CT and VER follow-up of reversible visual loss with fracture of the optic canal

1982 ◽  
Vol 62 (1-2) ◽  
pp. 91-94 ◽  
Author(s):  
A. Shaked ◽  
M. Hadani ◽  
M. Feinsod
Keyword(s):  
Visual Loss ◽  
Optic Canal ◽  
Reversible Visual Loss

Suprasellar meningiomas: the effect of tumor location on postoperative visual outcome

1988 ◽  
Vol 69 (4) ◽  
pp. 523-528 ◽  
Author(s):  
Brian T. Andrews ◽  
Charles B. Wilson
Keyword(s):  
Visual Loss ◽  
Visual Outcome ◽  
Tumor Location ◽  
Postoperative Recovery ◽  
Optic Canal ◽  
Visual Disability ◽  
Content Type ◽  
Tuberculum Sellae ◽  
Diaphragma Sellae ◽  
Planum Sphenoidale

✓ The authors reviewed 38 cases of suprasellar meningioma to determine the correlation between tumor site and postoperative visual outcome. Progressive visual loss, the most frequent initial complaint (94.7%), occurred over a mean of 24½ months, was most often unilateral (18 patients) or bilateral but asymmetrical (14 patients), and was severe (20/200 vision or worse) in 23 patients; 24 patients had visual field abnormalities. Computerized tomography or magnetic resonance studies clearly delineated the lesions but did not appear to permit earlier diagnosis. Eleven patients had tumors limited to the tuberculum sellae; the tumor extended from the tuberculum sellae onto the planum sphenoidale in nine patients, into one optic canal in eight, onto the diaphragma sellae in seven, and onto the medial sphenoid wing in three. Patients with tumors affecting the optic canal had severe unilateral visual loss more often than those with tumors at other sites. Tumors limited to the tuberculum sellae were most often completely resected; postoperative recovery of vision was also most frequent in patients with tumors at this site. Tumors involving the diaphragma sellae or the medial sphenoid wing were least often completely removed and most likely to be associated with postoperative visual deterioration. Overall, 42% of patients had improved vision postoperatively, 30% remained unchanged, and 28% were worse. After a mean follow-up period of 38 months, 24 patients are doing well, four have significant visual disability, and three are blind or doing poorly. Two patients died of causes unrelated to their tumor. Three patients have had tumor recurrence.

Bilateral Optic Canal Meningiomas

Neurosurgery ◽  
1978 ◽  
Vol 3 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Jonathan D. Trobe ◽  
Joel S. Glaser ◽  
Judith D. Post ◽  
Larry K. Page
Keyword(s):  
Surgical Treatment ◽  
Visual Loss ◽  
Correct Diagnosis ◽  
Clinical Suspicion ◽  
Optic Canal ◽  
The Future ◽  
Planum Sphenoidale ◽  
Radiological Studies

Abstract In the case presented, bilateral optic canal meningiomas produced binocular visual loss. Correct diagnosis was delayed because of inadequate and misinterpreted radiological studies. Careful radiological and surgical examination of the planum sphenoidale later suggested this as the source of both canalicular masses. The pertinent aspects of this case are reviewed in relation to information from similar cases reported previously. In the future, increased clinical suspicion and more accurate neuroradiological studies should improve the detection and afford earlier surgical treatment of meningiomas of the optic canal.

scholarly journals Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Salvatore Di Lauro ◽  
Melissa Castrejón ◽  
Itziar Fernández ◽  
Jimena Rojas ◽  
Rosa M. Coco ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Loss ◽  
Vision Loss ◽  
Multicentric Study ◽  
Prospective Multicentre Study ◽  
Snellen Chart ◽  
Pars Plana ◽  
Phakic Eyes

Purpose. To quantify the frequency of visual loss after successful retinal detachment (RD) surgery in macula-on patients in a multicentric, prospective series of RD.Methods. Clinical variables from consecutive macula-on RD patients were collected in a prospective multicentric study. Visual loss was defined as at least a reduction in one line in best corrected visual acuity (VA) with Snellen chart. The series were divided into 4 subgroups: (1) all macula-on eyes (n=357); (2) macula-on patients with visual loss at the third month of follow-up (n=53) which were further subdivided in (3) phakic eyes (n=39); and (4) pseudophakic eyes (n=14).Results. Fifty-three eyes (14.9%) had visual loss three months after surgery (n=39phakic eyes;n=14pseudophakic eyes). There were no statistically significant differences between them regarding their clinical characteristics. Pars plana vitrectomy (PPV) was used in 67.2% of cases, scleral buckle in 57.7%, and scleral explant in 11.9% (36.1% were combined procedures).Conclusions. Around 15% of macula-on RD eyes lose VA after successful surgery. Development of cataracts may be one cause in phakic eyes, but vision loss in pseudophakic eyes could have other explanations such as the effect of released factors produced by retinal ischemia on the macula area. Further investigations are necessary to elucidate this hypothesis.

