scholarly journals Revisiting the Awareness and Understanding the Associations between Intracranial Tumors and Optic Neuropathy

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2374
Author(s):  
Tomasz Żarnowski ◽  
Urszula Łukasik ◽  
Iwona Żarnowska ◽  
Ewa Kosior-Jarecka
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Retrospective Analysis ◽  
Color Vision ◽  
Optic Neuropathy ◽  
Clinical Picture ◽  
Wide Spectrum ◽  
Differential Diagnostics ◽  
Intracranial Tumors ◽  
Clinical Scenarios

The aim of this paper is to report clinically various cases of intracranial tumors in patients referred to glaucoma clinic for consultation. The secondary aim was to increase the awareness of intracranial tumors in atypical cases of glaucoma. We present the retrospective analysis of five patients referred to glaucoma clinic for consultation. Due to atypical course of the disease, in addition to standard glaucoma examinations, all patients had a neurologic full visual field, color vision, and MRI done. In all patients, intracranial malignancies were found, some patients underwent surgery of the lesions with consecutive clinical improvements. Interestingly, in some patients, coexisting glaucoma was diagnosed. Patients were selected deliberately to present a wide spectrum of possible clinical scenarios when glaucoma may be complicated by intracranial tumors. Sometimes, the relevance of intracranial tumors with respect to their influence on the clinical picture of the optic nerve cannot be established. To conclude, in the “atypical cases of glaucoma” the assessment of the optic nerve may indicate the necessity of neuroimaging in differential diagnostics.

Post-decompression optic neuropathy

1985 ◽  
Vol 63 (2) ◽  
pp. 196-199 ◽  
Author(s):  
Roy W. Beck ◽  
Harry S. Greenberg
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Neuropathy ◽  
Fiber Bundle ◽  
Visual Field Loss ◽  
Intracranial Tumors ◽  
Visual Recovery ◽  
Content Type ◽  
Decompressive Craniotomy ◽  
Fine Print

✓ Blindness resulting from a decompressive craniotomy is uncommon. Five patients with intracranial tumors and papilledema who developed a bilateral optic neuropathy during an apparently uncomplicated craniotomy are presented. Symptoms of visual field loss were minimal preoperatively in four. Visual recovery in general was poor. The nerve fiber bundle pattern of visual field loss in these cases implicates the optic disc as the site of damage in this disorder. It is postulated that hypoperfusion to the prelaminar portion of the optic nerve is the underlying cause.

Clinical and Etiological Profile of Patients with Optic Disc Edema in Tertiary Care Centre of Nepal

2019 ◽  
Vol 41 (1) ◽  
pp. 24-30
Author(s):  
Ritish K Shah
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Optic Neuritis ◽  
Color Vision ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Tertiary Care ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Edema ◽  
Disc Edema

Introduction: Optic disc edema can be a manifestation of various neurological disorders. Identification of those causes is possible in most cases using tests like visual acuity, color vision, visual field and suitable radiological imaging. Study in Nepalese population with regard to optic disc edema is scarce. Hence this study aims to act as a guideline for evaluation of such cases and help in further studies in this regard. Methods: A descriptive, cross-sectional study was conducted in all cases of optic disc edema presenting to neuro-ophthalmology clinic of B.P. Koirala Lions Centre for Ophthalmic Studies from January 2011 to June 2012. A detailed history was obtained and proper ocular and nervous examination was done by ophthalmologist and neuro-physician. Assessment of visual acuity, color vision, contrast sensitivity and visual field along with radiological tests were done in all possible cases. Results: Out of all the cases evaluated, 38 cases where causes of optic disc edema could be established were included in the study. The commonly affected age group was 31 to 40 years (26.3%) and most of them were males. The commonest cause observed was optic neuritis (36.8%). Others were papilledema, idiopathic intracranial hypertension, toxic optic neuropathy, non-arteritic anterior ischemic optic neuropathy (NA-AION), compressive and traumatic optic neuropathy. Conclusion: Optic neuritis and papilledema should be considered as common differential diagnosis in patients with optic disc edema. NA-AION is a relatively uncommon disease among Nepalese population.

