Tumors of the Optic Nerve

Abstract

In corroboration of Dr. Schoenberg's statement that there are undoubted cases of tuberculosis of the eye that do not react to tuberculins, I wish to recall the article by my associates Drs. Dodd and Lane of Chicago, read before this Section two years ago, in which miliary tuberculosis with the organism was identified in the ciliary body and iris. Successive doses up to 10 mg. had been used with no reaction on the part of the patient.Dr. R. L. Randolph, Baltimore : How did Dr. Schoenberg inject living organisms into the eye, in what medium were they suspended and how much was injected? The organ¬ isms I have dealt with, no matter how slightly pathogenic they may have been, have always been followed by more or less reaction when injected into the eye. I was very much surprised to hear Dr. Schoenberg's interesting observations on this point.Dr. F. H. Verhoeff, Boston : I cannot agree with Dr. Schoenberg that my experiments on rabbits were vitiated by the fact that dead instead of living tubercle bacilli were injected into the vitreous or aqueous humors. The purpose of the exper¬ iments was simply to show where the bacilli finally lodged in the eye, that is, to show the location of the lesions to be expected relatively avirulent if tubercle bacilli should be secreted by the ciliary body into the aqueous humor. In this respect the experiments were eminently successful. I agree with Dr. Schoenberg that the involvement of the human eye in chronic ocular tuberculosis is due, at least in part, to some peculiarity in the character of the bacilli, and in my paper I attempt to give the reason for this peculiarity.

Fractionated radiotherapy for optic nerve sheath meningiomas

“…40,41 Although Byers was the first to report the use of RT for ONSM in the early 1900s, 42 it was not until 1981 that Smith first demonstrated clinically effective results for RT for ONSM. 16 Other early reports documented the use of RT with total doses at around 55 Gy showing favorable outcomes.…”

Primary optic nerve sheath meningioma

“…More successful was the lateral orbital approach, particularly for tumors located in the anterior or midorbit, but the problem of adequate treatment of apical orbital ONSM largely remained. 46 An intracranial approach (frontal craniotomy) 47 and its modifications 48,49 enabled complete extirpation of ONSM up to the chiasm. This approach, coupled with orbitotomy for biopsy, was largely standard practice in the past decades.…”

“…The history of RT alone in ONSM starts with the report of Byers, 46 who credited McReynolds with the first use of this treatment modality. However, it was Smith et al 28 who were the first to clearly document the effectiveness of RT in pONSM.…”