HE use of oxidized cellulose as a hemostatic agent was first described in 1945 by Frantz; 1 its application to neurological surgery was described in 1949 by Scarff, et al.-' The hemostatic properties of this product depend in part upon its adhesive nature when saturated with blood and upon its capacity to swell and exert pressure. It is this capacity to swell which may cause problems when oxidized cellulose is used around the optic nerves and chiasm. We are reporting two cases in which small amounts of this material have caused eye disturbances.
LIOMAS Of the optic nerve are relatively rare tumors, 4 but, when present, are frequently associated with other intracranial tumors as part of von Recklinghausen's neurofibromatosis. 1-3 The following case demonstrates the simultaneous occurrence of a glioma of the optic nerve and a pituitary adenoma. There were no obvious manifestations of von Recklinghausen's disease. Either one of these unrelated tumors could have involved the optic apparatus.
Case ReportA 51-year-old colored man was admitted to Johns Hopkins Hospital on August 12, 1962, because of gradual diminution of vision in the left eye of 6 years' duration, which had increased in recent months.Examination. There was severe primary optic atrophy in the left eye with a visual acuity of 10/200 and a suggestion that the temporal field was lost to a greater degree than the nasal field. Visual acuity, fields, and funduscopic examination were completely normal in the right eye. The remainder of the neurological examination was normal. There was no complaint of headache and nothing to suggest pituitary dysfunction. Routine x-rays of the skull revealed an enlarged sella turcica ( Fig. 1), suggesting an adenoma of the pituitary.A second tumor was suspected since all findings were confined to the left eye. X-rays of the optic foramina (Fig. 2) showed enlargement of the left foramen. This strengthened our suspicion of a second tumor since, in our experience, a pituitary adenoma does not cause enlargement of the optic foramen.
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