206 results match your criteria neuro-ophthalmologic examination

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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Characterization of Ebola Virus-Associated Eye Disease.

JAMA Netw Open 2021 01 4;4(1):e2032216. Epub 2021 Jan 4.

National Public Health Institute of Liberia, Monrovia, Liberia.

Importance: Survivors of Ebola virus disease (EVD) may experience ocular sequelae. Comparison with antibody-negative individuals from the local population is required to characterize the disease.

Objective: To assess features of ophthalmic disease specific to EVD. Read More

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January 2021

Oculomotor Nerve Palsy Due to Unusual Causes.

J Neuroophthalmol 2021 Jun;41(2):e244-e250

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.

Background: An isolated oculomotor nerve (CN III) palsy is a diagnostic concern because of the potential for serious morbidity or life-threatening causes. We present 5 unusual causes of oculomotor nerve palsy that escaped initial diagnosis in order to raise awareness of their associated features that will facilitate correct diagnosis.

Methods: This study consisted of a retrospective analysis of clinical features and imaging of 5 patients who were referred for neuro-ophthalmologic evaluation with presumed diagnosis of oculomotor nerve palsy of unknown reasons. Read More

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Diagnostic Error of Neuro-ophthalmologic Conditions: State of the Science.

J Neuroophthalmol 2021 03;41(1):98-113

Departments of Ophthalmology and Visual Sciences (LS) and Neurology (LS), Washington University in St. Louis School of Medicine, St. Louis, Missouri; Department of Neurology (DEN-T), The Johns Hopkins University School of Medicine, Baltimore, Maryland; and Departments of Ophthalmology (NJN, VB), Neurology (NJN, VB), and Neurological Surgery (NJN), Emory University School of Medicine, Atlanta, Georgia.

Background: Diagnostic error is prevalent and costly, occurring in up to 15% of US medical encounters and affecting up to 5% of the US population. One-third of malpractice payments are related to diagnostic error. A complex and specialized diagnostic process makes neuro-ophthalmologic conditions particularly vulnerable to diagnostic error. Read More

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Utility of Optical Coherence Tomography in the Diagnosis and Management of Optic Neuropathy in Patients with Fibrous Dysplasia.

J Bone Miner Res 2020 11 24;35(11):2199-2210. Epub 2020 Aug 24.

Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.

Optic neuropathy (ON) is a highly disabling complication of fibrous dysplasia (FD). The optimal test for identifying and monitoring ON in FD is unknown. Optical coherence tomography (OCT) is an imaging modality that detects retinal nerve fiber layer (RNFL) thinning, a sign of optic nerve atrophy. Read More

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November 2020

The Chiasmal Compression Index: An Integrative Assessment Tool for Visual Disturbances in Patients with Pituitary Macroadenomas.

World Neurosurg 2020 11 17;143:e44-e50. Epub 2020 Jun 17.

Department of Neurosurgery, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.

Objective: Visual status is routinely evaluated by neuro-ophthalmologic examination and computerized visual field (VF) tests in patients with chiasmal compression secondary to pituitary macroadenoma. Currently, no relevant data exists to accurately quantify the extent of optic apparatus compromise to further guide clinical decision-making. We aimed to assess for a possible quantitative correlation between optic chiasm geometric properties on magnetic resonance imaging (MRI) and VF deficits. Read More

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November 2020

Optic Neuropathy Due to Compression by an Ectatic Internal Carotid Artery Within the Orbital Apex.

J Neuroophthalmol 2021 03;41(1):e103-e104

Departments of Radiology (MTC, AAZ) and Neurosurgery (RD), Brigham and Women's Hospital, Boston, Massachusetts; and Department of Neurology (SP), Division of Neuro-Ophthalmology, Brigham and Women's Hospital, Boston, Massachusetts.

Abstract: Neurovascular compression is a rare but potentially treatable cause of optic neuropathy. Although incidental contact of the cisternal optic nerve and internal carotid artery (ICA) is common, compressive optic neuropathy occurring within the orbital apex has not been comprehensively described. We report a case of intra-orbital and intracanalicular optic nerve compression due to an ectatic ICA in a patient with congenital absence of the contralateral ICA. Read More

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Clinical Characteristics, Management, and Treatment Outcomes of Primary Hypophysitis: A Monocentric Cohort.

Horm Metab Res 2020 Apr 8;52(4):220-227. Epub 2020 Apr 8.

