Optic Neuropathy, Secondary to Ethmoiditis, and Onodi Cell Inflammation during Childhood: A Case Report and Review of the Literature

2019 ◽  
Vol 50 (06) ◽  
pp. 341-345 ◽  
Author(s):  
Marina Mazzurco ◽  
Piero Pavone ◽  
Milena Di Luca ◽  
Pierluigi Smilari ◽  
Elena Pustorino ◽  
...  
Keyword(s):  
Optic Neuropathy ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Resonance Imaging ◽  
Gradual Improvement ◽  
Cerebral Magnetic Resonance Imaging ◽  
Presenting Symptoms ◽  
Onodi Cell ◽  
Acute Form

AbstractOptic neuropathy consists of several etiological events. The primary etiologies of its acute form include optic neuritis, ischemic optic neuropathy, inflammatory (nondemyelinating) disorders, and trauma. Its subacute and chronic forms are most often linked to compressive, toxic, nutritional, or hereditary-genetic causes. Visual loss, dyschromatopsia, and visual field defects are the presenting symptoms. The Onodi cell (sphenoethmoidal air cell) is an anatomic variant located laterally and superior to the sphenoid sinus; it is closely related to the optic nerve. Onodi cell disorders are rare and may be unnoticed in differential diagnoses of patients with ocular and neurological manifestations. Here, we present the case of a 12-year-old boy with headache and acute loss of sight characterized by hemianopsia in the left eye and retrobulbar optic neuropathy caused by left sphenoethmoidal sinusitis with the presence of Onodi cell inflammation. The diagnosis was confirmed by multilayered paranasal computed tomography and cerebral magnetic resonance imaging. Therapeutic treatment resulted in gradual improvement: at the 2-week follow-up, the patient no longer had headaches and his visual acuity returned to normal. Inflammation of Onodi cells should be considered in children with headache and abnormal vision.

scholarly journals Successful treatment of neuro-Behçet’s disease with infliximab: four years follow-up

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Manjinder Kaur ◽  
Emily S. Nia ◽  
Rebecca A. Millius ◽  
Dominick G. Sudano ◽  
Jeffrey R. Lisse
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Conventional Therapy ◽  
Cerebral Vasculitis ◽  
High Morbidity ◽  
Resonance Imaging ◽  
Cerebral Magnetic Resonance Imaging ◽  
Treatment Gaps ◽  
Severe Manifestation

Neuro-Behçet’s disease (NBD) is a rare but severe manifestation of Behçet’s disease. Patients with NBD tend to have high morbidity and mortality. Some patients do not respond adequately to conventional therapy (corticosteroids and immunosuppressants). This has led to treatment gaps in the therapy of NBD. There are reports in the literature of patients with Behçet’s disease responding to anti-TNF therapy. We present a case of a male patient with biopsy proven cerebral vasculitis presenting as NBD who has been in remission with near resolution of cerebral magnetic resonance imaging lesions for 4 years following treatment with infliximab and azathioprine.

scholarly journals AZATHIOPRINE INDUCED PANCYTOPENIA-A CASE REPORT

2017 ◽  
Vol 9 (2) ◽  
pp. 324 ◽  
Author(s):  
Jeslyn Mary Philip ◽  
Parvathypriya C. ◽  
Christeena George ◽  
Meenu Vijayan
Keyword(s):  
Optic Neuropathy ◽  
Tpmt Activity ◽  
Ischemic Optic Neuropathy ◽  
Normal Range ◽  
Total Blood ◽  
Oral Steroids ◽  
Low Levels ◽  
Severe Pancytopenia ◽  
Stimulating Factor

<p>Azathioprine (AZA), a prodrug of 6 mercaptopurine, is an immunosuppressant that can be used as adjunctive therapy with corticosteroids in the treatment of arteritic form of ischemic optic neuropathy. Although myelotoxicity is known to occur while using azathioprine, severe pancytopenia is rarely seen. Patients with thiopurine methyltransferase (TPMT) deficiency are at high risk of developing severe myelosuppression. A 63 year* old female with ischemic optic neuropathy was initiated treatment with oral methylprednisone. As two courses of oral steroids showed no significant improvement, oral azathioprine 25 mg twice daily was added and gradually increased to 50 mg twice daily with relief of symptoms. 6 mo later, she was admitted with acute stroke and lab reports showed low levels of total blood counts or pancytopenia. The patient was put on broad spectrum antibiotics; given injection of granulocyte colony stimulating factor 300 mcg subcutaneously and blood transfusion as correction till counts normalised. She improved over 14 d and on next follow-up counts were in normal range. Causality was assessed by Naranjo causality assessment scale and a probable relationship was obtained between azathioprine and pancytopenia with a score of 6. Variations in TPMT activity occurs due to genetic polymorphism. Physicians should be aware of the possibility of myelosuppression while prescribing azathioprine. Frequent blood count monitoring is the most convenient way to avoid this problem where testing for TPMT deficiency is not possible.</p>

Anterior and posterior ischemic optic neuropathy following liposuction surgery in a previously healthy young woman

2020 ◽  
pp. 112067212096206
Author(s):  
Kaveh Abri Aghdam ◽  
Ali Sadeghi ◽  
Mostafa Soltan Sanjari ◽  
Ali Aghajani ◽  
Saba Gholamalizadeh
Keyword(s):  
Optic Neuropathy ◽  
Vision Loss ◽  
Ischemic Optic Neuropathy ◽  
Laboratory Studies ◽  
Level Of Evidence ◽  
Healthy Young Woman ◽  
Posterior Ischemic Optic Neuropathy ◽  
The Right ◽  
Liposuction Surgery

A previously healthy 28-year-old female developed bilateral painless vision loss, more prominent in the right eye than in the left, following abdominoplasty and liposuction surgery. Laboratory studies showed severe peri- and post-operative anemia. Over a 5-month follow-up, visual function remained decreased but stable in the right eye and improved in the left eye. This is the second reported case of anterior ischemic optic neuropathy in one eye and posterior ischemic optic neuropathy in the other eye after liposuction. Level of evidence: Level VI, case report study.

Bilateral Ischemic Optic Neuropathy Following Intravenous Immunoglobulin

2019 ◽  
Vol 3 (2) ◽  
pp. 111-113
Author(s):  
Waseem H. Ansari ◽  
Brittany K. Patrick ◽  
Bradley T. Smith
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Intravenous Immunoglobulin ◽  
Optic Neuropathy ◽  
Temporal Relationship ◽  
Ischemic Optic Neuropathy ◽  
Ivig Infusion ◽  
Minimal Improvement ◽  
Contralateral Eye

Purpose: The purpose of this work is to report an association between intravenous immunoglobulin (IVIG) infusions and the development of bilateral ischemic optic neuropathy. Methods: A case report is described. Results: A 76-year-old male receiving IVIG infusions developed loss of vision in the left eye and was diagnosed with ischemic optic neuropathy. Two months later, he developed another episode of ischemic optic neuropathy in the contralateral eye. The investigation for giant-cell arteritis, vasculopathy, and infiltrative processes was negative. The patient had minimal improvement in visual acuity over several months of follow-up. Conclusions: Bilateral ischemic optic neuropathy was likely caused by IVIG infusion in this case, given the temporal relationship and the negative workup for other risk factors.

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