scholarly journals Optical coherent tomography in the diagnosis of inflammatory and ischemic optical neuropathies (clinical cases)

2021 ◽  
pp. 35-40
Author(s):  
Nataliya Moyseyenko
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Pulse Therapy ◽  
Diagnostic Techniques ◽  
Nerve Fibres ◽  
Optical Coherent Tomography ◽  
Acute Period ◽  
Choice Of Treatment ◽  
Predominant Factor ◽  
Nerve Fibre Layer

Optic neuropathy is a group of diseases of the optic nerve. Using diagnostic techniques such as ophthalmoscopy and perimetry diagnosis are insufficient, as the found abnormalities are not specific for either inflammation or ischemia. Establishing the predominant factor in the pathogenesis of neuropathy is crucial in determining the method of treatment. The aim of the study: to investigate the features of optic nerve damage using optical coherent tomography (OCT) in optic neuropathy in the acute period. Materials and methods: two patients with visual impairment were examined. Result. Patient G. had concomitant rheumatoid arthritis with unregulated Methotrexate therapy. OCT revealed edema of the nerve fibre layer convinced of the predominance of inflammatory neuropathy (atypical neuritis). Pulse therapy with corticosteroids was prescribed, which gave a positive functional effect. A patient O. with pneumonia on the background of Covid-19 with a history of OST showed a decrease in the thickness of the layer of nerve fibres in the lower segment, and in the angio mode – drusen of the optic disc. Conclusions. Thus, the use of OCT for the diagnosis of optic neuropathies in the acute period showed that under conditions of inflammatory lesions is more characteristic of edema and an increase in the thickness of the layer of nerve fibres. In ischemic neuropathy, on the contrary, a decrease in the thickness of nerve fibres is more characteristic, which correlates in location with the localization of scotoma in the field of view. Therefore, the use of OCT of the optic nerve will help in understanding the pathogenesis of forms of optic neuropathy. This will help in the choice of treatment tactics

Sensory loss—vision

2020 ◽  
pp. 345-354
Author(s):  
Paul J Foster ◽  
Anthony Khawaja ◽  
Lisanne J Balk ◽  
Zaynah Muthy ◽  
Axel Petzold
Keyword(s):  
Multiple Sclerosis ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Retinal Nerve Fibre Layer ◽  
Sensory Loss ◽  
Retinal Microvasculature ◽  
Cell Layers ◽  
The Central Nervous System ◽  
Nerve Fibre Layer ◽  
The Brain

This chapter focuses on degenerative optic neuropathy. The retina and optic nerve share their embryological origin with the brain and are widely regarded as part of the central nervous system. Retinal microvasculature and neuronal components offer a unique ‘window’ on tissues that are closely allied to intracranial structures. Consequently, the eye is vulnerable to the same processes that cause neurodegenerative diseases. Axonal damage in the brain may affect the retinal nerve fibre layer (RNFL), the inner plexiform, and ganglion cell layers, halting at the level of the inner nuclear layer. On this basis, it seems that it is likely that patterns and trends in the inner retinal layers mirror those in the brain, and that these patterns may reflect wider risk of neurodegenerative changes. The dementias and Parkinson’s disease are associated with measurable changes in the retina and optic nerve. Two specific forms of degenerative optic neuropathy that deserve special consideration on the basis of their greater frequency are glaucoma and multiple sclerosis (MS) associated optic neuritis (MSON).

scholarly journals The Difficulty of Diagnosing Invasive Aspergillosis Initially Manifesting as Optic Neuropathy

2019 ◽  
Vol 10 (1) ◽  
pp. 11-18
Author(s):  
Sotaro Mori ◽  
Takuji Kurimoto ◽  
Kana Kawara ◽  
Kaori Ueda ◽  
Mari Sakamoto ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Invasive Aspergillosis ◽  
Optic Neuropathy ◽  
Fungal Infections ◽  
Pulse Therapy ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Light Perception ◽  
Steroid Pulse ◽  
The Right

Background: Invasive aspergillosis is often fatal. Here, we report a patient with invasive aspergillosis primarily involving the optic nerve diagnosed on autopsy. Case Presentation: A 77-year-old female with underlying diabetes mellitus, hyperlipidemia, and hypertension presented with disc swelling of the left eye. Although mini-pulse steroid therapy improved visual acuity (VA) of the left eye, it abruptly decreased to no light perception within a month, followed by a decrease in VA of the right eye to 0.5. At referral, VA was 0.3 in the right eye, and there was no light perception in the left eye. Results: Fundus examination revealed optic disc swelling of both eyes. Goldmann perimetry showed irregular visual field defects, whereas magnetic resonance imaging (MRI), general, and cerebrospinal fluid (CSF) examinations revealed no distinct abnormalities. We suspected anterior ischemic optic neuropathy and invasive optic neuropathy. As with the left eye, steroid pulse therapy temporarily improved VA of the right eye and then decreased to 0.2. Additional anticoagulant therapy did not improve VA. Concurrent to therapy, the patient became febrile with depressed consciousness. Repeat MRI identified suspected midbrain infarction, and CSF examination indicated cerebral meningitis. In spite of administering transfusions and antibiotics, she died on hospital day 40. Autopsy revealed large amounts of Aspergillus hyphae mainly localized in the dura mater of the optic nerve and destruction of the cerebral artery wall, suggesting an etiology of subarachnoid hemorrhage. Conclusions: When examining refractory and persistent disc swelling, we should rule out fungal infections of the optic nerve.