Department of Endocrinology and Metabolism, Hacettepe University Medical School, Ankara, Turkey.

Primary hypophysitis (PH) is a rare autoimmune inflammatory disease of the pituitary gland. The aim of the study was to evaluate clinical characteristics, disease management, and outcomes of cases with PH. Medical records of PH patients admitted to Hacettepe University Hospital between 1999 and 2017 were analyzed retrospectively. Read More

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Spaceflight associated neuro-ocular syndrome (SANS) and the neuro-ophthalmologic effects of microgravity: a review and an update.

NPJ Microgravity 2020 7;6. Epub 2020 Feb 7.

12Department of Emergency Medicine, Baylor College of Medicine, Houston, TX USA.

Prolonged microgravity exposure during long-duration spaceflight (LDSF) produces unusual physiologic and pathologic neuro-ophthalmic findings in astronauts. These microgravity associated findings collectively define the "Spaceflight Associated Neuro-ocular Syndrome" (SANS). We compare and contrast prior published work on SANS by the National Aeronautics and Space Administration's (NASA) Space Medicine Operations Division with retrospective and prospective studies from other research groups. Read More

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February 2020

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant.

Am J Ophthalmol Case Rep 2019 Dec 11;16:100569. Epub 2019 Nov 11.

School of Medicine, National University of Ireland, Galway, Ireland.

Purpose: Recognize a rare yet existing risk of severe visual loss as a postoperative complication of bilateral lung transplant.

Observations: A 62-year-old male had undergone bilateral lung transplant for end-stage idiopathic pulmonary fibrosis and emphysema overlap syndrome. The operation was initially off-pump; however, during the left lung transplantation, cardiopulmonary bypass conversion was necessary to maintain intraoperative hemodynamic stability. Read More

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December 2019

Decreased retinal thickness in patients with Alzheimer's disease is correlated with disease severity.

PLoS One 2019 5;14(11):e0224180. Epub 2019 Nov 5.

Department of Neurology, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Korea.

Background And Purpose: The loss of retinal ganglion cells observed in Alzheimer's disease (AD) may be attributable to a neurodegeneration of the neuro-retinal structure. Amnestic mild cognitive impairment (aMCI) has been considered a prodromal stage of AD. We evaluated retinal thicknesses in patients with aMCI and AD compared to healthy controls using spectral-domain optical coherence tomography (OCT) to investigate whether changes in retinal thickness are correlated with the clinical severity of dementia. Read More

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Co-occurrence of Convergence Insufficiency and Cognitive Impairment in Parkinsonian Disorders: A Pilot Study.

Front Neurol 2019 9;10:864. Epub 2019 Aug 9.

Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States.

Convergence insufficiency (CI) in parkinsonian conditions causes disabling visual symptoms during near tasks and usually manifests as double vision. Since double vision is more common in patients who report cognitive symptoms, we sought to determine if symptomatic CI, as opposed to asymptomatic CI, could serve as a marker of cognitive impairment in parkinsonian disorders. Twenty-four participants with parkinsonian disorders (18 Parkinson's disease, 5 progressive supranuclear palsy, 1 multiple system atrophy) and objective findings of convergence insufficiency on neuro-ophthalmologic examination were included. Read More

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Completely Dehiscent Posterior Sphenoid Sinus Wall During Endoscopic Pituitary Surgery.

World Neurosurg 2019 Aug 18;128:452-453. Epub 2019 May 18.

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

A 53-year-old man presented with a 1-week history of headache and double vision. On examination, he was found to have right cranial nerve III palsy. Computed tomography and magnetic resonance imaging of the brain showed a sellar mass with right cavernous sinus invasion. Read More

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A rare cause of Horner's syndrome: cervicothoracic spinal root cysts.

Neurol Sci 2019 Jun 21;40(6):1311-1314. Epub 2019 Feb 21.

Department of Neurology, Ege University, İzmir, Turkey.

Objection: We herein report cervicothoracic spinal root cysts as a rare cause of Horner's syndrome.

Case Report: A 62-year-old woman was admitted to our neuro-ophthalmology clinic complaining of drooping of her right upper eyelid. The history, physical examination, and laboratory tests were normal. 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

Double vision in adults.

J Binocul Vis Ocul Motil 2018 Jul-Sep;68(3):63-69. Epub 2018 Jun 21.

a Department of Medicine , Tower Health System , Reading , Pennsylvania.