Visual Outcome of Tuberculum Sellae Meningiomas after Extradural Optic Nerve Decompression

Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. 570-576 ◽  
Author(s):  
Tiit Mathiesen ◽  
Lars Kihlström
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Diabetes Insipidus ◽  
Visual Outcome ◽  
Optic Canal ◽  
Visual Deterioration ◽  
Nerve Decompression ◽  
Visual Outcomes ◽  
Tuberculum Sellae

Abstract OBJECTIVE: Meningiomas of the tuberculum sellae have a close relationship with the optic apparatus. Even modern series show a 10 to 20% risk of visual deterioration after surgery. We have attempted to improve visual outcome by extradural decompression of the optic canal and anterior clinoid process, followed by intradural release of the optic nerve; this study provides an analysis of visual outcomes with this approach. METHODS: Treatment, histopathology, and follow-up data of 29 consecutive patients undergoing surgery for tuberculum sellae meningiomas with initial release of the optic nerve were prospectively collected. RESULTS: Radical tumor removal was possible in all 23 patients with primary tumors and in three out of six patients with recurrent tumors. All patients but two of the worst affected with preoperative visual compromise improved from surgery; there were no instances of visual deterioration. Five patients with normal preoperative vision remained intact and visual improvement was 22 (91%) out of 24 patients in the remaining patients. In total, 13 patients (42%) had completely normal vision at follow-up. Mainly patients younger than 60 years experienced complete normalization after surgery. Two patients underwent transsphenoidal surgery for cerebrospinal fluid leaks. Postoperative endocrinological symptoms were temporary diabetes insipidus in one patient and permanent diabetes insipidus in another patient undergoing elective sectioning of the pituitary stalk because of a recurrent tumor with invasive growth into the stalk. CONCLUSION: Adding early optic nerve decompression by extradural clinoidectomy and optic canal unroofing to a frontopterional approach seemed to improve visual outcomes because there were no instances of visual deterioration. Simpson Grade 1 to 2 removal was possible in all patients with primary surgery, whereas recurrent cases could only be treated with lower grades of radicality. Radical removal, however, required readiness to reoperate for cerebrospinal fluid leakage at the site of the drilled tumor origin in bone.

Republished: Transfemoral thrombectomy in the cavernous sinus and superior ophthalmic vein

2018 ◽  
Vol 10 (5) ◽  
pp. e8-e8 ◽  
Author(s):  
Justin Bauer ◽  
Kartik Kansagra ◽  
Kuo H Chao ◽  
Lei Feng
Keyword(s):  
Cavernous Sinus ◽  
Visual Loss ◽  
Sinus Thrombosis ◽  
Symptomatic Relief ◽  
Rare Condition ◽  
Visual Deficits ◽  
Acute Visual Loss ◽  
Neurologic Disability ◽  
Neurologically Intact

Cavernous sinus thrombosis (CST) is a rare condition that can cause death, neurologic disability, and visual loss. A pre-teen with septic CST leading to ocular hypertension and acute visual loss was treated at our institution with thrombectomy and thrombolysis of the cavernous sinuses and superior ophthalmic veins. Successful recanalization of the bilateral cavernous sinuses and superior ophthalmic veins was achieved in two separate procedures without complication. The patient showed immediate symptomatic relief. He was neurologically intact without visual deficits at the 2 month follow-up. This is the first report in the literature showing the feasibility of cavernous sinus thrombectomy using current devices and techniques. Early endovascular therapy may help preserve vision in patients with acute CST.

Reversible Visual Loss in Subperiosteal Hematoma of the Orbit

1981 ◽  
Vol 12 (3) ◽  
pp. 203-209
Author(s):  
William N Gillum ◽  
Richard L Anderson
Keyword(s):  
Visual Loss ◽  
Reversible Visual Loss

A Feasibility Randomised Control Trial of Vitrectomy Plus Standard Care Intravitreal Ranibizumab or Aflibercept Injections versus Standard Care Intravitreal Ranibizumab or Aflibercept injections Alone In Patients With Centre Involving Diabetic Macular Edema

2021 ◽  
Author(s):  
Alistair Laidlaw ◽  
Chris Hammond ◽  
Matthew James Maguire
Keyword(s):  
Standard Care ◽  
Visual Loss ◽  
Rescue Therapy ◽  
Macular Thickness ◽  
Randomised Control Trial ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
One Year

