Retinal disease in the neurology clinic
Purpose of review
Retinal disease can manifest with visual symptoms similar to those which result from central nervous system disorders. We provide a framework for considering retinal causes of common visual complaints presenting to a neurology clinic.
Recent findings
Technological advances have afforded quicker detection and a more thorough understanding of these retinal entities and are crucial to consider when evaluating visual complaints in the neurology clinic.
Summary
It is essential to maintain a working knowledge of common retinal conditions that symptomatically overlap with common neurologic cond...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Optic neuropathy and diplopia from thyroid eye disease: update on pathophysiology and treatment
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.
Recent findings
We discussed diagnostic criteria for TED and differentiating TED from other causes of binocular diplopia. We also reviewed the pathophysiology and differential diagnoses for dysthyroid optic neuropathy as well as recent developments on c...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Updates on ophthalmic imaging features of optic disc drusen, papilledema, and optic disc edema
Purpose of review
Optic nerve head elevation can be associated with vision loss. This review provides an update regarding key features of optic disc drusen (ODD) compared with papilledema from increased intracranial pressure and optic disc edema from other causes.
Recent findings
Clinical history and funduscopic examination are not sufficient to correctly diagnose different causes of optic nerve head elevation. Multimodal ophthalmic imaging is noninvasive and should be used as first-line diagnostic testing to distinguish optic disc edema or papilledema from pseudoedema. Advanced ophthalmic imaging, including enh...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Advances in ophthalmic structural and functional measures in multiple sclerosis: do the potential ocular biomarkers meet the unmet needs?
Purpose of review
Multiple sclerosis is a heterogeneous disorder. Biomarkers to monitor disease activities are highly desirable especially because of the recent shift toward personalized medicine that coincides with the expansion of disease-modifying therapy. The visual system is highly involved in multiple sclerosis, and the rapid advancement of ophthalmic techniques has boosted the development of potential ocular biomarkers for multiple sclerosis management.
Recent findings
Recent studies have found that the rapid thinning of the peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer (...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Methods of visual assessment in children with cortical visual impairment
Purpose of review
Cortical visual impairment (CVI) is the leading cause of pediatric visual impairment in developed countries. Currently, there is no standardized method of visual assessment in these children, who usually cannot participate in tests designed for typically developing children. A reproducible method of visual assessment that accurately reflects the multitude of visual deficits in CVI is critical to evaluate proposed therapies for this disorder. This review analyzes current research on methods of visual assessment in children with CVI.
Recent findings
Earlier studies focused on measuring visual acu...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Vision loss and hallucinations: perspectives from neurology and ophthalmology
Purpose of review
The aim of this article is to summarize the evidence for visual impairment as a risk factor for visual hallucinations in neurologic disease and recent advances in our understanding of the central visual pathways that mediate this association.
Recent findings
Recent studies have described the prevalence Charles Bonnet syndrome and questioned its lack of association with cognitive impairment, used advanced neuroimaging to show that disinhibition of the occipital lobe is involved in the pathogenesis of visual hallucinations in Parkinson's disease, and demonstrated that visual impairment because of...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
MRI findings as markers of idiopathic intracranial hypertension
Purpose of review
Negative findings on neuroimaging are part of the diagnostic criteria for idiopathic intracranial hypertension (IIH), a syndrome characterized by increased intracranial pressure (ICP). Some positive neuroimaging findings are associated with increased ICP, but their role in diagnosis of IIH has not been established. We provide an overview of these findings and their relevance for diagnosis of raised intracranial pressure.
Recent findings
MRI acquisition techniques have significantly improved in the last few decades leading to better characterization of the intracranial changes associated with II...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Rehabilitation of cortically induced visual field loss
Purpose of review
Homonymous visual field defects are a common sequela of stroke, and are assumed to be permanent within a few weeks of the event. Because consensus about the efficacy of rehabilitation is lacking, visual therapy is rarely prescribed. Here, we review current rehabilitation options and strategies in the translational pipeline that could change these perspectives.
Recent findings
The mainstays of available therapy for homonymous visual defects are compensation training and substitution, which allow patients to better use their spared vision. However, early clinical studies suggest that vision can p...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Telemedicine for neuro-ophthalmology: challenges and opportunities
Purpose of review
Telemedicine for neuro-ophthalmology (tele-neuro-ophthalmology) has the potential to increase access to neuro-ophthalmic care by improving efficiency and decreasing the need for long-distance travel for patients. Requirements for decreased person-to-person contacts during the COVID-19 pandemic accelerated adoption of tele-neuro-ophthalmology. This review highlights the challenges and opportunities with tele-neuro-ophthalmology.
