scholarly journals Anticoagulation for Radiation-Induced Optic Neuropathy

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 97-103
Author(s):  
Narayanaswamy Venketasubramanian ◽  
Kong Yong Goh ◽  
Paul T. Chew ◽  
Keyword(s):  
Visual Acuity ◽  
Optic Neuropathy ◽  
Visual Fields ◽  
Controlled Clinical Trial ◽  
Ophthalmological Examination ◽  
Corrected Visual Acuity ◽  
Oral Warfarin ◽  
Radiation Induced ◽  
Randomised Controlled ◽  
Field Defect

Radiation-induced optic neuropathy (RION) is a severely disabling complication of radiotherapy, without any known effective treatment. Three patients, one female and two males, aged 60, 34, and 45 years, respectively, developed progressive deterioration in visual acuity over 1 month, 8 years, and 2 months, starting 3, 12, and 9 years after radiotherapy for nasopharyngeal carcinoma. They received 70.15, 60.89, and 56.11 Gy over a period of 6–7 weeks, with fractionated doses of 2, 1.79, and 1.81 Gy, respectively. Ophthalmological examination revealed a relative afferent pupillary defect in the latter 2 patients, best-corrected visual acuity was 6/12 or better in all. Visual field charting showed a superior altitudinal field defect in the first two, and generalised visual loss in the third patient in the symptomatic eyes. Anticoagulation with heparin bridging and oral warfarin with an INR target of 2.0–3.0 was commenced within 2 months of symptom onset. All showed improvement in visual fields within 2 weeks, and remained stable for at least 2 years while on warfarin. Our encouraging findings will need to be confirmed in a randomised controlled clinical trial.

Contrast Sensitivity and Visual-Field Thresholds in Patients with Thyroid Optic Neuropathy

Perception ◽  
1997 ◽  
Vol 26 (1_suppl) ◽  
pp. 194-194
Author(s):  
J Jankauskiene ◽  
R Lukauskiene ◽  
B Mickiene
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Contrast Sensitivity ◽  
Optic Neuropathy ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Threshold Test ◽  
Spatial Frequencies ◽  
Snellen Visual Acuity ◽  
The Mean

Thyroid optic neuropathy is one of the most troubling complications of endocrine ophthalmopathies. It is related to the degree of extraocular muscle swelling in the apex of the orbit. The purpose of this study was to investigate contrast sensitivity and visual-field thresholds in patients with thyroid optic neuropathy. We examined twenty-two patients aged 29 – 63 years (mean 45.3 years). The control group consisted of fifteen healthy persons of similar age. Contrast sensitivity was measured by means of Volkov's charts (sinusoidal gratings) at eight spatial frequencies from 17.5 to 0.46 cycles deg−1. The visual field was investigated with a static automatic perimeter (Allgan Humphrey Field Analyzer) by means of the central 30-2 threshold test. All patients underwent a complete ophthalmological examination including best corrected Snellen visual acuity, fundus copy, and proptosis measurement with the Hertel exophthalmometer. The mean proptosis of patients was 19.4 mm. Fifteen of the patients had decreased visual acuity. Contrast sensitivity at low spatial frequencies was significantly reduced in the patients. It was established that a reduction of visual-field threshold accompanies the decrease of visual acuity. Our results show that contrast sensitivity and visual-field threshold testing are very sensitive at detecting early optic neuropathy and may be a useful means of following patients after treatment.

scholarly journals Recovery of Visual Function in a Patient with an Onodi Cell Mucocele Compressive Optic Neuropathy Who Had a 5-Week Interval between Onset and Surgical Intervention: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Wencan Wu ◽  
Michelle T. Sun ◽  
Paul S. Cannon ◽  
Shi Jianbo ◽  
Dinesh Selva
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Optic Neuropathy ◽  
Visual Function ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Compressive Optic Neuropathy ◽  
Initial Onset ◽  
Onodi Cell ◽  
Field Defect

Purpose. To report on a patient with compressive optic neuropathy secondary to an Onodi cell mucocele, who fully recovered visual function following surgery.Method. Case report.Results. A 28-year-old male was admitted with a right visual acuity of 20/100 following treatment for an initial diagnosis of optic neuritis. Subsequent examination suggested compressive optic neuropathy, and neuroimaging confirmed the presence of an Onodi mucocele compressing the optic nerve. The patient underwent a right endonasal sphenoethmoidectomy with decompression 5 weeks after the initial onset of symptoms. Three weeks following surgery, the visual acuity was 20/20, and there was complete resolution of the visual field defect, which has remained stable at 1 year.Conclusion. Onodi cell mucocele should be included in the differential diagnosis of a young patient with compressive optic neuropathy. Surgical decompression should be considered even when symptoms have been present for over a month.

