scholarly journals Various Types of Neuroleukemia with Optic Nerve Involvement

2020 ◽  
Vol 17 (3) ◽  
pp. 375-381
Author(s):  
E. E. Grishina ◽  
A. A. Ryabtseva ◽  
O. M. Andryukhina ◽  
A. A. Kovrizhkina
Keyword(s):  
Cerebrospinal Fluid ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Clinical Manifestations ◽  
Optic Disk ◽  
Leukemic Infiltration ◽  
Blast Cells ◽  
Hodgkin's Lymphomas ◽  
The Brain ◽  
Peripapillary Retina

Neuroleukemia is a severe complication of hemoblastosises characterized by infiltration of blast cells of the meninges, the substance of the brain, cranial and peripheral nerves.The purpose. To analyze the clinical manifestations of leukemia with optic nerve damage in leukemia and malignant lymphomas.Patients and Methods. From January 2016 to January 2020, one center-based non-randomized prospective study was conducted on patients with leukemia and non-Hodgkin’s lymphomas who were treated in the hematology department of MONIKI and made complaints about reduced vision. 26 patients were examined, 4 of them were diagnosed neuroleukosis with leukemic infiltration of the optic nerves: three women aged 41, 44, 46 years and a man aged 50 years.Results. All patients had one common ophthalmological symptom — decreased visual acuity. Complaints of reduced vision in one patient appeared at the onset of the disease, in other patients-during a relapse. The picture of the eye’s fundus in all patients was identical: the optic disk had blurred borders, and elevated above the retina. In the first days, the vascular funnel was viewed, then closed by infiltration. A dense white infiltrate of the peripapillary retina spread over the entire macular area. The retinal veins were sharply dilated of uneven caliber. Along the course of the vessels, there were a large number of different sizes and shapes of hemorrhages. Various types of neuroleukemia with lesion of the optic nerve were described: a combination of focal lesions of the brain and the optic nerve, isolated damage to the optic nerve with blast cytosis in the cerebrospinal fluid (CSF), isolated damage to the intraocular part of the optic nerve without changing the cerebrospinal fluid. In three patients the diagnosis of neuroleukemia exhibited on the basis of changes according to magnetic resonance imaging (MRI) and/or the number of blast cells in punctate liquorologic research. In the fourth patient, in the absence of changes in the liquor and MRI, the diagnosis of leukemic infiltration of the optic nerve was confirmed by data from a cytological examination of a punctate from the peripapillary retina. After the beginning of antitumor treatment, the significant improvement visual acuity and decrease in leukemic infiltrate of the optic disc and retina of the affected eye was noted in all patients.Discussion. Damage of the optic nerve can develop both at the onset of the disease, and relapses of leukemia or aggressive non-Hodgkin’s lymphomas. Leukemic infiltration evolves in all parts of the optic nerve, but more often affects its intraocular portion. The damage to the intraocular part is characterized by the presence of a dense infiltrate both in the area of the papilla and the peripapillary retina.Conclusion. Leukemic infiltration of the optic nerve is manifested by a significant decrease in visual acuity. Careful attention to complaints of reduced vision in patients with leukemia can help to recognize the development of the disease’s debut or its progression. Timely antitumor treatment leads to an improvement in visual acuity and, consequently, an improvement in the quality of life of patients. 

scholarly journals Influence of retrobulbar neuritis and papillitis on echographically measured optic nerve diameter

2010 ◽  
Vol 67 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Ivan Stefanovic ◽  
Milos Jovanovic ◽  
Bojana Dacic-Krnjaja ◽  
Dragan Veselinovic ◽  
Predrag Jovanovic
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Significant Negative Correlation ◽  
Optic Disk ◽  
Partial Loss ◽  
Retrobulbar Neuritis ◽  
Optic Nerve Diameter ◽  
Ophthalmologic Examination ◽  
Retrobulbar Optic Neuritis

Background/Aim. Retrobulbar (optic) neuritis is inflammation of the optic nerve that may cause a complete or partial loss of vision. This inflammation can affect a part of the nerve within the eyeball (neuropapillitis) or a part of the nerve behind the eyeball (retrobulbar neuritis). The aim of this study was to establish whether there is a correlation between the diameter of a retrobulbar part of the optic nerve and either visual acuity, prominence of the optic disk (papillitis), or nature of the neuritis (papillitis or retrobulbar). Methods. We tested 23 patients with retrobulbar neuritis and papillitis. In addition to a complete ophthalmologic examination, the diameter of retrobulbar region of the optic nerve was measured by the B-scan method. Following this, the 30-degree test was carried out. Results. We found an increased thickness of the retrobulbar region in 22 patients and different responses to the 30-degree test, as well as a statistically significant negative correlation between the thickness of retrobulbar part of the optic nerve and visual acuity. Conclusion. The retrobulbar part of the optic nerve is thicker in 94% of the patients with retrobulbar neuritis and in all the patients with papillitis. There is a correlation between the reduction of visual acuity and thickening of a retrobulbar part.

