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J Neuroophthalmol 2021 12;41(4):452-460

Department of Radiology (M. Marsiglia), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology (BKC), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology (BKC), Massachusetts Eye & Ear, Harvard Medical School, Boston, Massachusetts; and Department of Radiology/Division of Neuroradiology (M. Maher), University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.

Background: To review the literature and provide a summary of COVID-19-related neurologic and neuro-ophthalmic complications.

Methods: The currently available literature was reviewed on PubMed and Google Scholar using the following keywords for searches: CNS, Neuro-Ophthalmology, COVID-19, SARS-CoV-2, coronavirus, optic neuritis, pseudotumor cerebri, Acute Disseminated Encephalomyelitis, posterior reversible encephalopathy syndrome (PRES), meningitis, encephalitis, acute necrotizing hemorrhagic encephalopathy, and Guillain-Barré and Miller Fisher syndromes.

Results: Neuroradiologic findings of neurologic and neuro-ophthalmologic complications in relationship to COVID-19 infection were reviewed. Read More

J Neuroophthalmol 2021 06;41(2):154-165

Department of Ophthalmology and Visual Sciences (AKT), University of Iowa Hospital and Clinics, University of Iowa Carver College of Medicine, Iowa City, Iowa; Departments of Ophthalmology and Neurology (MD), New York- Presbyterian Hospital, Weill Cornell Medical College, New York City, New York; Department of Ophthalmology (BKC), Massachusetts Eye & Ear; and Department of Neurology (BKC), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Purpose: To provide a summary of the neuro-ophthalmic manifestations of coronavirus disease 19 (COVID-19) documented in the literature thus far.

Methods: The PubMed and Google Scholar databases were searched using the keywords: Neuro-Ophthalmology, COVID-19, SARS-CoV-2, and coronavirus. A manual search through reference lists of relevant articles was also performed. Read More

Ocul Immunol Inflamm 2021 May 18;29(4):656-661. Epub 2021 Mar 18.

Department of Neuro-ophthalmology, Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India.

: The Ocular manifestations of coronavirus disease 2019 (COVID-19) reported include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, episcleritis, retinal manifestations included cotton wool spots (CWS), micro-hemorrhages, papillophlebitis and neuro-ophthalmic manifestations.: To report post COVID-19 ophthalmic manifestations using multimodal imaging.: A 66-year-old Asian Indian male presented to us with bilateral blurring of vision, RE>LE, of 3 days following a diagnosis of COVID-19 disease. Read More

Curr Opin Ophthalmol 2018 Nov;29(6):485-494

Department of Neuro-Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA.

Purpose Of Review: IgG4-related disease (IgG4-RD) is increasingly recognized as a fibroinflammatory disease with a plethora of organ-specific manifestations but a particular predilection for head and neck tissues, including the nervous system. This review discusses general features and organ-specific presentations of IgG4-RD as well as treatment considerations, particularly emphasizing features of neuro-ophthalmic interest.

Recent Findings: IgG4-RD is emerging as a common cause of several fibroinflammatory disorders in the head and neck that were previously considered idiopathic, such as sclerosing orbital pseudotumor, orbital myositis, hypophysitis, and hypertrophic pachymeningitis. Read More

Surv Ophthalmol 2016 Jan-Feb;61(1):95-101. Epub 2015 Jul 23.

Department of Ophthalmology, University of Virginia Health System, Charlottesville Virginia, USA.

A 51-year-old man with rheumatoid arthritis and diabetes mellitus presented with new onset left-sided hemiparesis, left-sided neglect, and left-sided incongruous, denser inferiorly, homonymous hemianopsia. Magnetic resonance image of the brain showed prominent swelling of the right frontal, parietal, and occipital lobes greater than on the left with significant change in the fluid-attenuated inversion recovery signal in the gray matter. Perinuclear antineutrophil cytoplasmic antibodies titers were elevated, and skin biopsy demonstrating leukocytoclastic vasculitis. Read More

West Indian Med J 2013 ;62(4):305-12

Department of Surgery, Radiology Anaesthesia and Intensive Care, the University of the West Indies and University Hospital of the West Indies, Kingston 7, Jamaica.

