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Suk-Yeon Lee, Seung-Hyun Kim, Suk-Gyu Ha
Central nervous system (CNS) involvement, including optic nerve involvement, in a patient with acute myeloid leukaemia (AML) is an extremely rare condition. We report a case of bilateral optic nerve involvement combined with unilateral facial palsy in a patient with AML who achieved complete remission following allogenic peripheral blood stem cell transplantation as a young patient. After further evaluation, the patient was diagnosed with a recurrence of AML with CNS involvement. The presentation of multiple types of CNS involvement in AML may be suspicious evidence of AML recurrence...
April 2018: Neuro-ophthalmology
John J Chen, Neeraj Kumar, Kathleen M McEvoy, Jacqueline A Leavitt
A 33-year-old female presented with bilateral papilloedema and constricted visual fields from autoimmune retinopathy. She then developed a painful peripheral neuropathy that led to further work-up and the diagnosis of systemic lupus erythematosus. Papilloedema and autoimmune retinopathy from systemic lupus erythematosus is a unique presentation.
April 2018: Neuro-ophthalmology
Francesco Pellegrini, Andrew G Lee, Cristina Cercato
A 49-year-old previously healthy woman presented with acute painless visual loss in the right eye, a right relative afferent pupillary defect, and a normal fundus examination. She was diagnosed with retrobulbar "optic neuritis" and given a course of intravenous steroids. Despite treatment, however, she continued to lose vision and serial visual field testing confirmed a junctional scotoma in the fellow eye. Cranial magnetic resonance imaging (MRI) showed a mass at the junction between the right optic nerve and the anterior aspect of the chiasm and a right frontal lesion that proved to be multicentric glioblastoma multiforme...
April 2018: Neuro-ophthalmology
Aastha Takkar, Karthik Vinay Mahesh, Ritu Shree, Julie Sachdeva, Sahil Mehta, Vivek Lal
Tuberculosis never stops fascinating physicians. The burden of tuberculosis is a major cause of disability. While drugs are often blamed when patients develop new focal deficits on treatment, the deterioration in these patients can have a myriad of causes including the development of new tuberculomas. Recognizing the critically located tuberculomas as potential causes of vision loss is indispensable. Here, we report two patients with strategic tuberculomas leading to vision loss. In one patient, the cause of visual morbidity was compression of the optic pathways; in the other patient, cortical vision loss was noted due to strategic location of tuberculomas...
April 2018: Neuro-ophthalmology
Bokkwan Jun, Frederick W Fraunfelder
The existence of vaccine-associated optic neuritis is essentially based on the temporal relationship between the administration of a vaccine and the development of optic neuritis in patients with no other known aetiologies for infectious or non-infectious inflammation that could account for the optic neuritis. Influenza vaccine (inactivated or live attenuated) is considered to be one of vaccines that could be related to optic neuritis. The authors describe a rare case of bilateral asymmetric optic neuritis with leptomeningeal enhancement on magnetic resonance imaging (MRI) in a previously healthy young woman who received inactivated influenza vaccination 2 weeks before the onset of symptoms...
April 2018: Neuro-ophthalmology
Catherine Hornby, Hannah Botfield, Michael W O'Reilly, Connar Westgate, James Mitchell, Susan P Mollan, Konstantinos Manolopoulos, Jeremy Tomlinson, Alexandra Sinclair
Idiopathic intracranial hypertension (IIH) is strongly associated with obesity. We aimed to utilise dual-energy X-ray absorptiometry (DEXA) to characterise fat distribution, and to evaluate change in fat mass and distribution following weight loss. IIH patients ( n = 24) had a similar fat distribution to body mass index (BMI)- and gender-matched obese controls ( n = 47). In the IIH cohort, truncal fat mass correlated with lumbar puncture pressure. Weight loss in IIH patients resulted in a significant reduction in disease activity and fat mass, predominantly from the truncal region (-4...
April 2018: Neuro-ophthalmology
Ore-Ofe O Adesina, J Scott McNally, Karen L Salzman, Bradley J Katz, Judith E A Warner, Molly McFadden, Kathleen B Digre
Non-arteritic anterior ischaemic optic neuropathy (NAION) and optic neuritis (ON) may be difficult to distinguish early in their disease courses. Our goal was to determine if specific magnetic resonance imaging characteristics differentiate acute NAION from ON. Neuroradiologists, masked to diagnosis, reviewed the diffusion-weighted imaging (DWI) and post-contrast enhancement (PCE) characteristics of the optic nerve in 140 eyes. PCE and DWI signals of the optic disc alone did not discriminate between NAION and ON...
