110 results match your criteria Neuro-Ophthalmic History

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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Neuro-Ophthalmic Phenotype of OPA3.

J Neuroophthalmol 2021 Apr 14. Epub 2021 Apr 14.

Neuro-Ophthalmology Unit (RH-B), Goldschleger Eye Institute Chaim Sheba Medical Center, Tel-Hashomer, Israel; Department of Neurology (GY, SH-B), Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Movement Disorders Clinic and Department of Neurology (GY), Shaare Zedek Medical Center, Jerusalem, Israel; Metabolic Disease Unit Edmond and Lily Safra Children's Hospital (YA), Chaim Sheba Medical Center, Tel-Hashomer, Israel; Pediatric Neurology Unit (BBZ), Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Radiology Department (CH), Chaim Sheba Medical Center, Tel-Hashomer, Israel; and Sackler Faculty of Medicine (RH-B, YA, BBZ, CH, SH-B), Tel-Aviv University, Tel-Aviv, Israel.

Background: Type III 3-methylglutaconic aciduria (OPA 3) is a neuro-ophthalmologic syndrome consisting of early-onset bilateral optic atrophy. Since Costeff described the phenotype of 19 patients in 1989, several reports described approximately 50 patients, but most of them lack details about neuro-ophthalmic phenotype. Our aim was to characterize the clinical neuro-ophthalmic phenotype of this syndrome. Read More

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Extraocular Muscle Enlargement and Proptosis Associated with Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

Ophthalmic Plast Reconstr Surg 2021 Mar 31. Epub 2021 Mar 31.

Orbital Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia Centre for Eye Research, University of Melbourne, Melbourne, Australia Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an inflammatory neuropathy, which commonly causes peripheral neuropathy. It has rarely been associated with cranial nerve hypertrophy and neuro-ophthalmic manifestations. Proptosis secondary to cranial nerve hypertrophy has been reported in association with CIDP. Read More

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Case 292.

Radiology 2021 Apr;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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Neuro-ophthalmic presentation of COVID-19 disease: A case report.

Indian J Ophthalmol 2021 Apr;69(4):992-994

Department of Ophthalmology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India.

COVID-19 is a respiratory virus, which has affected various organ systems as well. Here we report a neuro-ophthalmic presentation of pituitary apoplexy under the setting of COVID-19 infection in a middle-aged man who presented to ophthalmic emergency with sudden bilateral loss of vision along with a history of fever past 10 days. There was sluggishly reacting pupils and RT-PCR for COVID was positive. Read More

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

Ophthalmology 2021 Mar 11. 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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Neuro-ophthalmic Complications of Immune-Checkpoint Inhibitors.

Semin Ophthalmol 2021 Feb 27:1-9. Epub 2021 Feb 27.

Department of Ophthalmology, Massachusetts Eye & Ear/Harvard Medical School, Boston, MA, USA.

Immune checkpoint inhibitors (ICIs) have revolutionized the field of oncology by modulating the immune cell-cancer cell interaction and thereby promoting immune system disinhibition in order to target several types of malignancies. There are three classes of immune checkpoint inhibitors (ICIs): anti-cytotoxic T-lymphocyte associated antigen 4 (CTLA-4), anti-programmed cell death protein-1 (PD-1), and anti-programmed cell death ligand-1 (PD-L1).It is not uncommon for physicians across all specialties to encounter a patient with a history of malignancy and ICI exposure, necessitating familiarity with their potential complications. Read More

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February 2021

An Ophthalmic Insight into Novel Coronavirus 2019 Disease: A Comprehensive Review of the Ocular Manifestations and Clinical Hazards.

J Curr Ophthalmol 2020 Oct-Dec;32(4):315-328. Epub 2020 Dec 12.

Department of Ophthalmology, Faculty of Medicine, Benha University, Banha, Egypt.

Purpose: To discuss the ocular manifestations provoked by novel coronavirus 2019 (COVID-19) disease in humans, the natural history of the disease in the eye, and its treatment.

Methods: We designed a narrative review of the ocular manifestations of COVID-19 based on the literature published till July 30, 2020. The databases were PubMed, Scopus, Cochrane Library, Google Scholar, and ScienceDirect. Read More

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December 2020

Low Contrast Visual Acuity Might Help to Detect Previous Optic Neuritis.

Front Neurol 2020 22;11:602193. Epub 2020 Dec 22.

Department of Neurology, Dongguk University Ilsan Hospital and Dongguk University-Seoul Graduate School of Medicine, Goyang, South Korea.

Optic neuritis (ON) has been considered to be an important factor in the diagnosis of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), making ON detection increasingly critical for early diagnosis. Furthermore, subclinical ONs presenting no distinct decrease in visual acuity can be missed. Low contrast visual acuity (LC-VA) is known to be able to capture visual loss not seen in conventional high-contrast visual acuity (HC-VA) in MS. Read More

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December 2020

Nelson Syndrome: Clival Invasion of Corticotroph Pituitary Adenoma Resulting in Alternating Sixth Nerve Palsies.

