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Neuroophthalmology 2019 Feb 27;43(1):67-69. Epub 2018 Jul 27.

Pharmacovigilance, Medical Affairs & Pharmacovigilance, Pharmaceuticals, Bayer Oy, Espoo, Finland.

The current letter to the editor describes some of the limitations of Valenzuela et al.'s study on the association between levonorgestrel-releasing intrauterine system use and pseudotumor cerebri/idiopathic intracranial hypertension and further reinforces the authors' interpretations of the findings. Read More

Neuroophthalmology 2019 Feb 23;43(1):56-57. Epub 2018 May 23.

Medical School Department of Neurology, Ege University, Bornova, Izmir, Turkey.

Lesions located in the anterior cavernous sinus or posterior orbit are known to cause divisional oculomotor palsy. We herein report a patient with fascicular infarction causing superior division paresis of the nerve. Read More

Neuroophthalmology 2019 Feb 25;43(1):53-55. Epub 2018 Apr 25.

Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.

A 61-year-old male presents with diplopia of acute onset and progressive course. He has a history of previous intracranial haemorrhage that was surgically evacuated 7 years ago and was also associated with diplopia. Examination revealed left complete oculomotor nerve paralysis with a fixed and dilated left pupil. Read More

Neuroophthalmology 2019 Feb 26;43(1):49-52. Epub 2018 Jun 26.

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA.

Idiopathic intracranial hypertension is a syndrome of elevated intracranial pressure without an identifiable cause. The majority of cases appear to be sporadic, and incidence is highest in obese women of childbearing age. The role of genetics in the pathophysiology of the disease is unclear, and familial cases are rare. Read More

Neuroophthalmology 2019 Feb 19;43(1):43-48. Epub 2018 Jun 19.

Hospital Pedro Hispano, Matosinhos, Portugal.

Hypotension is the most frequent complication of haemodialysis. We report a case of acute visual impairment after one session of haemodialysis in a context of an acute optic neuropathy. The immunological and serological studies were negative. Read More

Neuroophthalmology 2019 Feb 23;43(1):36-42. Epub 2018 May 23.

Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.

A 73-year-old female with a past medical history of breast cancer, who 10 years earlier experienced complete remission, complained of bilateral visual field disturbances and photopsia, 2 months prior. Tumour recurrence and metastatic lesions were not found during the medical examination, but antibodies against recoverin were detected in her serum. Despite immunosuppressive treatment with prednisolone and plasmapheresis, rapid and diffuse degeneration of the patient's photoreceptors and deterioration of her visual field were observed. Read More

Neuroophthalmology 2019 Feb 13;43(1):32-35. Epub 2018 Jun 13.

Department of Radiology and Imaging Services, Senior Interventional Radiologist Apollo Hospitals, Chennai, India.

Authors describe a case of traumatic pseudoaneurysm of cavernous internal carotid artery in a young male who presented with complaints of progressive decrease in vision, inability to move the eye, and delayed epistaxis 8 months after the head injury sustained during a motor vehicle accident. The presence of optic atrophy and epistaxis in the setting of head trauma alerted the authors to look for this potentially life-threatening condition. Timely intervention in the form of endovascular coil occlusion of the internal carotid artery was performed and the epistaxis stopped without any ischaemic or thromboembolic sequaelae. Read More

Neuroophthalmology 2019 Feb 13;43(1):26-31. Epub 2018 Jun 13.

School of Medicine, University of Southampton, Southampton, UK.

A rare condition characterized by a transient inability to open one or both eyes upon awakening from sleep was first described in 1897. Although less than a handful of papers have been written about this condition since its initial description, a well-defined clinical entity emerges from the available literature. This article reviews the history and clinical features of this unusual condition. Read More

Neuroophthalmology 2019 Feb 19;43(1):18-25. Epub 2018 Jun 19.

Harvard University Ophthalmology, Beth Israel Deaconness, Boston, Massachusetts, USA.

Purpose: To determine the positive yield (utility rate) of temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA).

Study Design: Systematic review (CRD42017078508) and meta-regression.

