OF LATE a number of publications have appeared on the surgical treatment of syphilitic primary atrophy of the optic nerves.1 Neurosurgical intervention in treatment of this condition is based on the recently advanced theory that syphilitic arachnoiditis, involving the optic nerves, produces atrophy of the nerves. The purpose of the operation is to free the optic nerves of the adhesions believed responsible for pressure and constriction, which is followed by atrophy of the nerves.
In the past other hypotheses of the pathogenesis of primary syphilitic optic nerve atrophy, formerly called tabetic optic nerve atrophy, have been advanced. The earliest theory placed the essential lesion in the ganglion cells of the retina. Some investigators expressed the belief that the atrophy originated as a primary degeneration of the nerve fibers. The "retinal theory" was disproved by the work of Léri,2 who, on the basis of the histologic examination of a
BRUETSCH WL. SURGICAL TREATMENT OF SYPHILITIC PRIMARY ATROPHY OF THE OPTIC NERVES (SYPHILITIC OPTOCHIASMATIC ARACHNOIDITIS)A Clinicoanatomic Study. Arch Ophthalmol. 1947;38(6):735-754. doi:10.1001/archopht.1947.00900010754001