scholarly journals Progress in Gene Therapy to Prevent Retinal Ganglion Cell Loss in Glaucoma and Leber’s Hereditary Optic Neuropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Sara E. Ratican ◽  
Andrew Osborne ◽  
Keith R. Martin
Keyword(s):  
Gene Therapy ◽  
Clinical Trials ◽  
Optic Nerve ◽  
Genome Editing ◽  
Optic Neuropathy ◽  
Single Gene ◽  
Leber’S Hereditary Optic Neuropathy ◽  
Leber's Hereditary Optic Neuropathy ◽  
Potential Use ◽  
Hereditary Optic Neuropathy

The eye is at the forefront of the application of gene therapy techniques to medicine. In the United States, a gene therapy treatment for Leber’s congenital amaurosis, a rare inherited retinal disease, recently became the first gene therapy to be approved by the FDA for the treatment of disease caused by mutations in a specific gene. Phase III clinical trials of gene therapy for other single-gene defect diseases of the retina and optic nerve are also currently underway. However, for optic nerve diseases not caused by single-gene defects, gene therapy strategies are likely to focus on slowing or preventing neuronal death through the expression of neuroprotective agents. In addition to these strategies, there has also been recent interest in the potential use of precise genome editing techniques to treat ocular disease. This review focuses on recent developments in gene therapy techniques for the treatment of glaucoma and Leber’s hereditary optic neuropathy (LHON). We discuss recent successes in clinical trials for the treatment of LHON using gene supplementation therapy, promising neuroprotective strategies that have been employed in animal models of glaucoma and the potential use of genome editing techniques in treating optic nerve disease.

The synaptic organization of optic afferents in the amphibian tectum

1974 ◽  
Vol 187 (1089) ◽  
pp. 421-447 ◽  
Keyword(s):  
Optic Nerve ◽  
Cell Layer ◽  
Maximum Amplitude ◽  
Synaptic Organization ◽  
Nerve Fibres ◽  
Synaptic Potentials ◽  
Postsynaptic Cell ◽  
Optic Fibre ◽  
Stimulation Of

Potentials in the amphibian tectum, evoked by stimulation of the optic nerve, were recorded extracellularly. Four discrete potentials, referred to as the m 1 , m 2 , u 1 and u 2 waves, occur at different latencies after stimulation. We have shown that these waves represent summed post-synaptic potentials generated by synchronous activation of four different groups of optic nerve fibres. The m 1 and m 2 waves are generated by two classes of myelinated optic nerve fibres, previously characterized as ‘dimming’ and ‘event’ fibres. The maximum amplitude of the m 2 wave occurs just below, and of the m 2 wave just above, cell layer 8 of P. Ramón. The u 1 and u 2 waves are generated by ‘edge’ and ‘convexity’ fibres, respectively. The maximum amplitude of the u 1 wave occurs near the surface of the tectum, and of the u 2 wave some 100 μm below it. Postsynaptic cell bodies for all four classes of optic fibre are located in layer 8.

Parapapillary atrophy in optic neuropathies: Histology and clinical relevance

2021 ◽  
pp. 112067212110606
Author(s):  
Ana Banc ◽  
Stefania Bianchi Marzoli
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Optic Nerve Head ◽  
Clinical Findings ◽  
Age Related Macular Degeneration ◽  
Glaucomatous Optic Neuropathy ◽  
Age Related ◽  
High Resolution Images ◽  
Parapapillary Atrophy ◽  
Optic Nerve Disorders

Parapapillary atrophy is one of the parameters of the optic nerve head area which are assessed during the ophthalmoscopic examination particularly useful to characterize glaucomatous optic neuropathy. Optical coherence tomography evaluation provides high-resolution images of the optic nerve head and surrounding area, and can be used to study parapapillary atrophy. Different parapapillary atrophy zones were described depending on their histological features and research has been conducted to investigate the possible association between the presence and/ or size of parapapillary atrophy zones and several optic nerve disorders. In this review we discuss the histology and the clinical findings related to parapapillary atrophy in patients with glaucomatous optic neuropathy, non-glaucomatous optic neuropathies (e.g. arteritic and non-arteritic anterior ischemic optic neuropathies; suprasellar and parasellar tumors), and other ocular conditions (e.g. high myopia; age-related macular degeneration). Two different histologic classifications were identified. Parapapillary atrophy was demonstrated in glaucoma and glaucoma-like neuropathies, but not in other types of optic nerve disorders.

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