Publications by authors named "Andrew G Lee"

423 Publications

CNS hemorrhage owing to chronic lymphocytic leukemia.

Can J Ophthalmol 2021 Jul 22. Epub 2021 Jul 22.

Blanton Eye Institute, Houston Methodist Hospital, Houston, TX; Weill Cornell Medicine, New York, New York; University of Texas MD Anderson Cancer Center, Houston, Texas; University of Texas Medical Branch, Galveston, Texas; Texas A and M College of Medicine, Bryan, Texas; The University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

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http://dx.doi.org/10.1016/j.jcjo.2021.06.021DOI Listing
July 2021

Papilledema and intracranial hypertension in leukemia: case series report and review.

Can J Ophthalmol 2021 Jul 21. Epub 2021 Jul 21.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Tex.; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY; Department of Ophthalmology, University of Texas Medical Branch (UTMB), Baylor College of Medicine; the University of Texas MD Anderson Cancer Center (UTMDACC), Texas A and M College of Medicine; and the University of Iowa Hospitals and Clinics; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1016/j.jcjo.2021.06.022DOI Listing
July 2021

Paracentral Acute Middle Maculopathy in Pregnancy.

J Neuroophthalmol 2021 Jul 2. Epub 2021 Jul 2.

Department of Ophthalmology (RAS), University of Colorado, Aurora, Colorado; Department of Ophthalmology (NB, SHB, HKL, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Community Retina Group (HKL), Houston, Texas; The Houston Methodist Research Institute (HKL, AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; Department of Ophthalmology (AGL) University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Ophthalmology (AGL) Texas A and M College of Medicine (AGL), Texas; Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa; and Department of Ophthalmology (AGL) Baylor College of Medicine, Houston, Texas.

Abstract: A 31-year-old previously healthy, pregnant woman presented with acute, unilateral, painless paracentral vision loss in the left eye. The results of neuroimaging studies were normal. Hypercoagulable workup was negative, and fundus examination showed no retinal emboli and no retinal vascular abnormalities. The patient had well-controlled blood pressure and did not have eclampsia/preeclampsia. Although a presumptive referral diagnosis of "optic neuritis" was made, optical coherence tomography (OCT) of the macula showed a hyperreflective band involving the inner nuclear layer, consistent with paracentral acute middle maculopathy (PAMM). Furthermore, OCT angiography (OCT-A) showed flow attenuation of the outer retinal capillary plexus, further supporting a diagnosis of PAMM in pregnancy. Clinicians should be aware of the benefit of OCT-A as a complement to macular OCT in the evaluation of acute monocular vision loss mimicking retrobulbar optic neuropathy, particularly when signs and findings of other retinal vasculopathy are absent. PAMM should be considered in pregnant patients with acute visual changes.
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http://dx.doi.org/10.1097/WNO.0000000000001307DOI Listing
July 2021

Roth Spot and a Homonymous Hemianopsia as the Presenting Manifestation of Polyarteritis Nodosa.

J Neuroophthalmol 2021 Jul 2. Epub 2021 Jul 2.

University of Texas Medical School at Houston (AJ), Houston, Texas; Department of Ophthalmology (SR, PWM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Rheumatology (SAK), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1097/WNO.0000000000001303DOI Listing
July 2021

Neuro-Ophthalmic Presentation of Myelomatous Meningitis.

J Neuroophthalmol 2021 Jul 1. Epub 2021 Jul 1.

McGovern Medical School at The University of Texas Health Science Center at Houston (ACT), Houston, Texas; Department of Neurology (MON), Houston Methodist Neurological Institute, Houston, Texas; Department of Ophthalmology (SR, PWM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1097/WNO.0000000000001287DOI Listing
July 2021

Hypnic Headaches in a Patient Post Coiling and Clipping of Intracranial Aneurysm.

J Neuroophthalmol 2021 Jul 1. Epub 2021 Jul 1.

University of Texas Health Science Center (MA), Houston, Texas; Department of Ophthalmology (SR, PM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1097/WNO.0000000000001284DOI Listing
July 2021

Homonymous hemianopsia as a reversible manifestation of normal-pressure hydrocephalus.

Can J Ophthalmol 2021 May 28. Epub 2021 May 28.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center, Houston, Texas; Texas A and M College of Medicine, Bryan, Texas; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

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http://dx.doi.org/10.1016/j.jcjo.2021.04.015DOI Listing
May 2021

Case of Progressively Worsening Vertical Nystagmus.