Purpose: To determine the patient characteristics, patterns in presentation and incidences of the various etiologies in adult patients with the chief complaint of double vision.

Design: Retrospective review.

Subjects: All persons greater than 18 years of age who presented to a single provider (DG) in a nonacademic private practice over a 2-year period, from 2011 to 2013, with the chief complaint of double vision. Read More

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Isolated Fourth Nerve Palsy in Nontraumatic Tentorial Hemorrhage.

J Neuroophthalmol 2019 03;39(1):122-124

Department of Ophthalmology and Visual Sciences (EW, JDT), Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; and Department of Neurology (JDT), University of Michigan, Ann Arbor, Michigan.

A 46-year-old woman being treated with warfarin for antiphospholipid antibody syndrome experienced a rise in international normalized ratio (INR) to 5.4 and developed sudden headache and diplopia. Neuro-ophthalmologic examination disclosed a right fourth nerve palsy. Read More

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Efficacy of Gaze Photographs in Diagnosing Ocular Myasthenia Gravis.

J Clin Neurol 2018 Jul 31;14(3):333-338. Epub 2018 May 31.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Background And Purpose: The various tests that are routinely used to diagnose generalized myasthenia gravis, such as the edrophonium test, serum anti-acetylcholine-receptor antibodies (AChR-Ab), and repetitive nerve stimulation (RNS) tests, have lower diagnostic sensitivity in ocular myasthenia gravis (OMG). Diagnosing OMG becomes even more difficult when the clinical symptoms are subtle. There is no gold-standard diagnostic test available for OMG patients, and so this study compared the diagnostic sensitivity of gaze photographs with conventional tests in OMG. Read More

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Ipilimumab-induced Adenohypophysitis and Orbital Apex Syndrome: Importance of Early Diagnosis and Management.

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

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Oculomotor palsy in diabetics.

J Fr Ophtalmol 2018 Jan 28;41(1):45-49. Epub 2017 Dec 28.

Internal security forces hospital, Mohamed Fadhel Ben Achour street, Marsa Safsaf, Tunis, Tunisia.

Introduction: Oculomotor palsy is one of the most frequent neuro-ophthalmologic complications of diabetic patients. It generates less interest in the literature than the other ocular manifestations. Our goal was to study the clinical, epidemiological, therapeutic and prognostic characteristics of oculomotor palsy in the diabetic. Read More

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January 2018

Ocular features of multiple system atrophy.

J Clin Neurosci 2018 Jan 21;47:234-239. Epub 2017 Oct 21.

Department of Ophthalmology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA; Department of Neurology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. Electronic address:

The aim of this paper is to gain better understanding of the ocular manifestations of multiple system atrophy (MSA), a neurodegenerative disorder rarely studied in terms of its ophthalmologic features. We performed a retrospective case series (1/1/05-12/31/14) to search for patients seen at Mayo Clinic, Rochester, MN, who had mention of MSA in the medical record and an eye examination, which yielded 285 cases. Of the 285, we identified 39 cases of true MSA. Read More

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January 2018

Vision Assessments and Interventions for Infants 0-2 Years at High Risk for Cerebral Palsy: A Systematic Review.

Pediatr Neurol 2017 Nov 20;76:3-13. Epub 2017 Jul 20.

Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; Department of Hearing and Speech Sciences, Vanderbilt Kennedy Center, Nashville, Tennessee. Electronic address:

We performed a systematic review and evaluated the level of evidence of vision interventions and assessments for infants at high risk for or with a diagnosis of cerebral palsy from zero to two years of age. Articles were evaluated based on the level of methodologic quality, evidence, and clinical utilization. Thirty publications with vision assessments and five with vision interventions met criteria for inclusion. Read More

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November 2017

Ophthalmic Manifestations of Xeroderma Pigmentosum: A Perspective from the United Kingdom.

Ophthalmology 2017 11 26;124(11):1652-1661. Epub 2017 May 26.

Nationally Commissioned Xeroderma Pigmentosum Service, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

Purpose: To document the ocular manifestations of xeroderma pigmentosum (XP), presenting via the United Kingdom (UK) XP service, and to analyze the correlations between XP genotype and ophthalmic phenotype.

Design: Prospective observational case series.

Subjects: Eighty-nine patients seen by the UK Nationally Commissioned XP Service, from April 2010 to December 2014, with a genetically confirmed diagnosis of XP. Read More

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November 2017

The QuantiFERON-TB Gold In-Tube Assay in Neuro-Ophthalmology.