J Neuroophthalmol 2021 Mar;41(1):114-118

Division of Neuro-Ophthalmology (VPD, KAAD, BKC), Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts; and Departments of Radiology (OR), Pathology (SNC), and Neurology (BKC), Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.

Abstract: A 44-year-old woman presented with 2 painful and self-limited episodes of binocular horizontal diplopia within 1 year that at the beginning were thought to be secondary to microvascular insult. Her medical history was significant for Cushing syndrome status post transsphenoidal resection with bilateral adrenalectomy 4 years prior, hypertension, and diabetes mellitus. Neuro-ophthalmic evaluation was significant for left abduction deficit and incomitant esotropia consistent with left abducens nerve palsy. Read More

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Population-Based Frequency of Ophthalmic Adverse Events in Melanoma, Other Cancers, and After Immune Checkpoint Inhibitor Treatment.

Am J Ophthalmol 2021 04 15;224:282-291. Epub 2021 Feb 15.

UCLA Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. Electronic address:

Purpose: To examine the frequency of ophthalmic immune-related adverse events (OirAEs) in melanoma, other cancers, and after immune checkpoint inhibitor (ICI) treatment.

Design: Retrospective clinical cohort study.

Methods: This study identified patients diagnosed with OirAEs between January 1, 2011, and December 31, 2018, in the Kaiser Permanente Southern California electronic health records. Read More

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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

Subjective intermittent colour vision loss as the initial presentation of chronic myeloid leukemia.

Am J Ophthalmol Case Rep 2020 Sep 8;19:100817. Epub 2020 Jul 8.

Department of Ophthalmology, University of Ottawa, The Ottawa Hospital and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Purpose: To report a case of subjective intermittent loss of bilateral colour vision and episodic white-out vision in a patient with undiagnosed chronic myeloid leukemia (CML).

Observations: A patient initially diagnosed with diabetic retinopathy presented with a chief complaint of subjective intermittent loss of colour vision in both eyes, as well as intermittent bilateral white-out vision. These symptoms previously went uninvestigated until a thorough history revealed concurrent constitutional symptoms including recent night sweats and fevers. Read More

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September 2020

Survey of Telehealth Adoption by Neuro-ophthalmologists During the COVID-19 Pandemic: Benefits, Barriers, and Utility.

J Neuroophthalmol 2020 09;40(3):346-355

Departments of Ophthalmology (HEM) and Neurology & Neurological Sciences (HEM), Stanford University, Palo Alto, California; Department of Ophthalmology (KEL, MWK), Indiana University School of Medicine, Indianapolis, Indiana; Ophthalmology Service (KEL), Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana; and Departments of Neurology and Neurosurgery (MWK), Indiana University School of Medicine, Indianapolis, Indiana.

Background: During the COVID-19 pandemic, telehealth modalities have come to prominence as a strategy for providing patient care when in-person care provision opportunities are limited. The degree of adoption by neuro-ophthalmologists has not been quantified.

Methods: Telehealth utilization pre-COVID-19 and peri-COVID-19 was surveyed among practicing neuro-ophthalmologists in and outside the United States using an online platform. Read More

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September 2020

A novel AFG3L2 mutation close to AAA domain leads to aberrant OMA1 and OPA1 processing in a family with optic atrophy.

Acta Neuropathol Commun 2020 06 29;8(1):93. Epub 2020 Jun 29.

Mitochondrial dysfunctions in neurodegeneration Unit, Division of Neuroscience, Ospedale San Raffaele, Milan, Italy.

Autosomal dominant optic atrophy (ADOA) is a neuro-ophthalmic condition characterized by bilateral degeneration of the optic nerves. Although heterozygous mutations in OPA1 represent the most common genetic cause of ADOA, a significant number of cases remain undiagnosed.Here, we describe a family with a strong ADOA history with most family members spanning three generation having childhood onset of visual symptoms. Read More

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Factors associated with ocular adverse event after immune checkpoint inhibitor treatment.

Cancer Immunol Immunother 2020 Dec 17;69(12):2441-2452. Epub 2020 Jun 17.

Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea.

Ocular adverse events (OAEs) including vision-threatening intraocular inflammation after immune checkpoint inhibitor (ICI) treatment have been increasingly reported; however, the risk factors associated with OAEs remain elusive. Here, we determined the factors associated with OAEs after ICI treatment. We analyzed 40 consecutive patients who experienced OAEs after ICI treatments. Read More

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December 2020

Investigation of Visual System Involvement in Spinocerebellar Ataxia Type 14.