Recent findings
Tele-neuro-ophthalmology programs can be used for triage, diagnostic consultation, and long-term treatment monitoring. Formats include telephone appointm...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
Implementation of the Stroke Action Plan for Europe 2018--2030 during coronavirus disease-2019
Purpose of review
To describe the background, principles and implementation of the Stroke Action Plan for Europe 2018--2030 (SAP-E) in the perspective of the current COVID-19 pandemic.
Recent findings
SAP-E sets targets for the implementation of evidence-based preventive actions and stroke services to 2030. A recent mapping of stroke care in Europe has documented massive inequalities and even in high-income European countries access to reperfusion therapy and mortality after ischaemic stroke varies significantly. Organized stroke care providing stroke unit care and access to reperfusion therapies reduces mortali...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Valeria Caso Source Type: research
The 2020 breakthroughs in early secondary prevention: dual antiplatelet therapy versus single antiplatelet therapy
Purpose of review
Single antiplatelet therapy represents an established treatment in secondary prevention of ischemic strokes and transient ischemic attacks (TIAs). In contrast with coronary artery disease, the use of dual antiplatelet therapy (DAPT) for secondary prevention in patients with acute cerebral ischemia (ACI) remains under debate. In this narrative review, we present and analyse the most recent findings concerning the potential efficacy and safety of DAPT therapy after ischemic strokes or TIA.
Recent findings
Following the publication of the three (CHANCE, POINT and THALES) large, randomized-controll...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Valeria Caso Source Type: research
Challenges of treatment adherence with direct oral anticoagulants in pandemic
Purpose of review
Direct oral anticoagulants (DOAC) are crucial for the prevention of thromboembolic events in patients with nonvalvular atrial fibrillation. Drug adherence by the patient but also adherence to guidelines by the physician are suboptimal. This review highlights aspects of DOAC treatment during the coronavirus disease 2019 (COVID-19) pandemic and selected challenging scenarios.
Recent findings
For patients with a newly diagnosed indication for oral anticoagulation, a new interim clinical guidance recommends starting DOAC instead of vitamin K antagonists if DOAC are not contraindicated. The goal is ...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Valeria Caso Source Type: research
Digital health in stroke medicine: what are the opportunities for stroke patients?
Purpose of review
The European Stroke Organisation published a European Stroke Action Plan (SAP-E) for the years 2018–2030. The SAP-E addresses the entire chain of care from primary prevention through to life after stroke. Within this document digital health tools are suggested for their potential to facilitate greater access to stroke care. In this review, we searched for digital health solutions for every domain of the SAP-E.
Recent findings
Currently available digital health solutions for the cerebrovascular disease have been designed to support professionals and patients in healthcare settings at all stage...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Valeria Caso Source Type: research
The role of telemedicine in acute stroke treatment in times of pandemic
Purpose of review
The coronavirus disease 2019 (COVID-19) pandemic challenges many healthcare systems. This review provides an overview of the advantages of telemedicine during times of pandemic and the changes that have followed the outbreak of the COVID-19 disease.
Recent findings
Telemedicine has been utilized during infectious outbreaks for many years. COVID-19 has induced a variety of changes in laws (i.e. data privacy protection) and reimbursement procedures to accelerate new setups of telemedicine. Existing networks provide novel data about teleactivation resulting from social restrictions during the nadi...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Valeria Caso Source Type: research
Maintaining high thrombectomy rates during pandemics
Purpose of review
The aim of this article is to review the current literature on endovascular treatment of acute ischemic stroke in the aftermath of the coronavirus disease 2019 (COVID-19) lockdown.
Recent findings
The outbreak of the COVID-19 has had effect of unprecedented magnitude on the social, economic and personal aspects around the globe. Healthcare providers were forced to expand capacity to provide care to the surging number of symptomatic COVID-19 patients, while maintaining a fully operating service for all non-COVID patients. The recent literature suggesting an overall decrease in acute ischemic str...
Source: Current Opinion in Neurology - January 21, 2021 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Valeria Caso Source Type: research
