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Optical Coherence Tomography (Oct) and Fundus Fluorescein Angiography (FFA) in Neuro-Ophthalmology
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Ramandeep Singh, Deeksha Katoch, Mohit Dogra, Basavaraj Tigari, Simar Rajan Singh, Sahil Jain, Bruttendu Moharana, Sabia Handa, Mangat R. Dogra
On ocular examination the patient could not perceive light from either eyes. There was no relative afferent pupillary defect. Right eye fundus view was hazy due to the presence of cataract. Fundus examination showed bilateral pale disc edema (Figure 3A.6a and b). On palpation, the bilateral temporal artery was palpable. Clinical diagnosis of Bilateral Arteritic Anterior Ischemic Optic Neuropathy was considered. The patient received intravenous methyl prednisone (1 gram per day for 5 days). Fundus fluorescein angiography was planned. FFA showed patchy and delayed choroidal filling (Figure 3A.6c) with disc perfusion defect in choroidal phase. Late phase (Figure 3A.6d) showed disc staining.
Surgical treatment of macular holes
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Kamal Kishore, Gholam A Peyman
Melberg and Thomas198 described the occurrence of visual field defects after pars plana vitrectomy for macular hole surgery. Other authors subsequently reported similar cases.199–;205 Field defects are generally seen as an absolute scotoma in the inferior or temporal field (Fig. 33.21), and may be accompanied by segmental optic nerve pallor, a relative afferent pupillary defect,201 or decreased nerve fiber layer thickness in the affected segment.202,206 The incidence of peripheral visual field loss was 16% in a retrospective study.200 Anterior ischemic optic neuropathy and branch retinal arteriolar occlusion have accounted for visual field loss in some eyes.200 Postoperative glaucoma may cause arcuate visual field loss in some eyes.205
Clinical Applications of IVIM MRI to the Nervous System
Published in Denis Le Bihan, Mami Iima, Christian Federau, Eric E. Sigmund, Intravoxel Incoherent Motion (IVIM) MRI, 2018
Anterior ischemic optic neuropathy refers to a specific infarction of the optic nerve at the level of the optic disc, resulting in sudden, painless vision loss. In clinical practice, conventional MRI provides little information on the microcirculation disorders underlying this disease, probably because of the small region involved in a distal perfusion region. This might not be a problem for IVIM perfusion imaging because of the local nature of the method. Indeed, in an impressive study, Lu et al. [16] found a significant reduction in the IVIM perfusion fraction in the optic disc affected by anterior ischemic optic neuropathy compared to the nonaffected contralateral side, as well as compared to normal control. They suggest that IVIM could be helpful for the diagnosis as well as for the assessment of the treatment efficacy or prognosis of this disease.
Interferon Alpha-2a Treatment for Post-Uveitic Refractory Macular Edema
Published in Ocular Immunology and Inflammation, 2020
L. De Simone, A. Sangiovanni, R. Aldigeri, V. Mastrofilippo, E. Bolletta, A. Invernizzi, L. Fares, N. Pipitone, L. Fontana, C. Salvarani, L. Cimino
IFN alpha-2a therapy proved to be safe and well tolerated in our patients. Flu-like syndrome occurred in all patients at treatment initiation and was considered as an indirect sign of response to IFN alpha 2a, as suggested by Deuter et al.10,11 Minor side effects of IFN apha2a therapy, such as fatigue, dysthyroidism, fibromyalgia, and psoriasis reactivation, were infrequent in our cohort. Dysthyroidism and psoriasis (worsening or de novo onset) have been previously described in literature in correlation with IFN treatment.23,24, In our series no case of depression and no serious adverse event were reported. IFN-induced retinopathy has been reported in the past, mostly in patients with hepatitis or multiple Sclerosis treated with Interferon-ß.25 Anterior ischemic optic neuropathy has also been reported in patients treated with IFN.26 None of these ocular complications occurred in our cohort.
Optical Coherence Tomography-Based Scattering Properties of Retinal Vessels in Glaucoma Patients
Published in Current Eye Research, 2018
Robert Kromer, Sebastian Boelefahr, Brendan Eck, Shafin Rahman, Maren Klemm
The medical history and records of all participants were reviewed for diseases that could possibly affect the retinal nerve fiber layer (RNFL). Only participants satisfying inclusion and exclusion criteria were included. The ophthalmic inclusion criteria for all patients were that they needed to have (i) best-corrected visual acuity of 0.3 LogMAR or better, (ii) spherical equivalent within ± 5.0 diopters, and (iii) normal results for visual field testing. The exclusion criteria were (i) intense alcohol abuse, (ii) body mass index > 30 kg/m2, (iii) anterior ischemic optic neuropathy, (iv) congenital abnormalities of the optic nerve, (v) untreated cardiovascular diseases, and (vi) post status cardiovascular events (e.g. myocardial infarctions). Inclusion and exclusion criteria for patients with OAG were the same, with the exception of the normal visual field testing results.
Ocular Blood Volume Index Based on Scattering Properties of Retinal Vessels Using Spectral Domain Optical Coherence Tomography
Published in Current Eye Research, 2019
Robert Kromer, Brendan Eck, Shafin Rahman, Carsten Framme
Each participant’s history and medical records were carefully reviewed for retinal and cardiovascular diseases. Only participants satisfying inclusion and exclusion criteria were included. The ophthalmic inclusion criteria were: (i) best-corrected visual acuity of 0.3 LogMAR or better; (ii) spherical equivalent within ± 5.0 diopters; and (iii) cylindrical correction within ± 2.0 D. The exclusion criteria were: (i) intense alcohol abuse; (ii) body mass index > 30 kg/m2; (iii) IOP ≥ 21 mmHg; (iv) anterior ischemic optic neuropathy; and (v) congenital abnormalities of the optic nerve. Participants with any known cardiovascular diseases or risk factors were excluded from the study.