scholarly journals Optic Neuritis in Patients with Type 2 Diabetes Mellitus: A Case Series

2021 ◽  
Author(s):  
Niharika Krishna Shetty ◽  
Divya Prasad
Keyword(s):  
Diabetes Mellitus ◽  
Optic Neuritis ◽  
Optic Neuropathy ◽  
Case Series ◽  
Methyl Prednisolone ◽  
Background Retinopathy ◽  
Ischaemic Optic Neuropathy ◽  
Ocular Movement ◽  
Time Of Presentation ◽  
Age Range

Diabetes mellitus is a group of metabolic disorders characterised by a high blood sugar level over a prolonged period of time. Ocular associations of diabetes include diabetic retinopathy, cataract, diabetic papillopathy, ocular movement disorders and optic neuritis. Optic neuritis is a clinical condition causing inflammation of the myelin sheet of optic nerve. This leads to alteration in the nerve conduction towards the brain. Diabetics are more commonly affected with anterior ischaemic optic neuropathy compared to papillitis or optic neuritis. The present case series is of diabetes associated papillitis. The patients were in the age range of 35-60 years. All the patients had poor visual acuity at presentation, mild disc oedema and disc elevation with no peripapillary haemorrhage, suggestive of papillitis. The patients had minimum background retinopathy and were hyperglycaemic at the time of presentation. The response to Intravenous (IV) methyl prednisolone, at a dose of 1 gm IV in 100 mL of normal saline, was good. Improvement to vision was seen within 3-5 days and improvement in colour vision was seen at the end of 11-15 days. Papillitis can be a manifestation of diabetes and should be kept as a differential diagnosis to non-arteritic ishaemic optic neuropathy. Optic neuropathies and background retinopathy may not co-exist. Poor systemic control of glycaemic level may directly co-relate to papillitis manifestation.

scholarly journals Distinguishing ischaemic optic neuropathy from optic neuritis by ganglion cell analysis

2016 ◽  
Vol 94 (8) ◽  
pp. e721-e726 ◽  
Author(s):  
Natalie Erlich-Malona ◽  
Carlos E. Mendoza-Santiesteban ◽  
Thomas R. Hedges ◽  
Nimesh Patel ◽  
Caitlin Monaco ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Ganglion Cell ◽  
Optic Neuropathy ◽  
Cell Analysis ◽  
Ischaemic Optic Neuropathy ◽  
Ganglion Cell Analysis

Fractal analysis of fluoroangiographic patterns in anterior ischaemic optic neuropathy and optic neuritis: a pilot study

2008 ◽  
Vol 36 (4) ◽  
pp. 323-328 ◽  
Author(s):  
Claudio Traversi ◽  
Giorgio Bianciardi ◽  
Annalisa Tasciotti ◽  
Elisa Berni ◽  
Elisabetta Nuti ◽  
...  
Keyword(s):  
Pilot Study ◽  
Optic Neuritis ◽  
Optic Neuropathy ◽  
Fractal Analysis ◽  
Ischaemic Optic Neuropathy ◽  
Anterior Ischaemic Optic Neuropathy

scholarly journals Non-Arteritic Anterior Ischaemic Optic Neuropathy: Treatment and Risk Factors

2020 ◽  
Vol 76 (2) ◽  
pp. 78-87
Author(s):  
Silvie Kalábová ◽  
Klára Marešová ◽  
Marta Karhanová
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Visual Acuity ◽  
Risk Factor ◽  
Optic Neuropathy ◽  
Systemic Risk ◽  
Systemic Disease ◽  
Department Of Ophthalmology ◽  
Ischaemic Optic Neuropathy ◽  
Anterior Ischaemic Optic Neuropathy