Cerebellum 2020 Aug;19(4):469-482

Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

Spinocerebellar ataxia type 14 (SCA-PRKCG, formerly SCA14) is a rare, slowly progressive disorder caused by conventional mutations in protein kinase Cγ (PKCγ). The disease usually manifests with ataxia, but previous reports suggested PRKCG variants in retinal pathology. To systematically investigate for the first time visual function and retinal morphology in patients with SCA-PRKCG. Read More

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Optic atrophy in children: Current causes and diagnostic approach.

Eur J Ophthalmol 2020 Nov 7;30(6):1499-1505. Epub 2020 Jan 7.

NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.

Background/aims: Optic atrophy is one of the leading causes of sight impairment in children. It frequently poses a diagnostic challenge, as it can be caused by many ocular and systemic conditions. We aimed to determine the current causes of optic atrophy at our centre and to describe the use of investigations, including molecular genetic testing. Read More

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November 2020

Decoding PERG: A neuro-ophthalmic retinal ganglion cell function review.

Pedro Monsalve

Curr Ophthalmol Rep 2019 Mar 13;7(1):51-58. Epub 2019 Feb 13.

Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136.

Purpose Of Review: Currently, the clinical evaluation of neuro-ophthalmologic diseases are mainly focused on identifying stages where structural or functional damage occur. Recognition of retinal ganglion cell (RGC) functional patterns as well as monitoring RGC dysfunction can be performed using steady-state pattern electroretinogram (PERG). The analysis of the amplitude and latency shift aid on providing information on early damage or monitoring of the RGC, allowing for prompt clinical intervention and management modification, potentially changing the natural history of the disease. Read More

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Vertebrobasilar ischemia (VBI) related neuro-ophthalmic syndromes after routine activities involving hyperextension or rotation of the neck (hairdresser syndrome).

Eye (Lond) 2020 05 30;34(5):901-905. Epub 2019 Sep 30.

Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.

Background: Vertebrobasilar insufficiency (VBI) after rotation or hyperextension of the neck during otherwise routine activities is uncommon "hairdresser syndrome" (HDS). We report three such cases presenting with neuro-ophthalmic complaints (Horner syndrome, ophthalmoplegia, and transient vision loss).

Methods: A retrospective review was performed of the electronic health records of three patients seen in the neuro-ophthalmology clinic of Houston Methodist Hospital with acute neuro-ophthalmological signs after neck hyperextension. Read More

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An overview of spaceflight-associated neuro-ocular syndrome (SANS).

Neurol India 2019 May-Jun;67(Supplement):S206-S211

Blanton Eye Institute, Department of Ophthalmology, Houston Methodist Hospital, Houston; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York City, New York; Department of Ophthalmology, Baylor College of Medicine (BCM) and the BCM Center for Space Medicine, Houston, Texas, and University of Texas Medical Branch (UTMB), Galveston; Texas A and M College of Medicine (College Station, Texas), UT MD Anderson Cancer Center, Houston, Texas; University of Iowa Hospitals and Clinics (Iowa City Iowa), and the University of Buffalo, Buffalo, New York, USA.

Over the last decade, the National Aeronautics and Space Administration's (NASA) Space Medicine Division has documented a variety of unusual physiological and pathological neuro-ophthalmic findings in astronauts during and following long duration space flight. These ndings include optic disc swelling, globe flattening, choroidal folds, and hyperopic shifts in refraction. Cephalad fluid shift has been proposed as a possible unifying etiology, but the specific mechanism responsible for these changes remains obscure. Read More

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December 2019

Antiphospholipid syndrome and neurofibromatosis type I: a coincidence or new association?

Arq Bras Oftalmol 2019 Mar-Apr;82(2):155-157

Department of Neuro-radiology, Sheikh Khalifa Hospital, Abu Dhabi, UAE.

Numerous studies have reported on structural vascular anomalies and ischemia associated with neurofibromatosis type 1 that are thought to stem from dysfunction of neurofibromin, the neurofibromatosis type 1 protein. Documented cases of associated antiphospholipid syndrome fulfilling the accepted diagnostic criteria are exceptionally rare, with only three cases reported in the literature. Here, we report on a patient with neurofibromatosis type 1 and a history of spontaneous abortions presenting with sudden vision loss in the right eye and swelling of the optic nerve head. Read More

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December 2019

Glaucomatous optic disc changes despite normal baseline intraocular pressure in a child.

Am J Ophthalmol Case Rep 2019 Mar 14;13:104-109. Epub 2018 Dec 14.

Bascom Palmer Eye Institute, The University of Miami Miller School of Medicine, 900 NW 17th Street 450N, Miami, FL, 33136, USA.

Purpose: We describe a case of normal tension glaucoma in the setting of sickle cell disease in a 9-year-old patient with a five-year follow up.