Materials And Methods: All articles concerning TAB for suspected GCA with English language abstracts from 1998 to 2017 were retrieved. Read More

Neuroophthalmology 2019 Feb 19;43(1):10-17. Epub 2018 Jun 19.

The New England Eye Center, Tufts Medical Center, Boston, Massachusetts, USA.

Reliable visual field testing is the gold standard in identifying future vision loss in patients with Idiopathic Intracranial hypertension (IIH). However, when field performance is unreliable, GCC analysis may be useful. We evaluated IIH patients over three visits: initial visit, follow-up visit and a third visit, almost 1 year later. Read More

Neuroophthalmology 2019 Feb 26;43(1):3-9. Epub 2018 Jun 26.

Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.

A recent study found that increased optic canal area on magnetic resonance imaging was associated with worse papilloedema in idiopathic intracranial hypertension (IIH). We repeated this study using more accurate computerized tomography derived measurements. Optic canal dimensions were measured from 42 IIH patients and 24 controls. Read More

Neuroophthalmology 2018 Dec 25;42(6):414-417. Epub 2018 Apr 25.

Birmingham Neuro-ophthalmology Unit, University Hospital Birmingham, Edgbaston, Birmingham, UK.

The management of patients with cerebrospinal fluid disorders requires a multi-specialty approach involving specialists in neurosurgery, neurology, neuroradiology and neuro-ophthalmology. A symposium on CSF disorders was organised by the clinical and academic teams at University Hospitals Birmingham, United Kingdom. The meeting featured a synopsis of the latest scientific research on CSF disorders. Read More

Neuroophthalmology 2018 Dec 26;42(6):404-405. Epub 2018 Mar 26.

Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Bilateral intracavernous internal carotid artery aneurysms are rare. They are more common in elderly females and are associated with hypertension. We present the computed tomography angiography findings of an 81-year-old female with history of hypertension who came complaining of diplopia and headache. Read More

Neuroophthalmology 2018 Dec 5;42(6):402-403. Epub 2018 Feb 5.

Department of Haematology, Royal Free London Hospitals NHS Foundation Trust, London, UK.

Ocular features of Gaucher disease include gaze abnormalities, corneal clouding, ocular deposits and pigmentary changes in the macula. We report the presence of bilateral fovea sparing macular deposits in a 21-year-old woman with type 3 Gaucher disease. Macular deposits occur due to glucocerebroside accumulation within histiocytes and retinal deposits might correlate with the degree of systemic infiltration. Read More

Neuroophthalmology 2018 Dec 26;42(6):399-401. Epub 2018 Mar 26.

Department of Neurology, Ege University Medical School, İzmir, Turkey.

Oculogyric crisis (OGC) describes the clinical phenomenon of sustained dystonic, conjugate and typically upward deviation of the eyes. A few cases with downward or lateral deviations have been described.. Read More

Neuroophthalmology 2018 Dec 19;42(6):391-398. Epub 2018 Jun 19.

Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.

A 62-year-old male with a history of metastatic clear cell renal cell carcinoma (ccRCC) presented with decreased vision to 20/50 in the left eye. Fundus examination revealed an elevated, amelanotic mass lesion in the superotemporal macula, without involvement of the central macula by subretinal fluid or tumour. Given incongruity between the fundus findings and the degree of visual impairment, visual field testing was obtained, revealing a bitemporal hemianopia. Read More

Neuroophthalmology 2018 Dec 23;42(6):385-390. Epub 2018 May 23.

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

An 84-year-old woman presented with 3 months of vertical binocular diplopia and difficulty reading at near. She had a history of bilateral ophthalmic artery aneurysm repair involving use of muslin in the 1990s. The patient then developed bitemporal hemianopsia secondary to muslin-induced inflammation ("muslinoma") extending to the optic chiasm, which required surgical decompression. Read More

Neuroophthalmology 2018 Dec 25;42(6):367-384. Epub 2018 Apr 25.

Surgery & Anaesthesia, University of Otago Wellington, Wellington, New Zealand.