HIV-related eye disease can be classified as retinal HIV microangiopathy, opportunistic infections, neuro-ophthalmic manifestations and unusual malignancies. There is a 52-100% lifetime accumulative risk of HIV patients developing eye problems. Seventy-seven per cent of patients with ocular manifestations of HIV had CD4 counts < 200 cells/μL. Read More

J Neuroophthalmol 2011 Dec;31(4):381-7

Department of Ophthalmology, University of Utah, Salt Lake City, Utah 84132, USA.

Management of the pregnant woman with a neuro-ophthalmic disorder may be challenging. Physiologic changes in pregnancy make vascular conditions more frequent, including retinal artery occlusion, spontaneous orbital hemorrhage, and pituitary apoplexy. Papilledema may signal cerebral venous sinus thrombosis or idiopathic intracranial hypertension. Read More

Optometry 2010 Mar;81(3):137-41

Nova Southeastern University College of Optometry, Fort Lauderdale, Florida, USA.

Background: A cholesteatoma, also known as an epithelioma, is a mass of soft tissue that results from the accumulation of keratin protein debris enclosed by a layer of stratified squamous epithelium.

Case Report: A patient with cholesteatoma surrounding both internal carotid arteries presented with cerebral ischemic symptoms expressed as visual and ocular symptoms. Because of its location, mass effect, and potential stenosis of the internal carotids, this slow-growing tumor is potentially sight threatening. Read More

Rev Neurol 2009 Mar 16-31;48(6):300-3

Departamento de Enfermedades Infecciosas del Sistema Nervioso y Neuropediatría, Instituto Nacional de Ciencias Neurológicas Oscar Trelles Montes, Lima, Peru.

Introduction: Hypertrophic pachymeningitis is a clinical condition that is caused by a diffuse or localised thickening of the dura mater. It predominantly affects males and manifests as chronic headache, with or without association to neurological manifestations, such as paralysis of the cranial nerves, cerebellar ataxia and neuro-ophthalmic complications.

Case Report: A 61-year-old male, with no relevant past history, who, one month before admission, had begun to suffer from right frontotemporal headache that irradiated to the ipsilateral orbital region and was more pronounced at night. Read More

J Neuroophthalmol 2007 Mar;27(1):3-8

Departments of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: Monocular visual loss has often been labeled "retinal migraine." Yet there is reason to believe that many such cases do not meet the criteria set out by the International Headache Society (IHS), which defines "retinal migraine" as attacks of fully reversible monocular visual disturbance associated with migraine headache and a normal neuro-ophthalmic examination between attacks.

Methods: We performed a literature search of articles mentioning "retinal migraine," "anterior visual pathway migraine," "monocular migraine," "ocular migraine," "retinal vasospasm," "transient monocular visual loss," and "retinal spreading depression" using Medline and older textbooks. Read More

Lijec Vjesn 2005 May-Jun;127(5-6):123-8

Klinika za infektivne bolesti Dr. Fran Mihaljević, Zagreb.

The aim of this study was to determine and compare the incidence of various ophthalmlogic changes before anfd after the initiation of highly active antiretroviral therapy (HAART) in HIV-infected patients treated at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb. This retrospective longitudinal analysis included all adult patients with confirmed HIV-1 infection divided into two groups: period before HAART (1995-1997) and period after HAART (1998-2000). Read More

Surv Ophthalmol 2005 Nov-Dec;50(6):507-18

The New York Eye Cancer Center, and the New York University School of Medicine, New York, NY 10021, USA.

Herein, we review the associations between the kidney, renal cancers, and the eye. Renal cancers have been reported to metastasize to the eye and the orbit. As these tumors can be confused with other amelanotic or vascular tumors, a high index of suspicion is required for early detection and management of the primary tumor. Read More

Curr Opin Ophthalmol 2002 Dec;13(6):404-10

Retina and Vitreous Service, Clinica Oftalmologica, Centro Caracas PH-1, Av. Panteon, San Bernardino, Caracas 1010, Venezuela.

Systemic lupus erythematosus (SLE) is a chronic, immunologic disorder that may affect multiple organ systems. Keratoconjunctivitis sicca is the most common ocular manifestation, but visual morbidity is usually due to retinal and neuro-ophthalmic manifestations of the disease. Ocular manifestations of lupus are a reflection of systemic disease. Read More

Optom Vis Sci 2000 Aug;77(8):388-94

Illinois Eye Institute, Illinois College of Optometry, Chicago 60616, USA.

