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Atlas of Vitreous Biomicroscopy
  1. DAVID McLEOD

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    Atlas of Vitreous Biomicroscopy. By CL Schepens, M Takahashi, CL Trempe. Pp 176; £75. Oxford: Butterworth-Heinemann, 1999. ISBN 0-7506-7052-5.

    If only one had time in clinic to become fully dark adapted, instead of listening and talking to patients, all these illustrated wonders of vitreous architecture would yield to routine examination. As it is, much of what we perceive under unfavourable circumstances is, in fact, inferred although vitreous surgery provides regular opportunities for confirmation of the assumed pathology. This atlas of vitreous biomicroscopy provides a wealth of photographic documentation of vitreous disorders, especially as they affect transparent gel, and is supplemented by images of scanning laser ophthalmoscopy. Much of the material appears to have been published previously over many years and in a variety of journals, but that aspect of compilation and reproduction is welcome. However, the constantly recurring theme of a detached posterior hyaloid face, whether bounding a gel that has or has not collapsed, eventually tends to pall.

    The text which accompanies the colour figures is parochial in content and disappointingly dull in places. An alleged 10% incidence of PVD in the fifth decade of life is surely peculiar to the Japanese population, and the customary obfuscation of the pathogenic sequence in advanced diabetic eye disease by the Boston group is reiterated. Stickler's arthro-ophthalmolopathy isn't mentioned (only Wagner's disease under “degenerations”) and PVD is said to be unusual in association with giant retinal tears. The description of asteroid hyalosis implies a bag of balls instead of strings of pearls, and the text and photographs of vitreous amyloidosis fail to inspire, omitting to mention precipitation of opacity on the otherwise transparent vitreous microarchitecture and thus revealing, for example, remnants of the tunica vasculosa lentis.

    This atlas is more likely to figure on the departmental coffee table than in the clinician's own collection.

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