Unilateral visual impairment in a patient undergoing chemotherapy: a case report and clinical findings

Abstract Background Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute unilateral visual impairment after one cycle of intravenous chemotherapy of a normal dose, aiming at raising attention to chemotherapy-induced ocular toxicity. Case presentation The patient developed a progressive vision loss in the right eye during the chemotherapy. After one cycle of intravenous chemotherapy, her visual acuity decreased by 0.6 in the right eye (VOD = 0.4) compared to the previous value of 1.0 (VOD = 1.0). No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). During her follow-up period, we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in her right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of the optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested the impaired function of the optic nerve. Thus, a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by the ophthalmologist according to these results. The patient was prescribed prednisone combined with neuroprotective drugs, which did not work. After the cessation of chemotherapy, her impaired vision gradually recovered. Conclusions This is the first reported case of acute visual impairment in a patient who underwent chemotherapy of a normal dose. It is indicated that while receiving benefits from chemotherapy, cancer patients simultaneously suffer from the risk of vision loss.

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Unilateral visual impairment in a patient undergoing chemotherapy: a case report and clinical findings

10.21203/rs.2.9119/v2 ◽

2019 ◽

Author(s):

Xia Yuan ◽

Yuliang Feng ◽

Dan Li ◽

Mei Li

Keyword(s):

Visual Acuity ◽

Visual Impairment ◽

Fluorescein Angiography ◽

Optic Disc ◽

Vision Loss ◽

Fundus Photograph ◽

Fundus Fluorescein Angiography ◽

Intravenous Chemotherapy ◽

Normal Dose ◽

The Right

Abstract Background: Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute unilateral visual impairment after one cycle of intravenous chemotherapy of normal dose, aimed at raising attention to chemotherapy-induced ocular toxicity. Case presentation: During chemotherapy, the patient developed progressive vision loss in the right eye. She had worse visual acuity of 0.4 in the right eye (VOD0.4) than before (VOD1.0) after one cycle of intravenous chemotherapy. No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). During her follow-up period we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in the right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested that the function of optic nerve was impaired. A diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by an ophthalmologist and the patient received prednisone combined with neuroprotective drugs, which did not work. After cessation of chemotherapy, her impaired vision gradually improved. Conclusions: This is the first reported case of acute visual impairment in a patient undergoing chemotherapy of normal dose. It is warranted that cancer patients benefiting from chemotherapy simultaneously suffer from the risk of vision loss.

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Unilateral visual impairment in a patient undergoing chemotherapy: a case report and clinical findings

10.21203/rs.2.9119/v3 ◽

2019 ◽

Author(s):

Xia Yuan ◽

Yuliang Feng ◽

Dan Li ◽

Mei Li

Keyword(s):

Visual Acuity ◽

Visual Impairment ◽

Fluorescein Angiography ◽

Vision Loss ◽

Ischemic Optic Neuropathy ◽

Fundus Photograph ◽

Fundus Fluorescein Angiography ◽

Intravenous Chemotherapy ◽

Normal Dose ◽

The Right

Abstract Abstract Background: Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute unilateral visual impairment after one cycle of intravenous chemotherapy of a normal dose, aiming at raising attention to chemotherapy-induced ocular toxicity. Case presentation: The patient developed a progressive vision loss in the right eye during the chemotherapy. After one cycle of intravenous chemotherapy, her visual acuity decreased by 0.6 in the right eye (VOD=0.4) compared to the previous value of 1.0 (VOD=1.0). No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). During her follow-up period, we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in her right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of the optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested the impaired function of the optic nerve. Thus, a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by the ophthalmologist according to these results. The patient was prescribed prednisone combined with neuroprotective drugs, which did not work. After the cessation of chemotherapy, her impaired vision gradually recovered. Conclusions: This is the first reported case of acute visual impairment in a patient who underwent chemotherapy of a normal dose. It is indicated that while receiving benefits from chemotherapy, cancer patients simultaneously suffer from the risk of vision loss. Key words: Vision loss, Chemotherapy, Nonarteritic anterior ischemic optic neuropathy

