Etiology and Outcomes of Acquired Pediatric Sixth Nerve Palsies
Conclusions:
Our findings and chart reviews suggest that approximately 10% of isolated acquired pediatric CN6 palsies are associated with a newly diagnosed brain tumor. This risk must be discussed with parents when considering immediate vs delayed neuroimaging. In addition, infants and children ≤7 years with secondary amblyogenic risk factors (anisometropia or pre-existing strabismus) require close follow-up to monitor and treat amblyopia. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Development and Preliminary Validation of a Virtual Reality Approach for Measurement of Torsional Strabismus
Conclusions:
A VR method of ocular cyclodeviation measurement using sensory techniques was implemented using commercially available hardware. VR measurements compared favorably with gold-standard DMR measurements, and user feedback was positive. The VR methodology has application for in office and home use by nonexperts for purposes of strabismus monitoring. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Vertical Comitance of Hypertropia in Congenital and Acquired Superior Oblique Palsy
Conclusions:
Hypertropia is not characteristically greater in upgaze than downgaze in congenital SO palsy proven by SO atrophy on MRI. In fact, average HT is greater in downgaze than upgaze in both acquired and congenital palsy, sometimes strikingly so in the latter. The finding of HT greater in upgaze than downgaze, or equal to it, does not reliably indicate that SO palsy is congenital, nor does maximum SO cross section. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Evaluation of Diplopia by Emergency Medicine Physicians and Consulting Neurologists
Conclusions:
EMPs and CNs made frequent errors in the examination, diagnosis, and ordering of diagnostic studies, leading to inefficient care and unnecessary testing. EMPs largely delegated the evaluation of diplopia to their consultants. If such consultative support were not available, the care of diplopic patients would be delayed. CNs performed more complete examinations, but rarely enough to allow appreciation of the pattern of ocular misalignment, contributing to misdiagnoses and ordering errors. The identification of these provider errors allows for more targeted teaching in the evaluation of diplopia. (Source: J...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
No Light Perception Vision in Neuro-Ophthalmology Practice
Conclusions:
NLP vision may occur because of various diagnoses. Vision recovery was mainly seen in patients with ON. Serious systemic conditions may present or relapse with NLP vision, which clinicians should consider as an alarming sign in patients with known malignancies. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Binocular Visual Field and Vision-Related Quality of Life in Patients With Hemianopia
Background:
Hemianopias can have a severe impact on functional ability and quality of life (QoL). Binocular visual field (VF) analysis is clinically more relevant to visual function than monocular VF. The aim is to analyze the binocular VF of patients with hemianopias and its association with the monocular VF and to assess the QoL of these patients through questionnaires specifically related to vision compared with healthy controls.
Methods:
The case–control study included patients with hemianopias and controls. Sex, age, general history, etiology, location of the lesion, and time since the lesion appeared wer...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas
Background:
During the surgical resection of petroclival meningiomas, preserving the cranial nerves is crucial. The abducens nerve is particularly vulnerable during surgery. However, the preoperative risk factors and postoperative prognosis of abducens nerve palsy (ANP) are poorly understood.
Methods:
We retrospectively analyzed 70 patients who underwent surgery for petroclival meningiomas between May 2010 and December 2019, divided into gross-total resection (GTR) and subtotal resection (STR) groups. The relationship of preoperative clinical factors with the incidence and recovery of postoperative ANP was analy...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Junctional Scotoma and Patterns of Visual Field Defects Produced by Lesions Involving the Optic Chiasm
Conclusions:
JXS is more often seen with larger lesions and when there is compression of both the prechiasmatic ON and ON–OC junction. These patients have worse presenting visual acuity and poorer outcomes. Not all patients with radiologic compression had VF defects, although 50% of patients with normal VFs had evidence of compression on the macular GCC analysis, emphasizing the importance of macular OCT in the evaluation of patients with lesions involving the OC. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Diffusion Tensor Imaging and Neurite Orientation Dispersion and Density Imaging Assessment of Optic Pathway Function in Patients With Anterior Visual Pathway Compression
Background:
In patients with sellar or parasellar tumors, it is crucial to evaluate visual field impairment in the preoperative stage and to predict visual field improvement after the surgery. The purpose of this study was to investigate the associations of diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) parameters in the optic radiations with preoperative and postoperative visual field impairment.
Methods:
This prospective study included 81 participants with sellar or parasellar tumors. Multishell diffusion imaging and a visual field impairment score (VFIS) were acq...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Optic Perineuritis Presenting as the Initial Manifestation of Central Nervous System Involvement in Rai Stage 0 Chronic Lymphocytic Leukemia
Conclusions:
Optic perineuritis is often initially diagnosed as optic neuritis, yet the 2 have different etiologies and follow a different clinical course. Orbital MRI with contrast structurally separates the 2, revealing a characteristic pattern of peripheral optic nerve sheath rather than primary optic nerve enhancement. Etiologies of optic perineuritis are varied and include inflammatory, infectious, neoplastic, and toxic entities. Central nervous system (CNS) involvement by chronic lymphocytic leukemia is unusual, but cranial nerve and meningeal involvement have been reported. This case adds central nervous system ...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Diagnosis of Acute Promyelocytic Leukemia After Presentation to Neuro-Ophthalmology
Conclusion:
Neuro-ophthalmologic symptoms may be the first manifestations of APML, and a complete blood count is an essential test in patients presenting with optic disc edema, especially if hemorrhagic. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Optic Disc Edema in Syphilis
Conclusions:
Systemic symptoms are common in patients with syphilic optic neuropathy. Optic disc edema as a manifestation of syphilis is usually accompanied by subtle chorioretinitis, which is best appreciated on FA. Optic perineuritis is common in patients with syphilitic optic neuropathy, with its pathophysiology likely similar to meningitis seen in neurosyphilis. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Postradiation Optic Atrophy Is Associated With Intraocular Pressure and May Manifest With Neuroretinal Rim Thinning
Background:
To determine risk factors for postradiation optic atrophy (PROA) after plaque radiotherapy for uveal melanoma.
Methods:
A single center, retrospective cohort study of patients diagnosed with uveal melanoma involving choroid and/or ciliary body treated with plaque between January 1, 2008, and December 31, 2016. Outcomes included development of PROA with pallor alone or with concomitant neuroretinal rim thinning (NRT). Cox regression analysis was performed to identify risk factors for PROA.
Results:
Of 78 plaque-irradiated patients, PROA developed in 41 (53%), with concomitant NRT in 15 (19%). R...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Magnetic Resonance Imaging Findings in the Pregeniculate Visual Pathway in Leber Hereditary Optic Neuropathy
Conclusions:
T2 HS was common in the pregeniculate visual pathway in LHON. It was not correlated with the prevalence of m.11778G>A and did not benefit in disease staging. As it extended, the BCVA gradually decreased. Contrast enhancement was relatively rare, always occurring in the subacute stage. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Neuro-Ophthalmic Phenotype of OPA3
Conclusions:
This study compiled data regarding neuro-ophthalmic manifestation of OPA 3 Type III patients. Contrary to established literature, poor vision was the presenting symptom in only 50% of our patients. This is the first report of OCT findings in 3MGA patients. The results demonstrated diffused thinning of the RNFL and ganglion cell complex-IPL with correlation to VA, which is in contrast to OPA1 patients in whom the most severe thinning is at the level of the papillomacular bundle. Average retinal thinning was identified at second and third decades of life, possibly resulting from early ganglion cell loss. The...
Source: Journal of Neuro-Ophthalmology - February 25, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