scholarly journals Diseases of the eye in chronic alcoholism

2013 ◽  
Vol 94 (1) ◽  
pp. 101-105
Author(s):  
R R Iskhakova ◽  
F R Saifullina
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Peripheral Vision ◽  
Clinical Manifestations ◽  
Chronic Alcoholism ◽  
Low Grade ◽  
Optic Nerve Atrophy ◽  
Eye Disorders ◽  
Temporal Parts ◽  
Late Stages

Chronic alcoholism is a disease affecting all the vital organs, including development of functional and organic eye disorders in 2-70% of cases. Alcoholic (ethanol) amblyopia with such features as slow gradient visual acuity decrease in both eyes (although visual acuity can decrease down do a very low grade, the complete blindness is rare) is among the disorders in patients with chronic alcoholism. Fundus of the eye at the beginning of the disease is normal in most of the cases, sometimes an optic nerve congestion and mild features of optic neuritis can be observed. Sometimes optic nerve hyperemia or anemia can be observed. Simple optic nerve atrophy seen as the temporal parts or the entire disc blanching can be seen at the late stages. Alcohol toxicity can also result as peripheral vision decrease, with degree of it increasing depending on the clinical manifestations of the alcoholism. Generally, eye disorders in patients with chronic alcoholism in most of the cases manifest as central retinal area damage and combination of retinal and optic nerve involvement.

scholarly journals Retina and optic nerve complications and hearing injury caused by Sclerotherapy of Facial Vascular Malformation

2021 ◽  
Vol 2 (1) ◽  
pp. 1-7
Author(s):  
Li Xu ◽  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Vascular Malformation ◽  
Direct Injection ◽  
Retinal Hemorrhage ◽  
Optic Disk ◽  
Severe Toxicity ◽  
Eyelid Swelling ◽  
Acoustic Nerve ◽  
Magnetic Resonance Imaging Mri

This report describes a complication of symptoms consistent with transiency visual acuity damage and hearing injury following sclerotherapy with a polidocanol injection to a facial vascular malformation. After the direct injection of 5cc polidocanol-room air emulsion into the subcutaneous malformation, a 3-year-old boy developed bilateral eyelid swelling the next day, and on 7 days later at referral, visual acuity in the left eye was light perception. Fundoscopy revealed retinal hemorrhage; fluorescein angiography (FA) disclosed hyperreflective leakage on the optic disk 15 days later, and OCT showed nerve fiber edema between the disk and macular. The orbital magnetic resonance imaging (MRI) demonstrated the normal extraocular muscles. In a month later, bilateral eyelid swelling resolved but the visual acuity remained 20/500, and 20/20 in two months later, but the hearing injury remained. It needs much more special attention in sclerotherapy for facial malformation because the sclerosants may cause severe toxicity or inflammation in retina and optic nerve, resulting in transiency visual acuity damage and acoustic nerve injury. The related examination including ophthalmic investigation after the sclerotherapy is necessary.

scholarly journals NERVE GROWTH FACTOR AND S100B IN BLOOD AND CEREBROSPINAL FLUID AS INDICATORS OF THE SEVERITY OF ISCHEMIC STROKE

2019 ◽  
Vol 19 (1S) ◽  
pp. 34-35
Author(s):  
L P Pivovarova ◽  
I A Voznyuk ◽  
I V Osipova ◽  
E A Gogoleva
Keyword(s):  
Cerebrospinal Fluid ◽  
Ischemic Stroke ◽  
Nerve Growth Factor ◽  
Growth Factor ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Nerve Growth ◽  
Somatic Status ◽  
The Brain ◽  
D Dimer

