The spheroliths , mostly to be found in the brown nucleus of Morgagni's hypermature cataract, are up to 0.25 mm in diameter and consist of radially arranged crystals of calcium carbonate of oxalate. From the spheroliths extend, in varying degrees, marginally radial structures of a very fine filamentous, streaky character, that do not enter the altered protein of the lenticular nucleus. This, most probably, is a newly formed protein structure (a structure of mucopolysaccharides according to Zimmerman and Johnson 1958) in which secondary deposits of calcium carbonate or oxalate crystals accumulate. The spheroliths are usually round or kidney-shaped and rarely consist of more than one or two individual bodies.
The three important types of age-related senile cataract, namely deep supranuclear cortical cataract, superficial subcapsular cortical cataract (sometimes associated with secondary nuclear cataract), and primary nuclear cataract, are arranged in a table which may be used for quick reference with regard to clinical features - slit lamp findings, age at onset of opacification, rate of progression, and related biochemistry (e.g., ATP content, glutathione content, and the cation pump (K+ greater than Na+] - as well as etiological features. The significance of the table is illustrated on the basis of an important example from the literature ("Sunlight and Human Cataracts").
A retinoneuritis due to ethambutol (Myambutol) occurs with Myambutol doses of over 20 mg/kg per day after 3 weeks to 15 months. Visual acuity can deteriorate within the following 6 months even after immediate discontinuation of treatment with Myambutol. It may recover 2 months (though in some cases only 16 months) after the onset of the deterioration; in cases of optic atrophy a more severe loss of vision usually remains. If there was loss of vision to 1/10 or less there was in most cases no change in the visual acuity. On the other hand, a primary loss of vision to only 0.3 or 0.4 usually ended with recovery of full vision. The occasionally observed clinical picture of a reddish optic disk, retinal hemorrhages, a very fine granular pigment alteration of the macular region, and loss of vision for more than a year without optic disk pallor suggests a toxic retinitis or retinoneuritis rather than neuritis. This is confirmed by electrophysiological observations.
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