245 results match your criteria Neuro-Ophthalmic Examination


Unilateral Optic Nerve Diffusion Restriction After Sinus Surgery Secondary to Central Retinal Artery Occlusion: Case Report and Literature Review.

Neurologist 2022 Mar 29. Epub 2022 Mar 29.

Departments of Neurology.

Introduction: Permanent perioperative vision loss is caused by ischemic optic neuropathy (ION) or central retinal artery occlusion (CRAO). Whereas diffusion restriction of the optic nerve (ON) on brain magnetic resonance imaging has been previously reported in perioperative posterior ION (PION), there are no reports of ON diffusion restriction in patients diagnosed with acute perioperative CRAO. We present a case of perioperative CRAO to highlight this neuroimaging finding for neuroradiologists and neurologists. Read More

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Clinical approach to vision loss: a review for general physicians.

Clin Med (Lond) 2022 03;22(2):95-99

RoyalFree London NHS Foundation Trust, London, UK.

Visual loss describes temporary or permanent reduction in visual acuity and/or field. Its aetiology is diverse due to the contributions of the different neuro-ophthalmic structures (eye, optic nerve, and brain) to image formation and perception, but may be categorised into ocular causes (corneal, lenticular, vitreoretinal and macular) or optic neuropathies. Clinical evaluation of visual loss relies on thorough history and examination to guide further tests. Read More

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Neuro-Visual and Vestibular Manifestations of Concussion and Mild TBI.

Curr Neurol Neurosci Rep 2022 03 2;22(3):219-228. Epub 2022 Mar 2.

Department of Neurology, The Johns Hopkins School of Medicine, 600 N Wolfe St, Path 2-210, Baltimore, MD, 21287, USA.

Purpose Of Review: Mild traumatic brain injury, or concussion, is a major cause of disability. Vestibular and visual dysfunction following concussion is common and can negatively affect patients' well-being and prolong recovery. Etiologies of visual and vestibular symptoms are numerous, including ocular, neuro-ophthalmic, otologic, and neuro-vestibular conditions. Read More

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Bilateral sequential non-arteritic optic neuropathy post-COVID-19.

Indian J Ophthalmol 2022 Feb;70(2):676-679

Gurunanak Eye Center, Maulana Azad Medical College, New Delhi, India.

Corona virus disease 2019 (COVID-19) has been documented to have a spectrum of neuro-ophthalmic manifestations. However, bilateral non-arteritic anterior ischemic optic neuropathy (NAION) post-COVID-19 has not been reported in the literature. We studied the case of a 45-year-old male who presented to our outpatient department (OPD) with bilateral blurring of vision following an episode of COVID-19, 1 month back. Read More

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February 2022

Predictive value of OCT and MRI for postoperative visual recovery in patients with chiasmal compressive lesions.

Eur J Ophthalmol 2022 Jan 10:11206721211073216. Epub 2022 Jan 10.

Department of Ophthalmology, 220312School of Medicine, Pusan National University Hospital, South Korea.

Purpose: We aimed to investigate the predictive value of retinal thickness measured by optical coherence tomography (OCT) and mass biometrics measured using magnetic resonance image (MRI) for visual recovery after surgery for removal of a mass compressing the optic chiasm.

Methods: Consecutive patients who showed typical temporal visual field defect (VFD) with respect to the vertical meridian due to a chiasmal compressive mass and who underwent mass removal surgery were recruited. Ophthalmic examination was performed preoperatively and postoperatively. Read More

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January 2022

Bridging the Gap between Ophthalmology and Emergency Medicine in Community-Based Emergency Departments (EDs): A Neuro-Ophthalmology Guide for ED Practitioners.

Clin Pract 2021 Dec 2;11(4):919-932. Epub 2021 Dec 2.

Department of Ophthalmology, Central Valley Eye Medical Group, Stockton, CA 95207, USA.

