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Optic Nerve Involvement (optic + nerve_involvement)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

1263: Symptoms and signs of posterior uveitis

ACTA OPHTHALMOLOGICA, Issue 2010
M KHAIRALLAH
Purpose Posterior uveitis (PU) is an important anatomic form of uveitis in which the primary site of inflammation is the choroid or retina, with or without subsequent vitreous involvement. Methods Review of symptoms and signs of PU. Results The onset of PU can be sudden or less frequently insidious. Most common ocular symptoms include blurred vision, loss of vision, and floaters. Some patients with PU may have no symptoms, especially if inflammatory process is asymmetric. PU is usually associated with vitritis that can vary from mild to severe. Vitritis should be graded according to standardized grading systems. Other vitreous changes may include vitreous strands, vitreous hemorrhage, vitreous traction, and posterior vitreous detachment. Retinal and/or choroidal inflammation can be focal, multifocal, or more diffuse. It is important to distinguish between active and inactive chorioretinal disease. Retinal vasculitis can occur in the setting of several PU entities. It can involve retinal veins or arteries. It appears as focal, multifocal, or diffuse vascular cuffing or sheathing. Other retinal vasculitic changes include retinal hemorrhages, retinal vascular occlusion, retinal/optic disc neovascularization, and aneurysms. Maculopathy is common patients with PU. It may result from direct inflammatory infiltration, macular edema, serous retinal detachment, retinal ischemia, epiretinal membrane, or macular hole. Optic nerve involvement that can occur in association with PU include optic disc hyperemia/edema, optic neuritis, neuroretinitis, optic disc exudate, and optic disc granuloma. Conclusion Clinical examination is a key step in the diagnostic approach to PU. Clinician should be aware of the array of ocular symptoms of signs and their importance in orienting the differential diagnosis. [source]

Management of retinoblastoma with proximal optic nerve enhancement on MRI at diagnosis

PEDIATRIC BLOOD & CANCER, Issue 4 2008
Saro H. Armenian DO
Abstract Background In North America, retinoblastoma rarely presents with gross clinical evidence of tumor involving the optic nerve. Extent of microscopic tumor infiltration into the postlaminar optic nerve is a significant risk factor for metastasis, especially if there is tumor at the cut end. Due to poor outcomes in patients with metastatic disease, historical treatment for patients with clinical evidence of extraocular optic nerve involvement has included upfront enucleation followed by aggressive adjuvant chemotherapy. Additional orbital irradiation is advocated for individuals with optic nerve involvement at the surgical margin. Little is known about the role of neoadjuvant therapy in the setting of orbital optic nerve enhancement on magnetic resonance imaging (MRI) at diagnosis. Methods A retrospective review of consecutive retinoblastoma cases at Childrens Hospital Los Angeles over a 3-year period (2004,2006) found to have gadolinium contrast enhancement in the proximal portion of optic nerve on MRI at diagnosis. Results Nine patients fit the inclusion criteria. Two had secondary glaucoma of a sufficient degree to cause an enlarged eye (buphthalmos). Median age at presentation was 17 months (2,36 months). All patients received neoadjuvant chemotherapy prior to enucleation. Only two received external beam radiation. All are disease-free with a median follow-up of 22 months (12,41 months). Conclusions Neoadjuvant chemotherapy is well tolerated prior to enucleation of retinoblastoma-containing eyes associated with contrast enhancement of the proximal optic nerve on MRI at diagnosis. Such an approach may be used to decrease intensity or duration of chemotherapy and need for external beam radiation. Pediatr Blood Cancer 2008;51:479,484. © 2008 Wiley-Liss, Inc. [source]

Emerging and poorly known viral inflammatory eye diseases

ACTA OPHTHALMOLOGICA, Issue 2009
M KHAIRALLAH
Arthropod vector borne diseases are among the most important emergent infections. They include a wide variety of bacterial, viral, and parasitic diseases that are transmitted to humans by the bite of mosquito, tick, or other arthropod. Most of them are prevalent in tropical and subtropical areas, but they tend to spread into new regions mainly due to increasing temperatures worldwide, movement of people, increasing human population densities, wider dispersal of competent vectors, and transportation of goods and animals. Numerous arthropod vector borne diseases have been associated with uveitis. Among them, specific viral diseases recently emerged as important causes of uveitis in the developing and developed world. They include West Nile virus (WNV) infection, Rift Valley fever (RVF) , dengue fever (DF), and Chikungunya. These viral diseases have been recently associated with an array of ocular manifestations, including anterior uveitis, retinitis, chorioretinitis, retinal vaculitis, and optic nerve involvement. Proper clinical diagnosis of any of these infectious diseases is based on epidemiological data, history, systemic symptoms and signs, and the pattern of uveitis. The diagnosis is usually confirmed by detection of specific antibody in serum. A systematic ocular examination, showing fairly typical findings, can help establish an early clinical diagnosis of a specific systemic viral infection while serologic testing is pending. Prevention remains the mainstay for control of arthropod vector borne viral diseases. [source]

Anti-aquaporin-4 antibody-positive optic neuritis

ACTA OPHTHALMOLOGICA, Issue 5 2009
Mineo Takagi
Abstract. Purpose:, It has recently been reported that the anti-aquaporin-4 antibody (AQP4-Ab) can be a specific marker of neuromyelitis optica. We present three cases of optic neuritis (ON) where the patients tested positive for AQP4-Ab, but showed no neurological signs. Methods:, Sera were obtained from 32 Japanese patients with ON and no other neurological abnormalities (mean age 46 ± 20 years). AQP4-Ab was detected by indirect immunofluorescence staining using human-AQP4-transfected HEK 293 cells. Results:, AQP4-Ab was positive in three female patients (aged 9, 64 and 82 years). Their illness was characterized by bilateral severe optic nerve involvement, insufficient visual recovery, and autoimmune abnormalities (such as positive antinuclear antibody). Two of these patients experienced recurrent episodes of ON. In at least two episodes, the intracranial portion of the optic nerve showed significant inflammation on magnetic resonance imaging. Conclusions:, These cases indicate that some ON patients have an immunological pathogenesis similar to that seen in neuromyelitis optica. In addition, examination for AQP4-Ab positivity in the initial phase of ON is important in predicting the prognosis, including the possibility of the development of transverse myelitis. [source]