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Anterior Ischemic Optic Neuropathy (anterior + ischemic_optic_neuropathy)
Selected AbstractsAnterior ischemic optic neuropathy in moyamoya disease: a first case reportEUROPEAN JOURNAL OF NEUROLOGY, Issue 7 2007C. S. Chen Neuro-ophthalmological manifestations in moyamoya disease are usually the result of cerebrovascular involvement of the visual pathways. We report a case of ischemic optic neuropathy due to ocular hypoperfusion as a result of moyamoya disease, despite a prior internal to external carotid artery bypass with normal hemisphere perfusion. The blood supply of the optic nerve, a proposed pathogenesis of an anterior ischemic optic neuropathy and complications of the ocular ischemic syndrome are discussed. [source] Men's Sexual Health: Evaluating the Effectiveness of Print- and PDA-based CMETHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2009Gregory A. Broderick MD ABSTRACT Introduction., Personal digital assistant (PDA)-based continuing medical education (CME) activities have become widely available. Aims., To evaluate the effectiveness of print- and PDA-based CME materials in erectile dysfunction (ED). Methods., CME materials describing links between ED and comorbid medical conditions, effects of certain lifestyle modifications on ED, and treatment of ED with phosphodiesterase 5 (PDE5) inhibitors were distributed as a print supplement and as electronic modules, viewed with PDAs. We evaluated how effectively these materials improved evidence-based clinical choices, using survey questions about case vignettes and comparing responses of CME participants (N = 85) and matched nonparticipants (N = 94). Main Outcome Measures., Effect size, measuring the difference in evidence-based clinical scores between participants and nonparticipants. Results., CME certificates were awarded to 3,557 participants (459 print, 3,098 PDA). Among survey respondents, significantly more CME participants recognized that ED was associated with greater risk for myocardial infarction (61% participants; 34% nonparticipants; P , 0.001) and was a strong marker for diabetes mellitus (37% participants; 9% nonparticipants; P , 0.001). In contrast, participants and nonparticipants both displayed a good understanding of the relationships of smoking, obesity, and sedentary lifestyle with ED and of using PDE5 inhibitors to treat ED in patients with prostate cancer or benign prostatic hyperplasia; this likely reflects a good baseline understanding of these topics. Participants and nonparticipants each displayed a poor understanding of the recommendations regarding nonarteritic anterior ischemic optic neuropathy and PDE5 inhibitor use. Patient reluctance to discuss sexual concerns was perceived as the most significant barrier to optimal ED management. Conclusions., Given patient reluctance to discuss sexual concerns, future CME activities should focus on educating health-care providers and patients that ED is a risk factor for cardiovascular disease and diabetes. Both print- and PDA-based CME on ED were effective; the large number of lesson completers suggests a trend toward on-demand, self-selected CME is positive. Broderick GA, and Abdolrasulnia M. Men's sexual health: Evaluating the effectiveness of print- and PDA-based CME. J Sex Med 2009;6:2417,2424. [source] 4343: What next when the biopsy is negative in suspected giant cell arteritis (GCA)?ACTA OPHTHALMOLOGICA, Issue 2010A BOSCHI Purpose To present and discuss the approach of GCA when temporal artery biopsy (TAB) is negative. Recommendations for reducing the rate of negative TAB Methods GCA is the commonest vasculitis. Visual loss occurs in up to one-fifth of patients, which may be preventable by prompt recognition and treatment. Features predictive of ischaemic neuro-ophthalmic complications are: jaw claudication, diplopia, and temporal artery abnormalities on physical examination. These manifestations and particularly blindness and jaw claudication seems to be more commonly associated with positive TAB. Results Despite visual symptoms TAB may result negative. Rate of negative TAB varies from 7% to 40% in pat suspected of GCA. TAB should be done 2 to 6 weeks after commencement of treatment, and at least 1 cm. Contralateral biopsy is controversies, usually it increases the rate of GCA diagnosis of only 5%. Conclusion If TAB is still however negative, but clinical suspicion high or Ultra-Sound suggests GCA or complications typical of GCA, like anterior ischemic optic neuropathy, patient should be treat as biopsy-positive GCA patient. If the clinical suspicion is low, features considered atypical or alternative explanations available, rapid glucocorticoid therapy should be tapered. [source] 2423: Compartment syndrome in glaucoma damage, a new hypothesis?ACTA OPHTHALMOLOGICA, Issue 2010S ORGUL Purpose To evaluate the potential similarities in pathophysiology between non-arteritic anterior ischemic optic neuropathy (AION) and primary open-angle glaucoma (POAG). Methods The currently accepted views of the pathophysiology of AION and general understanding of the clinical picture of this ischemic condition were reviewed. Based on the hypothesis of the group in Wisconsin, who postulated a compartment syndrome of the anterior optic nerve within the tight anatomical structures of the lamina cribrosa, parallels were drawn for glaucomatous optic neuropathy, and a new hypothesis for the pathogenesis of the latter condition was suggested. Results The tight structures around, but also within the "disk at risk" observed in a majority of patients with AION are well compatible with the hypothesis of a compartment syndrome. Similar conditions may result from the restructuring process within the lamina cribrosa in POAG and lead to locally limited, but repeated "AION-like" processes, explaining why some patients progress despite reduced intraocular pressure. Conclusion The pathophysiology of POAG, especially in advanced cases, and AION seem to present similarities, which need to be better understood. [source] 2121: Sustained neuroprotection after a single intravitreal injection of PGJ2 in a rodent model of NAIONACTA OPHTHALMOLOGICA, Issue 2010V TOUITOU Purpose Prostaglandin-J2 (PGJ2) has been proposed as a potential neuroprotective agent. We wanted to evaluate the toxicity/efficacy of a single intravitreal (IVT) injection of PGJ2 in a rodent model of nonarteritic anterior ischemic optic neuropathy (NAION). Methods We used the laser-activated rose Bengal induction method to produce AION in Long-Evans rats. We evaluated IVT-PGJ2 retinal and ON toxicity. Following induction, PGJ2 was IVT-injected in the treatment-group. IVT phosphate-buffered-saline (PBS) was used as control. Functional studies (VEP) were performed at baseline and at 7days post-treatment. Structural studies included immunohistochemical (IHC), electron microscopic (EM) analysis of the optic nerve (ON), and stereologic analysis of retinal ganglion cell (RGC) numbers at30 day 30. Results Toxicity: IVT PGJ2 (5 eyes) did not induce any significant functional/structural changes in the retina or ON of treated animals compared with animals injected with PBS (5 eyes) 30 days post-injection. Efficacy: After a single IVT-injection, day7 VEPs in the PGJ2-treatment group (n=7) had amplitudes 103.6% of baseline, whereas the PBS-treated group (n=6) had VEPs that were 42.4% of the baseline. 30days post-stroke, EM of ON from the treatment-group demonstrated significant preservation of axons and decreased demyelination. Stereological RGCcounts confirmed significant (p<0.04) RGC preservation in PGJ2-treated animals (1462.6 cells/µm2) compared w the stroke+PBS group (1156.5 cells/µm2). Conclusion A single IVT of PGJ2 preserves RGCs and their axons, and provides sustained neuroprotection for at least 1 month following initial ischemic event. [source] | ||||||||||