PURPOSE: To report three cases of nonarteritic anterior ischemic optic neuropa thy (NAION) that occurred in patients with sleep apnea syndrome (SAS) while bein g treated with continuous positive airway pressure (CPAP)...PURPOSE: To report three cases of nonarteritic anterior ischemic optic neuropa thy (NAION) that occurred in patients with sleep apnea syndrome (SAS) while bein g treated with continuous positive airway pressure (CPAP). DESI- GN: A prospective, noncomparative case series. METHODS: Prospective review of 108 patients with NAION diagnosed between 2002 and 2003 to identify any patients who developed NAION while being treated for SAS with CPAP. RESULTS: One patient had bilateral sequential NAION and two patients had unilateral NAION despite tr eatment with CPAP for SAS. All the patients were being treated with CPAP for a p eriod ranging from 4 months to 6 years before the onset of NAION. CONCLUSIONS: I n this series, CPAP did not prevent the development of NAION in SAS patients. Larger observational studies are needed to study the benefit of CPAP in preven ting NAION in patients with SAS.展开更多
A 38-year-oldwoman presentedwith blurred vision and “jumping”of the right eye for 7 months. Magnetic resonance imaging of the head was normal. Intermittent intorsion of the right eye was noted on examination, consis...A 38-year-oldwoman presentedwith blurred vision and “jumping”of the right eye for 7 months. Magnetic resonance imaging of the head was normal. Intermittent intorsion of the right eye was noted on examination, consistent with superior oblique myokymia. She was initially treated with carbamazepine but stopped after becoming light-headed. The diagnosis and treatment of superior oblique myokymia are discussed.展开更多
PURPOSE: To report a case of isolated optic nerve lymphoma diagnosed by optic nerve biopsy. DESIGN: Case report. METHODS: A 66-year-old woman was referred t o the Neuro-Ophthalmology Service because of a decrease in v...PURPOSE: To report a case of isolated optic nerve lymphoma diagnosed by optic nerve biopsy. DESIGN: Case report. METHODS: A 66-year-old woman was referred t o the Neuro-Ophthalmology Service because of a decrease in visual acuity and ri ght optic disk edema. RESULTS: A magnetic resonance image of the brain showed on ly enhancement of the optic nerve. An examination that included ANA, c-ANCA, p -ANCA, Lyme titers, FTA-ABS, ACE level, chest x-ray, and lumbar puncture was negative. Because of rapid progression on clinical examination and serial imagin g, an optic nerve biopsywas performed, which showed B-cell lymphoma. CONCLUSION : Optic nerve lymphoma can be confused with a variety of inflammatory and neopla stic infiltrations of the optic nerve on clinical and radiographic examinations. Optic nerve biopsy can be valuable in diagnosing isolated optic nerve lymphoma if other diagnostic tests are unrevealing, but the procedure carries considerabl e risk of loss of visual acuity and should be recommended judiciously.展开更多
Aim: To determine the anatomical site and extent of electrophysiological dysfu nction in patients with ethambutol associated visual loss. Methods: A comparativ e case series. Four patients with ethambutol associated v...Aim: To determine the anatomical site and extent of electrophysiological dysfu nction in patients with ethambutol associated visual loss. Methods: A comparativ e case series. Four patients with ethambutol associated visual loss underwent mu ltifocal electroretinography (mERG). Two patients had advanced visual loss while two had early signs of toxicity. The N1-P1, N1, P1 amplitudes, N1, and P1 late ncies were compared to 10 age and sex matched controls. Results: mERG abnormalit ies were detected in the ethambutol treated patients. The N1 amplitude was signi ficantly lower in the ethambutol treated patients than in the control group. Con clusion: Ethambutol is possibly toxic to the retina, and not only the optic nerv e. The multifocal ERG may be of value to diagnose and monitor patients taking et hambutol.展开更多
Background/aim: Fractionated stereotactic radiotherapy (FSRT) is a new treatment for brain tumours that are close to critical structures, such as the visual apparatus. This study aims to assess the visual outcomes for...Background/aim: Fractionated stereotactic radiotherapy (FSRT) is a new treatment for brain tumours that are close to critical structures, such as the visual apparatus. This study aims to assess the visual outcomes for patients with parasellar meningioma following FSRT. Methods: A retrospective, non-comparative case series of 13 patients with parasellar meningiomas who were treated in one institution with FSRT between January 1995 and January 2001. Results: 13 patients (26 eyes) were followed for amean of 2 years. Visual acuity improved in four eyes (12.5% ), remained stable in 18 eyes (75% ), and worsened in three eyes (12.5% ). Visual field improved in 15 eyes (57% ), remained stable in six eyes (23% ), and worsened in four eyes (15% ). No adverse visual outcome occurred as a result of radiation. Conclusion: These preliminary findings suggest that FSRT is a safe and effective treatment for parasellar meningiomas.展开更多