Optic nerve head drusen are benign acellular calcium concretions that usually form early in life, just anterior to the lamina cribrosa. Improving imaging using optical coherence tomography suggests they are common and may be present in many clinically normal discs. These drusen may change in appearance in early life, but are generally stable in adulthood, and may be associated with visual field defects, anterior ischaemic optic neuropathy, or rarer complications. Read More

Neuroophthalmology 2018 Dec 22;42(6):356-366. Epub 2018 May 22.

Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

The purpose of this study was to evaluate retinal thickness in different Xeroderma Pigmentosum (XP) complementation groups using spectral-domain optical coherence tomography (SD-OCT). This was a cross-sectional pilot study of 40 patients with XP. All patients had healthy-looking retinae and optic nerves on slit lamp biomicroscopy, and subtle or no neurological deficits. Read More

Neuroophthalmology 2018 Dec 25;42(6):349-355. Epub 2018 Apr 25.

Department of Neuro-ophthalmology, Moorfields Eye Hospital, London, United Kingdom.

The Pulfrich phenomenon, originally described in normal observers, is a treatable disorder of the perception of movement in depth in cases of unilateral or asymmetric optic neuropathy. Treatment is highly bespoke and factors influencing treatment response and failure remain unclear. We assessed 25 adults with suspected Pulfrich phenomenon due to a range of conditions in two tertiary referral centres. Read More

Neuroophthalmology 2018 Dec 11;42(6):343-348. Epub 2018 Sep 11.

Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.

We investigated the diagnostic ability of a new criterion (simple temporal depression) for compressive lesions of the optic chiasm. The subjects were 124 eyes with compressive lesions of the optic chiasm. The controls were 84 eyes. Read More

Neuroophthalmology 2018 Dec 15;42(6):339-342. Epub 2018 Aug 15.

Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.

We describe here a case series of six patients referred to the Neuro-ophthalmology service in Sheffield, UK with possible acute unilateral optic neuritis. Each patient had a triad of unilateral photophobia, ipsilateral retro-ocular pain, and ipsilateral loss of vision. All patients had normal ocular examinations and investigation findings with no objective structural or functional abnormalities identified. Read More

Neuroophthalmology 2018 Oct 9;42(5):316-317. Epub 2018 Jan 9.

Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Lesions of the central nucleus of the third cranial nerve in midbrain leads to bilateral ptosis. We present a case of a 14 year old boy, who was found to have B/L non-correctable ptosis and medial rectus palsy. There was a ring enhancing lesion in the midbrain in contrast MRI which resolved with treatment. Read More

Neuroophthalmology 2018 Oct 24;42(5):334-338. Epub 2018 Aug 24.

Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois, USA.

A report on the Reunión Iberoamericana de Neuro-otologia 2018 Fundacion Iberoamericana de Neuro-otologia. Read More

Neuroophthalmology 2018 Oct 23;42(5):326-333. Epub 2018 May 23.

Department of Ophthalmology, Hong Kong Eye Hospital, Kowloon, Hong Kong.

The 33rd Asia-Pacific Academy of Ophthalmology (APAO) Congress was held on Feb 8-11, 2018 in Hong Kong. This report summarized the highlights of the neuro-ophthalmology program of the Congress, including the scientific symposia (invited and submitted) and the social activities. Read More

Neuroophthalmology 2018 Oct 9;42(5):312-315. Epub 2018 Jan 9.

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

A 50-year-old man presented with a 4-month history of right-sided trigeminal neuropathy in the V1 and V2 distribution, right sixth nerve palsy and Horner syndrome. Magnetic resonance imaging (MRI) showed enhancement and thickening along the right ophthalmic nerve and supraorbital nerve and fullness at the right cavernous sinus extending to Meckel's cave. Evaluation for a primary tumour was negative. Read More

Neuroophthalmology 2018 Oct 9;42(5):309-311. Epub 2018 Jan 9.

Division of Neurology, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.

Vertical gaze palsy is rarely a neurological symptom, although it has been observed in some cases. Here, we report the case of a patient presenting with complete upward and downward gaze palsy. In this case, a small lesion in the left rostral midbrain was observed on diffusion-weighted magnetic resonance (MR) images, and the lesion was considered to cause the ocular symptom. Read More

Neuroophthalmology 2018 Oct 11;42(5):306-308. Epub 2018 Jan 11.

