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Goldstein DE, Blinder KJ, Ide CH, Wilson RJ, Wiedmeyer HM, Little RR, England JD, Eddy M, Hewett JE, Anderson SK. Glycemic control and development of retinopathy in youth-onset insulin-dependent diabetes mellitus. Results of a 12-year longitudinal study. Ophthalmology 1993; 100:1125-31; discussion 1131-2. [PMID: 8341491 DOI: 10.1016/s0161-6420(93)31516-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In 1979, the authors began a prospective study of the natural history of retinopathy in youth-onset insulin-dependent diabetes mellitus (IDDM). Their major goal was to determine if there was an association between glycemic control and the development and progression of retinopathy. METHODS The study consisted of 420 individuals with IDDM (onset younger than 20 years of age) and no retinopathy at baseline. Study subjects were enrolled between 1979 and 1988. Stereo color fundus photographs were obtained annually. Two eye endpoints were recorded: duration when retinopathy was first detected, and when proliferative retinopathy was detected. Glycemic control was assessed by quarterly determinations of glycohemoglobin (GHb). Life-table analyses were performed relating duration of diabetes, sex, GHb, and age of diabetes onset to development of retinopathy. RESULTS Retinopathy did not develop before 2 years' duration or before puberty. The prevalence of retinopathy was 50% by 9 years' duration and 100% by 20 years' duration. Retinopathy developed in females approximately 2 years sooner than in males, but plotting duration as postpubertal years resulted in nearly identical rates. Retinopathy developed significantly earlier in subjects with prepubertal onset of diabetes than in subjects with postpubertal onset if duration was plotted as postpubertal years. When separated into three groups based on GHb levels (< 7.5%, 7.5%-9%, > 9%), retinopathy developed approximately 2 years later in subjects in the less than 7.5% GHb group than those in the higher GHb groups. Proliferative retinopathy developed in 11 subjects. Their mean GHb level was higher than the mean GHb for those without proliferative retinopathy (10.9 versus 8.6%; P < 0.01). The higher the level of GHb, the sooner proliferative changes were detected. CONCLUSION Long-term glycemic control is significantly related to both development and progression of retinopathy. Prepubertal duration of diabetes is a significant risk factor for the development of retinopathy.
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Affiliation(s)
- D E Goldstein
- Department of Child Health, University of Missouri School of Medicine, Columbia
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Abstract
We conducted a randomly assigned, double-masked, controlled clinical trial to assess the efficacy of 1% apraclonidine hydrochloride in controlling postoperative intraocular pressure increases in patients undergoing extracapsular cataract extraction. Apraclonidine hydrochloride was given either one hour preoperatively or immediately after uncomplicated, extracapsular cataract extraction with posterior chamber intraocular lens implantation and compared with artificial tears given immediately postoperatively. Those who received apraclonidine hydrochloride preoperatively had significantly lower mean intraocular pressure at the first postoperative reading (P = .0005). After preoperative and postoperative apraclonidine hydrochloride, the mean early postoperative intraocular pressure was 19.8 mm Hg and 32.0 mm Hg, respectively, and 27.6 mm Hg after artificial tears. No patient who received preoperative apraclonidine hydrochloride had an intraocular pressure increase to 30 mm Hg or higher postoperatively. Nine of 20 patients (45%) who received postoperative apraclonidine hydrochloride and eight of 18 patients (44%) who received postoperative artificial tears had an increase of intraocular pressure to 30 mm Hg or higher in the early postoperative period. These differences were also highly significant (P = .0005).
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Affiliation(s)
- S B Wiles
- University of Missouri-Columbia, Mason Institute of Ophthalmology 65212
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Blinder KJ, Khan JA, Giangiacomo J, Ide CH. Optociliary veins and visual prognosis after central retinal vein occlusion. Ann Ophthalmol 1989; 21:192-4, 197. [PMID: 2742293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The effect of acquired optociliary veins on visual acuity after ischemic central retinal vein occlusion in patients 45 years of age or older was assessed retrospectively. Fundus photographs and medical records of 21 patients, 45 years of age or older, with photographically documented central retinal vein occlusion and at least six-months follow-up were analyzed. Eleven of 21 patients developed acquired optociliary veins. Patients with acquired optociliary veins were more likely to experience stable or improved visual acuity (nine of 11 patients) than were patients without them (four of ten patients) over a mean follow-up period of 30 months (P = .049).