Evaluating Central Serous Chorioretinopathy with Multifocal Electroretinogram

2009 ◽  
Vol 03 (01) ◽  
pp. 71
Author(s):  
Marilita M Moschos ◽  
Michael Moschos ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Central Serous Chorioretinopathy ◽  
Multifocal Electroretinogram ◽  
Ophthalmological Examination ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Retinal Response ◽  
Normal Controls ◽  
Best Corrected Visual Acuity

Purpose: To evaluate central serous chorioretinopathy (CSCR) by multifocal electroretinogram (mf-ERG). Patients and methods: Twenty-one patients (21 eyes) with unilateral CSCR were examined. Both eyes of each patient underwent complete ophthalmological examination, including measurement of best corrected visual acuity, fluorescein angiography and mf-ERG recording. Our results were compared with the corresponding findings of 33 age-matched normal volunteers. Results: At presentation, the mean retinal response density (RRD) of the affected eyes in area 1 was 50.8% lower compared with normal controls (p<0.001). After CSCR regression, the mean RRD of the affected eyes was 30.1% lower compared with normal controls (p<0.001). Six fellow unaffected eyes showed a mean RRD in area 1 equal to 12nV/deg2. Conclusion: During the acute phase of CSCR, the mean RRD of the fovea was significantly abnormal. After its regression, mf-ERG values ameliorate, but they remain significantly abnormal. Abnormal values in area 1 were also found in the unaffected eyes.

scholarly journals The anterior ischemic optic neuropathy treatment using the dispersed “Alloplant”

2013 ◽  
Vol 6 (2) ◽  
pp. 20-24
Author(s):  
Venera Uzbekovna Galimova ◽  
Irina Viktorovna Verzakova ◽  
Yevgeniy Musinovich Gareyev ◽  
Zarina Khikhmetullovna Karimova
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Blood Supply ◽  
Optic Neuropathy ◽  
Visual Fields ◽  
Resistance Index ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Ciliary Arteries ◽  
Lateral Branches

In this article, the results of a study are presented on the influence of the therapeutic retroscleral filling by dispersed “Alloplant” biomaterial upon blood supply and visual functions of the eye. 47 patients (69 eyes) suffering from anterior ischemic optic neuropathy sequelae were examined. Obtained results allowed to study the degree of relationship between the following indices: resistance index of ocular vessels, visual acuity and electrophysiological data, visual field limits. The majority of cases with significant visual fields widening (79 %) correlated with post-operative decrease of resistance index in posterior short ciliary arteries (medial and lateral branches). The results of performed investigation allow to assume that the dispersed “Alloplant” biomaterial use in the treatment of patients with anterior ischemic optic neuropathy sequelae could promote the optic nerve blood supply improvement with further amelioration of visual function indices.

scholarly journals Features of pathological changes in the retina and vitreoretinal interface in the macular zone in patients with diabetic macular edema

2021 ◽  
Vol 6 (6-1) ◽  
pp. 136-143
Author(s):  
E. V. Boiko ◽  
D. Kh. Oskanov ◽  
S. V. Sosnovskii
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Morphometric Parameters ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Pathological Changes ◽  
Vitreoretinal Interface ◽  
Corrected Visual Acuity

Background. Diabetic macular edema (DME) is one of the main causes of decreased central vision. Determining the reasons for the refractoriness of DME to treatment is an urgent problem.Aims. Based on the analysis of optical coherence tomography, to study the features of pathological changes in the retina and vitreoretinal interface (VRI) in the macular zone in patients with DME.Materials and methods. We studied 587 patients (587 eyes) with diffuse DME in the setting of nonproliferative diabetic retinopathy. In addition to the standard ophthalmological examination, everyone underwent optical coherence tomography of the macular zone with an assessment of structural changes in the retina, morphometric parameters, and the state of the VRI.Results. In 351 patients (59.80 %) with DME, pathological variants of the VRI were revealed, in which the best corrected visual acuity was significantly lower, and the morphometric parameters (retinal thickness and macular volume) were signifi cantly higher. Analysis of morphostructural changes in the macular zone revealed that in pathological VRI, neuroepithelial detachment and high edema are more common, and cystic edema is larger in area compared to the group with a normal VRI. With detachment of neuroepithelium against the background of a pathological VRI, the worst morphometric data are determined, with solid exudates in the macula, the worst indices of visual loss are determined.Conclusions. The pathological VRI in patients with diabetic macular edema occurs in more than half of the cases and is characterized by a high incidence of neuroepithelial detachment, high edema, higher morphometric parameters with worse visual acuity. At the same time, the presence of neuroepithelial detachment corresponds to the worst morphometric indicators of the macular zone, and the presence of solid exudates corresponds to a lower maximum corrected visual acuity. Further research is needed to assess the effect of the listed morphostructural and morphometric changes in combination with various pathological variants of VRI on the effectiveness of DME treatment.