Acquired Optic Nerve Diseases

Visual Fields ◽  
2010 ◽  
Author(s):  
Peter A. Quiros ◽  
Alfredo A. Sadun
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Neuritis ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Mass Effect ◽  
Ischemic Optic Neuropathy ◽  
Optic Nerve Diseases

This chapter focuses on the most frequently acquired optic nerve diseases: their signs and symptoms, visual field findings, and the required basic workup and management. Acquired optic nerve diseases are often vision threatening and sometimes even life threatening. There is a need for accurate and timely diagnosis. Therefore, it is incumbent on the clinician to identify optic neuropathies, separate them from chronic congenital and hereditary problems, and aggressively pursue the diagnosis and treatment as necessary. In the workup of optic neuropathies, the visual field is extremely helpful. All patients with suspected optic neuropathies require careful examination of the visual fields for detection, characterization, and monitoring. Acquired optic neuropathies include inflammatory, ischemic, compressive, metabolic, and central nervous system–reflected pathology (papilledema). Inflammatory optic neuropathies include optic neuritis and its various etiologies such as demyelination, infective, immune-mediated (atypical), and slowly progressive/ chronic. Ischemic optic neuropathies include nonarteritic ischemic optic neuropathy (NAION) and arteritic ischemic optic neuropathy (AAION). Metabolic optic neuropathies include nutritional and/or toxic etiologies. Compressive optic neuropathies can occur due to mass effect on the disc optic, gliomas, and perioptic meningiomas. Papilledema may be primary (pseudotumor cerebri) or secondary to central nervous system mass effect. Optic neuritis is defined as a primary inflammation of the optic nerve. It is characterized by central visual loss that worsens over days and usually peaks about 1 to 2 weeks after the onset. It is usually unilateral but may be bilateral, especially in children, following viral infections like measles, mumps, and chickenpox. It occurs most commonly in adults (18-45 years old). Orbital or periocular pain may be present or precede the visual loss and is exacerbated with eye movements. Etiologies include demyelinating diseases/multiple sclerosis;, idiopathic, viral, or bacterial infections (syphilis); contiguous inflammation of the meninges, orbit, or sinuses,; granulomatous inflammation (tuberculosis, sarcoidosis, and cryptococosis); and autoimmune diseases. It is the most common cause of acute visual loss from optic nerve disease in the young and middle-aged adult group.

scholarly journals Optic Nerve Head Microcirculation in Eyes with Vogt-Koyanagi-Harada Disease Accompanied by Anterior Ischemic Optic Neuropathy

2021 ◽  
pp. 899-908
Author(s):  
Yui Yamashita ◽  
Yuki Hashimoto ◽  
Kenichi Namba ◽  
Kazuomi Mizuuchi ◽  
Susumu Ishida
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Optic Nerve Head ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Swelling ◽  
Vkh Disease ◽  
Field Defects

Anterior ischemic optic neuropathy (AION) is infrequently complicated with Vogt-Koyanagi-Harada (VKH) disease. We quantitatively examined sequential changes in the morphology and circulation hemodynamics, using a C-scan of optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG) in a patient with VKH disease accompanied by AION. A 65-year-old female complained of blurred vision in both of her eyes. The patient presented with optic disc swelling and remarkable choroidal thickening detected by OCT bilaterally. The diagnosis of VKH disease was established based on the presence of pleocytosis detected in the cerebrospinal fluid and hypofluorescent dark dots scattered all around the fundus, detected by indocyanine green angiography. Goldmann perimetry detected visual field defects, similar to superior altitudinal hemianopsia in the right eye and similar to inferior altitudinal hemianopsia in the left eye. The patient was suspected to have developed AION in both eyes. The patient received methylprednisolone pulse therapy, followed by oral prednisolone. With these treatments, the optic disc swelling disappeared. However, optic disc atrophy with visual field defects remained in both eyes. An OCT C-scan showed the ganglion cell complex (GCC) and circumpapillary retinal nerve fiber layer (cpRNFL) thickness getting thinner below the normal range, and LSFG showed the decrease in optic nerve head (ONH) tissue microcirculation. These results supported the occurrence of AION in this patient with VKH disease. The analysis of GCC and cpRNFL thickness and ONH microcirculation would be useful for supporting the occurrence of AION in a case of VKH disease.