J Neuroophthalmol 2021 Jun;41(2):e270

School of Medicine (SP), Baylor College of Medicine, Houston, Texas.

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http://dx.doi.org/10.1097/WNO.0000000000001254DOI Listing
June 2021

Should Immunosuppressive Therapy Be Modified During a Pandemic?

J Neuroophthalmol 2021 Jun;41(2):266-271

Department of Neurology (MB), Beth Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Department of Neurology (ML), Mass General and Harvard Medical School, Boston, Massachusetts; Ophthalmology (AL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; and Ophthalmology and Visual Sciences (GVS), St. Louis School of Medicine, Washington University, St. Louis, Missouri.

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http://dx.doi.org/10.1097/WNO.0000000000001274DOI Listing
June 2021

Reversible Nutritional Deficiency-Related Conjunctival Xerosis and Optic Neuropathy Secondary to an Exclusively Potato-Based Diet.

J Neuroophthalmol 2021 Apr 14. Epub 2021 Apr 14.

Baylor College of Medicine (MDB, AGL), Houston, Texas; Department of Ophthalmology (PM, SR, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas Maryland Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1097/WNO.0000000000001217DOI Listing
April 2021

Head-Down Tilt Bed Rest Studies as a Terrestrial Analog for Spaceflight Associated Neuro-Ocular Syndrome.

Front Neurol 2021 26;12:648958. Epub 2021 Mar 26.

Departments of Ophthalmology, Stanford University, Palo Alto, CA, United States.

Astronauts who undergo prolonged periods of spaceflight may develop a unique constellation of neuro-ocular findings termed Spaceflight Associated Neuro-Ocular Syndrome (SANS). SANS is a disorder that is unique to spaceflight and has no terrestrial equivalent. The prevalence of SANS increases with increasing spaceflight duration and although there have been residual, structural, ocular changes noted, no irreversible or permanent visual loss has occurred after SANS, with the longest spaceflight to date being 14 months. These microgravity-induced findings are being actively investigated by the United States' National Aeronautics Space Administration (NASA) and SANS is a potential obstacle to future longer duration, manned, deep space flight missions. The pathophysiology of SANS remains incompletely understood but continues to be a subject of intense study by NASA and others. The study of SANS is of course partially limited by the small sample size of humans undergoing spaceflight. Therefore, identifying a terrestrial experimental model of SANS is imperative to facilitate its study and for testing of preventative measures and treatments. Head-down tilt bed rest (HDTBR) on Earth has emerged as one promising possibility. In this paper, we review the HDTBR as an analog for SANS pathogenesis; the clinical and imaging overlap between SANS and HDTBR studies; and potential SANS countermeasures that have been or could be tested with HDTBR.
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http://dx.doi.org/10.3389/fneur.2021.648958DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032981PMC
March 2021

Paraneoplastic Cone Dysfunction Secondary to Renal Cell Carcinoma: A Case Report.

J Neuroophthalmol 2021 Mar 19. Epub 2021 Mar 19.

Texas A&M University College of Medicine (AG, AGL), Bryan, Texas; Department of Ophthalmology (SHB, NB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1097/WNO.0000000000001250DOI Listing
March 2021

Impact of COVID-19 pandemic on ophthalmology medical student teaching: educational innovations, challenges, and future directions.

Surv Ophthalmol 2021 Apr 7. Epub 2021 Apr 7.

Blanton Eye Institute, Houston Methodist Hospital, Department of Ophthalmology, Houston, Texas, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, USA; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, USA; University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA; Departments of Neurology and Neurological Surgery, Weill Cornell Medical College, New York, New York, USA; Department of Ophthalmology, Baylor College of Medicine (Adjunct Professor), Houston, Texas, USA; The UT MD Anderson Cancer Center, Houston, Texas, USA; The University of Iowa Hospitals and Clinics (Adjunct Professor), Iowa City, Iowa, USA.