Observations: A 9-year-old male patient with a history of sickle cell disease presented initially at the age of 4 years for evaluation of a brief episode of nonspecific eye pain that had spontaneously resolved prior to the clinic visit. Over the course of several years, the patient was noted to have progressive optic disc cupping bilaterally, retinal nerve fiber layer thinning bilaterally, and has developed a corresponding inferior arcuate defect on automated visual field testing in the right eye, all without elevated intraocular pressures (IOP). Read More

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Value of medical history in ophthalmology: A study of diagnostic accuracy.

J Curr Ophthalmol 2018 Dec 27;30(4):359-364. Epub 2018 Sep 27.

Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, USA.

Purpose: This study aimed to demonstrate the value of the chief compliant and patient history to accurately diagnose patient pathology without requiring ocular examination or imaging in an outpatient neuro-ophthalmology clinic.

Methods: We prospectively evaluated 115 consecutive patients at our institution from January to April 2009. The attending neuro-ophthalmologist committed to a single most likely diagnosis while solely being exposed to patient demographic information (age, gender, race) and chief complaint, but was otherwise blinded to ocular examination or imaging. Read More

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December 2018

Acute visual loss and optic disc edema followed by optic atrophy in two cases with deeply buried optic disc drusen: a mimicker of atypical optic neuritis.

BMC Ophthalmol 2018 Oct 26;18(1):278. Epub 2018 Oct 26.

Ocular Oftalmologia, Vitória, Brazil.

Background: Sudden visual loss and optic disc edema caused by optic neuritis (ON) is usually followed by significant visual recovery. However, little or no recovery occurs when the loss is caused by atypical ON, especially in patients with neuromyelitis optica (NMO). Optic disc drusen (ODD) is a cause of pseudo optic disc edema and may be a predisposing factor for non-arteritic anterior ischemic optic neuropathy (NAION), thereby mimicking atypical ON. Read More

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October 2018

Bilateral oculomotor ocular neuromyotonia: a case report.

BMC Neurol 2018 Sep 3;18(1):137. Epub 2018 Sep 3.

Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand.

Background: Ocular neuromyotonia (ONM) is characterized by episodic diplopia, which is usually triggered by prolonged eccentric gaze of the affected extraocular muscles. The spell is characterized by involuntary, occasionally painful, sustained contraction of one or more extraocular muscles innervated by the oculomotor, trochlear, or abducens nerve. ONM usually occurs as a late consequence of radiotherapy around the parasellar area, although idiopathic cases have been reported. Read More

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September 2018

The Outcomes of Pituitary Apoplexy with Conservative Treatment: Experiences at a Single Institution.

World Neurosurg 2018 Jul 27;115:e703-e710. Epub 2018 Apr 27.

Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Objective: Pituitary apoplexy is an unpredictable complication caused by hemorrhage or infarction in a pituitary adenoma. We retrospectively analyzed the radiologic and clinical outcomes of patients with conservatively managed pituitary apoplexy.

Methods: A total of 32 patients who had undergone conservative treatment with high-dose corticosteroid replacement were enrolled in this study. Read More

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Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough.

Am J Ophthalmol Case Rep 2018 Jun 15;10:128-131. Epub 2018 Feb 15.

Department of Ophthalmology, Stanford School of Medicine, 2452 Watson Court, Palo Alto, CA 94303-5353, USA.

Purpose: Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease.

Observations: A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Read More

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An atypical case of neurosarcoidosis presenting with neovascular glaucoma.

J Ophthalmic Inflamm Infect 2018 Apr 18;8(1). Epub 2018 Apr 18.

Department of Ophthalmology, University Hospital Ghent, De Pintelaan 185, 9000, Ghent, Belgium.

Background: Sarcoidosis, a multisystem, granulomatous disorder, sometimes manifests with a neuro-ophthalmic subtype. The latter can pose a diagnostic challenge, especially when ocular symptoms appear before systemic involvement, as the clinical picture then can be non-specific and systemic laboratory and standard imaging investigations can be negative.

Findings: A 71-year-old woman presented with a 4-month history of sudden-onset visual loss in the left eye. Read More

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Gene Therapy for Leber Hereditary Optic Neuropathy: Low- and Medium-Dose Visual Results.

Ophthalmology 2017 11 21;124(11):1621-1634. Epub 2017 Jun 21.

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.

Purpose: To determine the effects of AAV2(Y444,500,730F)-P1ND4v2 in patients with Leber hereditary optic neuropathy (LHON).

Design: Prospective open-label, unilateral single-dose, intravitreal injection of AAV2(Y444,500,730F)-P1ND4v2 per participant.

Participants: Fourteen patients with visual loss and mutated G11778A mitochondrial DNA. Read More

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November 2017