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Affiliation(s)
- K J Blinder
- Mason Institute of Ophthalmology, University of Missouri, Columbia 65212
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West DR, Lischwe TD, Thompson VM, Ide CH. Comparative efficacy of the beta-blockers for the prevention of increased intraocular pressure after cataract extraction. Am J Ophthalmol 1988; 106:168-73. [PMID: 2899977 DOI: 10.1016/0002-9394(88)90829-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We conducted a randomized, double-masked study of intraocular pressure in 80 patients treated with betaxolol, levobunolol, timolol, or placebo after extracapsular cataract extraction. Intraocular pressures were measured preoperatively and early (four to seven hours) and late (20 to 24 hours) postoperatively. There was a significant mean increase in pressure from the preoperative period to the early postoperative period for the placebo group (5.35 mm Hg), betaxolol group (6.73 mm Hg), and the timolol group (3.83 mm Hg). However, the levobunolol group had a mean decrease in pressure (0.43 mm Hg). There was no significant difference between preoperative and late postoperative pressures for any of the groups. One-way analysis of covariance of the changes in pressure from the preoperative to early postoperative period showed a significant increase for the placebo and betaxolol groups compared to the levobunolol group, without significant difference between the levobunolol and timolol groups. Overall, levobunolol proved most effective in preventing an increase in intraocular pressure after extracapsular cataract extraction; timolol was partially effective.
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Affiliation(s)
- D R West
- Mason Institute of Ophthalmology, University of Missouri, Columbia 65212
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Abstract
Coats'-like changes (i.e., retinal telangiectasia and/or exudative detachment) have been reported in as many as 1.2 to 3.6 percent of patients with retinitis pigmentosa. In severe cases this disorder may progress to total retinal detachment and visual loss in the context of longstanding retinitis pigmentosa. Forty-six cases of Coats'-type retinitis pigmentosa gathered from the literature are reviewed. Historical and epidemiological features, hereditary factors, clinical features, histopathological findings, pathogenesis, differential diagnosis, prognosis and possible treatment are discussed.
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Affiliation(s)
- J A Khan
- Kansas Eye Center, Kansas University Medical Center, Kansas City
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Abstract
A new method allows accurate testing of visual function behind mild-to-moderate cataracts or capsular opacities. Patients were asked to compare the number of corpuscles visualized with the blue field entoptoscope with a series of projected slides having progressively fewer drawn corpuscles. To standardize the equipment, the test was performed on 69 patients with varying degrees of macular impairment. Of the patients who selected 120 corpuscles or more, 89% had visual acuities of 20/40 or better, and those who selected 100 corpuscles or less, 82% had visual acuities of 20/50 or worse. The percentages were higher for age-related macular degeneration (ARMD) patients (100 and 85%) than for diabetic patients (33 and 75%). The same apparatus was then used to predict the potential visual acuity in 56 preoperative cataract or YAG-capsulotomy patients. Of the 23 patients with a preoperative acuity of 20/200 or better and who selected 120 corpuscles or more, 100% were 20/40 or better postoperatively.
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Affiliation(s)
- T D Lischwe
- University of Missouri, Mason Institute of Ophthalmology, Columbia 65212
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Abstract
Tangier disease, or familial high-density lipoprotein deficiency, is an inherited disorder resulting in tissue deposition of excessive cholesterol esters. Although associated corneal clouding has been reported to produce little visual impairment, this patient with Tangier disease had corneal clouding, decreased corneal sensation, and cicatricial ectropion and experienced slowly progressive marked visual impairment. All ocular cases of Tangier disease are reviewed. Ectropion and incomplete eyelid closure may precede corneal clouding and should be recognized as signs associated with Tangier disease. The combination of exposure keratopathy and corneal infiltration can cause significant visual impairment.
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Affiliation(s)
- T A Pressly
- Department of Medicine, University of Missouri-Columbia
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Abstract
A case is presented of a 16-year-old anticoagulated, immunocompromised male presenting with a blind, proptotic left eye, total ophthalmoplegia, and central retinal artery occlusion. Ophthalmic examination revealed other features of the orbital apex syndrome. Mucormycosis misdiagnosed as a traumatic orbital hemorrhage led to the patient's death. In this review, differential diagnosis of the orbital apex syndrome (loss of cranial nerves II, III, IV, ophthalmic division of V, and VI) is outlined, and features, diagnosis, and treatment of mucormycosis are discussed. Although mucormycosis is most commonly seen in diabetics, it should be considered in any immunocompromised patient presenting with the constellation of features of orbital apex syndrome.
