Cases Of Optic Atrophy Research Articles

Clinical Assessment and Etiological Evaluation of Optic Nerve Atrophy

Optic atrophy results from the disease process that cause irreversible damage to the ganglion cells and the anterior visual pathway, but may also result from posterior visual pathway involvement. The etiology causing this condition is vast and regardless of underlying cause it carries bad visual prognosis and at times may be life threatening. The study aims to assess patients with optic nerve atrophy presenting to B.P. Koirala lions centre for ophthalmic studies and identify the underlying etiology. This is a descriptive study conducted at B.P. Koirala Lions Centre for Ophthalmic studies. All cases of optic atrophy who presented to our outpatient department from March 2016 to March 2017 were included in the study. In addition to detailed evaluation, assessment of visual acuity, color vision, contrast sensitivity and visual field were done if feasible. Other relevant investigations were conducted to establish the underlying etiological cause. A total of 62 patients were included in the study, with 35 patients having bilateral disease and 27 having unilateral disease accounting for 97 eyes with optic atrophy. The mean age of the affected was 40.63±17.36 years with male to female ratio of 1.2:1. The most common etiology for optic atrophy was traumatic neuropathy (n=16, 25.8%). Majority of eyes had pale disc (n=70, 72.2%) and the rest had temporal pallor (n=27, 27.8%). Traumatic optic neuropathy was the most common etiological cause of optic nerve atrophy.

Visual and ocular motor function in the atypical form of neurodegeneration with brain iron accumulation type I

Background/aimsNeurodegeneration with brain iron accumulation (NBIA) type I is a rare disease that can be divided into a classical or atypical variant, according to age of onset and clinical pattern....

Anterior chamber inflammation after intraocular lens implantation in patients with rheumatoid arthritis

Objective To compare the postoperative anterior chamber inflammation between extracapsular cataract extraction with intraocular lens implantation (ECCE + IOL) and phacoemulsification with intraocular lens implantation (Phaco + IOL) on patients with rheumatoid arthritis,and to investigate the relation of rheumatoid factor and inflammation in anterior chamber.Methods The medical records of 23 eyes of 21patients with rheumatoid arthritis were reviewed,who underwent cataract extraction with intraocular lens implantation.ECCE + IOL was performed in 11 cases (11 eyes),and Phaco + IOL was performed in 10 cases (12 eyes).Patients had been followed up for 3 months.Results All the eyes,except for one case of optic atrophy and one case of age-related macular degeneration,acquired visual acuity of 0.6 or better.Inflammation in anterior chamber disappeared 3 months after surgery,and left no operative complication in any of the eyes.The inflammation in anterior chamber on patients who performed Phaco + IOL was lighter than patients who performed ECCE + IOL.Postoperative difference of 3 days between the two groups was statistically significant (mann-whitney u test P =0.0258).There was no significant of anterior chamber reaction difference between the two groups 3 days or 1 month after the operation (mann-whitney u test P ＞ 0.05).Conclusion The inflammation in anterior chamber on patients who performed Phaco + IOL was lighter than patients who performed ECCE + IOL.The persistence of inflammation in anterior chamber after surgery was not related to rheumtoid factor. Key words: Extraction, cataract, extracapsular; Phacoemulsification; Lens, intraocular; Reaction, inflamatory, anterior chamber; Factor, rheumatoid

A Case of Optic Atrophy and Visual Field Defect in Periventricular Leukomalacia

A Case of Optic Atrophy and Visual Field Defect in Periventricular Leukomalacia

Evaluation of the Optic Nerve Complex in the Orbit Using Coronal Fast Magnetic Resonance Imaging

Recently available coronal fast magnetic resonance imaging (MRI) has very high spatial resolution with good contrast between the optic nerves and cerebrospinal fluid (CSF). The aim of this study was to evaluate the diagnostic value of coronal fast imaging in optic nerve diseases. Thirty-five patients with various Neuro-ophthalmic conditions including 9 with optic neuritis, 6 with optic atrophy, 5 with glaucoma, 4 with segmental optic nerve hypoplasia and 11 with other optic neuropathies including orbital apex syndrome were evaluated with the three-dimensional fast imaging employing steady-state acquisition (FIESTA) sequence in addition to standard MRI protocols. The optic nerve complexes were evaluated on coronal images of the orbits. Detailed demonstration of the optic nerve complex—the optic nerve, the perineural CSF space and dural sheath—could be readily obtained with FIESTA sequence. The acute phase of both optic neuritis and perineuritis showed enlargement of the perineural CSF space; the optic nerve was swollen in optic neuritis but not in perineuritis. Cases of optic atrophy and glaucoma showed perineural CSF space enlargement with normal optic sheath circumference and a thinner optic nerve, while optic nerve hypoplasia showed a smaller dural sheath circumference without perineural CSF space enlargement. In the cases of orbital apex syndrome optic nerve compression by the extraocular muscles was clearly shown. Coronal FIESTA imaging of the orbit is capable of delineating detailed structural changes in the optic nerve complex and is of diagnostic value for the differentiation of optic nerve diseases.

