Improvement of visual acuity in patients with severe visual loss affected by multiple sclerosis treated with natalizumab: a case report

2010 ◽  
Vol 31 (S3) ◽  
pp. 325-327 ◽  
Author(s):  
Ciro Florio ◽  
Giorgia Teresa Maniscalco
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Case Report ◽  
Visual Loss ◽  
Severe Visual Loss

scholarly journals MOG Antibody Positive Optic Perineuritis: an Observational Study in Han Chinese

2021 ◽  
Author(s):  
CHAO MENG ◽  
Jia-wei Wang ◽  
Lei Liu ◽  
Wen-jing Wei ◽  
Jian-hua Tao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Loss ◽  
Clinical Symptoms ◽  
Optic Chiasm ◽  
Han Chinese ◽  
Younger Patients ◽  
Brainstem Lesions ◽  
Severe Visual Loss ◽  
Mri Changes ◽  
Magnet Resonance

Abstract ObjectiveTo shed light on the clinical characteristics, magnet resonance imaging(MRI) changes, and prognosis of myelin oligodendrocyte glycoprotein antibody (MOG-IgG) positive OPN in Han Chinese.MethodsWe observed 39 MOG-IgG positive patients in our ward from January 1, 2017 , to December 31, 2019. Twenty patients met OPN inclusion criteria included contrast enhancement surrounding the optic nerve, and at least one of the following clinical symptoms: 1) reduction of visual acuity, 2) impairment of visual field, and 3) eye pain. Single course group(n=11) and recurrence group(n=9) were used for comparison. Outcome variables included Wingerchuk visual acuity classification.Results Of the 20 patients with MOG-IgG positive OPN, 12(60%) were women. Ten cases (50%) presented with bilateral and 17 eyes (56.67%) with severe visual loss (SVL,≤ 0.1). Twenty-one(70.00%) eyes showed edema of optic disc. Twenty-five eyes (83.3%) had longitudinally extensive perineural enhancement. At follow-up, 4 (13%) eyes still had SVL, while 26 (87%) eyes had no SVL, and of the 19 ON patients, 3 (9%) eyes still had SVL. Seven patients (35.00%) experienced at least a relapse(median interval 13.5 months ), and of the 19 ON cases, 4 (21%) patients experienced relapse. The relapse occurred more often in younger patients than the older (mean year: 38.00 vs. 45.54 years; P = 0.025). There were no optic chiasm and brainstem lesions.ConclusionsMOG-IgG positive OPN in Han Chinese often causes severe bilateral visual loss and longitudinally extensive perineural lesion. Younger patients are more likely to relapse. Optic chiasm and brainstem lesions were relatively rare.

VISUAL ACUITY AND CONTRAST SENSITIVITY IN MULTIPLE SCLEROSIS—HIDDEN VISUAL LOSS

Brain ◽  
1977 ◽  
Vol 100 (3) ◽  
pp. 563-579 ◽  
Author(s):  
D. REGAN ◽  
R. SILVER ◽  
T. J. MURRAY
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Visual Loss

WED 143 Chronic relapsing inflammatory optic neuritis (CRION) in the neuroinflammatory clinic

2018 ◽  
Vol 89 (10) ◽  
pp. A16.4-A17
Author(s):  
Cousins Oliver ◽  
Khan Hina ◽  
Harikrishnan Sreedharan
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Correct Diagnosis ◽  
Corticosteroid Treatment ◽  
Oligoclonal Bands ◽  
Short Course