Coordination of care for patients with neuro-ophthalmic disorders can be very challenging in the community emergency department (ED) setting. Unlike university- or tertiary hospital-based EDs, the general ophthalmologist is often not as familiar with neuro-ophthalmology and the examination of neuro-ophthalmology patients in the acute ED setting. Embracing image capturing of the fundus, using a non-mydriatic camera, may be a game-changer for communication between ED physicians, ophthalmologists, and tele-neurologists. Read More

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December 2021

Ocular findings in cats with blastomycosis: 19 cases (1978-2019).

J Am Vet Med Assoc 2021 12 21;260(4):422-427. Epub 2021 Dec 21.

Objective: To document ocular findings in cats with blastomycosis.

Animals: 35 cats with blastomycosis.

Procedures: Medical records from 1978 through 2019 were reviewed to identify cats with confirmed Blastomyces infection. Read More

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December 2021

[Ischemic optic neuropathy despite pulse methylprednisolone therapy in a giant cell arteritis patient with perineural optic nerve enhancement].

Rinsho Shinkeigaku 2021 Dec 18;61(12):851-855. Epub 2021 Nov 18.

Department of Neurology, Japan Community Healthcare Organization Kyushu Hospital.

A 76-year-old woman with a 1-month history of headache, jaw claudication, scalp tenderness, and blurred vision was admitted to our hospital. Erythrocyte sedimentation rate was highly elevated. Brain MRI showed marked perineural optic nerve enhancement and superficial temporal artery enhancement bilaterally. Read More

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December 2021

A haploscope based binocular pupillometer system to quantify the dynamics of direct and consensual Pupillary Light Reflex.

Sci Rep 2021 10 26;11(1):21090. Epub 2021 Oct 26.

Department of Neuroscience, Vestibular and Ocular Motor Research Group, Erasmus MC, Room EE 1453, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.

This study described the development of a haploscope-based pupillometer for the parametrization of the Pupillary Light Reflex (PLR), and its feasibility in a set of 30 healthy subjects (light or dark-colored irides) and five patients diagnosed with Relative Afferent Pupillary Defect (RAPD). Our supplementary aim focused on evaluating the influence of iris colour on the PLR to decide whether a difference in PLR parameters should be anticipated when this system is used across ethnicities. All the participants underwent a customized pupillometry protocol and the generated pupil traces, captured by an eye tracker, were analyzed using exponential fits to derive PLR parameters. Read More

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October 2021

Case Report: Bilateral Cranial Nerve VI Palsy in Miller Fisher Syndrome.

Optom Vis Sci 2021 10;98(10):1151-1155

Department of Neuro-Ophthalmic Disease, Pennsylvania College of Optometry, Salus University, Philadelphia, Pennsylvania.

Significance: Miller Fisher syndrome, a variant of Guillain-Barré syndrome, is a condition characterized by ophthalmoplegia, ataxia, and areflexia. Diplopia, particularly secondary to a bilateral abduction deficit, is the most common presenting symptom. The telltale neurologic symptoms associated with this condition can easily be overlooked by eye care providers, delaying timely diagnosis and treatment. Read More

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October 2021

Ophthalmic manifestations of dementing disorders.

Curr Opin Ophthalmol 2021 Nov;32(6):515-520

Division of Neuro-ophthalmology, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: Dementia is a term for loss of memory, language, problem-solving, and other thinking abilities, which significantly interferes with daily life. Certain dementing conditions may also affect visual function. The eye is an accessible window to the brain that can provide valuable information for the early diagnosis of people who suffer from Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies as well as from more rare causes of dementias, such as Creutzfeldt-Jacob and Huntington's diseases. Read More

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November 2021

Efficacy and Safety of Proton Beam Therapy for Primary Optic Nerve Sheath Meningioma.

Eye Brain 2021 24;13:219-229. Epub 2021 Aug 24.

Neurosurgery Department, Hôpital Fondation A. de Rothschild, Paris, France.

