Bilateral idiopathic optic perineuritis with severe vision loss: A case report

Abstract Background Friedreich ataxia is the most frequent hereditary ataxia worldwide. Subclinical visual and auditory involvement has been recognized in these patients, with co-occurrence of severe blindness and deafness being rare. Case report We describe a patient, homozygous for a 873 GAA expansion in the FXN gene, whose first symptoms appeared by the age of 8. At 22 years-old he developed sensorineural deafness, and at 26 visual impairment. Deafness had a progressive course over 11 years, until a stage of extreme severity which hindered communication. Visual acuity had a catastrophic deterioration, with blindness 3 years after visual impairment was first noticed. Audiograms documented progressive sensorineural deafness, most striking for low frequencies. Visual evoked potentials disclosed bilaterally increased P100 latency. He passed away at the age of 41 years old, at a stage of extreme disability, blind and deaf, in addition to the complete phenotype of a patient with Friedreich ataxia of more than 30 years duration. Discussion Severe vision loss and extreme deafness has been described in very few patients with Friedreich ataxia. Long duration, severe disease and large expanded alleles may account for such an extreme phenotype; nonetheless, the role of factors as modifying genes warrants further investigation in this subset of patients.

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Optic Disc Pits: A Case Report and Review

Optometric Clinical Practice ◽

10.37685/uiwlibraries.2575-7717.2.1.1000 ◽

2020 ◽

pp. 23-34

Author(s):

Jeffrey A. Sterling

Keyword(s):

Case Report ◽

Optic Disc ◽

Clinical Finding ◽

Vision Loss ◽

Treatment Options ◽

Clinical Findings ◽

Potential Treatment ◽

Optic Disc Pit ◽

Clinical Presentations ◽

Severe Vision Loss

Background: Congenital optic disc pits (ODP) are a rare clinical finding affecting approximately 1 in 11,000 people. Affected individuals are generally asymptomatic unless fluid accumulates in the macula resulting in severe vision loss. The management of ODPs depends mostly on clinical findings and can range from observation to surgery. Optometrists need to be aware of clinical presentations and possible complications of ODPs. Case Report: This report will review a case of an asymptomatic optic disc pit and discuss the potential treatment options if complications arise. Conclusion: Although rare, congenital optic disc pits need to be accurately assessed and diagnosed. Symptoms can range from none to severe vision loss. Proper observation and management may lead to improved visual outcomes.

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The Positive Legacy of Vision Loss: Pathways to Posttraumatic Growth

Innovation in Aging ◽

10.1093/geroni/igaa057.2094 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 616-617

Author(s):

Corinna Tanner ◽

Michael Caserta ◽

Jia-Wen Guo ◽

Margaret Clayton ◽

Paul Bernstein ◽

...

Keyword(s):

Posttraumatic Growth ◽

Cognitive Processing ◽

Mixed Method ◽

Vision Loss ◽

Social Issues ◽

Qualitative Interviews ◽

Age Related Macular Degeneration ◽

Age Related ◽

Severe Vision Loss ◽

Age Range

Abstract This mixed method study describes posttraumatic growth (PTG) accruing form experience with vision loss caused by severe age related macular degeneration (AMD) and explores relationships between depression, social support, and cognitive processing, on the path to PTG. Research describing the psychological and social issues surrounding AMD has focused on negative outcomes. However, learning from highly challenging experiences, such as vision loss, can offer benefits. In this study, these included an increased sense of personal strength, increased spirituality, and empathy for others (all domains of PTG). 89 participants with severe vision loss (mean age = 85.3 years, age range = 74–98 years) completed the interviewer-administered composite questionnaire, which identified elements of Tedeschi and Calhoun’s model of PTG. Relationships between variables were examined using path analysis. Findings were contextualized with data from 15 qualitative interviews. Findings underscored the importance of supportive others and deliberate cognitive processing in the path to PTG.

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Functional optical coherence tomography of retinal photoreceptors

Experimental Biology and Medicine ◽

10.1177/1535370218816517 ◽

2018 ◽

Vol 243 (17-18) ◽

pp. 1256-1264 ◽

Cited By ~ 9

Author(s):

Xincheng Yao ◽

Taeyoon Son ◽

Tae-Hoon Kim ◽

Yiming Lu

Keyword(s):

