scholarly journals Optic nerve head retinal artery macroaneurysm: Report of a case

2019 ◽  
Vol 7 ◽  
pp. 2050313X1986947
Author(s):  
Ramesh Venkatesh ◽  
Prachi Gurav
Keyword(s):  
Optic Nerve ◽  
Fluorescein Angiography ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Hypertensive Retinopathy ◽  
Fundus Examination ◽  
Elderly Male ◽  
Spontaneous Involution ◽  
Retinal Artery ◽  
Retinal Artery Macroaneurysm

A 61-year-old elderly male, hypertensive patient presented to the retina clinic with sudden drop in vision in the left eye for 6 days. His best-corrected visual acuity at presentation was counting fingers close to face. Fundus examination of the left eye revealed the presence of subretinal and preretinal haemorrhage at the macula along with hypertensive retinopathy changes in both eyes. Fluorescein angiography was done, which showed a retinal artery macroaneurysm at the optic nerve head. Optical coherence tomogram through the optic nerve head also confirmed the presence of retinal artery macroaneurysm. The patient was treated with injection of 0.4 cc of 100% C3F8 to displace the blood off the macula. At final follow-up visit at 2 months post treatment, his vision improved to 6/12, N8. Fundus examination showed a small residual altered blood nasal to the fovea. No treatment was however done to the retinal artery macroaneurysm due to its atypical location and chance of spontaneous involution. In conclusion, retinal artery macroaneurysm at the optic disc is extremely uncommon. Identification of the retinal artery macroaneurysm lesion is more difficult in glaucoma patients due to the large and deep optic cup. Fluorescein angiography remains the main investigative modality to confirm the diagnosis. Spontaneous involution still remains the mainstay of treatment in optic disc retinal artery macroaneurysm.

scholarly journals Optic disc drusen presenting as papilledema: a case report

2014 ◽  
Vol 4 (1) ◽  
pp. 42-44
Author(s):  
S Sitaula ◽  
M Thapa ◽  
AK Sharma
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Nerve ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Clinical Suspicion ◽  
Fundus Examination ◽  
Disc Edema ◽  
Medical College ◽  
Optic Disc Drusen ◽  
High Index Of Suspicion

Optic disc drusens, which are congenital anomalies of optic nerve head, are depositions of mucopolysaccharides and pro­teinaceous material within the optic nerve head. They are usually bilateral and diagnosed incidentally during routine fundus examination where they may be mistaken for papilledema. We report a case of 63 year old female referred to the neuro-ophthalmology department with the clinical suspicion of disc edema. Simple noninvasive investigations like ultrasound B-scan, fundus autofluorescene along with the newer test like spectral domain optical coherence tomography helped us to diagnose it as a case of pseudopapilledema, as optic disc drusen. Thus, a high index of suspicion along with the ancillary tests is helpful in differentiating optic disc drusen from true papilledema. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10848 Journal of Chitwan Medical College 2014; 4(1): 42-44

scholarly journals Two-Stage Mask-RCNN Approach for Detecting and Segmenting the Optic Nerve Head, Optic Disc, and Optic Cup in Fundus Images

2020 ◽  
Vol 10 (11) ◽  
pp. 3833 ◽  
Author(s):  
Haidar Almubarak ◽  
Yakoub Bazi ◽  
Naif Alajlan
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Fine Tuning ◽  
Fundus Images ◽  
Two Stage ◽  
Second Stage ◽  
Retinal Fundus Images ◽  
Tuning Strategy ◽  
Retinal Fundus

In this paper, we propose a method for localizing the optic nerve head and segmenting the optic disc/cup in retinal fundus images. The approach is based on a simple two-stage Mask-RCNN compared to sophisticated methods that represent the state-of-the-art in the literature. In the first stage, we detect and crop around the optic nerve head then feed the cropped image as input for the second stage. The second stage network is trained using a weighted loss to produce the final segmentation. To further improve the detection in the first stage, we propose a new fine-tuning strategy by combining the cropping output of the first stage with the original training image to train a new detection network using different scales for the region proposal network anchors. We evaluate the method on Retinal Fundus Images for Glaucoma Analysis (REFUGE), Magrabi, and MESSIDOR datasets. We used the REFUGE training subset to train the models in the proposed method. Our method achieved 0.0430 mean absolute error in the vertical cup-to-disc ratio (MAE vCDR) on the REFUGE test set compared to 0.0414 obtained using complex and multiple ensemble networks methods. The models trained with the proposed method transfer well to datasets outside REFUGE, achieving a MAE vCDR of 0.0785 and 0.077 on MESSIDOR and Magrabi datasets, respectively, without being retrained. In terms of detection accuracy, the proposed new fine-tuning strategy improved the detection rate from 96.7% to 98.04% on MESSIDOR and from 93.6% to 100% on Magrabi datasets compared to the reported detection rates in the literature.