Aim. To determine the relationship between the content of nerve growth factor (NGF) and S100b with the clinical manifestations of acute ischemic stroke (IS). Material and methods. A total of 17 patients with IS, age 68.5 (67; 78.5) years were examined; comparison group: 15 volunteers, age 65.0 (62.0; 66.5) years. The patients’ condition was assessed by the size of the brain lesion, the NIHSS and mRS, somatic status. Serum and cerebrospinal fluid (CSF) NGF, S100b, IL6, plasma D-dimer (ELISA) were determined at 1, 3, 10 days after IS. Results. We found NGF decreased in a serum of patients IS with a fatal outcome in 1-10 days. The dependency of serum (r = -0.300, p < 0.05) and CSF (r = -0.271, p < 0.05) NGF with the size of the lesion and patients somatic status (r = -0.322, p < 0.05) was discovered. The concentration of S100b increased from 3 days in deceased patients in the CSF and blood. The S100b correlated with the outcome of the disease (r = 0.650, p < 0.01), NIHSS (r = 0.651, p < 0.01), mRS (r = 0.451, p < 0.05). NGF and S100b levels were associated with the increasing of plasma D-dimer and CSF IL-6. Thus the NGF and S100b reflect the brain damage severity and the patients’ condition in the acute IS and associates with inflammation activity.

scholarly journals Leukemic changes of the brain: the involvement of the choroid plexus

1978 ◽  
Vol 36 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Aristides Cheto de Queiroz ◽  
Dorcas Almeida Ribeiro
Keyword(s):  
Choroid Plexus ◽  
Nervous Tissue ◽  
Clinical Manifestations ◽  
Therapeutic Agents ◽  
Routine Procedure ◽  
Leukemic Infiltration ◽  
Meningeal Involvement ◽  
Frequent Site ◽  
The Brain ◽  
Cytologic Study

In the study of 38 cases of leukemia, neoplastic infiltration of the brain was the most frequent lesion, occuring in 70,5%, compared to 48,5% for hemorrhage. The leptomeninges were the most frequent site of leukemic infiltration followed by the choroid plexus (57,8%) and the nervous tissue (50%). In few cases leukemic infiltration of choroid plexus was seen in the absence of meningeal involvement. Very often the leukemic infiltration of the CNS courses without clinical manifestations. The paper points out the importance of the cytologic study of the cerebro-spinal fluid as a routine procedure in cases of leukemia, since it is well known that the therapeutic agents have difficulty in penetrating the blood-brain barrier and that foci of CNS leukemic infiltration may represent points of reactivation of the disease even during the therapeutic remission.

scholarly journals Panhypopituitarism Presenting as Progressive Visual Acuity Deterioration Secondary to Suprasellar Germinoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A596-A596
Author(s):  
Rainer Wandrew Young Po ◽  
Monica Therese B Cating-Cabral
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Disc ◽  
Clinical Sign ◽  
External Beam Radiation ◽  
Optic Nerve Atrophy ◽  
Beam Radiation ◽  
Intracranial Mass ◽  
The Right ◽  
The Brain

Abstract Background: Overall the incidence of germ cell tumors worldwide is 0.1% with 60% comprising of germinomas. These may present in the suprasellar region a third of the time and thus impart variability in its presenting characteristics. Clinical Case: A 27-year male presented with progressive blurring of vision with incongruent visual acuity and refraction grade with optic disc pallor assessed with normal angiography. Patient also presented with increasing docility, sluggishness and more withdrawn behavior paired with polyuria, polydipsia and cold intolerance. Progressive worsening of vision led to cranial CT revealing an enhancing hyper density in the right caudate head later elucidated via MRI with several interspersed non-enhancing foci in the right caudate nucleus, both internal capsules with associated mild mass effect. The largest component located in the right capsular region with measurement of 21 x 21 x 16 mm with enhancing lesions in the hypothalamus and pituitary stalk. Endocrine evaluation revealed low serum cortisol at 91.03nmol/L (NV 138-685 nmol/L), responsive to ACTH stimulation test (65.94nmol/L to 387nmol/L), high prolactin at 856.9 mIU/L (42.4-296.8mIU/L) and low FT4 8.62pmol/l (9.01-19.05 pmol/L) despite normal TSH 1.528uIU/ml (0.35-4.94 uIU/mL). Optic nerve atrophy was now attributed to compressive intracranial mass. Secondary adrenal insufficiency was managed with hydrocortisone 50mgIV every 8 hours, and central hypothyroidism was managed with levothyroxine 75mcgtab 1tab once a day. Increased urinary output assessed as diabetes insipidus was given desmopressin 60mcg/tab ½ tab 2x a day at this time. Stereotactic biopsy of the brain revealed a germinoma of the right caudate lobe. Given the nature of the intracranial mass with high sensitivity to chemotherapeutic and radiotherapy, a multidisciplinary approach to treatment was taken with radiotherapy, hormonal and steroid replacement. Patient underwent external beam radiation therapy of the brain and spine for a total of 51 treatments allowing for improvement of visual acuity to counting, with polyuria less than 2-3 diaper changes per day. Conclusion: Optic disc pallor is a clinical sign that indicates optic nerve atrophy reflective of the optic tract. This may be an important clinical sign to increase clinical suspicion for intracranial mass lesion especially with correlation to manifestation of pituitary hormone deficiencies.