Vision Loss ◽

Objective Assessment ◽

Age Related Macular Degeneration ◽

Retinal Stimulation ◽

Age Related ◽

Retinal Photoreceptors ◽

Severe Vision Loss ◽

Further Development

Age-related macular degeneration (AMD) is the leading cause of severe vision loss and legal blindness. It is known that retinal photoreceptors are the primary target of AMD. Therefore, a reliable method for objective assessment of photoreceptor function is needed for early detection and reliable treatment evaluation of AMD and other eye diseases such as retinitis pigmentosa that are known to cause photoreceptor dysfunctions. Stimulus-evoked intrinsic optical signal (IOS) changes promise a unique opportunity for objective assessment of physiological function of retinal photoreceptor and inner neurons. Instead of a comprehensive review, this mini-review is to provide a brief summary of our recent in vitro and in vivo optical coherence tomography (OCT) studies of stimulus-evoked IOS changes in animal retinas. By providing excellent axial resolution to differentiate individual retinal layers, depth-resolved OCT revealed rapid IOS response at the photoreceptor outer segment. The fast photoreceptor-IOS occurred almost right away (∼ 2 ms) after the onset of retinal stimulation, differentiating itself from slow IOS changes correlated with inner neural and hemodynamic changes. Further development of the functional IOS instruments and retinal stimulation protocols may provide a feasible solution to pursue clinical application of functional IOS imaging for objective assessment of human photoreceptors. Impact statement Retinal photoreceptors are the primary target of age-related macular degeneration (AMD) which is the leading cause of severe vision loss and legal blindness. An objective method for functional assessment of photoreceptor physiology can benefit early detection and better treatment evaluation of AMD and other eye diseases that are known to cause photoreceptor dysfunctions. This article summarizes in vitro study of IOS mechanisms and in vivo demonstration of IOS imaging of intact animals. Further development of the functional IOS imaging may provide a revolutionary solution to achieve objective assessment of human photoreceptors.

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Introduction to the multi-author review on macular degeneration

Cellular and Molecular Life Sciences ◽

10.1007/s00018-019-03418-5 ◽

2020 ◽

Vol 77 (5) ◽

pp. 779-780 ◽

Cited By ~ 1

Author(s):

Anu Kauppinen

Keyword(s):

Macular Degeneration ◽

Vision Loss ◽

The Elderly ◽

Developed Countries ◽

Age Related Macular Degeneration ◽

Age Related ◽

Severe Vision Loss ◽

Author Review ◽

Dry Amd ◽

Endothelial Growth Factor

AbstractProlonged life expectancies contribute to the increasing prevalence of age-related macular degeneration (AMD) that is already the leading cause of severe vision loss among the elderly in developed countries. In dry AMD, the disease culminates into vast retinal atrophy, whereas the wet form is characterized by retinal edema and sudden vision loss due to neovascularization originating from the choroid beneath the Bruch’s membrane. There is no treatment for dry AMD and despite intravitreal injections of anti-vascular endothelial growth factor (VEGF) that suppress the neovessel formation, also wet AMD needs new therapies to prevent the disease progression and to serve patients lacking of positive response to current medicines. Knowledge on disease mechanisms is a prerequisite for the drug development, which is hindered by the multifactorial nature of AMD. Numerous distinguished publications have revealed AMD mechanisms at the cellular and molecular level and in this multi-author review, we take a bit broader look at the topic with some novel aspects.

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PSEUDOTUMOR CEREBRI AS A DIFFERENTIAL DIAGNOSIS FOR VISION LOSS IN SYSTEMIC LUPUS ERYTHEMATOSUS: CASE REPORT

10.5151/sbr2019-215 ◽

2019 ◽

Author(s):

MARCO FELIPE MACÊDO ALVES ◽

CAIO FELIPE FARIAS BARROS ◽

JARDELINA BRENA ROCHA LEITE ◽

MARINA ACEVEDO ZARZAR DE MELO ◽

PEDRO JOSÉ GALVÃO FREIRE ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Differential Diagnosis ◽

Case Report ◽

Lupus Erythematosus ◽

Vision Loss ◽

Pseudotumor Cerebri ◽

Systemic Lupus ◽

Systemic Lupus Erythematosus Case

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Early Recognition of Stroke by Confrontation Visual Field Test – Is It Possible?

Journal of Psychology and Neuroscience ◽

10.47485/2693-2490.1010 ◽

2020 ◽

Keyword(s):

Case Report ◽

Visual Field ◽

Cerebral Artery ◽

Vision Loss ◽

Posterior Cerebral Artery ◽

Early Recognition ◽

Past History ◽

Neurological Deficits ◽

Visual Field Defects ◽

Axial Tomography

Introduction: Visual field loss is often the first sign of lesion of the anterior or posterior visual pathways. Screening for visual field defects should be a part of all routine eye examinations, mainly when neurological lesions are suspected. A confrontation visual field (CVF) test provide a rapid and practical method of visual field assessment, allowing the recognition of major neurological deficits. Materials and Research Methods: To report a case of posterior cerebral artery (PCA) stroke early suspected by CVF test. Case-Report: A 77 year-old male presented to our emergency department with vision blurring complaints and a strange sensation of a vision loss on one side on the left eye (OS), for the previous 15 days. He explained that symptoms initiated after an episode of dizziness followed by lipothymia. He denied diplopia or headaches. Past history revealed hypertension and diabetes as cardiovascular risk factors. The best corrected visual acuity was 20/25 on right eye (OD) and 20/60 on OS and pupillary reflexes were normal. CVF test was performed and showed a decrease on left hemicampus of OS. The biomicroscopy was normal and the fundus examination showed optic nerve edema bilaterally, also documented by Optical Coherence Tomography. Considering the findings and the history, neuroimaging and a neurological observation were requested. Computerized axial tomography revealed a hypodense lesion in right occipital posterior region, with hematic density. He was hospitalized for proper treatment with the diagnosis of posterior cerebral artery ischemic stroke, with further hemorrhagic transformation. Discussion: In acute stroke, visual disorders may form all or part of the initial presentation. Homonymous visual field deficits are well-known almost universal characteristics of PCA ischemia, however, due to the absent of cognitive impairment or speech problems associated to many cases, the diagnosis can be challenging at early stages. Our case-report highlights the importance of using CVF test to an immediate inspection of the peripheral visual field, in order to detect acute major defects, including homonymous deficits, to understand if a further prompt neurological examination is mandatory.