Graduate medical education (GME) in ophthalmology has faced and overcome many challenges over the past years, and 2020 has been a game-changer. Although the severe acute respiratory syndrome coronavirus pandemic disrupted medical education globally, ophthalmic educators rapidly transformed their curricula to novel and effective virtual learning formats. Thus, while the COVID-19 outbreak has been one of the most significant challenges faced in the history of medical education, it has also provided an impetus to develop innovative teaching practices, bringing with it unprecedented success in allowing medical students to continue their education in ophthalmology despite these challenges. We review and appraise novel educational interventions implemented by various institutions in response to the COVID-19 pandemic, highlighting their effectiveness, challenges and proposing future directions beyond the pandemic. Many of these innovations will persist even after the end of the pandemic because they have proven that face-to-face learning is not required for all aspects of the ophthalmic GME curriculum. As ophthalmic educators harness the power of educational technology it is critical that their novel educational initiatives are incorporated into competency-based curricula with assessments mapped to the competencies. Future research should focus on evaluating the impact of this transformation to virtual learning environments on student performances as well as implementing longitudinal assessment strategies for clinical competence in workplace-based practice.
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http://dx.doi.org/10.1016/j.survophthal.2021.03.011DOI Listing
April 2021

Bilateral myelin oligodendrocyte glycoprotein-related optic neuritis presenting after herpes zoster subunit vaccination.

Can J Ophthalmol 2021 Mar 23. Epub 2021 Mar 23.

Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Tex.; University of Texas MD Anderson Cancer Center, Houston, Tex.; Texas A and M College of Medicine, Bryan, Tex.; Department of Opthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

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http://dx.doi.org/10.1016/j.jcjo.2021.02.036DOI Listing
March 2021

Persistent Globe Flattening in Astronauts following Long-Duration Spaceflight.

Neuroophthalmology 2021 3;45(1):29-35. Epub 2020 Sep 3.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA.

Posterior globe flattening has been well-documented in astronauts both during and after long-duration space flight (LDSF) and has been observed as early as 10 days into a mission on the International Space Station. Globe flattening (GF) is thought to be caused by the disc centred anterior forces created by elevated volume and/or pressure within the optic nerve sheath (ONS). This might be the result of increased intracranial pressure, increased intraorbital ONS pressure from compartmentalisation or a combination of these mechanisms. We report posterior GF in three astronauts that has persisted for 7 years or more following their return from LDSFs suggesting that permanent scleral remodelling may have occurred.
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http://dx.doi.org/10.1080/01658107.2020.1791189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946045PMC
September 2020

Corticosteroid Usage in Giant Cell Arteritis.

Neuroophthalmology 2021 16;45(1):17-22. Epub 2020 Jul 16.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA.

Giant cell arteritis (GCA) is a condition that can cause irreversible visual loss if untreated. While corticosteroids remain the mainstay of treatment to prevent visual loss, the type, dose, route, and duration of corticosteroid treatment of GCA remain controversial. Our study surveyed neuro-ophthalmologists to determine commonly prescribed dosages of corticosteroids for the treatment of GCA with or without visual loss. For patients with acute visual loss, 52% would use intravenous (IV), 46% would use IV or oral and 2% would use oral corticosteroids. Seventy-three per cent would use 500 to 1000 mg IV methylprednisolone in this group. For patients with GCA without acute visual loss, 67% would use the oral route, 30% would use IV or oral, and 3% indicated they would use IV route of treatment. Seventy-five per cent would use 1.0 to 1.5 mg/kg oral prednisone in this group. Our results suggest a majority but not a complete consensus for route and dose of corticosteroid treatment in GCA and confirm conventional recommendations for high dose IV corticosteroids for GCA with visual loss and lower dose oral regimens for GCA without visual loss.
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http://dx.doi.org/10.1080/01658107.2020.1767656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946056PMC
July 2020

Functional Vision Disorders in adults: A paradigm and nomenclature shift for ophthalmology.

Surv Ophthalmol 2021 Mar 15. Epub 2021 Mar 15.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, USA; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Texas A and M College of Medicine, Bryan, Texas, USA; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