April 2018: Neuro-ophthalmology
Ozge Yabas Kiziloglu, Okan Toygar, Baha Toygar, Ali Murat Hacimustafaoglu
To determine normal values, repeatability, and interocular symmetry of optic nerve head measurements, three spectral-domain optical coherence tomography (SD-OCT) scans were obtained from 128 healthy Turkish children aged 5-17 years consecutively and prospectively. The mean disc area, rim area, cup volume, cup to disc area ratio, and vertical and horizontal cup to disc ratios were 2.30 ± 0.42 mm2 , 1.84 ± 0.45 mm2 , 0.09 ± 0.10 mm3 , 0.20 ± 0.13, 0.37 ± 0.17, and 0.45 ± 0.20, respectively. The intraclass correlation coefficients were >0...
April 2018: Neuro-ophthalmology
Alberto Galvez-Ruiz, Alicia Galindo-Ferreiro, Patrik Schatz
In this study, the authors present a sample of 71 patients with hereditary optic neuropathy and negative genetic test results for OPA1/OPA3/LHON. All of these patients later underwent genetic testing to rule out WFS. As a result, 53 patients (74.7%) were negative and 18 patients (25.3%) were positive for some type of mutation or variation in the WFS gene. The authors believe that this study is interesting because it shows that a sizeable percentage (25.3%) of patients with hereditary optic 25 neuropathy and negative genetic test results for OPA1/OPA3/LHON had WFS mutations or variants...
April 2018: Neuro-ophthalmology
Shakoor Ba-Ali, Rigmor Højland Jensen, Line Sofie Larsen, Henrik Lund-Andersen, Steffen Hamann
Previously, it has been reported that melanopsin-mediated pupillary light response (PLR), measured with pupillometry, is reduced in patients with idiopathic intracranial hypertension (IIH), indicating the clinical utility of the tool in the diagnosis of IIH. In the current study, the authors aimed to measure the PLR in 13 treatment-naive patients with new-onset IIH and 13 healthy controls. In contrast to the previous report, which was based on patients with longstanding IIH ( n = 13), the authors found no significant difference in the melanopsin-mediated PLR ( p = 0...
April 2018: Neuro-ophthalmology
Gabriella Szatmáry
No abstract text is available yet for this article.
February 2018: Neuro-ophthalmology
Yao Wang, Timothy J McCulley, Jefferson J Doyle, Jessica Chang, Michael S Lee, Collin M McClelland
Brown syndrome is characterised by impaired supraduction worse in adduction due to a restricted superior oblique tendon passing through the trochlea. A few reports have previously described Brown syndrome after upper eyelid surgery, including blepharoplasty and ptosis repair. The authors describe two additional cases of Brown syndrome following ptosis repair. The first case is a 65-year-old woman with new-onset vertical binocular diplopia following bilateral levator advancement surgery. Ocular motility examination demonstrated moderate impairment of elevation in adduction...
February 2018: Neuro-ophthalmology
Alberto Galvez-Ruiz, Elena Riva-Amarante, Adolfo Jimenez-Huete, Jose Fernandez Lorente, Oriol Franch Ubia
Saccadic intrusions are small involuntary saccadic movements that disrupt visual fixation. Among saccadic intrusions without intersaccadic intervals, ocular flutter and opsoclonus are prominent. The saccade amplitude can occasionally be very small, which is referred to as ocular microflutter. The authors present a patient with acute-onset oscillopsia following a non-specific viral condition. An ocular microflutter was subsequently detected using video-oculography. After extensive investigation, a diagnosis of isolated idiopathic or post-viral ocular microflutter was made...
February 2018: Neuro-ophthalmology
Viran Jayanetti, Michael Rossiter-Thornton, Domit Azar, Clare L Fraser
Ethambutol is utilised in the treatment of Mycobacterium avium and Mycobacterium tuberculosis infection. The authors report two siblings who developed the adverse effect of ethambutol-induced optic chiasmopathy, with recovery following cessation of ethambutol. Discussion explores potential genetic predisposition to development of this condition and its resolution. Ethambutol optic neuropathy (EON), Leber's hereditary optic neuropathy (LHON), and other optic neuropathies of mitochondrial origin share a common pathophysiology...
