied. For each training trial, the memory delay was again 2 s, but the time allocated for fixation of the central dot and the time allocated for fixation of the remembered target in the dark was reduced to increase the frequency of saccades made. Saccades became rapidly disconjugate and their disconjugacy was retained in a subsequent neutral condition using non-disparate targets. These findings indicate that stimulus frequency and thereby saccade frequency is important for disconjugate oculomotor learning based on disparity memorization. Nevertheless, additional experiments using longer memory delays of 3 s or 4 s show a definite failure of memorization and disconjugate learning.