Purpose: Management of optic nerve sheath meningiomas (ONSM) remains challenging. Photon radiation therapy (PhRT) is the most common treatment for sight-threatening ONSM. Proton beam therapy (PBT) is less commonly used because it is more expensive and because there are questions about its efficacy specifically in relation to ONSM. Read More

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Segmented retinal analysis in pituitary adenoma with chiasmal compression: A prospective comparative study.

Indian J Ophthalmol 2021 Sep;69(9):2378-2384

Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Purpose: The aim of this study was to determine the alteration in ganglion cell complex and its relationship with retinal nerve fiber layer (RNFL) thickness as measured by spectral-domain optical coherence tomography (OCT) in pituitary adenoma cases and also its correlation with visual field (VF).

Methods: This is a prospective comparative study wherein detailed neuro-ophthalmic examination including perimetry, RNFL and ganglion cell layer inner plexiform layer (GCL-IPL) thickness were measured preoperatively in the cases of pituitary adenoma with chiasmal compression with visual symptoms and field changes who were planned for neuro-surgical intervention. These parameters were repeated 1 year after the surgery. Read More

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September 2021

Telemedicine in neuro-ophthalmology.

Curr Opin Ophthalmol 2021 Nov;32(6):499-503

Kaiser Permanente Northern California, Vallejo, California, USA.

Purpose Of Review: The COVID-19 public health emergency accelerated the adoption of telemedicine in neuro-ophthalmology. This review surveys the current telemedicine landscape and discusses associated limitations and opportunities.

Recent Findings: Logistic considerations and regulatory changes related to the COVID-19 pandemic have spurred a proliferation of tele-neuro-ophthalmic practice. Read More

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November 2021

Case 292: Lyme Neuroborreliosis.

Radiology 2021 08;300(2):484-488

From the Departments of Ophthalmology (V.P.D., K.A.A.D., B.K.C.) and Radiology (K.L.R.), Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles St, Boston, MA 02114; and Department of Neurology, Neuro-Ophthalmology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (B.K.C.).

History A 24-year-old right-handed woman presented to a neuro-ophthalmology clinic in Massachusetts in the summer with acute binocular diplopia when looking down and to the left, which started about 1 month earlier. Her medical history was notable for Raynaud syndrome, recurrent streptococcal pharyngitis, and an allergy to amoxicillin. Three days prior to developing diplopia, she presented to an outside emergency department due to fever, chills, and back pain. Read More

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Freezing of saccades in dopa-responsive parkinsonian syndrome.

Am J Ophthalmol Case Rep 2021 Sep 23;23:101124. Epub 2021 May 23.

Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.

Purpose: Ocular motor abnormalities such as abnormal saccades are common in idiopathic Parkinson's disease (PD) and atypical parkinsonian syndrome, such as progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). In this study, we describe a case of patient with PD and show a video illustrating severe delay of reflexive saccades.

Observations: A 68-year-old Caucasian woman with diagnosis of PD presented for evaluation of diplopia. Read More

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September 2021

Monocular Diplopia in Idiopathic Intracranial Hypertension: A Case Report and Literature Review.

Eur J Case Rep Intern Med 2021 4;8(5):002509. Epub 2021 May 4.

Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.

Background: Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e. Read More

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Disorders of the Fourth Cranial Nerve.

J Neuroophthalmol 2021 Jun;41(2):176-193

Department of Ophthalmology, University of Alabama School of Medicine (LBK, MSV, MT), Birmingham, Alabama; The Shiley Eye Institute, University of California San Diego (LBK), San Diego, California; and The Jules Stein Eye Institute, University of California, Los Angeles (JLD), Los Angeles, California.

Abstract: This review of disorders of the fourth cranial nerve includes discussion on anatomy, examination techniques, congenital and acquired etiologies, differential diagnosis, and management options. The findings of the superior oblique muscle on orbital MRI in patients with fourth nerve palsy have had a major impact on our understanding of this cranial neuropathy. In addition, briefly reviewed are rare disorders of the fourth nerve: superior oblique myokymia, Brown syndrome, and ocular neuromyotonia. Read More

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Neuro-Ophthalmology for Internists.

