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 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.

Traumatic “TERSON SYNDROME PLUS”: Pneumocephalocele with optic atrophy

2020 ◽  
Vol 18 (2) ◽  
pp. 116-120
Author(s):  
Sanjoy Chowdhury ◽  
◽  
Madhumita Srivastava ◽  
Nilanjan Chowdhury ◽  
◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Atrophy ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Internal Limiting Membrane ◽  
Retinal Hemorrhage ◽  
Terson Syndrome ◽  
Nerve Sheath ◽  
Long Run ◽  
Magnetic Resonance Imaging Mri

Introduction. Terson Syndrome is subarachnoid hemorrhage (SAH) with sub retinal hemorrhage flowing through channel. Reduced vision in such fresh case is due to hemorrhage itself, blocking macula/other photo receptors in the long run macular cellophane retinopathy which causes profound visual loss. SAH causes neurological problems which can become a risk factor for evacuating blood from vitreous. Hypertension is commonest cause to cause Terson Syndrome, but trauma is also devastating cause as it can lead to irreversible visual consequences like total loss of perception of light or blindness. Aim. Here we describe a case of Terson Syndrome plus disease features SAH in frontal lobe. Description of the case. When there is traumatic pneumocephalocele, it gives space to blood to imbibe towards bony optic canal and form hematoma around nerve sheath which causes compression around the same and leads to optic atrophy. Optic nerve can be injured by direct traumatic dissection during road traffic accidents (RTA), but even without that blood may accumulate around optic nerve and in turn leads to formation of hematoma and subsequently pressure induced optic atrophy. Moreover, blood can slowly travel to sub hyaloid space/sub retinal space (beneath internal limiting membrane or sub ILM) with probable gliosis covering typical boat shaped blood as seen in this case. This sub ILM hemorrhage or gliosis may have resolved through three injections of Triamcinolone in the orbital floor (OFTA) near apex, but optic atrophy snatches vision. This protocol was followed to treat traumatic compressive (peri optic hematoma) optic neuropathy and traumatic retinopathy associated with sub hyaloid hemorrhage. Conclusion. Diagnosis of Terson syndrome plus disease was established by addressing all features on computed tomography (CT) scan and magnetic resonance imaging (MRI). Plus, features include pneumocephalus, optic nerve sheath hematoma, optic atrophy and gliosis over sub-hyaloid hemorrhage, typical boat shaped. The part of hemorrhage still endured as seen on optical coherence topography, but vision was lost by virtue of optic atrophy. OCT shows clot in sub hyaloid space.

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. 

Unilateral optic nerve relapse after acute lymphoblastic leukaemia remission

2021 ◽  
pp. 1-3
Author(s):  
Alia Mousli ◽  
Rim Abidi ◽  
Safia Yahyeoui ◽  
Samia Zarraa ◽  
Asma Belaid ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Complete Response ◽  
Optic Disk ◽  
Imaging Features ◽  
History Of ◽  
Abnormal Cells ◽  
Magnetic Resonance Imaging Mri ◽  
Oral Corticosteroid Therapy

Abstract Background: The aim of this case report is to describe the clinical presentation and imaging features of a patient with optic nerve leukaemic infiltration as the first site of relapse after complete response to systemic treatment. Materials and methods: We report the case of a 23-year-old man with history of acute lymphoblastic leukaemia (ALL) in complete remission. Six months later, the ocular examination revealed decreased visual acuity. Fundus examination showed a pale optic disk with blurred margins and multiple flame-shaped and dot and blot retinal haemorrhages in his left eye. A diagnosis of leukaemic infiltration to the optic nerve was made by magnetic resonance imaging (MRI). Cytological analysis of the cerebrospinal fluid did not show any abnormal cells or blasts. Results: A course of oral corticosteroid therapy was prescribed and 20 Gy of radiation was administered to the whole brain including the left orbit. Vision was improved dramatically in the left eye. Isolated optic nerve relapse of leukaemic infiltration is of paramount importance to early diagnosis, as vision can be saved if treatment with orbital radiotherapy is initiated promptly.

Some aspects of diagnosis and treatment of a сircumscribed form of choroidal hemangioma complicated by macular edema

2021 ◽  
pp. 240-246
Author(s):  
J.A. Magaramov ◽  
◽  
R.A. Loginov ◽  
O.B. Klepinina ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Macular Edema ◽  
Subretinal Fluid ◽  
Diagnostic Methods ◽  
Treatment Results ◽  
Transpupillary Thermotherapy ◽  
Choroidal Hemangioma ◽  
Nasal Side ◽  
Intraretinal Cysts

Introduction. The interest are rare cases of a сircumscribed choroidal hemangioma located juxtapapillary (JP) on the nasal side of the optic nerve disc (OND) and complicated by macular edema. Purpose. Studying the possibility of timely diagnosis and evaluating the effectiveness of treatment of a сircumscribed choroidal hemangioma complicated by macular edema. Material and methods. A retrospective analysis of the diagnostics and treatment results of 5 patients (5 eyes) with JP сircumscribed choroidal hemangioma, localized on the nasal side of the optic disc, complicated by macular edema, was carried out. Results. As a result, in all patients, already 1 month after the session of selective laser transpupillary thermotherapy (TTT), an increase in visual acuity and quality was observed, which was accompanied by pronounced resorption of intraretinal cysts and / or subretinal fluid in the macula. Conclusion. The purposeful use of modern diagnostic methods and the use of a sparing method of laser TTT makes it possible to identify and cure patients with CPCH complicated by macular edema without loss of visual functions. Key words: сircumscribed choroidal hemangioma, selective transpupillary thermotherapy, cystic macular edema.