Fibrinolytic Activity of Cerebro-Spinal Fluid and the Development of Artificial Cerebral Haematomas in Dogs

1969 ◽  
Vol 21 (02) ◽  
pp. 294-303 ◽  
Author(s):  
H Mihara ◽  
T Fujii ◽  
S Okamoto
Keyword(s):  
Cerebrospinal Fluid ◽  
Carboxylic Acid ◽  
Fibrinolytic Activity ◽  
Clinical Implications ◽  
Trans Form ◽  
Plate Method ◽  
Blood Samples ◽  
Fibrin Plate ◽  
The Brain

SummaryBlood was injected into the brains of dogs to produce artificial haematomas, and paraffin injected to produce intracerebral paraffin masses. Cerebrospinal fluid (CSF) and peripheral blood samples were withdrawn at regular intervals and their fibrinolytic activities estimated by the fibrin plate method. Trans-form aminomethylcyclohexane-carboxylic acid (t-AMCHA) was administered to some individuals. Genera] relationships were found between changes in CSF fibrinolytic activity, area of tissue damage and survival time. t-AMCHA was clearly beneficial to those animals given a programme of administration. Tissue activator was extracted from the brain tissue after death or sacrifice for haematoma examination. The possible role of tissue activator in relation to haematoma development, and clinical implications of the results, are discussed.

Vasopressin enhances the clearance of β-endorphin immunoreactivity from rat cerebrospinal fluid

1990 ◽  
Vol 122 (2) ◽  
pp. 191-200 ◽  
Author(s):  
C. G. J. Sweep ◽  
Margreet D. Boomkamp ◽  
István Barna ◽  
A. Willeke Logtenberg ◽  
Victor M. Wiegant
Keyword(s):  
Cerebrospinal Fluid ◽  
Receptor Antagonist ◽  
Short Duration ◽  
Lateral Ventricle ◽  
Underlying Mechanism ◽  
Terminal Phase ◽  
Intracerebroventricular Injection ◽  
Intracerebroventricular Administration ◽  
Biphasic Pattern ◽  
The Brain

Abstract The effect of intracerebroventricular (lateral ventricle) administration of arginine8-vasopressin (AVP) on the concentration of β-endorphin immunoreactivity in the cerebrospinal fluid obtained from the cisterna magna was studied in rats. A decrease was observed 5 min following injection of 0.9 fmol AVP. No statistically significant changes were found 5 min after intracerebroventricular treatment of rats with 0.09 or 9 fmol. The decrease induced by 0.9 fmol AVP was of short duration and was found 5 min after treatment but not 10 and 20 min. Desglycinamide9-AVP (0.97 fmol), [pGlu4, Cyt6]-AVP-(4–9) (1.44 fmol), Nα-acetyl-AVP (0.88 fmol), lysine8-vasopressin (0.94 fmol) and oxytocin (1 fmol) when intracerebroventricularly injected did not affect the levels of β-endorphin immunoreactivity in the cerebrospinal fluid 5 min later. This suggests that the intact AVP-(1–9) molecule is required for this effect. Intracerebroventricular pretreatment of rats with the vasopressin V1-receptor antagonist d(CH2)5Tyr(Me)AVP (8.63 fmol) completely blocked the effect of AVP (0.9 fmol). In order to investigate further the underlying mechanism, the effect of AVP on the disappearance from the cerebrospinal fluid of exogenously applied β-endorphin was determined. Following intracerebroventricular injection of 1.46 pmol camel β-endorphin-(1–31), the β-endorphin immunoreactivity levels in the cisternal cerebrospinal fluid increased rapidly, and reached peak values at 10 min. The disappearance of β-endorphin immunoreactivity from the cerebrospinal fluid then followed a biphasic pattern with calculated half-lifes of 28 and 131 min for the initial and the terminal phase, respectively. Treatment of rats with AVP (0.9 fmol; icv) during either phase (10, 30, 55 min following intracerebroventricular administration of 1.46 pmol β-endorphin-(1–31)) significantly enhanced the disappearance of β-endorphin immunoreactivity from the cerebrospinal fluid. The data suggest that vasopressin plays a role in the regulation of β-endorphin levels in the cerebrospinal fluid by modulating clearance mechanisms via V1-receptors in the brain.

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