Med Clin North Am 2021 May;105(3):511-529

Department of Ophthalmology, University of Pennsylvania, 51 N 39th St, Philadelphia, PA 19104, USA.

Neuro-ophthalmology is the study of the neurologic underpinnings of vision and includes a fascinating variety of disorders that span the broad spectrum of ophthalmic and neurologic disease. This subspecialty relies heavily on accurate neuroanatomic localization and examination. This article discusses neuro-ophthalmic complaints that frequently present to the internist, including acute vision loss, double vision, and unequal pupils. Read More

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Internuclear ophthalmoplegia as a presenting feature in a COVID-19-positive patient.

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Child Sight Institute, Jasti V Ramanamma Children's Eye Care Centre, LV Prasad Eye Institute, Hyderabad, India

A 58-year-old man presented with vertical diplopia for 10 days which was sudden in onset. Extraocular movement examination revealed findings suggestive of internuclear ophthalmoplegia. Investigations were suggestive of diabetes mellitus, and reverse transcription-PCR for SARS-CoV-2 was positive. Read More

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Binasal visual field defects caused by temporal posterior subcapsular cataracts.

Taiwan J Ophthalmol 2021 Jan-Mar;11(1):101-103. Epub 2021 Jan 28.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.

A 55-year-old female presented with binasal visual field defects and normal neuro-ophthalmic examination. Slit-lamp examination demonstrated posterior subcapsular cataracts that were located temporally in the visual axis. Due to the location of the nodal point in the eye, her visual field defect was contralateral to the opacity. Read More

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January 2021

Neuro-ophthalmic manifestations of mitochondrial disorders and their management.

Taiwan J Ophthalmol 2021 Jan-Mar;11(1):39-52. Epub 2020 Dec 4.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.

The visual system has high metabolic requirements and is therefore particularly vulnerable to mitochondrial dysfunction. The most commonly affected tissues include the extraocular muscles, photoreceptors, retinal pigment epithelium, optic nerve and visual cortex. Hence, the most common manifestations of mitochondrial disorders are progressive external ophthalmoplegia, macular pattern dystrophy, pigmentary retinopathy, optic neuropathy and retrochiasmal visual field loss. Read More

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December 2020

Case 292.

Radiology 2021 04;299(1):234-236

From the Departments of Ophthalmology (V.P.D., K.A.A.D., B.K.C.) and Radiology (K.L.R.), Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles St, Boston, MA 02114; and Department of Neurology, Neuro-Ophthalmology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (B.K.C.).

History A 24-year-old right-handed woman presented to a neuro-ophthalmology clinic in Massachusetts in the summer with acute binocular diplopia when looking down and to the left, which started about 1 month earlier. Her medical history was notable for Raynaud syndrome, recurrent streptococcal pharyngitis, and an allergy to amoxicillin. Three days prior to developing diplopia, she presented to an outside emergency department due to fever, chills, and back pain. Read More

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Comparative evaluation of Octopus semi-automated kinetic perimeter with Humphrey and Goldmann perimeters in neuro-ophthalmic disorders.

Indian J Ophthalmol 2021 04;69(4):918-922

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Purpose: The aim of this study was to compare the performance of Octopus 900(OVF) kinetic module with Goldmann perimeter (GVF) and Humphrey 750i (HVF) perimeters in neuro-ophthalmic disorders.

Methods: During this prospective observational cross-sectional study, 17 patients (26 eyes) with neuro-ophthalmic disorders underwent visual field examination on the three perimeters. Field defects on OVF were matched with HVF and GVF for the number of quadrants involved. Read More

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Patient Harm Due to Diagnostic Error of Neuro-Ophthalmologic Conditions.

Ophthalmology 2021 09 11;128(9):1356-1362. Epub 2021 Mar 11.

