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Ocular Inflammation. Basic and clinical concepts
  1. PHILIP I MURRAY

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    Ocular Inflammation. Basic and clinical concepts. Ed David BenEzra. Pp 528; £120. London: Martin Dunitz, 1999. ISBN: 1-85317-507-2.

    This is a multiauthored book with the main author responsible for 12 out of the 30 chapters. All contributors (mainly European) are well known in their respected fields. It is just over 500 pages long and the majority of the text is devoted to uveitis with a chapter each on conjunctival, corneal, scleral, and orbital inflammations. The book is divided into five main sections: General aspects; Diagnostic tests of potential value in chronic non-infectious ocular inflammation; External ocular inflammatory diseases; Intraocular inflammation; and Optic nerve. The first two of these sections deal with underlying disease mechanisms at the basic science level, but just in relation to uveitis and not the other inflammatory disease included in the book. The first chapter on immunosuppression and immunomodulation is uninspiring and cyclosporin A is even described as a new drug. The chapters on immunological mechanisms underlying uveitis are rather disconnected as they are written by different authors so there is no common theme and they could be quite confusing to the novice. Nevertheless, the chapters on cytokines and HLA are informative but more could have been written on the latter topic and it cries out for a diagram. There are a large number of colour figures but not all of good quality; some fail to show the pathology and some are unnecessary. Diagrams explaining the taking of intraocular specimens would have been useful, as would the inclusion of treatment algorithms using corticosteroids and cyclosporin A for immunosuppression (although one does appear in the chapter on Behçet's disease). The layout is unexciting and this is basically just another textbook on uveitis. In the age of multimedia, a more imaginative layout with shading, coloured text and diagrams, and boxes highlighting key points would have made it much more readable. The non-uveitis chapters are too brief and just as they start to whet one's appetite for more—they end. Yet there are some good chapters, particularly on orbital inflammations (thyroid eye disease is not included), ICG, birdshot, and AIDS. The chapter on Behçet's disease briefly mentioned the standard, recognised ISG classification but failed to document it. The most glaring omission was the topic of corneal graft rejection. Apart from a short paragraph on rejection lines it was never mentioned.

    This book is overambitious as it tries to cram intraocular, conjunctival, corneal, and orbital inflammations into one text and fails to succeed. I am unsure what market the book is aimed at but it may have a place on some library shelves. Ophthalmology residents, however, should keep their credit cards firmly in their wallet.

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