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

A 6-year-old girl with acute pharyngitis presented with complaints of hypernasal speech and double vision. Examination revealed a bilateral abduction deficit associated with soft palate palsy causing rhinolalia aperta. Cerebrospinal fluid analysis showed albuminocytologic dissociation. Read More

Neuroophthalmology 2018 Oct 26;42(5):302-305. Epub 2018 Jan 26.

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA.

Carboplatin is a platinum-based chemotherapeutic agent used for the treatment of many solid tumors. Peripheral neuropathy is a common side effect; but, to our knowledge, ocular motor cranial neuropathies have not been reported in the literature. We describe a case of persistent third and fourth nerve palsies after systemic administration of intra-arterial carboplatin for glioblastoma multiforme. Read More

Neuroophthalmology 2018 Oct 9;42(5):299-301. Epub 2018 Jan 9.

Vascular Surgery Department, University Hospital of Valladolid, Valladolid, Spain.

We describe a patient with Horner's syndrome caused by an extensive intraparietal hematoma in the wall of the internal carotid artery confused with an arterial dissection. Detection of such pathology instead of dissection or arteritis is important as the management is different. As far as the authors know, it is the first case in which a haematoma within an atherosclerotic plaque is clinically related Horner's syndrome. Read More

Neuroophthalmology 2018 Oct 9;42(5):295-298. Epub 2018 Jan 9.

Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

A 54-year-old woman developed increased intracranial pressure due to chronic dural venous sinus thrombosis in the absence of significant comorbidity. In the years preceding diagnosis, the patient underwent routine diabetic retinopathy screening; however, gradual loss of optic cup and disc swelling was only retrospectively noted after marked papilloedema was evident at an optometry visit. The patient made a full recovery once the diagnosis was established. Read More

Neuroophthalmology 2018 Oct 9;42(5):287-294. Epub 2018 Jan 9.

Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.

The aim of this study was to assess the possible relationship between AAION (arteritic anterior ischemic optic neuropathy) and NAION (non-arteritic anterior ischemic optic neuropathy) with blood platelet parameters and NLR (neutrophil-to-lymphocyte ratio). The medical records of 12 patients with AAION, 33 patients with NAION, and 35 healthy subjects were examined. MPV, PDW, and PCT values showed marked elevation in AAION and NAION groups compared with control group. Read More

Neuroophthalmology 2018 Oct 5;42(5):284-286. Epub 2018 Feb 5.

Toronto Eyelid, Strabismus & Orbit Surgery Clinic, Toronto, Ontario, Canada.

Objective: To illustrate the utility of a nomogram for the prediction of giant cell arteritis (GCA).

Method: A nomogram was constructed from a multivariable logistic regression prediction model with 10 covariates: age, sex, clinical temporal artery abnormality, new-onset headache, jaw claudication, vision loss, diplopia, erythrocyte sedimentation rate, C-reactive protein, and platelet level.

Results: The magnitude and location of the nomogram scale for each predictor variable graphically illustrates the net effect of each covariate and is especially useful for continuous variables such as age and bloodwork values. Read More

Neuroophthalmology 2018 Oct 9;42(5):275-283. Epub 2018 Jan 9.

Division of Neuro-ophthalmology, Inouye Eye Hospital, Tokyo, Japan.

Focal dystonia is regarded as a characteristic feature of blepharospasm. However, patients do not always present with motor symptoms. To clarify the clinical features of blepharospasm in Japan, we conducted a retrospective observational study involving a large population of patients from a single institution. Read More

Neuroophthalmology 2018 Oct 26;42(5):269-274. Epub 2018 Jan 26.

Ophthalmology, Emory University, Atlanta, Georgia, USA.

We evaluated a web-based training aimed at improving the review of fundus photography by emergency providers. 587 patients were included, 12.6% with relevant abnormalities. Read More

Neuroophthalmology 2018 Aug 9;42(4):256-260. Epub 2018 Jan 9.