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Affiliation(s)
- W H Bray
- Mason Institute of Ophthalmology, University of Missouri-Columbia
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Abstract
A twenty-two-year-old woman with a history of long-Standing retinitis pigmentosa and recently discovered bilateral exudative retinal detachments of the Coats' type is described. This widely unrecognized association has been reported to occur in up to 2% of patients with retinitis pigmentosa. Unlike the usual Coats' syndrome, it is more often bilateral, shows no sex preference and occurs in older individuals. Heightened awareness of this potentially treatable complication of retinitis pigmentosa may facilitate earlier recognition of the problem, which may lead to more timely treatment and a better prognosis.
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Abstract
Self-enucleation or oedipism is a specific manifestation of psychiatric illness distinct from the milder forms of self-inflicted ocular injury. In this article, we discuss the previously unreported medical complication of subarachnoid hemorrhage accompanying self-enucleation. The diagnosis was suspected from the patient's history and was confirmed by computed tomographic scan of the head. This complication may be easily missed in the overtly psychotic patient. Specific steps in the medical management of self-enucleation are discussed, and medical complications of self-enucleation are reviewed.
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Abstract
Blepharoconjunctivitis caused by methicillin-resistant strains of Staphylococcus epidermidis occurred in two hospitalized patients, a 74-year-old man and a 19-year-old man. Both strains were resistant to multiple courses of topical antibiotic therapy. Successful treatment in both cases depended upon antibiotic sensitivity testing. These methicillin-resistant strains of S. epidermidis, like methicillin-resistant strains of Staphylococcus aureus, demonstrated almost complete cross-resistance to cephalosporins despite apparent sensitivity on Kirby-Bauer disk sensitivity testing. Topical vancomycin was curative in one case. In the other case, treatment with topical gentamicin, intravenous cefoperazone, and oral rifampin led to resolution of the symptoms.
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Abstract
Induced prolonged complementary chromatopsia in four subjects (two men, 26 and 34 years old, and two women, 34 and 45 years old) was documented by abnormal responses to pseudoisochromatic color plates 30 minutes after cessation of monochrome video display terminal use. This phenomenon was unrelated to preexisting color vision anomalies, known ocular disease, or drug use, and defines a specific phenomenon probably related to afterimages. All four patients missed AOH-R-R plate 3 after using the video display terminal. One patient also had a delayed response to plate 6. One patient patched one eye before using the video display terminal and noted that the complementary chromatopsia occurred only in the unpatched eye.
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Jackson RL, Ide CH, Guthrie RA, James RD. Retinopathy in adolescents and young adults with onset of insulin-dependent diabetes in childhood. Ophthalmology 1982; 89:7-13. [PMID: 7041037 DOI: 10.1016/s0161-6420(82)34852-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Retinal studies were done in 181 postpubescent, insulin-dependent diabetic patients who developed diabetes before the age of 20. Retinal studies included serial direct ophthalmoscopic examinations, stereoscopic fundus photography and fluorescein angiography. At the time of retinal studies, muscle biopsies also were done to measure capillary basement membrane thickness (CBMT) as an index of early microvascular changes in skeletal muscles. Assessment of clinical metabolic control, interpretation of retinal findings, and CBMT were done independently. No retinopathy was detected in patients observed continuously and known to have been in higher degrees of metabolic control. Twenty-five patients in lower degrees of control for extended periods had retinopathy. CBMT was found to be labile and to progress or regress within a year depending on the degree of control. All patients in lower degrees of control with retinopathy had increased CBMT, but if they subsequently attained and maintained a high degree of control for a year, then CBMT diminished and there was no progression of retinopathy. Our study demonstrates that a high degree of metabolic control delays, and may prevent, microvascular changes, and confirms other studies indicating that most postpubescent, insulin-dependent diabetic patients will develop retinopathy within 15 years unless a relatively high degree of control is maintained.