OCT based interpretation of the optic nerve head anatomy in young adults with retinal vascular occlusions and ischemic optic neuropathy

2020 ◽  
pp. 112067212095759
Author(s):  
Amy Dai ◽  
Lasse Malmqvist ◽  
Simon P Rothenbuehler ◽  
Steffen Hamann
Keyword(s):  
Young Adults ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Vascular Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Ischemic Optic Neuropathy ◽  
Vein Occlusion ◽  
Retinal Vascular Occlusion ◽  
Retinal Artery

Purpose: To examine optic nerve head (ONH) anatomy in young adults with central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO) or nonarteritic anterior ischemic optic neuropathy (NA-AION) in order to look for associated, potentially predisposing anomalies. Methods: Cross-sectional study including 54 patients (ages 16–50 years) diagnosed from 2009 to 2018 with CRVO, BRVO, CRAO, BRAO, or NA-AION. Using Optical Coherence Tomography the presence of optic disc drusen (ODD), prelaminar hyperreflective lines and peripapillary hyperreflective ovoid mass-like structures (PHOMS), and determination of scleral canal size, retinal nerve fiber layer thickness (RNFLT) and macular ganglion cell layer thickness (GCLT) was obtained. Data for retinal vascular occlusion patients were grouped and analyzed together. Results: ODD were found in 13% of all patients, 2% of retinal vascular occlusion patients and 67% of NA-AION patients ( p < 0.0001). Prelaminar hyperreflective lines were found in 35% of all patients, 24% of retinal vascular occlusion patients and 89% of NA-AION patients ( p = 0.0005). PHOMS were found in 20% of all patients, 13% of retinal vascular occlusion patients and 56% of NA-AION patients ( p = 0.012). RNFLT was decreased in ODD patients compared to patients without ODD ( p = 0.01). Scleral canal diameter and GCLT was not correlated with ODD, prelaminar hyperreflective lines or PHOMS. Conclusion: ODD, prelaminar hyperreflective lines and PHOMS were more frequent in NA-AION patients compared to retinal vascular occlusion patients. The prevalence of ODD in retinal vascular occlusion patients was similar to the reported prevalence in the general population.

scholarly journals Retinal hemorrhages as one of complications of optic disc drusen during pregnancy

2014 ◽  
Vol 67 (5-6) ◽  
pp. 185-189
Author(s):  
Marija Trenkic-Bozinovic ◽  
Predrag Jovanovic ◽  
Gordana Zlatanovic ◽  
Dragan Veselinovic ◽  
Aleksandra Aracki-Trenkic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Ganglion Cells ◽  
Therapeutic Interventions ◽  
Visual Field Defects ◽  
Retinal Hemorrhages ◽  
Optic Disc Drusen

Introduction. Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. Case Report. A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. Conclusion. Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

Organized Vitreous Hemorrhage Masquerading as an Optic Disc Melanocytoma

2003 ◽  
Vol 13 (2) ◽  
pp. 215-217
Author(s):  
P. Puri ◽  
S. Prasad ◽  
I.G. Rennie
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Vitreous Hemorrhage ◽  
Diagnostic Dilemma ◽  
Pigmented Lesion ◽  
Blood Clots

Purpose To present a case of organized vitreous hemorrhage masquerading an optic disc melanocytoma. Discussion Optic nerve head melanocytoma is a benign slightly pigmented lesion arising from the edge of the disc presenting with a filed defect. Pigmented nature of the lesion in question due to presence of haemosidrin laden macrophages led a diagnostic dilemma. Trans vitreal biopsy confirmed the diagnosis. Conclusions Althought classical in presentation organized blood clots can masquerade a number of lesions including a melanocytoma as in the present scenario.

scholarly journals Is Magnetic Resonance Imaging Diffusion Restriction of the Optic Disc Head a New Marker for Idiopathic Intracranial Hypertension?

2019 ◽  
Vol 11 (01) ◽  
pp. 170-174
Author(s):  
Elanagan Nagarajan ◽  
Lakshmi P. Digala ◽  
Manjamalai Sivaraman ◽  
Pradeep C. Bollu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Intracranial Pressure ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Clinical Picture ◽  
Raised Intracranial Pressure ◽  
Resonance Imaging ◽  
Diffusion Restriction

Abstract Background Idiopathic intracranial hypertension (IIH) is a headache syndrome due to raised intracranial pressure of unknown etiology. Before making the diagnosis of IIH, secondary causes of raised intracranial pressure must be ruled out. The radiological features associated with this condition have variable sensitivity and specificity. In this case series, we aim to describe a potential new radiological marker of IIH, that is, diffusion restriction, in the optic disc head and propose that this can be a specific finding in the appropriate clinical picture. Importance IIH causes vision loss and disabling daily headaches. The diagnosis of this condition is based on history and physical examination findings. Magnetic resonance imaging (MRI) is used to exclude other causes, but specific radiological markers for the diagnosis of IIH are lacking. Observations Five patients presented with the main complaint of headache, which was associated with blurry vision. All of our patients had a formal neuro-ophthalmological evaluation that confirmed the presence of optic disc edema in both eyes. They also underwent an MRI of the brain that showed diffusion restriction in the optic nerve head in either eye or both eyes. Patients underwent lumbar puncture in the lateral decubitus position, which revealed cerebrospinal fluid opening pressures > 25 cm H2O. They all responded well to standard treatments, with the resolution of symptoms in their follow-up appointments. Conclusion and Relevance The MRI diffusion restriction in the optic nerve head may be a reliable noninvasive marker for the diagnosis of IIH in the appropriate clinical picture.

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