Vision loss with clinical findings that are incompatible with the symptoms and recognized neurological or ophthalmic conditions is a common presentation of patients to neurologists, ophthalmologists, and neuro-ophthalmologists. The accepted terminology to describe such patients has evolved over time including functional visual disorder (FVD), non-organic vision loss, non-physiologic vision loss, functional vision loss, psychogenic, psychosomatic, and medically unexplained visual loss. Likewise, attitudes and recommended management options have changed over the years in the fields of psychiatry and neurology. FVD is a diagnosis of inclusion, and it is critical that the diagnosis be made and delivered efficiently and effectively to reduce patient and physician duress. We review the current Diagnostic and Statistical Manual (DSM V) terminology and the prior literature on FVD and describe how the approaches to diagnosis and management have changed. We provide recommendations on the appropriate techniques and diagnostic approach for patients with FVD. We also propose a protocol for consistent and standardized discussion with the patient of the diagnosis of FVD. We believe that the adoption of FVD as both a paradigm and nomenclature shift in ophthalmology will improve patient care.
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http://dx.doi.org/10.1016/j.survophthal.2021.03.002DOI Listing
March 2021

Fascicular Sixth Nerve Palsy as a Presenting Sign of Metastatic Ovarian Carcinoma.

J Neuroophthalmol 2021 Feb 19. Epub 2021 Feb 19.

Baylor College of Medicine (NR, AGL), Houston, Texas; Department of Ophthalmology (PM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; and Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas.

Abstract: The most common etiology of an isolated abducens nerve palsy in an older adult with vasculopathic risk factors is presumed microvascular ischemia. Because the diagnosis of microvascular ischemia in this setting would not alter patient management, there is debate as to whether further workup is warranted under these circumstances. In this report, we describe a fascicular sixth nerve palsy as the initial presenting sign of metastatic ovarian carcinoma, and we highlight the importance of considering additional workup in select cases of isolated abducens nerve palsies.
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http://dx.doi.org/10.1097/WNO.0000000000001188DOI Listing
February 2021

Superior oblique myositis following targeted therapy for papillary thyroid carcinoma.

Can J Ophthalmol 2021 Feb 17. Epub 2021 Feb 17.

College of Medicine, Texas A&M University Health Science Center, Bryan, Texas.; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY; University of Texas Medical Branch, Galveston, Texas.; University of Texas MD Anderson Cancer Center, Houston, Texas.; The University of Iowa Hospitals and Clinics, Iowa City, Iowa.; University of Texas Medical Branch, Galveston, Texas.; University of Texas MD Anderson Cancer Center, Houston, Texas; The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1016/j.jcjo.2021.01.016DOI Listing
February 2021

Outcomes of optic nerve sheath fenestration from superomedial eyelid crease approach.

Orbit 2021 Feb 15:1-9. Epub 2021 Feb 15.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA.

: The purpose of this study is to report the safety and outcomes of optic nerve sheath fenestration (ONSF) performed via superomedial eyelid crease approach.: A retrospective chart review was performed on patients undergoing superomedial eyelid crease ONSF at a single institution between 2014-2019. Data obtained included preoperative visual acuity (VA), mean deviation (MD) on visual field (VF), papilledema grade, intraoperative time, estimated blood loss, intraoperative complications and optic nerve sheath biopsy results. Postoperative month 6 (POM6) data collected included VA, MD, papilledema grade, and lid contour. Outcome measures included overall change in VA, MD, and papilledema grade at POM6. Statistical analysis was performed using STATA version 16 statistical software. Data analysis was done comparing all patients pre- and postoperatively. Additional subgroup analysis was performed on patients undergoing ONSF for IIH vs other indications, and on the contralateral unoperated eye.: A total of 31 eyes of 24 patients were identified, four of whom were excluded due to being lost to follow-up. At POM6, improvement was seen in VA (p<0.001) across all groups. There was improvement in POM6 median papilledema grade and MD, but these did not reach statistical significance. Additional subgroup analysis on patients with IIH showed statistically significant improvement in POM 6 VA (p=0.009), papilledema (p=0.009) and MD (p<0.001), as well as VA improvement in the contralateral unoperated eye (p<0.001).: Superomedial eyelid crease approach for ONSF is a safe and effective surgery in IIH and other conditions of excess pressure within the optic nerve sheath.
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http://dx.doi.org/10.1080/01676830.2021.1880444DOI Listing
February 2021

Resident and Fellow Training in a Pandemic.