Background: Systemic lupus erythematosus (SLE) is an autoimmune, multisystem disorder with diverse manifestations. There are limited reports on the neuro-ophthalmic and neuropsychiatric findings in childhood SLE.

Case Report: An 8-year-old patient with suspected SLE with a history of skin rash, joint pain, transient hematologic abnormality, headaches, seizures, and psychosis, presented with papilledema secondary to acquired, obstructive hydrocephalus. Read More

Neurosurg Clin N Am 1999 Oct;10(4):731-57, x

Department of Ophthalmology, University of Virginia Medical Center, Charlottesville, USA.

The parasellar region, in particular the cavernous sinus, represents the confluence of critical structures involved in both the afferent and efferent visual pathways. It is not surprising that lesions affecting the area of the cavernous sinus most frequently present with neuro-ophthalmic complaints, which include double vision, decreased vision, pain, and numbness. Neuro-surgical intervention in the area of hte cavernous sinus often produces neuro-ophthalmic complications. Read More

Am J Ophthalmol 1998 Oct;126(4):565-77

Department of Neurology, Lariboisière Hospital, Paris, France.

Purpose: To report the ophthalmologic symptoms and signs associated with extracranial internal carotid artery dissection.

Methods: One hundred forty-six consecutive patients with extracranial internal carotid artery dissection were evaluted; 29 were studied retrospectively from 1972 to 1984 and 117 prospectively from 1985 to 1997.

Results: Sixty-two percent of patients (91/146) with extracranial internal carotid artery dissection had ophthalmologic symptoms or signs that were the presenting symptoms or signs of dissection in 52% (76/146). Read More

Ther Umsch 1996 Jan;53(1):58-67

Augenklinik, Universitätsspital Zürich.

The association of visual disturbances and rheumatic disease has been known for centuries. This review provides a synopsis of the ocular conditions that are associated with inflammatory rheumatic disease. The major ophthalmic manifestations of the rheumatic diseases include keratoconjunctivitis sicca, ulcerative keratitis, scleritis, uveitis, retinal vascular disease, and neuro-ophthalmic lesions. Read More

Curr Opin Ophthalmol 1995 Dec;6(6):10-9

University of Virginia Health Sciences Center, Department of Ophthalmology, Charlottesville 22908, USA.

This last year has been a particularly busy one in the field of neuro-ophthalmology. The publication of the second, important, randomized multicentered trial in neuro-ophthalmology highlights the power of randomized trials to answer important clinical questions. This and other publications emphasize the pivotal role of vascular pathophysiology in production of neuro-ophthalmic disease. Read More

Arch Neurol 1995 Sep;52(9):880-5

Midwest Eye Institute/Methodist Hospital, Indianapolis, USA.

Objective: To characterize the neuro-ophthalmologic manifestations of impaired cranial venous outflow.

Design: A retrospective study of 20 patients who developed increased intracranial pressure as the result of impaired cerebral drainage.

Setting: Three neuro-ophthalmologic referral centers. Read More

J Am Optom Assoc 1994 Jan;65(1):49-57

VA Medical Center, Boston, MA 02215.

Background: Painstaking attention to detail is absolutely necessary for optometrists to provide the appropriate clinical management of the geriatric patient.

Methods: Clinical management techniques (pearls) are discussed which aid in the diagnosis and treatment of problems specific to geriatric patients. Factors noted in patient presentation are stressed and include physical appearance, ability to move about, and use of other senses. Read More

J Clin Neuroophthalmol 1985 Mar;5(1):63-6

The case of a 23-year-old woman with systemic lupus erythematosus and homonymous hemianopia is presented. A calcarine cortical infarct occurred as a result of a postpartal exacerbation of her disease and was demonstrated by CT scanning of the brain. The neuro-ophthalmic manifestations of SLE are reviewed briefly. Read More

Arch Ophthalmol 1984 Feb;102(2):225-8

Neuro-ophthalmic manifestations led to the diagnosis of diffuse disseminated atheroembolism (DDA) in three men whose systemic symptoms had remained unexplained for years. The cholesterol emboli that cause DDA originate from friable plaques in the aorta and great vessels. Ophthalmologists should be alert to the diagnosis of DDA in patients with elevated ESRs, stroke, transient amaurosis, or cholesterol emboli in the fundi. Read More