文摘PURPOSE: To report three cases of nonarteritic anterior ischemic optic neuropa thy (NAION) that occurred in patients with sleep apnea syndrome (SAS) while bein g treated with continuous positive airway pressure (CPAP). DESI- GN: A prospective, noncomparative case series. METHODS: Prospective review of 108 patients with NAION diagnosed between 2002 and 2003 to identify any patients who developed NAION while being treated for SAS with CPAP. RESULTS: One patient had bilateral sequential NAION and two patients had unilateral NAION despite tr eatment with CPAP for SAS. All the patients were being treated with CPAP for a p eriod ranging from 4 months to 6 years before the onset of NAION. CONCLUSIONS: I n this series, CPAP did not prevent the development of NAION in SAS patients. Larger observational studies are needed to study the benefit of CPAP in preven ting NAION in patients with SAS.
文摘A 38-year-oldwoman presentedwith blurred vision and “jumping”of the right eye for 7 months. Magnetic resonance imaging of the head was normal. Intermittent intorsion of the right eye was noted on examination, consistent with superior oblique myokymia. She was initially treated with carbamazepine but stopped after becoming light-headed. The diagnosis and treatment of superior oblique myokymia are discussed.
文摘PURPOSE: To report a case of isolated optic nerve lymphoma diagnosed by optic nerve biopsy. DESIGN: Case report. METHODS: A 66-year-old woman was referred t o the Neuro-Ophthalmology Service because of a decrease in visual acuity and ri ght optic disk edema. RESULTS: A magnetic resonance image of the brain showed on ly enhancement of the optic nerve. An examination that included ANA, c-ANCA, p -ANCA, Lyme titers, FTA-ABS, ACE level, chest x-ray, and lumbar puncture was negative. Because of rapid progression on clinical examination and serial imagin g, an optic nerve biopsywas performed, which showed B-cell lymphoma. CONCLUSION : Optic nerve lymphoma can be confused with a variety of inflammatory and neopla stic infiltrations of the optic nerve on clinical and radiographic examinations. Optic nerve biopsy can be valuable in diagnosing isolated optic nerve lymphoma if other diagnostic tests are unrevealing, but the procedure carries considerabl e risk of loss of visual acuity and should be recommended judiciously.
文摘Aim: To determine the anatomical site and extent of electrophysiological dysfu nction in patients with ethambutol associated visual loss. Methods: A comparativ e case series. Four patients with ethambutol associated visual loss underwent mu ltifocal electroretinography (mERG). Two patients had advanced visual loss while two had early signs of toxicity. The N1-P1, N1, P1 amplitudes, N1, and P1 late ncies were compared to 10 age and sex matched controls. Results: mERG abnormalit ies were detected in the ethambutol treated patients. The N1 amplitude was signi ficantly lower in the ethambutol treated patients than in the control group. Con clusion: Ethambutol is possibly toxic to the retina, and not only the optic nerv e. The multifocal ERG may be of value to diagnose and monitor patients taking et hambutol.
文摘Background/aim: Fractionated stereotactic radiotherapy (FSRT) is a new treatment for brain tumours that are close to critical structures, such as the visual apparatus. This study aims to assess the visual outcomes for patients with parasellar meningioma following FSRT. Methods: A retrospective, non-comparative case series of 13 patients with parasellar meningiomas who were treated in one institution with FSRT between January 1995 and January 2001. Results: 13 patients (26 eyes) were followed for amean of 2 years. Visual acuity improved in four eyes (12.5% ), remained stable in 18 eyes (75% ), and worsened in three eyes (12.5% ). Visual field improved in 15 eyes (57% ), remained stable in six eyes (23% ), and worsened in four eyes (15% ). No adverse visual outcome occurred as a result of radiation. Conclusion: These preliminary findings suggest that FSRT is a safe and effective treatment for parasellar meningiomas.