scholarly journals Removal of an Impaled Intraocular Hair Comb Following Self-inflicted Trauma

2020 ◽  
Vol 4 (1) ◽  
pp. 8-11
Author(s):  
Michele Markovitz ◽  
Jordan Hamburger ◽  
Brian Fromm ◽  
Brendan Carr ◽  
Xiao Zhang
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
Ocular Trauma ◽  
Wide Spectrum ◽  
Saline Irrigation ◽  
Globe Rupture ◽  
Orbital Wall

Ocular trauma is one of the most common and vision-threatening ophthalmic presentations with a wide spectrum of complications, such as bleeding, infection, vision loss, and enucleation. A 64-year-old-male presented to the emergency department (ED) with a self-inflicted orbital penetrating injury with a hair comb. Computed tomography showed the comb traversed the medial orbit inferior to the medial rectus but did not damage the optic nerve; there were no globe or orbital wall fractures. His ocular exam was significant for a right eye afferent pupillary defect and decreased visual acuity 20/800, consistent with optic neuropathy. Primary concerns were stabilizing and removing the foreign body without causing further damage in the setting of an uncooperative patient. The comb was removed with the aid of local and systemic analgesia using gentle traction and normal saline irrigation. The patient was admitted for systemic and topical antibiotics and showed improvement in visual acuity and resolution of his optic neuropathy. This case illustrates the importance of rapid ED assessment and management of complex penetrating ocular trauma. Examination should specifically look for signs of globe rupture and optic nerve injury. Expedited foreign body removal should be managed together with an ophthalmologist with procedural sedation and broad-spectrum antibiotics to avoid further visual and infectious complications.

Optic Nerve Sheath Meningiomas: Visual Improvement after Stereotactic Radiotherapy

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 950-957 ◽  
Author(s):  
James K. Liu ◽  
Scott Forman ◽  
Gerard L. Hershewe ◽  
Chitti R. Moorthy ◽  
Deborah L. Benzil
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Color Vision ◽  
Stereotactic Radiotherapy ◽  
Optic Nerve Sheath ◽  
Dramatic Improvement ◽  
Visual Deterioration ◽  
Nerve Sheath ◽  
The Right

Abstract OBJECTIVE: The management of primary optic nerve sheath meningioma (ONSM) is controversial. Surgery often results in postoperative blindness in the affected eye and thus has been abandoned as a treatment option for most patients. When these tumors are left untreated, however, progressive visual impairment ensues, which also leads to blindness. Recently, radiation therapy has gained wider acceptance in the treatment of these lesions. Experience with stereotactic radiotherapy (SRT) in the treatment of ONSMs is limited because of the rare incidence of this tumor. We present a series of patients with ONSM who were treated with SRT. METHODS: Five patients (three women, two men), ranging in age from 40 to 73 years, presented with progressive visual loss with decreased visual field, visual acuity, and color vision affecting six eyes (one patient had tumor involving both optic nerves). One patient also presented with proptosis and diplopia. Five eyes had functional residual vision (range, 20/20 to 20/40), and one eye was completely blind. All five patients were diagnosed clinically and radiographically to have an ONSM. Three were intraorbital, one was intracanalicular as well as intraorbital, and one was a left ONSM extending through the optic foramen into the intracranial space and involving the right optic nerve. The five functional eyes were treated with SRT by use of 1.8-Gy fractions to a cumulative dose of 45 to 54 Gy. RESULTS: Follow-up ranged from 1 to 7 years, and serial magnetic resonance imaging revealed no changes in the size of the tumor in all five patients. Four patients experienced dramatic improvement in visual acuity, visual field, and color vision within 3 months after SRT. One patient remained stable without evidence of visual deterioration or disease progression. None had radiation-induced optic neuropathy. CONCLUSION: SRT may be a viable option for treatment of primary ONSM in patients with documented progressive visual deterioration, and it may be effective in improving or stabilizing remaining functional vision.