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Unilateral visual impairment in a patient undergoing chemotherapy: a case report and clinical findings

10.21203/rs.2.9119/v4 ◽

2019 ◽

Author(s):

Xia Yuan ◽

Yuliang Feng ◽

Dan Li ◽

Mei Li

Keyword(s):

Visual Acuity ◽

Visual Impairment ◽

Fluorescein Angiography ◽

Vision Loss ◽

Ischemic Optic Neuropathy ◽

Fundus Photograph ◽

Fundus Fluorescein Angiography ◽

Intravenous Chemotherapy ◽

Normal Dose ◽

The Right

Abstract Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute unilateral visual impairment after one cycle of intravenous chemotherapy of a normal dose, aiming at raising attention to chemotherapy-induced ocular toxicity. Case presentation: The patient developed a progressive vision loss in the right eye during the chemotherapy. After one cycle of intravenous chemotherapy, her visual acuity decreased by 0.6 in the right eye (VOD=0.4) compared to the previous value of 1.0 (VOD=1.0). No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). During her follow-up period, we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in her right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of the optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested the impaired function of the optic nerve. Thus, a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by the ophthalmologist according to these results. The patient was prescribed prednisone combined with neuroprotective drugs, which did not work. After the cessation of chemotherapy, her impaired vision gradually recovered. Conclusions: This is the first reported case of acute visual impairment in a patient who underwent chemotherapy of a normal dose. It is indicated that while receiving benefits from chemotherapy, cancer patients simultaneously suffer from the risk of vision loss. Key words: Vision loss, Chemotherapy, Nonarteritic anterior ischemic optic neuropathy

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Monocular visual impairment in a patient undergoing cisplatin-based chemotherapy: a case report and clinical findings

10.21203/rs.2.9119/v1 ◽

2019 ◽

Author(s):

Xia Yuan ◽

Yuliang Feng ◽

Dan Li ◽

Mei Li

Keyword(s):

Visual Impairment ◽

Fluorescein Angiography ◽

Optic Disc ◽

Vision Loss ◽

Ischemic Optic Neuropathy ◽

Fundus Photograph ◽

Fundus Fluorescein Angiography ◽

Cerebral Magnetic Resonance Imaging ◽

Normal Dose ◽

The Right

Abstract Background Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute monocular visual impairment after one cycle of intravenous cisplatin-based chemotherapy of normal dose, aimed at raising attention to chemotherapy-induced ocular toxicity. Case presentation The patient consulted to an ophthalmologist, and during her follow-up period we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). During chemotherapy, the patient developed progressive vision loss in the right eye. No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in the right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested that the function of optic nerve was impaired. A diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by an ophthalmologist and the patient received prednisone combined with neuroprotective drugs, which did not work. After cessation of chemotherapy, her impaired vision gradually improved. Conclusions This is the first reported case of acute visual impairment in a patient undergoing cisplatin-based chemotherapy of normal dose. It is warranted that cancer patients benefiting from chemotherapy simultaneously suffer from the risk of vision loss.

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Melanocytoma of the optic disc – a case report

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i2.6553 ◽

2012 ◽

Vol 4 (2) ◽

pp. 323-325 ◽

Cited By ~ 1

Author(s):

H Sharma ◽

L R Puri

Keyword(s):

Case Report ◽

Malignant Melanoma ◽

Visual Impairment ◽

Fluorescein Angiography ◽

Optic Disc ◽

Benign Lesion ◽

Fundus Examination ◽

The Right

Introduction: Melanocytoma of the optic disc is a benign lesion. Objective: To describe a case of optic disc melanocytoma Case: A 48-year old lady presented with gradual visual impairment associated with a floater. The right eye fundus examination showed a mass uniformly dark black in colour on the optic disc. The mass completely obscured the fluorescence on fluorescein angiography and was thus differentiated from malignant melanoma. Conclusion: Optic disc melanocytoma can present with visual impairment and a floater. Fluorescein angiography can be useful to differentiate between malignDOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6553 Nepal J Ophthalmol 2012; 4 (2): 323-325