J Neuroophthalmol 2021 03;41(1):6-9

Departments of Neurology (SG) and Ophthalmology (SG, SLG), NYU Grossman School of Medicine, New York, New York; Department of Ophthalmology (AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Neurology (AGL), Neurosurgery, and Ophthalmology, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; Department of Ophthalmology (AGL), University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Ophthalmology (AGL), Texas A&M University College of Medicine, Houston, Texas; Department of Ophthalmology (AGL), Baylor College of Medicine and the Center for Space Medicine (AGL), Houston, Texas; Department of Ophthalmology (AGL), University of Iowa Hospitals and Clinics (AGL), Iowa City, Iowa; and Department of Ophthalmology (AGL), University of Buffalo (AGL), Buffalo, New York.

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http://dx.doi.org/10.1097/WNO.0000000000001215DOI Listing
March 2021

Murine typhus presenting as pseudotumor cerebri.

Can J Ophthalmol 2021 Jan 30. Epub 2021 Jan 30.

Baylor College of Medicine Houston, Tex; Blanton Eye Institute, Houston Methodist Hospital Houston, Tex; The Houston Methodist Research Institute, Houston Methodist Hospital Houston, Tex; Weill Cornell Medicine New York, NY; Weill Cornell Medicine New York, NY; University of Texas Medical Branch Galveston, Tex; University of Texas MD Anderson Cancer Center Houston, Tex; Texas A and M College of Medicine Bryan, Tex; The University of Iowa Hospitals and Clinics Iowa City, Iowa. Electronic address:

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http://dx.doi.org/10.1016/j.jcjo.2021.01.013DOI Listing
January 2021

Neuroimaging in space flight associated neuro-ocular syndrome (SANS).

Authors:
Andrew G Lee

Eye (Lond) 2021 07 29;35(7):1799-1800. Epub 2021 Jan 29.

Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.

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http://dx.doi.org/10.1038/s41433-021-01410-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225669PMC
July 2021

Improvement in Near Vision Following Silodosin Treatment in Patients With Lower Urinary Tract Symptoms.

Int Neurourol J 2021 Jun 19;25(2):164-171. Epub 2021 Jan 19.

Department of Urology, Konkuk University School of Medicine, Seoul, Korea.

Purpose: The objective of this study was to investigate the change in near visual function after the administration of oral silodosin to patients with lower urinary tract symptoms (LUTS).

Methods: This prospective study included treatment-naive patients who were scheduled to start treatment with silodosin for LUTS. A comprehensive ophthalmological evaluation including the near vision and the automated pupillometry was performed at baseline and after 3 months of silodosin treatment. For subjective assessment of near visual ability and satisfaction, a Near Activity Visual Questionnaire-10 (NAVQ-10) was also used at the same time (higher scores indicating worse quality).

Results: Of 23 patients enrolled in this study, 15 continued with silodosin (8 mg once daily) treatment for 3 months and completed a follow-up evaluation. The mean age of participants was 60.4±8.4 years. Distant visual acuity and spherical error were unchanged after silodosin treatment. However, near vision acuity (logMAR) was improved after treatment (right, 0.47±0.36 vs. 0.38±0.39, P=0.018; left, 0.41±0.37 vs. 0.31±0.34, P=0.068; both, 0.27±0.26 vs. 0.21±0.27, P=0.043). Pupil size under room light decreased significantly in both eyes (right, 3.77±0.60 vs. 3.16±0.58, P=0.001; left, 3.72±0.80 vs. 3.21±0.75, P=0.002). The Rasch scale at NAVQ-10 improved from 54.7±9.9 to 48.5±11.2 (P=0.004).

Conclusion: This preliminary study demonstrated that highly selective alpha-1A adrenergic receptor antagonists such as silodosin improve near visual acuity and quality in patients with LUTS/benign prostatic hyperplasia. Decrease in pupil size caused by inhibition of adrenergic alpha 1 mediated contraction of iris dilator muscle is a possible mechanism underlying improved near vision.
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http://dx.doi.org/10.5213/inj.2040274.137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255821PMC
June 2021

Transconjunctival versus Transcutaneous Injection of Botulinum Toxin into the Lacrimal Gland to Reduce Lacrimal Production: A Randomized Controlled Trial.

Toxins (Basel) 2021 01 21;13(2). Epub 2021 Jan 21.

Department of Ophthalmology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.