Department of Ophthalmology, Emory University, Atlanta, Georgia; Department of Neurology, Emory University, Atlanta, Georgia. Electronic address:

Purpose: To prospectively examine diagnostic error of neuro-ophthalmic conditions and resultant harm at multiple sites.

Design: Prospective, cross-sectional study.

Participants: A total of 496 consecutive adult new patients seen at 3 university-based neuro-ophthalmology clinics in the United States in 2019 to 2020. Read More

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September 2021

[Treatment outcomes in patients with central nervous system germinoma (neuro-ophthalmic aspects)].

Zh Vopr Neirokhir Im N N Burdenko 2021 ;85(1):78-86

Burdenko Neurosurgery Center, Moscow, Russia.

Objective: The analyze the neuro-ophthalmic outcomes in patients with pineal and suprasellar germinoma after complex treatment.

Material And Methods: There were 125 patients (88 males, 37 females) with primary CNS germinoma for the period 2008-2017. All patients were divided into 3 groups depending on the tumor localization: pineal area - 62 patients, suprasellar neoplasm - 38 patients, bifocal germinoma - 25 patients. Read More

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February 2021

Unilateral Isolated Paucisymptomatic Optic Disc Edema.

J Neuroophthalmol 2021 12;41(4):e523-e534

Departments of Ophthalmology (EH, RAS, JHP, MD, NJN, VB), Pediatrics (JHP), Neurology (NJN, VB), and Neurological Surgery (NJN), Emory University School of Medicine, Atlanta, Georgia.

Background: Unilateral isolated optic disc edema (UIODE) represents a challenging clinical presentation that frequently precipitates an extensive diagnostic work-up. Patients without an apparent diagnosis despite appropriate investigations are often categorized as having "papillophlebitis," an entity that is poorly defined in the existing literature. Our aim was to describe the characteristics of a series of patients with paucisymptomatic UIODE, determine the optimal diagnostic approach to such cases, and clarify the clinical features of presumed papillophlebitis. Read More

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December 2021

Umbilical cord-derived mesenchymal stem cell implantation in patients with optic atrophy.

Eur J Ophthalmol 2021 Nov 14;31(6):3463-3470. Epub 2020 Dec 14.

Department of Ophthalmology, Acibadem Hospital, Kayseri, Turkey.

Background: Optic nerve cells can be irreversibly damaged by common various causes. Unfortunately optic nerve and retinal ganglion cells have no regenerative capacity and undergo apoptosis in case of damage. In this study, our aim is to investigate the safety and efficacy of suprachoroidal umbilical cord-derived MSCs (UC-MSCs) implantation in patients with optic atrophy. Read More

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November 2021

Methylphenidate-associated Alice in Wonderland syndrome.

Eur J Ophthalmol 2020 Dec 9:1120672120978882. Epub 2020 Dec 9.

Service d'Ophtalmologie, Hôpital Erasme, Brussels, Belgium.

Introduction: We describe the case of a child affected by typical symptoms of Alice in Wonderland syndrome (AIWS), related to the methylphenidate treatment he was taking for an attention deficit hyperactivity disorder (ADHD). To our knowledge, this is the first case of methylphenidate-associated AIWS.

Methods: Retrospective single center observational case report. Read More

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December 2020

Optic neuropathy and diplopia from thyroid eye disease: update on pathophysiology and treatment.

Curr Opin Neurol 2021 02;34(1):116-121

Department of Ophthalmology and Visual Sciences, Illinois Center for Thyroid Eye Disease, Illinois Eye and Ear Infirmary UIC, Chicago, Illinois, USA.

Purpose Of Review: Thyroid eye disease (TED) is a disfiguring disease that can lead to neuro-ophthalmic manifestations including diplopia and optic neuropathy. The aim of this review is to shed light on the diagnosis of TED based on clinical examination findings and diagnostic imaging. We will also discuss gold standard as well as newly emerging therapies for TED. Read More

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February 2021