Atatürk Training and Research Hospital, Department of Ophthalmology, Yildirim Beyazit University, Ankara, Turkey.

A 32 year old female patient with CM 1 diagnosis was referred for the management of papilledema. Ophthalmologic examination revealed normal visual acuity (20/20 in both eyes), normal optic nerve function tests and normal slit-lamp biomicroscopic findings. Fundoscopy revealed bilateral irregular optic nerve heads with blurred margins. Read More

Neuroophthalmology 2018 Aug 3;42(4):251-255. Epub 2017 Nov 3.

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.

A 61-year-old man with hyperthyroidism had exophthalmos with dilated conjunctival vessels in both eyes. Magnetic resonance imaging showed that the superior ophthalmic veins had a funicular-like appearance. Cerebral angiography showed no blood flow from both internal carotid arteries to the cavernous sinus, thus excluding a carotid-cavernous fistula. Read More

Neuroophthalmology 2018 Aug 25;42(4):246-250. Epub 2017 Oct 25.

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.

A 76-year-old woman was diagnosed with thyroid-associated orbitopathy (TAO) associated with hypothyroidism at another clinic. Magnetic resonance imaging showed enlargements of the extraocular muscles. Because her best-corrected visual acuity (BCVA) was 0. Read More

Neuroophthalmology 2018 Aug 29;42(4):242-245. Epub 2017 Sep 29.

Department of Ophthalmology, The Rothschild Foundation, Paris, France.

We report the case of a woman who developed right third nerve dysfunction with synkinesis and ocular neuromyotonia secondary to a compressive arterial aneurysm. Surprisingly, our examination showed a downward drift of the right eye in sustained up-gaze resulting in transient hypotropia, suggesting either fatigability of the superior rectus or contraction of the inferior rectus. We believe this ocular motility pattern is secondary to a co-contraction of the inferior rectus in up-gaze caused by synkinesis (explaining the downward drift), followed by failure of the inferior rectus to relax upon return to primary position caused by ocular neuromyotonia (explaining the hypotropia). Read More

Neuroophthalmology 2018 Aug 19;42(4):237-241. Epub 2017 Sep 19.

Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA.

Amyloid beta-related angiitis (ABRA) is a subtype of cerebral amyloid angiopathy-related inflammation, with distinctive pathology and prognosis compared with cerebral amyloid angiopathy (CAA). On a spectrum of increasing severity, ABRA is considered to be in-between the less aggressive inflammatory-CAA and the more severe primary central nervous system (CNS) angiitis. Whereas retinal pathological changes were described in subjects with primary or secondary CNS angiitis, and non-inflammatory CAA, bilateral posterior pole superficial and peripapillary retinal hemorrhages have not been reported as initial signs in patients with pathology-confirmed ABRA, accompanying neurological spells and characteristic neuroimaging findings. Read More

Neuroophthalmology 2018 Aug 6;42(4):233-236. Epub 2017 Oct 6.

Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA.

Ecchordosis physaliphora (EP) is a rare non-malignant mass that originates from remains of the notochord and is typically asymptomatic. A 42-year-old man presented with sudden onset of painless horizontal diplopia and his neurological exam showed sixth cranial nerve palsy. Magnetic resonance imaging (MRI) identified a non-enhanced retroclival mass (EP) with increased signal intensity on T2 and decreased signal intensity on T1-weighted sequences. Read More

Neuroophthalmology 2018 Aug 12;42(4):229-232. Epub 2017 Oct 12.

Wilmer Eye Institute, Johns Hopkins Hospital School of Medicine, Baltimore, Maryland, USA.

Cavernous angiomas of the cranial nerves are extremely rare, and those of the oculomotor (third) cranial nerve are rarer still, with no previous cases having been reported in the literature. We report herein the first case of a presumed cavernous angioma involving the subarachnoid portion of the left third nerve presenting as an acute left third nerve palsy in an infant. The child was followed without intervention and the palsy completely resolved. Read More

Neuroophthalmology 2018 Aug 9;42(4):222-228. Epub 2017 Nov 9.

Department of Ophthalmology, Yildirim Beyazit University Ataturk Research and Training Hospital, Ankara, Turkey.