The purpose of this study was to determine and compare the effects between injecting botulinum toxin A (BTX-A) transconjunctivally into the palpebral lobe and transcutaneously into the orbital lobe of the lacrimal gland in patients with epiphora due to lacrimal outflow obstruction. This randomized controlled study included 53 eyes of 31 patients with unilateral or bilateral epiphora. Patients were randomly allocated to receive an injection of BTX-A (3 units) either transconjunctivally ( = 15, 25 eyes) or transcutaneously ( = 16, 28 eyes). For objective assessments, the tear meniscus height and Schirmer's I test with topical anesthesia were measured at baseline and after 2, 6, 12, and 24 weeks of follow-up. Subjective evaluations were performed using the Munk score. After BTX-A injection, patients in both groups experienced significant objective and subjective reductions in tearing at all follow-up times compared to pre-injection (success rate 86.8%), and the effect lasted for a mean duration of 5.63 months. The two delivery routes showed similar clinical effectiveness for a single injected dose of BTX-A. In conclusion, injecting BTX-A via either a transconjunctival or transcutaneous route helps to reduce normal tear production and results in significant improvements in the symptoms in patients with epiphora.
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http://dx.doi.org/10.3390/toxins13020077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911887PMC
January 2021

Isolated Fourth Nerve Palsy as the Presenting Sign of Clival Chordoma.

J Neuroophthalmol 2021 Jan 11. Epub 2021 Jan 11.

McGovern Medical School at the University of Texas Health Science Center at Houston (MNH), Houston, Texas ; Department of Ophthalmology (SR, PM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1097/WNO.0000000000001169DOI Listing
January 2021

Neurosyphilis Masquerading as Guillain-Barre Syndrome.

J Neuroophthalmol 2021 Jan 11. Epub 2021 Jan 11.

Western University of Health Sciences (CM), Lebanon, Oregon; Department of Ophthalmology (NB, SHB, SR, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa; and Baylor College of Medicine (AGL), Houston, Texas.

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http://dx.doi.org/10.1097/WNO.0000000000001176DOI Listing
January 2021

Idiopathic Intracranial Hypertension and Anemia: A Matched Case-Control Study: Response.

J Neuroophthalmol 2021 06;41(2):e273-e274

Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.

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http://dx.doi.org/10.1097/WNO.0000000000001184DOI Listing
June 2021

Neuro-Ophthalmic Manifestations of Mollaret Meningitis.

J Neuroophthalmol 2021 Jan 4;Publish Ahead of Print. Epub 2021 Jan 4.

McGovern Medical School (BP), Houston, Texas; Department of Ophthalmology (SHB, NB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Neurology (MON), Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; MD Anderson Cancer Center (AGL), University of Texas, Houston, Texas; and Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Abstract: Mollaret meningitis (MM) refers to benign recurrent aseptic meningitis usually following herpes simplex virus 2 (HSV-2) infection. Neuro-ophthalmic manifestations associated with MM are rarely reported. We present a case of recurrent HSV-2 meningitis with the neuro-ophthalmic presentation of papilledema and sixth nerve palsy. To our knowledge, this is the first such description in the English language ophthalmic literature.
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http://dx.doi.org/10.1097/WNO.0000000000001152DOI Listing
January 2021

Postinfectious Optic Neuritis After Hand-Foot-Mouth Disease.

J Neuroophthalmol 2021 Jan 4;Publish Ahead of Print. Epub 2021 Jan 4.

Department of Ophthalmology, Baylor College of Medicine (SCB, AGL), Houston, Texas; Department of Ophthalmology (NB, SHB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Ophthalmology, The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; Department of Ophthalmology, MD Anderson Cancer Center (AGL), University of Texas, Houston, Texas; Department of Ophthalmology, Texas A and M College of Medicine (AGL), Texas; and Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Abstract: A 33-year-old man presented with acute painless loss of vision in his right eye after hand-foot-mouth disease (HFMD). Examination confirmed a right optic neuropathy. Neuroimaging and routine evaluations for alternative causes for an optic neuropathy were negative. He was treated with high dose corticosteroids and made an almost complete visual recovery. Postinfectious optic neuritis has been reported after a vast array of infections including: varicella zoster virus, influenza virus, herpes simplex virus, Epstein-Barr Virus, Lyme disease, and many others. Although Coxsackie virus infections are a known cause of HFMD and have been reported to cause maculopathy, to the best of our knowledge, this is the first reported case of optic neuritis after HFMD in the English language ophthalmic literature.
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http://dx.doi.org/10.1097/WNO.0000000000001163DOI Listing
January 2021
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