China
Africa
Explore chapters and articles related to this topic
Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Absence of: Prominent sensory signs.Visual disturbances.Autonomic dysfunction (excluding spastic bladder, which may be present).Parkinson's disease.Alzheimer's-type dementia.ALS “mimic syndromes” (see Differential Diagnosis, above).
Ophthalmic system
Published in Pankaj Desai, Pre-eclampsia, 2020
There are some subjects in whom the visual disturbance does not get completely reversed. These are subjects who have a central cause of visual disturbance. Optic nerve fibres once emerging from the deep layer of the retina goes to the optic chiasma. From the optic chiasma, these fibres pass to the occipital lobe from where they are directed to the anterior brain. In subjects with the central cause of visual disturbances, the cause of visual disturbance is at the occipital lobe. It usually causes permanent damage to nerve fibres here. Unluckily, this central cause does not reverse because the damage is permanent. The women in such a situation may not get the complete restoration of vision. This is because of the central nervous system having an inherent inability to regenerate and repair once injured or destroyed.
Adrenoleukodystrophy
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Visual disturbances are common in these patients and may occur early. Homonymous hemianopsia has been observed in at least two patients [2], and there may be a striking loss in visual recognition of objects. There may be a transient horizontal nystagmus in the early stages of visual loss. There may be strabismus or double vision. Ultimately, virtually all patients have a loss of vision as a prominent feature. Optic atrophy is usually a late finding, but rarely it may be seen early. The pupillary response to light remains intact until late in the illness. Hearing loss is also characteristic and may occasionally be seen as an early finding. Difficulty in understanding speech in a noisy room or over the telephone may be an early sign of impaired auditory discrimination. In testing patients at risk, the earliest manifestations may be detected by neuropsychometric testing for abnormalities in visual or auditory processing, new learning or short-term visual memory [26].
Recurrent Uveitis Related to Ibrutinib for Treatment of Chronic Lymphocytic Leukemia
Published in Ocular Immunology and Inflammation, 2022
Parsa Mehraban Far, Jacob Rullo, James Farmer, Todd Urton
The clinical significance of our case report in the context of previously published cases is unknown due to the complex nature of systemic medication interactions on the development and severity of idiopathic uveitis. The findings present in this paper complement the ocular adverse events reported by the U.S. Food and Drug Administration (FDA) based on both animal and clinical studies. The original studies performed on canine models demonstrated only corneal toxicity as a potential ocular adverse effect in animals receiving high-dose ibrutinib.13 The most recent report published by the FDA based on a decade of evidence from randomized controlled trials also recognizes ocular manifestations as an important adverse event and highlights that 11% of ibrutinib patients from a large cohort of 1157 patients experienced decreased or blurred vision of any grade within a median of 91 days after starting the medication.14 The visual disturbance experienced by these patients persisted until the termination of the studies in 40% of the patients, highlighting the importance of intervening early and aggressively.14 Based only on the limited information available from these randomized controlled trials, however, the exact etiology behind vision loss in this subgroup of patients is unknown.
Common systemic medications that every optometrist should know
Published in Clinical and Experimental Optometry, 2022
A number of case studies have reported ocular complications associated with PPI use. Six reports detailed findings of irreversible anterior ischaemic optic neuropathy with PPI use.77 However, a large retrospective cohort study of 94,063 subjects showed a minimal association between inflammatory and vascular disorders of the eye and omeprazole or histamine H2-receptor antagonists.78 However, when the data was analysed dividing the patients into separate medication groups, researchers discovered an increased risk of visual impairment in the treatment group using PPIs. Visual impairment included incidence of visual disturbance, blurred vision, unilateral or bilateral blindness, transient blindness, night blindness, visual field defect, or sudden vision loss. This large-scale data analysis provides reinforcement to the case studies reporting ocular side effects of PPI use and this medication side effect should be considered as part of the work up of patients with newly reported visual impairment.79 Discontinuation of the medication may be necessary in order to determine whether the ocular symptoms are linked to GERD medication use.
Accelerating precision ophthalmology: recent advances
Published in Expert Review of Precision Medicine and Drug Development, 2022
Loay Rahman, Ammaarah Hafejee, Rajeevan Anantharanjit, Wei Wei, Maria Francesca Cordeiro
The ERM is a pathological fibrocellular tissue that can form on the inner surface of the retina. It may be idiopathic or secondary to conditions such as inflammatory eye disease, retinal vascular disease or retinal detachment [49]. Patients may be asymptomatic; however, in some cases, there is risk of visual disturbance and even vision loss if left untreated [50]. Diagnosis is typically through clinical examination which can be challenging and limited by expertise, therefore technological support for ophthalmologists may help mitigate this. Current DL models in ERM detection have been non-inferior to expert grading, however Lo et al. created a DL model to try and further improve the accuracy [51]. The DL model created was applied to OCT image dataset to detect ERM and compared to those diagnosed by non-retinal specialized ophthalmologists, the gold standard for this study. It was found to have a diagnostic accuracy of 98.1% (95% CI 96.5–99.1%), sensitivity of 98.7% and specificity of 98%, concluding that an ophthalmologist-level DL model can be built to help assist clinicians in diagnosing ERM, which would ultimately promote efficiency and safety of healthcare in the future.