Ophthalmology Volume 107, Number 7, July 2000
`
`The EOG evaluates the retinal pigment epithelium (RPE)
`and the RPE-photoreceptor outer segment complex; how-
`ever, it is not necessarily linked to visual field constriction.
`Taking into account these findings, both peripheral visual
`field and electrophysiologic tests (ERG and EOG), could be
`necessary to evaluate visual function impairment in each
`patient treated by vigabatrin. A larger population sample
`should be studied over a longer period to determine the
`prevalence and course of visual impairment associated with
`vigabatrin therapy and to evaluate the most sensitive and
`earlier diagnostic tool. The results obtained could be useful
`in understanding the pathogenesis of this disorder.
`GEMA REBOLLEDA, MD
`FRANCISCO J. MU˜NOZ-NEGRETE, MD
`CONSUELO GUTIERREZ, MD
`Madrid, Spain
`
`References
`1. Daneshvar H, Racette L, Coupland SG, et al. Symptomatic
`and asymptomatic visual loss in patients taking vigabatrin.
`Ophthalmology 1999;106:1792– 8.
`2. Arndt CF, Derambure P, Defoort-Dhellemmes S, Hache JC.
`Outer retinal dysfunction in patients treated with vigabatrin.
`Neurology 1999;52:1201–5.
`
`Author’s reply
`
`Dear Editor:
`We appreciate the authors’ validation of our findings with
`respect to visual field constriction in patients taking viga-
`batrin. In all, we found scotopic ERG abnormalities in 43%
`of all eyes and photopic abnormalities in 29% of all eyes of
`patients taking vigabatrin. In addition, a subnormal Arden
`ratio on the EOG was observed in 41% of eyes.
`We remain cautious about overinterpreting the signifi-
`cance of electrophysiologic abnormalities in patients taking
`vigabatrin because it is not yet clear whether these abnor-
`malities are indicative of present or future functional abnor-
`malities or whether they are in fact the normal electrophysi-
`ologic correlates of vigabatrin therapy.
`DAVID H. ZACKON, MD, FRCSC
`Ottawa, Ontario, Canada
`
`Our Apologies
`
`Dear Editor:
`We wish to correct two errors in our manuscript, “Two
`Multicenter, Randomized Studies of the Efficacy and Safety
`of Cyclosporine Ophthalmic Emulsion in Moderate to Se-
`vere Dry Eye Disease” (Ophthalmology 2000;107:631–9).
`In Figure 1, the P value depicted for “CsA 0.1%,” six
`month time point, did not match the text. In Figure 4, an
`incorrect data set was plotted. The correct figures appear
`here. These mistakes probably originated at the time of the
`revisions and we appreciate the opportunity to correct them.
`We apologize for any inconvenience this may have
`caused.
`
`KENNETH SALL, MD
`Bellflower, California
`
`1220
`
`Figure 1. Change from baseline in corneal staining. Mean value 6
`standard error. Graded on a scale from 0 to 5.
`
`Figure 4. Change from baseline in assigned lubricating eyedrop use. Mean
`value 6 standard error.
`
`Malignant Glaucoma (Aqueous Misdirection)
`after Pars Plana Vitrectomy
`
`Dear Editor:
`The article by Massicotte and Schuman (Ophthalmology
`1999;106:1375–9) describes two cases of a “malignant
`glaucoma-like syndrome” after pars plana vitrectomy. Both
`eyes developed elevated intraocular pressure (IOP) and ax-
`ial shallowing of the anterior chamber after surgery. One
`patient was treated with Nd:YAG peripheral iridotomy (PI)
`with hyaloidotomy and intracameral tissue plasminogen ac-
`tivator. The other patient received a surgical peripheral
`iridectomy through the pars plana.
`A possible confounding factor in both of these cases was
`the use of intraocular C3F8 as part of the original procedure.
`This probably contributed to the development of aqueous
`misdirection, the term we prefer, and elevated IOP. The
`authors removed gas with only a transient drop in IOP and
`noted persisting shallowing of the anterior chamber. Ultra-
`sound biomicroscopy (UBM) showed no other reason for
`axial anterior chamber shallowing and elevated IOP, such as
`annular choroidal detachment. One might argue that case 2
`may have had angle closure with pupillary block because a
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