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Optic Neuropathies Associated with Systemic Disorders And Radiation-Induced Optic Neuropathy
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
GCA is a systemic vasculitis affecting large to medium-sized arteries. This disease shows preferential involvement of the ophthalmic artery and its branches, including the posterior ciliary arteries and the central retinal artery. Pathologically, GCA is characterized by granulomatous inflammation and narrowing (or occlusion) of extradural arteries with an internal elastic lamina (11–13). Giant cell arteritis is diagnosed predominantly in elderly adults, with cases under the age of 50 years being rare, and the incidence increasing with advancing age (13). The diagnosis is more common in females, with a threefold relative risk in women compared to men (13). Of note, GCA is more likely to affect Caucasians relative to other ethnic groups (13).
Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Atherosclerotic narrowing of the posterior ciliary arteries may result in nonarteritic optic nerve infarction – especially after an episode of hypotension. The arteritic form may follow giant cell arteritis, also known as Horton’s disease, or other inflammatory conditions such as periarteritis nodosa, systemic lupus erythematosus, chickenpox, and amyloidosis. The nonarteritic form is linked to acute ischemia of the optic nerve that is secondary to low blood flow in the posterior ciliary arteries.
Cranial Neuropathies II, III, IV, and VI
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Tanyatuth Padungkiatsagul, Heather E. Moss
The RGCs in the retina derive their blood supply from the central retinal artery. The optic nerve head is supplied by a circular anastomosis of the posterior ciliary arteries called the circle of Zinn–Haller. These anastomoses are variable and scant, so the optic nerve head can be a watershed area.3 The posterior ciliary arteries and the central retinal artery are both branches of the ophthalmic artery, which is the first branch of the internal carotid artery.
Imaging-based Assessment of Choriocapillaris: A Comprehensive Review
Published in Seminars in Ophthalmology, 2023
Rohan Bir Singh, Tatiana Perepelkina, Ilaria Testi, Benjamin K. Young, Tuba Mirza, Alessandro Invernizzi, Jyotirmay Biswas, Aniruddha Agarwal
The arterial blood supply to the choroid predominantly arises from the ophthalmic artery branches from the internal carotid artery.19 The ophthalmic artery branches into two posterior ciliary arteries (in 48% of eyes) or three posterior ciliary arteries (in 38% of eyes). The posterior ciliary branches into the medial and lateral posterior ciliary arteries, showing different anatomical variations. The long posterior ciliary arteries arise from the medial and lateral posterior ciliary arteries, whereas the short posterior ciliary arteries arise from other branches of the posterior ciliary arteries. These branches are further divided into choroidal arterioles, which ultimately branch and segmentally feed into the choriocapillaris lobule.17 The recurrent branches of the long posterior and anterior ciliary artery supply the anterior choriocapillaris, and the short posterior ciliary arteries primarily supply the posterior choriocapillaris.
Simultaneous Unilateral Abducens Nerve Palsy and Contralateral Anterior Ischaemic Optic Neuropathy as the Presenting Signs of Giant Cell Arteritis
Published in Neuro-Ophthalmology, 2023
Leonardo E. Ariello, Thais de Souza Andrade, Luiz Guilherme Marchesi Mello, Maria Kiyoko Oyamada, Leonardo Provetti Cunha, Mário L. R. Monteiro
In GCA, the vasculitic process involves transmural inflammation of large and middle-sized arteries.7 Although the inflammatory response starts in the internal elastic lamina, the entire arterial wall can be involved during its progression.8 Visual manifestations are extremely important in the clinical setting of GCA. One of the most serious ocular complications is the involvement of the short posterior ciliary arteries leading to anterior ION, which accounts for approximately 80% of cases with visual loss.9 Posterior ION, choroidal ischaemia, and retinal arterial occlusions are other causes of visual impairment.10 Less commonly but also very importantly, vasculitis may affect the efferent ocular pathway mostly of the distal portion of the oculomotor system, causing diplopia.
Transient vision loss after optic nerve sheath fenestration
Published in Orbit, 2020
Bayan Al Othman, Jared Raabe, Amina Malik, Helen Li, Ashwini Kini, Andrew G. Lee
In our case of post-ONSF-related visual loss, the patient had acute inflammatory orbital signs including proptosis, chemosis, pain with eye movement, and significant periorbital edema along with extensive orbital enhancement and inflammation on the post-contrast MRI of the orbit. Table 1 summarizes the previous cases of transient vision loss after optic nerve sheath fenestration (ONSF) reported by Brodsky and Rettele, Flynn et al., and Knight et al.5–7 Two out of three cases were treated with IV steroids followed by an oral steroid taper. The third report did not discuss treatment, but all three patients were reported to have experienced eventual significant recovery. In these cases, post-operative ophthalmoscopy revealed disc edema in two-thirds cases.5,7 In one case it showed occlusion of cilioretinal and long posterior ciliary arteries, as well as increased retinal arterial caliber and venous pulsations.7 Post-operative MRI was only mentioned in one case and showed no signs of orbital or nerve sheath hemorrhage.5 Clinical evidence of inflammation (conjunctival chemosis and eyelid edema) was described in one case.7