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Ide CH. Congenital anomalies of the eye and its adnexa. Ear Nose Throat J 1979; 58:463-73. [PMID: 120805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
An orbital teratoma with extension into the maxillary sinus, pterygopalatine fossa nasal cavity, and middle cranial fossa is presented. Through combined efforts of the services of Ophthalmology, Otolaryngology, and Neurosurgery, a tumor that was 4.5 cm in greatest diameter was removed, leaving the globe and optic nerve within the orbit. Within the 2 1/2-year period since surgery, the condition of the patient has been satisfactory.
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Bilginturan AN, Jackson RL, Ide CH. Transitory cataracts in children with diabetes mellitus. Pediatrics 1977; 60:106-9. [PMID: 406594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Ide CH. Juvenile retinoschisis. Eye Ear Nose Throat Mon 1976; 55:174-5. [PMID: 1269677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Ide CH, Matta C, Holt JE, Felker GV. Dysgenesis mesodermalis of the cornea (Peters' anomaly) associated with cleft lip and palate. Ann Ophthalmol 1975; 7:841-2. [PMID: 1147511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Ide CH, Holt JE. Median cleft face syndrome associated with orbital hypertelorism and polysyndactyly. Eye Ear Nose Throat Mon 1975; 54:150-1. [PMID: 164373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
A case of acrodermatitis enteropathica is presented that is the first to manifest punctal stenosis, the fourth to show corneal changes, and the sixth to survive into adulthood.
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Ide CH, Holt R, Holt JE. [Familial occurrence of congenital diffuse hemangiomatosis (author's transl)]. Klin Monbl Augenheilkd 1974; 165:644-6. [PMID: 4449175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Krueger JL, Ide CH. Acrocephalosyndactyly. (Apert's syndrome). Ann Ophthalmol 1974; 6:787-9 passim. [PMID: 4411823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Matta CS, Ide CH, Wilson RJ. Specimen stand for the Zeiss Photo Slit Lamp. Ann Ophthalmol 1974; 6:715-6. [PMID: 4843886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Ide CH, Wollschlaeger PB, Wollschlaeger G. Sturge-Weber syndrome: an infrared thermographic and an angiographic study. Ann Ophthalmol 1973; 5:678-83. [PMID: 4718632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Felker GV, Ide CH, Hart WM. Congenital ocular motor apraxia. Eye Ear Nose Throat Mon 1973; 52:103-4. [PMID: 4704960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Ide CH, Jung JM, Jarudi NI, Hart WM. Unilateral exophthalmos. Mo Med 1973; 70:175-8. [PMID: 4686980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Ide CH, Wollschlaeger PB, Wollschlaeger G. Oculovertebral syndrome associated with cardiovascular abnormalities. Ann Ophthalmol 1972; 4:836-41. [PMID: 5078356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Goldstein AL, Ide CH. Cyclocryotherapy for secondary glaucoma due to rubeosis iridis. Case reports. Mo Med 1972; 69:736-9 passim. [PMID: 5065964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Ide CH, Jarudi NI, Guthrie RA. [Ocular findings in congenital diffuse hemangiomatosis]. Klin Monbl Augenheilkd 1972; 160:464-6. [PMID: 5032569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Wollschlaeger PB, Wollschlaeger G, Ide CH, Hart WM. Arterial blood supply of the human optic chiasm and surrounding structures. Ann Ophthalmol 1971; 3:862-4 passim. [PMID: 5163780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Ide CH, Almond CH, Hart WM, Simmons EM, Wilson RJ. Hematogenous dissemination of microemboli. Eye findings in a patient with Starr-Edwards aortic prosthesis. Arch Ophthalmol 1971; 85:614-7. [PMID: 5087602 DOI: 10.1001/archopht.1971.00990050616017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Ide CH. The diagnosis of retinal detachment. Mo Med 1971; 68:173-5. [PMID: 5542770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Wollschlaeger PB, Wollschlaeger G, Hart WM, Ide CH. [Own observations on the blood supply of fasciculus opticus, chiasma fasciculorum opticorum, tractus opticus, tuber cinereum and infundibulum]. Radiologe 1970; 10:433-7. [PMID: 5498207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Ide CH, Kantor S, Irvine JW. Removal of mirror fragments from the orbital and maxillary cavities: case report. Eye Ear Nose Throat Mon 1966; 45:66-70. [PMID: 5904783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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