CRION is a rare cause of optic neuritis. It is usually bilateral, painful and associated with profound visual loss. Significant response to corticosteroid treatment is typical but relapse is common when treatment is withdrawn. We present 2 cases of possible CRION and discuss the diagnostic and management considerations.Case 1: 50-year-old woman presented with right optic neuritis which spontaneous recovered. A year later she had left painful visual loss which improved with a short course of corticosteroids. MRI neuroaxis revealed left optic nerve enhancement. Non-specific, faint unmatched OCBs were detected. AQP4-IgG was negative. Nine months later she had further visual loss in her left eye. Prednisolone and azathioprine were commenced.Case 2: 55-year-old woman with bilateral, painless visual acuity deterioration over two weeks. Investigations revealed negative anti-aquaporin 4 antibodies (AQP4-IgG), normal MRI of the neuroaxis, negative oligoclonal bands (OCBs) and visual evoked potentials showed bilateral delay. Serum ACE was slightly elevated. She was started on a tapering course of steroids and had significant visual acuity improvement.The diagnosis of CRION involves the exclusion of other causes of optic neuritis, particularly multiple sclerosis (MS), Neuromyelitis Optica (NMO) and sarcoidosis. Correct diagnosis is important as aggressive and long-term immunosuppression is required.

Effect of Sinus Surgery on Visual Disturbance Caused by Spheno-ethmoid Mucoceles

1997 ◽  
Vol 11 (5) ◽  
pp. 337-344 ◽  
Author(s):  
Eiji Yumoto ◽  
Masamitsu Hyodo ◽  
Seiji Kawakita ◽  
Ryuichi Aibara
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Visual Loss ◽  
Visual Disturbance ◽  
The Other ◽  
Sinus Surgery ◽  
Bony Defect ◽  
Blurred Vision ◽  
Severe Visual Loss ◽  
Sphenoid Sinuses

Fifteen patients suffering from visual disturbance of varying degrees caused by a mucocele of the posterior ethmoid and/or sphenoid sinuses underwent marsupialization of a mucocele into the nasal cavity. Five of the eight patients with severe visual loss worse than 20/200 showed recovery of measurable vision. Two of these five were operated on within 24 hours after the onset of visual loss and showed marked recovery to 20/25 and 20/15. The other seven patients who had relatively mild visual disturbance experienced improvement of visual acuity or remission of subjective complaints such as blurred vision postoperatively. During operation partial bony defect was found in the optic canal in 12 patients and in the skull base in 12 patients. A good understanding of this disease by ophthalmologists and otolaryngologists is essential for early diagnosis and prompt surgical treatment to avoid permanent visual dysfunction and operative sequelae.

scholarly journals Postoperative Reversal of Complete (Monocular) Blindness in Skull Base Meningioma: Case Report

2003 ◽  
Vol 30 (1) ◽  
pp. 72-74 ◽  
Author(s):  
Joseph Bampoe ◽  
Paul Ranalli ◽  
Mark Bernstein
Keyword(s):  
Visual Acuity ◽  
Differential Diagnosis ◽  
Case Report ◽  
Visual Field ◽  
Visual Function ◽  
Visual Loss ◽  
Surgical Excision ◽  
Skull Base Meningioma ◽  
Cranial Fossa ◽  
Optic Discs

ABSTRACT:Background:Meningiomas of the anterior cranial fossa frequently present with impaired visual function. Recognition of this entity in the differential diagnosis of painless, progressive, and asymmetric optic neuropathy is important since reversal of visual loss is possible given timely surgical excision of the tumour.Methods:A 76-year-old man presented with no perception of light in his right eye and a reduced visual acuity of 20/60 in his left eye with a markedly constricted visual field. His visual deterioration had progressed over the previous three months and was not associated with headache. Ophthalmoscopy showed normal optic discs. MRI scanning showed a large frontal basal meningioma, which was subsequently resected.Results:The patient noticed an immediate improvement in his vision in his right eye. Visual acuity in his right eye improved to 20/50 at six weeks postoperatively and to 20/25 at five months, with corresponding improvement of the visual field.Conclusion:Complete monocular blindness due to tumour compressing or distorting the anterior visual pathways does not preclude recovery following timely decompressive surgery, especially when the appearance of the optic disc is normal.

scholarly journals Causes of visual loss in uveitis

2009 ◽  
Vol 66 (9) ◽  
pp. 701-704 ◽  
Author(s):  
Zora Stankovic
Keyword(s):  
Visual Acuity ◽  
Visual Loss ◽  
Age Of Onset ◽  
Epidemiological Studies ◽  
Cystoid Macular Oedema ◽  
Severe Visual Loss ◽  
Visual Damage ◽  
Number Of Patients ◽  
Working Age ◽  
Definition Of