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Valsalva Retinopathy Associated with Sexual Activity

Case Reports in Medicine ◽

10.1155/2014/524286 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Khalid Al Rubaie ◽

J. Fernando Arevalo

Keyword(s):

Visual Acuity ◽

Sexual Activity ◽

Vision Loss ◽

Internal Limiting Membrane ◽

Internal Limiting Membrane Peeling ◽

Sudden Loss ◽

Initial Visual Acuity ◽

Pars Plana ◽

23 Gauge ◽

The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

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Prevalence and causes of visual impairment and blindness among school children in Muzaffarabad, Pakistan

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20181393 ◽

2018 ◽

Vol 4 (4) ◽

pp. 93

Author(s):

Abdul Rauf Awan ◽

Junaid Jamshed ◽

Muhammad Mushtaq Khan ◽

Zahid Latif

Keyword(s):

Visual Acuity ◽

Public Schools ◽

Visual Impairment ◽

Private Schools ◽

School Children ◽

School Health ◽

Vision Loss ◽

Screening Program ◽

Sampling Technique ◽

Cross Sectional

Background: Vision loss in childhood has serious implications in all stages of child’s growth and development. It poses social, educational and occupational challenges, with affected children being at greater risk of developing behavioral, psychological and emotional problems, lower self-esteem and poorer social integration. The aim of this study was to assess the prevalence and identify the causes of visual impairment and blindness in school children of UC Gojra, Muzaffarabad, Pakistan so that prevention strategies could be implemented.Methods: This was a school-based descriptive cross-sectional study conducted among public and private schools. A multi-stage stratified random sampling technique was used for selecting study participants aged 5-20 years from 24 schools in Muzaffarabad. The vision of school children was examined for visual acuity using standard Snellen chart. Those participants who had visual acuity of <6/18 in either eye underwent a more detailed ophthalmic examination to diagnose the causes of VI. An exploration of demographic variables was conducted using Chi-square test. Results: The mean age of participants was 10±2.83. The prevalence of visual impairment was 19.6% and 2.3% for severe visual impairment. The age group most affected by VI was 11-15 years (74.2%). There were increased chances of developing VI with advancing age of the participants. Males contributed 88.7% of the cases of VI while females contributed only 11.3%. The class category 5-6 had higher percentage of VI cases (32.7%). Public schools contributed 52.8% of the cases of VI while for private schools the corresponding percentage was 47.2%. The leading cause of VI was refractive error (89.3%) followed by amblyopia (5.0%). Other causes of VI included cataract (1.2%), corneal disease (1.8%), strabismus (1.8%) and nystagmus (0.6%).Conclusions: There is a need to implement school health policy on visual screening prior to admissions in schools and annual eye screening program for early detection and prompt treatment of eye problems among school children in Muzaffarabad.

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Prevalence and risk factors for visual impairment among elderly residents in ‘homes for the aged’ in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315678 ◽

2020 ◽

Vol 105 (1) ◽

pp. 32-36 ◽

Cited By ~ 4

Author(s):

Srinivas Marmamula ◽

Navya Rekha Barrenakala ◽

Rajesh Challa ◽

Thirupathi Reddy Kumbham ◽

Satya Brahmanandam Modepalli ◽

...

