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

BMC Ophthalmology ◽

10.1186/s12886-019-1246-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

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 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/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/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/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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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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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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Establishing an experimental model of photodynamically induced anterior ischemic optic neuropathy

Visual Neuroscience ◽

10.1017/s0952523810000398 ◽

2011 ◽

Vol 28 (2) ◽

pp. 155-162 ◽

Cited By ~ 5

Author(s):

R.S. WANG ◽

P.L. LV ◽

W.J. WANG ◽

X.D. WANG ◽

X.J. ZHANG ◽

...

Keyword(s):

Optic Disc ◽

Optic Neuropathy ◽

Visual Evoked Potential ◽

Nerve Fibers ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Fundus Fluorescein Angiography ◽

Functional Changes ◽

Depth Study ◽

Flash Visual Evoked Potential

AbstractNumerous methods and drugs have been used to treat anterior ischemic optic neuropathy (AION); however, further investigations to determine the value of treatments for AION have been impeded by the lack of appropriate animal models of AION, significantly impacting on in-depth study of the disease. A rat model of AION was established, and corresponding functional changes of the fundus were observed using fundus fluorescein angiography (FFA), optical coherence tomography (OCT), and flash visual-evoked potential (F-VEP) in order to confirm the reliability of the AION model histopathologically. One day after model establishment, histopathology demonstrated that portions of the optic disc were highly edematous, with edema of nerve fibers and loose tissue, accompanied by displacement of the surrounding retina. At 23 days, the optic disc and surrounding nerve fiber layers had become thinner. None of the above-mentioned changes was observed in the laser, hematoporphyrin derivative (HPD), or naive groups. The results of fundus, FFA, F-VEP, and OCT—within 90 days after model establishment—confirmed that krypton red laser irradiation (647 nm), applied 2 h after HPD injection, can establish an ideal animal model of AION.

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A Case of Streptococcus Suis Meningitis With Visual Impairment and Hearing Loss Diagnosed by Metagenomic Next-generation Sequencing

10.21203/rs.3.rs-636827/v1 ◽

2021 ◽

Author(s):

Haina Zhao ◽

Lanlan Chen ◽

Lin Zhu ◽

Tingting Qiao ◽

Peipei Liu ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Hearing Loss ◽

Next Generation Sequencing ◽

Infectious Diseases ◽

Visual Impairment ◽

Vision Loss ◽

Streptococcus Suis ◽

Next Generation ◽

The Right ◽

Generation Sequencing

Abstract Background: Streptococcus suis is responsible for several kinds of zoonosis worldwide. It can cause meningitis, sepsis, osteoarthritis, endocarditis, endophthalmitis, and other diseases. Human infection typically occurs in occupational settings associated with pig husbandry or pork processing. At present, metagenomic next-generation sequencing (mNGS) is prominent testing method for achieving an early and rapid diagnosis of some infectious diseases. Case presentation: A 48-year-old Chinese man who denied exposure to pigs or pork was to admitted the hospital because he had experienced a fever for three days, visual impairment, and hearing loss for one day. After a series of examinations and laboratory tests, Streptococcus suis was detected in the aqueous humor culture as well as the vitreous humor and cerebrospinal fluid with mNGS. But bacteria were not detected in the blood or cerebrospinal fluid culture. The patient's condition improved, and he was discharged after 2 weeks of active treatment. However, at present, poor vision in the right eye, poor hearing in the right ear and recurrent vertigo remain.Conclusions: In a patient presenting with meningitis, vision loss, and/or hearing loss, Streptococcus suis infection should be strongly suspected regardless of the patient's occupation. mNGS has excellent diagnostic value to determine which was the etiological agent for infectious diseases.

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

European Journal of Ophthalmology ◽

10.1177/1120672120962063 ◽

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.

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Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence

Case Reports in Ophthalmological Medicine ◽

10.1155/2021/5126254 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Rika Tsukii ◽

Yuka Kasuya ◽

Shinji Makino

Keyword(s):

Visual Acuity ◽

Visual Field ◽

Optic Disc ◽

Optic Neuropathy ◽

Visual Field Defect ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Optic Disc Swelling ◽

The Right ◽

Field Defect

To report a patient with nonarteritic anterior ischemic optic neuropathy (NA-AION) occurring soon after the COVID-19 vaccination. A 55-year-old woman presented with a 4-day history of inferior visual field disturbance in the right eye 7 days after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. Examination revealed a best-corrected visual acuity of 20/20 in both eyes. A relative afferent pupillary defect was observed in the right eye. Fundoscopy revealed diffuse optic disc swelling in the right eye, which was prominent above the optic disc. Goldmann visual field testing identified an inferior altitudinal visual field defect with I/2 isopter in the right eye. Although typical complete inferior visual field defect was not detected, a diagnosis of NA-AION was made. The patient was followed without any treatment. During the 2-month follow-up period, the optic disc swelling was gradually improved, and visual acuity was maintained 20/20; however, the optic disc looked diffusely pale in the right eye. Although it is uncertain whether the development of NA-AION after COVID-19 vaccination was consequential or coincidental, we speculate that the close temporal relationship with COVID-19 vaccination suggests the possibility of vasculopathy on the microvascular network of optic nerve head as background of inflammatory or immune-mediated element to the timing of the onset of NA-AION. The aim of this case report is to present this biological plausibility and to elucidate potential ophthalmological complications.

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