Glioma retinae : with report of five cases / by Christian R. Holmes.

  • Holmes, Christian R. (Christian Rasmus), 1857-1920.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: Glioma retinae : with report of five cases / by Christian R. Holmes. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    The diagnosis between gliomata and other tumors is easily made, but the differentiation of the pseudo-glioma is fraught with many difficulties, but only when the disease is well advanced. We must differentiate from: 1, detachment or cysts of the retina; 2, tumors of the choroid and ciliary region; 3, masses of inflammatory exudate in the vitreous (pseudo-glioma), and 4, the combination of true glioma with any of the above. The greatest difficulty in making a correct diagnosis occurs when the cornea, aqueous or lens have undergone such changes as to prevent inspection of the interior of the globe, cataract being the most frequent condition encountered. As a rule, we may state that inflammatory exudates into the vitreous give a yellowish reflex, with a metallic luster and smooth surface, while the color of glioma may be a light yellow, reddish or greenish-yel- low and the growth is nodular. The diagnosis may be complicated further by the for- mation of a post-inflammatory membrane or exudate upon the hyaloid membrane directly behind the lens, by chronic inflammation and fibrinous exudate into the vitreous, or by acute suppurative hyalitis. From detach- ment of the retina it should be readily differentiated by a careful ophthalmoscopic examination, and from tu- mors of the choroid by the fact that they are nearly all pigmented. Leucosarcoma of the choroid is rare and its growth is dissimilar to that of gliomata. It develops as a solitary half-round mass over which the retina may be atrophied, but does not form reduplications and thickened masses. That there is often great difficulty in making a differ- ential diagnosis between the true and the pseudo-glioma, is proved by the fact that Eaab found in the collection of Otto Becker of Heidelberg twenty eyes that had been enucleated by various expert diagnosticians, after the diagnosis of glioma retina?, had been made, and yet in 25 per cent, of these no gliomatous or cancerous tissue was present, but only inflammatory changes in the uveal