In this prospective study, the biomechanical properties of optic nerve head (ONH) and cornea in both eyes of patients with non-arteritic anterior ischaemic optic neuropathy and healthy control eyes were investigated. ONH elastometry was measured with real-time elastography, and corneal elastometry was measured with ocular response analyser. Elastometry of cornea and ONH was lower in both eyes of patients with unilateral non-arteritic ischaemic optic neuropathy than in healthy control eyes. Read More

Neuroophthalmology 2018 Aug 21;42(4):215-221. Epub 2017 Dec 21.

Immunology Eye Unit, Azienda USL IRCCS, Reggio Emilia, RE, Italy.

Acute idiopathic blind spot enlargement (AIBSE) is often caused by Acute Zonal Occult Outer Retinopathy (AZOOR), an outer retinal disease. We report two illustrative cases of AZOOR. The first one was a 21-year-old white female who presented with a scotoma and "shimmering lights" in her left eye. Read More

Neuroophthalmology 2018 Aug 7;42(4):209-214. Epub 2017 Nov 7.

Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia.

Invasive fungal sinusitis causes painful orbital apex syndrome with ophthalmoplegia and visual loss; the mechanism is unclear. We report an immunocompromised patient with invasive fungal sinusitis in whom the visual loss was due to posterior ischaemic optic neuropathy, shown on diffusion-weighted MRI, presumably from fungal invasion of small meningeal-based arteries at the orbital apex. After intensive antifungal drugs, orbital exenteration and immune reconstitution, the patient survived, but we were uncertain if the exenteration helped. Read More

Neuroophthalmology 2018 Aug 9;42(4):201-208. Epub 2018 Jan 9.

Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Despite the potential of Idiopathic Intracranial Hypertension (IIH) to cause visual morbidity, limited literature is available focussing on predictors of visual outcome in IIH. This study was planned to assess visual morbidity in patients of IIH in terms of clinical and neuro-ophthalmo- logical parameters. In this prospective study of 40 patients of IIH, neuro-ophthalmological parameters were noted in the form of visual acuity, visual field, contrast sensitivity, Retinal Nerve Fibre Layer thickness, and visual evoked potential. Read More

Neuroophthalmology 2018 Jun 13;42(3):191-193. Epub 2017 Oct 13.

Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA.

The authors describe diffusion-weighted magnetic resonance imaging (DWI) as an accessible way to screen for acute retinal pathology in emergency setting. They describe three proof-of-principle patients who had abrupt onset of vision loss from acute retinal pathology where DWI was diagnostic. The deficits included central retinal artery occlusion and acute retinitis with retinal necrosis. Read More

Neuroophthalmology 2018 Jun 14;42(3):187-190. Epub 2017 Sep 14.

Baylor College of Medicine, Houston, Texas, USA.

A 23-year-old man with a history of metastatic melanoma developed painful vision loss to counting fingers with enhancement of optic nerve on contrast-enhanced magnetic resonance imaging (MRI) and received a diagnosis of optic neuritis from an outside hospital. Despite empiric corticosteroid therapy, the patient worsened and developed secondary central retinal vein occlusion with further deterioration of vision. Repeat MRI demonstrated optic nerve sheath (ONS) involvement suggestive of optic perineuritis (OPN) and an ONS biopsy confirmed a rare case of isolated metastatic melanoma. Read More

Neuroophthalmology 2018 Jun 14;42(3):182-186. Epub 2017 Sep 14.

Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain.

Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular systems. These usually produce ocular pain, increased intraocular pressure (IOP), and diplopia. Less frequently, they may cause retinal changes with visual impairment. Read More

Neuroophthalmology 2018 Jun 20;42(3):176-181. Epub 2017 Sep 20.

Department of Neurology, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA.

Ipilimumab is a novel anti-melanoma agent known to infrequently cause multi-organ autoimmunity. We report a case of pituitary hypophysitis and orbital inflammation followed by an orbital apex syndrome. A 64-year-old woman with a history of skin melanoma, receiving ipilimumab treatment, was seen for near total loss of vision in the right eye and proptosis. Read More