Bilateral Optic Nerve Hypoplasia with Normal Visual Acuity

1978 ◽  
Vol 86 (4) ◽  
pp. 524-529 ◽  
Author(s):  
Ake Bjork ◽  
C.-G. Laureix ◽  
Ulla Laurell
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Nerve Hypoplasia ◽  
Normal Visual Acuity

scholarly journals Transconjunctival Cryo-Assisted Extraction of Intraconal Cavernous Hemangioma

2019 ◽  
Author(s):  
Ayman E Abd El Ghafar ◽  
Sameh M Saleh ◽  
Ahmed S Elwehidy
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Postoperative Complications ◽  
Cavernous Hemangioma ◽  
Effective Technique ◽  
Safety And Efficacy ◽  
Transconjunctival Approach ◽  
Subconjunctival Hemorrhage ◽  
Assisted Extraction ◽  
Retrobulbar Hemorrhage

Abstract Background The aim of this study is to evaluate the safety and efficacy of transconjunctival cryo-assisted orbitotomy for extraction of intraconal cavernous hemangioma. Methods The study was performed at the Mansoura ophthalmic center, Mansoura University, Egypt from May 2015 to August 2018. It included 18 patients with orbital intraconal cavernous hemangioma. In all cases, preoperative orbital MRI with contrast was performed, transconjunctival approach was used and cryo-assisted extraction of the lesion was performed. Cases were followed for six months after surgery. Results This study included 18 patients with intraconal cavernous hemangioma, ten females (55.6%) and eight males (44.4%) with a mean age 35.6 years. All lesions were located in the intraconal space, eight cases (44.5%) were lateral to the optic nerve, four cases (22.2%) were above the optic nerve, and six cases (33.3%) were below the optic nerve. Postoperative complications included three cases (16.7%) that showed postoperative diplopia due to lateral rectus paresis that improved in all cases within six months, one case (5.6%) that showed postoperative retrobulbar hemorrhage and proptosis that resolved within two weeks without sequelae, and four cases (22.2%) that showed subconjunctival hemorrhage, which resolved within two weeks. Of the two cases with drop of visual acuity preoperative, one case (5.6%) showed improvement of visual acuity and one case (5.6%) did not improve. Conclusions Transconjunctival cryo-assisted extraction of intraconal cavernous hemangioma represents a safe more conservative and effective technique.

scholarly journals Recurrent Self-Induced Nontraumatic Orbital Emphysema Causing Orbital Compartment Syndrome with Optic Nerve Dysfunction

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Compartment Syndrome ◽  
Valsalva Manoeuvre ◽  
First Case ◽  
Orbital Emphysema ◽  
History Of ◽  
Nerve Dysfunction ◽  
The Right ◽  
Needle Decompression

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.

scholarly journals SINDROM TOLOSA HUNT DENGAN KETERLIBATAN SARAF OPTIKUS

2019 ◽  
Vol 37 (1) ◽  
Author(s):  
Astra Dea Simanungkalit ◽  
Maria Larasati Susyono ◽  
Vivien Puspitasari
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Optic Nerve ◽  
Pain Relief ◽  
Clinical Syndrome ◽  
Orbital Apex ◽  
Corticosteroid Administration ◽  
Hunt Syndrome ◽  
Nerve Dysfunction ◽  
Optic Nerve Involvement

TOLOSA HUNT SYNDROME WITH OPTIC NERVE INVOLVEMENTABSTRACTTolosa Hunt syndrome (THS) is a very rare clinical syndrome, which is characterized by unilateral headaches accompanied by dysfunction and painful ophthalmic nerves. In some cases, optic nerve involvement can be found due to inflammation at the orbital apex. Corticosteroid administration is a management of THS with pain relief generally occurring in the first 72 hours. However, corticosteroid administration is not significantly associated with nerve dysfunction or visual acuity improvement.This article is a case report of women with STH and optic nerve involvement.Keywords: Tolosa Hunt syndrome, painful ophtalmoplegia, orbital apex, superior orbital fissureABSTRAKSindrom Tolosa Hunt (STH) adalah sindrom klinik yang sangat jarang, yang ditandai oleh nyeri kepala unilateral disertai disfungsi dan nyeri saraf penggerak bola mata (painful ophtamloplegia). Pada beberapa kasus, dapat ditemukan keterlibatan saraf optikus akibat inflamasi pada apeks orbita. Pemberian kortikosteroid merupakan tatalaksana STH dengan perbaikan nyeri umumnya terjadi pada 72 jam pertama. Meskipun demikian pemberian kortikosteroid tidak berhubungan secara signifikan dengan perbaikan disfungsi saraf penggerak bola mata maupun tajam penglihatan. Artikel ini merupakan laporan kasus perempuan dengan STH dan keterlibatan saraf optikus.Kata kunci: Sindrom Tolosa Hunt, painful ophtalmoplegia, apeksorbita, fisura orbitalis superior

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