Spectral-domain optical coherence tomography foveal morphology as a prognostic factor for vision performance in congenital aniridia

2018 ◽  
Vol 30 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Pilar Casas-Llera ◽  
Ana Siverio ◽  
Gemma Esquivel ◽  
Cristina Bautista ◽  
Jorge L Alió
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Outer Segment ◽  
Spectral Domain ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Congenital Aniridia ◽  
Foveal Hypoplasia ◽  
Best Corrected Visual Acuity

Background: Patients with congenital aniridia usually have some degree of foveal hypoplasia, thus representing a limiting factor in the final visual acuity achieved by these patients. The purpose of this study was to analyze whether the foveal morphology assessed by spectral-domain optical coherence tomography may serve as a prognostic indicator for best-corrected visual acuity in congenital aniridia patients. Methods: Observational two-center study performed between January 2012 and March 2017 in the pediatric ophthalmology department at Vissum Alicante and Vissum Madrid, Spain. A total of 31 eyes from 19 patients with congenital aniridia were included. After a complete ophthalmological examination, a high-resolution spectral-domain optical coherence tomography with a three-dimensional scan program macular protocol was used. A morphological grading system of foveal hypoplasia was used varying from grade 1 in which there is a presence of a shallow foveal pit, extrusion of inner retinal layers, outer nuclear layer widening, and a presence of outer segment lengthening to grade 4 in which none of these processes occur. Results: No correlation between central, mid-peripheral, and peripheral macular thickness and logMAR best-corrected visual acuity was found. The presence of outer segment lengthening was associated with better best-corrected visual acuity with a median best-corrected visual acuity, 0.30 logMAR, whereas the absence of this morphologic feature was associated with poorer VA with a median best-corrected visual acuity of 0.61 logMAR (p < 0.001). Conclusion: Foveal hypoplasia morphology can predict the best-corrected visual acuity. Specifically, the morphologic optical coherence tomography feature that is related to a better best-corrected visual acuity in congenital aniridia patients is the presence of outer segment lengthening.

scholarly journals Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Rika Tsukii ◽  
Yuka Kasuya ◽  
Shinji Makino
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Visual Field Defect ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Swelling ◽  
The Right ◽  
Field Defect

To report a patient with nonarteritic anterior ischemic optic neuropathy (NA-AION) occurring soon after the COVID-19 vaccination. A 55-year-old woman presented with a 4-day history of inferior visual field disturbance in the right eye 7 days after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. Examination revealed a best-corrected visual acuity of 20/20 in both eyes. A relative afferent pupillary defect was observed in the right eye. Fundoscopy revealed diffuse optic disc swelling in the right eye, which was prominent above the optic disc. Goldmann visual field testing identified an inferior altitudinal visual field defect with I/2 isopter in the right eye. Although typical complete inferior visual field defect was not detected, a diagnosis of NA-AION was made. The patient was followed without any treatment. During the 2-month follow-up period, the optic disc swelling was gradually improved, and visual acuity was maintained 20/20; however, the optic disc looked diffusely pale in the right eye. Although it is uncertain whether the development of NA-AION after COVID-19 vaccination was consequential or coincidental, we speculate that the close temporal relationship with COVID-19 vaccination suggests the possibility of vasculopathy on the microvascular network of optic nerve head as background of inflammatory or immune-mediated element to the timing of the onset of NA-AION. The aim of this case report is to present this biological plausibility and to elucidate potential ophthalmological complications.

Visual Impairment and Objectively Measured Physical Activity in Middle-Aged and Older Adults

2021 ◽  
Author(s):  
Yurun Cai ◽  
Jennifer A Schrack ◽  
Hang Wang ◽  
Jian-Yu E ◽  
Amal A Wanigatunga ◽  
...  
Keyword(s):  
Physical Activity ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Daily Activity ◽  
Activity Patterns ◽  
Visual Fields ◽  
Corrected Visual Acuity ◽  
Objectively Measured ◽  
Objectively Measured Physical Activity ◽  
Best Corrected Visual Acuity

Abstract Background Vision loss is associated with increased falls risk and restricted physical activity, yet the relationship between multiple vision measures and objectively measured physical activity, especially activity patterns, in mid-to-late life is not well understood. Methods This study included 603 participants aged ≥ 50 years (mean age=73.5) in the Baltimore Longitudinal Study of Aging who had the following assessments: presenting and best-corrected visual acuity, contrast sensitivity, visual fields, stereo acuity, and free-living physical activity using a wrist-worn ActiGraph accelerometer for 7 days. Linear regression models were used to examine the association between vision measures and daily activity counts, active minutes, and activity fragmentation (defined as an active-to-sedentary transition probability), adjusting for potential confounders. Mixed-effects models estimated differences in activity by time of day comparing those with and without each visual impairment. Results In the fully adjusted model, worse presenting visual acuity, contrast sensitivity, and visual fields were associated with fewer activity counts, less active time, and more fragmented activity patterns (p&lt;0.05 for all). Participants with presenting or best-corrected visual acuity impairment had 19.2 and 29.3 fewer active minutes (p=0.05, p=0.03, respectively) per day. Visual field impairment was associated with 268,636 fewer activity counts (p=0.02), 46.2 fewer active minutes (p=0.02) per day, and 3% greater activity fragmentation (p=0.009). Differences in activity levels tended to be greatest from 6am-6pm (p&lt;0.05). Conclusions Older adults with visual impairment have restricted and more fragmented patterns of daily activity. Longitudinal studies to quantify the long-term impacts of visual impairments on activity decline are warranted.

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