Background/Aim. Epidemiological studies of blindness in a working age population require a precise definition of the true connection of uveitis and visual damage. Since most patients with more severe types of uveitis are hospitalized in tertiary referral uveitis service, our aim was to determine whether age, sex and age of onset of uveitis, as well as duration of visual loss and its causes influence the degree of visual damage in patients with different types of uveitis. Methods. The data were collected from medical records of 237 patients at the Department for Uveitis of the Institute for Eye Diseases in Belgrade over a three-year period (March 2005 to March 2008). Results. Visual acuity reduction (? 0.3) was found in 161/237 (67.9%) patients, 85 of whom had visual acuity of ? 0.1 later. Working age patients (up to 60 years of age) most often suffered from uveitis (173/237; 73%). The highest number of patients with visual loss was in the group suffering from panuveitis (77/94; 81.91%). The age of onset of uveitis and sex have no statistically significant influence on visual loss. The most common causes of visual loss (34/161; 21.1%) were cystoid macular oedema (CMO) (43/161; 26.7%), cataract (28/161; 17.39%) and combination of CMO and cataract. Conclusion. The risk factors for severe visual loss (? 0.1) are panuveitis, bilateral inflammation, prolonged visual reduction and a significant number of relapses. The main causes of visual loss in 65.2% of our patients were CMO and cataract.

Bilateral episcleritis followed by right optic perineuritis with severe visual loss: a case report

2015 ◽  
Vol 36 (11) ◽  
pp. 2139-2140 ◽  
Author(s):  
Haruo Nishijima ◽  
Chieko Suzuki ◽  
Masahiko Tomiyama
Keyword(s):  
Case Report ◽  
Visual Loss ◽  
Severe Visual Loss

104 Severe unilateral optic neuritis in multiple sclerosis

2018 ◽  
Vol 89 (6) ◽  
pp. A41.2-A41
Author(s):  
Natasha Gerbis ◽  
John Parratt
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Case Series ◽  
Retinal Nerve Fibre Layer ◽  
High Dose ◽  
List Type ◽  
The Mean

IntroductionOptic neuritis (ON) results in acute loss of vision with pain on eye movement. It may be the first manifestation of multiple sclerosis (MS) and usually follows a resolving course. Here we describe five patients with MS who developed severe unilateral ON resulting in persistent visual loss without significant resolution.MethodsA retrospective clinical review of five cases identified from a database of 550 patients with MS.ResultsAll patients were female and the mean age was 30 years at onset (range 25–40). All patients had no light perception at diagnosis, and received treatment with high dose intravenous methylprednisolone. Two patients also had plasma exchange. All of the patients were subsequently treated with immunomodulatory therapy. The patients were followed for a mean period of 13.3 years (range 2 months to 31 years). None of the patients had significant improvement in their visual acuity, with most achieving vision of 6/60. The mean retinal nerve fibre layer thickness was 66.33 microns (range 46–98 microns) in the affected eye, compared to 86.7 microns (69–105 microns) in the unaffected eye. All patients were aquaporin-4 antibody negative and oligoclonal band positive, with the MRI brain and spine being diagnostic for MS. Interestingly, none of the patients developed significant symptoms in the contralateral eye with vision of 6/5. All patients had an EDSS score of 4.0 predominantly due to visual impairment.ConclusionSevere unilateral ON is rarely seen in MS. This case series highlights a phenotypically distinct group of female MS patients with severe unilateral ON, and no improvement in visual acuity after prolonged follow-up and despite treatment with steroids and potent immune therapies. In such patients, where the diagnosis of MS is confirmed by MRI and CSF analysis, the patient might be reassured that visual loss in the fellow eye is unlikely.References. Wilhelm H, Schabet M. The diagnosis and treatment of optic neuritis. Deutsches Arzteblatt International2015;112(37):616–626.. Dachsel RM, et al. Optic neuropathy after retrobulbar neuritis in multiple sclerosis: Are optical coherence tomography and magnetic resonance imaging useful and necessary follow-up parameters?Der Nervenarzt2015;86(2):187–96.

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