Aim: To ascertain whether various therapeutic procedures in non-arteritic anterior ischaemic optic neuropathy (NAION) have an impact on the resulting visual acuity of the affected eye. To assess the prevalence of risk factors that accompany this disease according to the literature. Methods: The retrospective study enrolled 55 eyes of 53 patients (41 men, 12 women) with an age range of 46 to 85 years (mean 64.9; median 64.0) who were hospitalized at the Department of Ophthalmology of the Faculty of Medicine and Dentistry and the University Hospital in Olomouc with the diagnosis of NAION between 2005 and 2016, and who received systemic treatment with intravenous vasodilators, either alone or in combination with intravenous corticosteroids. Central visual acuity (CVA) prior to treatment and immediately after its termination was evaluated. CVA was measured using the Snellen chart and is presented in decimal values. Using medical history data and medical records, the presence of systemic disease, namely hypertension, type 2 diabetes mellitus, and hypercholesterolaemia, was studied in these patients and evaluated for a possible association with NAION. Results: In the group of patients who were treated with intravenous vasodilators, the resulting CVA improved by 0.083 on average. In the group of patients who, in addition to vasodilator therapy, also received treatment with corticosteroids, the resulting CVA improved by only 0.03 on average. Although there was a more prominent improvement in CVA in the group treated with intravenous vasodilators alone, this difference was not statistically significant. At least one risk factor was found in the vast majority of the patients (96%). Eighty percent of the patients had hypertension, 43.6% of them were treated for diabetes mellitus, and 72.7% of the patients took drugs for hypercholesterolaemia. A combination of all these conditions was found in 36.4% of the patients. The proportion of smokers and past smokers did not exceed that of non-smokers. Conclusion: The mean improvement in the resulting CVA in patients after systemic therapy with vasodilators alone was greater than in those treated with a combination of vasodilators and corticosteroids; however, this difference was not statistically significant. In most patients in the group, at least one systemic risk factor was noted, most frequently hypertension. The prevalence rate of systemic risk factors was comparable to that reported in the literature.

MRI signs helpful in the differentiation of patients with anterior ischaemic optic neuropathy and optic neuritis

2021 ◽  
pp. bjophthalmol-2021-319537
Author(s):  
Valentina Daphne Petroulia ◽  
Dominik Brügger ◽  
Robert Hoepner ◽  
Rino Vicini ◽  
Anna Winklehner ◽  
...  
Keyword(s):  
White Matter ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
White Matter Lesions ◽  
Enhancement Pattern ◽  
Significant Information ◽  
Ischaemic Optic Neuropathy ◽  
Anterior Ischaemic Optic Neuropathy

Background/AimsThe aim of this study was to identify specific MRI characteristics of anterior ischaemic optic neuropathy (AION) and optic neuritis (ON) that would aid in the differentiation between these two diagnoses.MethodsWe retrospectively analysed a consecutive case series including all patients with an MRI study of brain and orbit and the clinical diagnosis of either ON or AION. We examined the scans for restricted diffusion of the optic nerve, optic sheath diameter, enhancement and location of enhancement of the optic nerve and distribution of the white matter lesions.ResultsFifty patients met the inclusion criteria. We found an accuracy of 0.98 for the discrimination between AION and ON based solely on parameters extracted from MRI data. Dominance analysis to determine the most influential parameters showed that the enhancement pattern of the optic nerve and distribution of the white matter lesions had the biggest impact on the classification and led to a discrimination accuracy of 0.9 when used alone.ConclusionIn patients with an inconclusive clinical diagnosis, optic nerve enhancement pattern and distribution of white matter lesions can aid in the diagnosis and differentiation between AION and ON. Diffusion-weighted imaging did not add significant information to the diagnosis or help to differentiate between the two conditions.

Herpetic Whitlow of the Hand in Infants

2020 ◽  
Author(s):  
Mohammad M. Al-Qattan ◽  
Nada G. AlQadri ◽  
Ghada AlHayaza
Keyword(s):  
Bacterial Infection ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Senior Author ◽  
Secondary Bacterial Infection ◽  
Clinical Appearance ◽  
History Of ◽  
Mode Of Transmission ◽  
Time Of Presentation

Abstract Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual case reports. We present a case series of six infants. Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following data were collected: age, sex, digit involved in the hand, mode of transmission, time of presentation to the author, clinical appearance, presence of secondary bacterial infection, presence of other lesions outside the hand, method of diagnosis, treatment, and outcome. Results All six infants initially presented with classic multiple vesicles of the digital pulp. In all cases, there was a history of active herpes labialis in the mother. Incision and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary bacterial infection. Conclusion The current report is the first series in the literature on herpetic whitlows in infants. We stress on the mode of transmission (from the mother) and establishing the diagnosis clinically. In these cases, no need for obtaining viral cultures or polymerase chain reaction; and no medications are required. Once the vesicles are disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir and intravenous antibiotics will be required.

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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