Bilateral simultaneous non-arteritic ischaemic optic neuropathy: a rare complication of idiopathic systemic capillary leak syndrome (SCLS)

2021 ◽  
Vol 14 (5) ◽  
pp. e242847
Author(s):  
Yan Ning Neo ◽  
Manvi Sobti ◽  
Hadi Zambarakji
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Neuropathy ◽  
Capillary Leak Syndrome ◽  
Fluid Replacement ◽  
Visual Field Defects ◽  
Capillary Leak ◽  
Systemic Capillary Leak Syndrome ◽  
Severe Hypotension ◽  
Ischaemic Optic Neuropathy

We report a case of bilateral symmetrical superior visual field defects in a 72-year-old man first reported during the recovery from systemic capillary leak syndrome (SCLS). During the acute illness, he required extensive and prolonged fluid replacement and mechanical ventilation for severe hypotension, shock and multiorgan dysfunction. His visual field defect and optic nerve changes were consistent with a diagnosis of ischaemic optic neuropathy. These remained unchanged over 3 years and he retained excellent 6/7.5 visual acuity bilaterally. We hypothesised the mechanism of bilateral segmental infarction of the optic nerve head to be caused by the hypercoagulable and hypovolaemic state, in addition to pre-existing vascular disease and hypertension. This case highlights the importance of including optic nerve examination in the management plan of SCLS, particularly in individuals with underlying vascular risk factors.

scholarly journals An Unusual Presentation of Horton’s Disease

2018 ◽  
Vol 2 (3) ◽  
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Inflammatory Disease ◽  
Clinical Picture ◽  
Temporal Artery ◽  
Unusual Presentation ◽  
Biological Assessment ◽  
Choroidal Perfusion ◽  
Horton’S Disease

Horton’s disease or temporal giganto cellular arteritis is an inflammatory disease of the vessels, particularly affecting older female. We report the case of a 50-year-old patient with a classic clinical picture of anterior arteritic optic neuropathy with ischemia of the optic nerve, with a horizontal level and hypo-choroidal perfusion of the corresponding territory. The peculiarity in this patient is the negativity of the biological assessment and biopsy of the temporal artery

scholarly journals Amiodarone-Associated Optic Neuropathy

2018 ◽  
Vol 80 (4) ◽  
pp. 33-64
Author(s):  
Sara L. Weidmayer
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Neuropathy ◽  
Visual Function ◽  
Temporal Relationship ◽  
Visual Field Loss ◽  
Fiber Layer ◽  
Permanent Loss ◽  
Inferior Quadrant ◽  
Insight Into

A 72-year old male presented symptomatic for unilateral inferior visual field loss, but was found to have bilateral optic neuropathy. Clinical features, an extended minimally symptomatic course and a temporal relationship to amiodarone use implicated amiodarone-associated optic neuropathy.  Serial ancillary testing analyses provided insight into this entity’s natural course.  This patient developed the greatest retinal nerve fiber layer thinning in the inferior quadrant; this may correlate with anatomically larger-diameter axons, supporting a previous publication which suggested that larger-diameter optic nerve axons are more susceptible to amiodarone-induced lipidosis. While rare, amiodarone-associated optic neuropathy may develop and cause permanent loss of visual function.

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