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Logistic Regression ◽

Visual Impairment ◽

Vision Loss ◽

The Elderly ◽

Posterior Capsular Opacification ◽

Routine Practice ◽

Homes For The Aged ◽

Uncorrected Refractive Error

Background/AimTo investigate the prevalence, causes and risk factors of visual impairment (VI) among the elderly in ‘home for the aged’ in Hyderabad, India.MethodsIndividuals aged ≥60 years were recruited from 41 ‘homes for the aged’. All participants had complete eye examinations including presenting visual acuity, refraction, slit-lamp examination, intraocular pressure measurement and fundus imaging by trained clinicians. VI was defined as presenting visual acuity worse than 6/18 in the better eye. Multivariate logistic regression was used to determine the risk factors associated with VI.Results1512 elderly residents from 41 homes for the aged were enumerated, of whom 1182 (78.1%) were examined. The mean age of examined participants was 75.0 years (SD 8.8 years; range: 60–108 years); 35.4% of those examined were men. The prevalence of VI was 30.1% (95% CI 27.5 to 32.8). The leading cause of VI was cataract (46.3%, n=165), followed by uncorrected refractive error (27.0%, n=96), posterior capsular opacification (14.9%, n=53) and posterior segment disease (6.5%, n=23). Overall, 88.2% of the VI was either treatable or correctable. In multiple logistic regression, those aged 80 years and older (OR: 1.7, p<0.01), living in ‘free’ homes (OR: 1.5, p<0.01) and who were immobile/bedridden (OR: 3.02, p<0.01) had significantly higher odds of VI. Gender was not associated with VI.ConclusionsVI was common and largely avoidable in residents of ‘homes for the aged’ in Hyderabad, India. Screening for vision loss in ‘homes for aged’ and the provision of appropriate services should become routine practice to achieve the goal of healthy ageing in India.

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Exudative Type 3 Retinal Arteriovenous Malformation in a Pediatric Patient

Case Reports in Ophthalmology ◽

10.1159/000495656 ◽

2018 ◽

Vol 9 (3) ◽

pp. 504-509

Author(s):

Helena Dens ◽

Ingele Casteels

Keyword(s):

Optical Coherence Tomography ◽

Differential Diagnosis ◽

Arteriovenous Malformation ◽

Fluorescein Angiography ◽

Optic Disc ◽

Optical Coherence Tomography Angiography ◽

Imaging Techniques ◽

Optical Coherence ◽

The Right ◽

Type 3

We describe a 7-year-old girl who developed exudation nasally to the right optic disc due to retinal arteriovenous malformation. Fluorescein angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography were performed. We give an overview of the different imaging techniques and discuss the differential diagnosis. Since there was no visual impairment, no treatment was started. A spontaneous decrease in edema and exudation was noted after 6 months.

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Paediatric case of peripapillary choroidal neovascularisation associated with optic disc drusen treated with aflibercept

BMJ Case Reports ◽

10.1136/bcr-2018-228134 ◽

2019 ◽

Vol 12 (1) ◽

pp. bcr-2018-228134 ◽

Cited By ~ 1

Author(s):

Weh Loong Gan ◽

Vernon W Long

Keyword(s):

Visual Acuity ◽

Optic Disc ◽

Rare Complication ◽

Fundus Autofluorescence ◽

Choroidal Neovascularisation ◽

First Case ◽

Optic Disc Drusen ◽

Intravitreal Aflibercept ◽

The Right ◽

Subfoveal Fluid

Peripapillary choroidal neovascularisation (PPCNV) associated with optic disc drusen is a rare complication that can result in severe vision impairment in children. We report the first case of paediatric PPCNV secondary to optic disc drusen successfully treated with intravitreal aflibercept. A 6-year-old girl presented with a one week history of reduced vision in her right eye with best-corrected visual acuity of 20/500. Fundus examination revealed bilateral elevated discs with a peripapillary pigmentary lesion in the right eye. Optical coherence tomography of the right eye showed marked subfoveal fluid. Both B-scan ultrasonography and fundus autofluorescence demonstrated findings consistent with optic disc drusen. Diagnosis of PPCNV was further confirmed on fluorescein fundus angiography. The child received three intravitreal aflibercept injections with complete resolution of the subfoveal fluid. Her visual acuity improved to 20/25 with no recurrence at a 16-month follow-up. No adverse side effects were reported.

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