Abstract Background: Most studies indicate that vitrectomy delivers sustained improvements in macular thickness. Evidence on whether acuity is improved is inconsistent. In the presence of traction vitrectomy is thought to be visually effective. In the absence of traction vitrectomy was usually performed as rescue therapy when repeated laser treatments had failed and visual improvement may not have been possible. Studies where vitrectomy was performed early in the disease showed visual benefit. All these data also predate the current gold standard anti VEGF therapy for DME and SD OCT imaging of the vitreo retinal interface. We hypothesise that adding a vitrectomy and internal limiting membrane peel to standard care intravitreal Anti-VEGF injections in the management of CIDME will result in: improved or comparable visual outcomes, fewer anti-VEGF injections and reduced costs. Methodology: VIDEO is a pragmatic stratified, single-masked, randomised, multi centre, controlled, feasibility trial with 12 months follow up. Stratification will be based in the presence or absence of OCT evident vitreomacular traction or epiretinal membrane. The primary outcome is Distance best corrected visual acuity. Secondary outcomes are Number of injections, Rate of completed follow, Rate of recruitment, Central macular thickness on OCT, Area under the curve of CMT, Area under curve of BCVA, Rate of loss of 15 or more letters from baseline, Rate of Rescue therapy, Rate of cataract surgery, Rate of complications. Recruitment target is 100 patients with 1:1 randomisation to the treatment arm (vitrectomy + standard care) or control arm (standard care) with 12 month follow up. Standard care is treat and extend intravitreal anti-VEGF injections. Main inclusion criteria: -Patient over 18 years of age -Patient has capacity to give informed consent -Patient has not previously been enrolled in this study in regards to their other eye - Symptomatic visual loss attributable to diabetic macular oedema for less than one year -Patient has a formal diagnosis of Diabetes Mellitus -Patient has an HbA1c test (a blood test that looks at long term diabetic control) performed within the past 2 months. Ophthalmic criteria: -Symptomatic visual loss attributable to DMO for less than one year. -Best corrected visual acuity of better than 35 ETDRS letters on formal testing -Central macular thickness greater than 350 microns. Discussion: Outcomes should inform the effect size with which to inform the design of a definitive randomised control trial ISRCTN Registry ISRCTN59902040 18.12.20 retrospectively registered http://www.isrctn.com/ISRCTN59902040

scholarly journals Treatment of Optic Canal Decompression Combined with Umbilical Cord Mesenchymal Stem (Stromal) Cells for Indirect Traumatic Optic Neuropathy: A Phase 1 Clinical Trial

2020 ◽  
Vol 64 (3) ◽  
pp. 398-404
Author(s):  
Jia Li ◽  
Xu Bai ◽  
Xiaoyue Guan ◽  
Hongfeng Yuan ◽  
Xiang Xu
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Phase 1 ◽  
Optic Canal ◽  
Traumatic Optic Neuropathy ◽  
Corrected Visual Acuity ◽  
Group 2 ◽  
Best Corrected Visual Acuity ◽  
Group 1

<b><i>Purpose:</i></b> This study was aimed to investigate the safety and feasibility of umbilical cord-derived mesenchymal stem cell (MSC) transplantation in patients with traumatic optic neuropathy (TON). <b><i>Methods:</i></b> This is a single-center, prospective, open-labeled phase 1 study that enrolled 20 patients with TON. Patients consecutively underwent either optic canal decompression combined with MSC local implantation treatment (group 1) or only optic canal decompression (group 2). Patients were evaluated on the first day, seventh day, first month, third month, and sixth month postoperatively. Adverse events, such as fever, urticarial lesions, nasal infection, and death, were recorded at each visit. The primary outcome was changes in best-corrected visual acuity. The secondary outcomes were changes in color vision, relative afferent pupillary defect, and flash visual evoked potential. <b><i>Results:</i></b> All 20 patients completed the 6-month follow-up. None of them had any systemic or ocular complications. The change in best-corrected visual acuity at follow-up was not significantly different between group 1 and group 2 (<i>p</i> &#x3e; 0.05); however, group 1 showed better visual outcome than group 2. Both groups showed significant improvements in vision compared with the baseline (<i>p</i> &#x3c; 0.05); however, there were no statistically significant differences between the groups (<i>p</i> &#x3e; 0.05). In addition, no adverse events related to local transplantation were observed in the patients. <b><i>Conclusions:</i></b> A single, local MSC transplantation in the optic nerve is safe for patients with TON.

scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

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