February 2018: Neuro-ophthalmology
Michael Chia-Yen Chou, Chia-Yi Lee, Shih-Chun Chao
Posterior reversible encephalopathy syndrome is a clinical phenomenon associated with headache, altered mental status, seizures, and visual disturbances along with radiographic acute cerebral oedema. Several conditions are correlated with posterior reversible encephalopathy syndrome, with acute hypertension, eclampsia, and cytotoxic agents being the most common. This report presents a case of posterior reversible encephalopathy syndrome in a 45-year-old male with multiple underlying conditions, including hypertension, diabetes, and end-stage renal disease...
February 2018: Neuro-ophthalmology
Brandon J Baartman, Chrysavgi Adamopoulou
A 40-year-old African American man with recently diagnosed Human Immunodeficiency Virus (HIV) presented with isolated left abducens palsy. Initial neuro-imaging and laboratory evaluation, including cerebrospinal fluid (CSF) analysis, were unremarkable. Continued search for causative aetiology revealed systemic lymphoma diagnosed ultimately by bone marrow biopsy. Systemic lymphoma is commonly encountered in the HIV patient population, but presentation can be unusual and has been seen, albeit rarely, in the setting of isolated cranial neuropathy...
February 2018: Neuro-ophthalmology
Takehito Iwase, Hirotaka Yokouchi, Sonoko Misawa, Toshiyuki Oshitari, Takayuki Baba, Satoshi Kuwabara, Shuichi Yamamoto
The authors present findings in a 39-year-old man with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome with bilateral optic disc oedema. He was successfully treated with bortezomib and dexamethasone followed by autologous peripheral blood stem cell transplantation. The peripapillary retinal thickness was reduced in the optical coherence tomographic (OCT) images along with a decrease of the serum vascular endothelial growth factor (VEGF) levels. The authors recommend OCT to monitor the changes in the signs of POEMS syndrome after treatments...
February 2018: Neuro-ophthalmology
Sanjeeta Sitaula, Hira Nath Dahal, Ananda Kumar Sharma
This study aims to report the clinical features and role of different treatment modalities in final visual outcome in traumatic optic neuropathy (TON). The authors retrospectively reviewed the records of patients with TON over 4 years. There were 37 patients of unilateral TON. Mean age was 28.70 ± 15.20 years (range: 8-90) and 89% ( n = 33) were males. Road traffic accident was the common cause (43.2%), followed by fall injury (35.1%). There was improvement of visual acuity in 51.4% ( n = 19) cases. Out of different treatment modalities, high-dose intravenous methylprednisolone (1 g/day) led to significant improvement in final visual acuity ( p = 0...
February 2018: Neuro-ophthalmology
Francesco Pellegrini, Emanuela Interlandi, Giovanni Prosdocimo
A 42-year-old female presented with unilateral visual loss associated with systemic symptoms of fever and headache. Although initial ophthalmic examination revealed a unilateral neuroretinitis, investigation for infectious and non-infectious causes of neuroretinitis were negative. At our examination, retinal imaging (suggestive of bilateral involvement) along with the results of lumbar puncture (pleocytosis) and clinical findings was consistent with a diagnosis of Vogt-Koyanagi-Harada disease. The patient was treated with intravenous steroids with prompt resolution of her symptoms...
February 2018: Neuro-ophthalmology
Katrin Fasler, Ghislaine L Traber, Gregor Peter Jaggi, Klara Landau
Amiodarone-associated optic neuropathy (AAON) is a controversial diagnosis with possible impact on vital cardiac therapy decisions. This retrospective case series aims for application of distinguishing features of AAON versus non-arteritic ischaemic optic neuropathy (NAION): Bilaterality, mode of onset, degree of optic nerve dysfunction, structure of uninvolved disc (unilateral cases), and systemic toxic effects. Applying these criteria to patients with disc swelling under amiodarone, the authors identified four unilateral disc swellings, one with NAION-typical features only and three with one or more NAION-atypical features...
February 2018: Neuro-ophthalmology
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