J Neuroophthalmol 2017 09;37(3):242-246

Baylor College of Medicine (LML), Houston, Texas; Department of Ophthalmology (MR, AS, SVS), Department of Ophthalmology (EAG), Blanton Eye Institute, Houston Methodist Hospital; Department of Ophthalmology (RF), Baylor College of Medicine, Houston, Texas; Blanton Eye Institute of Houston Methodist Hospital (AGL), Houston, Texas; Department of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medical College; 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), Baylor College of Medicine, Houston, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Background: Although QuantiFERON-TB Gold In-Tube (QFT-GIT) testing is regularly used to detect infection with Mycobacterium tuberculosis, its utility in a patient population with a low risk for tuberculosis (TB) has been questioned. The following is a cohort study analyzing the efficacy of QFT-GIT testing as a method for detection of active TB disease in low-risk individuals in a neuro-ophthalmologic setting.

Methods: Ninety-nine patients from 2 neuro-ophthalmology centers were identified as having undergone QFT-GIT testing between January 2012 and February 2016. Read More

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September 2017

Neuro-Ophthalmology in Emergency Medicine.

Emerg Med Clin North Am 2016 Nov;34(4):967-986

Department of Emergency Medicine, University of Virginia, PO Box 800699, Charlottesville, VA 22902, USA.

Understanding the anatomy and physiology of the eye, the orbit, and the central connections is key to understanding neuro-ophthalmologic emergencies. Anisocoria is an important sign that requires a systematic approach to avoid misdiagnosis of serious conditions, including carotid dissection (miosis) and aneurysmal third nerve palsy (mydriasis). Ptosis may be a sign of either Horner syndrome or third nerve palsy. Read More

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November 2016

Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review.

World Neurosurg 2016 Nov 25;95:617.e13-617.e18. Epub 2016 Aug 25.

Department of Ophthalmology, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China.

Background: Ectopic thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are rare and can often be misdiagnosed as primary hyperthyroidism. We present a case of an ectopic suprasellar TSH-secreting pituitary adenoma. A literature review of previously reported ectopic TSH-secreting and suprasellar pituitary adenomas is included to illustrate the clinical characteristics of this disease entity and the diversity of operative approaches to treating ectopic suprasellar pituitary adenomas. Read More

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November 2016

Retinal Ganglion Cell and Inner Plexiform Layer Loss Correlate with Visual Acuity Loss in LHON: A Longitudinal, Segmentation OCT Analysis.

Invest Ophthalmol Vis Sci 2016 Jul;57(8):3872-83

Neuro-Ophthalmology Department Wills Eye Hospital, Departments of Ophthalmology and Neurology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, United States.

Purpose: Describe changes in the retina as vision loss progresses in Leber's Hereditary Optic Neuropathy (LHON) using spectral-domain optical coherence tomography (SD-OCT) autosegmentation, and determine if relationship exists between retinal changes and vision loss.

Methods: From patient records we identified nine LHON patients who underwent periodic neuro-ophthalmologic examinations and high-resolution SD-OCT as part of their care. We describe the impact of LHON progression on each retinal layer, and the relationship between these structural changes and visual acuity using generalized estimating equations and nonparametric tests. Read More

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Clinical Features of Ocular Sarcoidosis in Patients with Biopsy-proven Pulmonary Sarcoidosis in Serbia.

Ocul Immunol Inflamm 2017 Dec 18;25(6):785-789. Epub 2016 May 18.

b University of Belgrade, School of Medicine , Belgrade , Serbia.

Purpose: To analyze clinical characteristics of ocular sarcoidosis in a group of biopsy-proven sarcoid patients treated at the single referral center for sarcoidosis in Serbia.

Methods: A prospective study carried out on 88 biopsy-proven sarcoid patients between January 2012 and December 2014. All patients underwent complete ophthalmological examination. Read More

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December 2017

Impact of obesity and binge eating disorder on patients with idiopathic intracranial hypertension.

Cephalalgia 2017 Mar 11;37(3):278-283. Epub 2016 Jul 11.

2 Headache and Neuroalgology Unit - Neurological Institute C. Besta IRCCS Foundation, Milano, Italy.

Background Idiopathic intracranial hypertension (IIH) is associated with obesity, and obesity is associated with binge eating disorder (BED). The aim of this paper is to address the presence and impact of BED in patients undergoing an IIH diagnostic protocol. Methods This was a cross-sectional study. Read More

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