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Tacrolimus-induced bilateral optic neuropathy: A case report

Vojnosanitetski pregled ◽

10.2298/vsp201126004z ◽

2021 ◽

pp. 4-4

Author(s):

Lepsa Zoric ◽

Aleksandra Ilic ◽

Emina Colak ◽

Milos Mirkovic ◽

Jelica Pantelic ◽

...

Keyword(s):

Case Report ◽

Adverse Effects ◽

Optic Neuropathy ◽

Vision Loss ◽

White Male ◽

Immunosuppressive Drug ◽

Organ Rejection ◽

Toxic Optic Neuropathy ◽

Tacrolimus Therapy ◽

Male Patients

Intrduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive drug with growing usage. It is usually used in prevention of transplanted organ rejection. Its use is highly valuable, but like other immunosupressants, it has adverse effects. One of them is optic neuropathy. Case report. A 47-year-old white male patients who had received tacrolimus therapy for nine years, after kidney transplantation, developed a subacute, painless vision loss on both eyes. He was thoroughly examined on different possible optic neuropathies and other causes of vision loss. After exclusion of other possible causes, the diagnosis of toxic optic neuropathy was established. His therapy was converted to cyclosporine, by his nephrologist, but his vision had improved only slightly. Conclusion. Toxic optic neuropathies are presented in everyday ophthalmological practice, but they are underestimated. Diagnosis can be demanding, especially when it comes to drugs and substances whose possible toxic effect on the optic nerve is not widely known. Unlike other adverse effects of tacrolimus therapy on nervous system, optic neuropathy can causes great and permanent functional impairment.

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Bilateral juxtapapillary choroidal neovascularization secondary to Birdshot chorioretinopathy -- case report

10.22541/au.161483816.62051911/v1 ◽

2021 ◽

Author(s):

Sania Vidas Pauk ◽

Nenad Vukojević ◽

Sonja Jandroković ◽

Miro Kalauz ◽

Martina Tomić ◽

...

Keyword(s):

Case Report ◽

Macular Edema ◽

Choroidal Neovascularization ◽

High Myopia ◽

Vision Loss ◽

Detailed Examination ◽

Central Vision ◽

Birdshot Chorioretinopathy ◽

Central Vision Loss ◽

The Right

Central vision loss, photopsia, floaters and macular edema in a highly myopic patient can easily be misrelated to high myopia complications. However, in atypical cases, detailed examination along with a thorough diagnostic is required to establish the right diagnosis, which is often beyond the limits of the condition originally considered.

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Metastatic Intraocular Tumor Due to Colorectal Adenocarcinoma: Case Report and Literature Review

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i4.7794 ◽

2020 ◽

Author(s):

Deivy Cruzado-Sánchez ◽

Luis A. Saavedra-Mejía ◽

Walter A. Tellez ◽

Grissnery Maquera-Torres ◽

Solon Serpa-Frias

Keyword(s):

Case Report ◽

Literature Review ◽

Colorectal Adenocarcinoma ◽

Vision Loss ◽

Serous Retinal Detachment ◽

Tumor Resection ◽

Histopathological Diagnosis ◽

Tubular Adenocarcinoma ◽

Survival Times ◽

Intraocular Metastasis

Purpose: To describe the clinical and histopathological findings of a case of intraocular metastasis due to colorectal adenocarcinoma and to carry out a literature review. Case Report: A 64-year-old man with a history of tumor resection due to infiltrating colorectal adenocarcinoma three years previously sought ophthalmological care because of severe ocular pain without response to medical treatment and progressive vision loss in the left eye. On ultrasonographic examination, there was a heterogeneous intraocular choroidal tumor, which occupied approximately 40% of the vitreous cavity, as well as peritumoral serous retinal detachment. The patient underwent left eyeball enucleation. The histopathological diagnosis was metastatic tubular adenocarcinoma involving the retina and choroid that partially infiltrated the sclera and the proximal optic nerve. Conclusion: The present case highlights a rare pathological entity associated with variable therapeutic schemes and survival times and poor prognosis in patients with metastatic intraocular tumors due to colorectal adenocarcinoma.

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