Widespread Choroidal Insufficiency in Primary Open-Angle Glaucoma

The purpose of this study was to investigate choroidal perfusion in glaucoma, using histological and angiographic techniques. We examined the choroidal vasculature in clinicopathological slides from 25 cases of primary open-angle glaucoma, five cases of optic atrophy, and 18 normal eyes. We measured choroidal thickness at fixed distances from the disk margin with light microscopy. Using a quantitative computer image analysis system, we established the depth of all vessels and the best fitting diameter and width-to-length ratio for each vessel in three pairs of eyes. Separate statistical analyses were done on the parapapillary area and the whole choroid. We compared standard fluorescein angiographic measures to peak choroidal filling time in a further 78 glaucoma and 84 normal eyes. Choroids were significantly (approximately 50 microns) thinner in glaucoma than in normal or optic atrophy irrespective of fundal position. Vessel frequency and mean diameter, relative to normal, showed greatest decrease near the choriocapillaris. Peak choroidal filling was the only fluorescein angiographic measure that was significantly delayed in glaucoma irrespective of age. Reduced choroidal thickness in primary open-angle glaucoma is primarily due to loss of the innermost choroidal vessels. Overall size decreases without significant flattening. These changes are not seen with optic atrophy alone and may be correlated with the delayed choroidal perfusion seen in fluorescein angiography.

The differential effect of optic nerve disease on pattern and focal electroretinograms.

We studied nine cases of retrobulbar neuritis with confirmed multiple sclerosis and six cases of optic atrophy from other causes. Pattern and focal electroretinograms (macular ERGs) were recorded with high (400 cd/m2) and low (40 cd/m2) intensity stimuli. Contrast sensitivity was also measured with a simple printed test. Luminance was not markedly important. High spatial frequency contrast sensitivity was significantly correlated with pattern ERG amplitude. Pattern and focal ERG amplitude ratio was usually reduced, but the effect was not correlated with contrast sensitivity or large enough to be useful clinically. In optic atrophy the pattern ERG (PERG) was clearly more severely reduced than the focal ERG (FERG). In retrobulbar neuritis both ERGs were equally and more severely reduced even though the visual losses were less. In unilateral cases the PERG increased then decreased after the initial attack, as previously described (Arden et al., 1982). The results suggest that retinal layers beyond the ganglion cells may be affected in retrobulbar neuritis, but proximally generated, pattern-specific ERG components are selectively lost in optic atrophy.

Zinc Deficiency, Acrodermatitis Enteropathica, Optic Atrophy, Subacute Myelo-optic Neuropathy, and 5,7-Dihalo-8-quinolinols

Acrodermatitis enteropathica, a heritable disease of zinc deficiency, was formerly amenable to treatment only with dihaloquinolinol drugs. A few cases of optic atrophy were reported in surviving patients and were proposed as examples of ocular drug toxicity, principally because of the association between iodochlorhydroxyquin and subacute myelo-optic neuropathy (SMON) in Japan. An alternate hypothesis is now offered: that the optic atrophy was secondary to the zinc deficiency, which is consistent with diverse evidence cited from the literature. Therefore, it would seem worthwhile to investigate zinc in cases of disk pallor described as idiopathic or drug associated, and to investigate visual function in cases of severe malnourishment.

Antihypertensive Drugs and Danger to Vision-Reply

A few comments are in order regarding Dr Brown's letter about antihypertensive drugs and the production of optic nerve atrophy as a result of decreased optic nerve circulation. It is no doubt true that a rapid, precipitous drop in blood pressure can temporarily decrease the circulation in the optic nerve and that, theoretically at least, optic atrophy might result. No one is advocating this type of therapy, even in patients with accelerated or malignant hypertension, where rapid lowering of blood pressure is necessary but precipitous lowering of blood pressure is often dangerous. In our long experience, I do not recall having seen a case of optic atrophy as a result of the use of the commonly effective antihypertensive agents, even in patients where inadvertent sudden blood pressure lowering and severe orthostatic hypotension have been produced over a short period. It is possible, of course, for glaucoma to be

A Case of Optic Atrophy Following the Drinking of Methyl Alcohol

A Case of Optic Atrophy Following the Drinking of Methyl Alcohol

Spontaneous Cures of Hopeless Diseases

Spontaneous cures, being nature's technic of curing, are of immense theoretical and practical interest. Hamburger's idea of collecting from the ophthalmic literature and from his personal experience hopeless cases in which the conditions have healed spontaneously is a felicitous one. Of the cases reported, the following are worthy of mention : three cases of sympathetic ophthalmia in which the condition disappeared during an attack of an acute febrile disease ; one case of severe tuberculosis of the cornea and conjunctiva which cleared up after an attack of erysipelas of the face ; another case of the same type in which the condition disappeared after a severe tuberculin anaphylaxis ; a case of recurrent hemorrhages in the vitreous in which the condition was cleared up by repeated venesections ; a few cases of severe trachoma with pannus which cleared up by an induced gonorrheic ophthalmia ; one case of optic atrophy in which the patient

Treatment of tabial optic atrophy by malaria

According to Fischer-Ascher'a such treatment in the clinic of Hermann was applied in 18 cases of optic atrophy in tabiki, and the patients were injected partly under the skin, partly intravenously 4-8 cc of malarial blood, taken during the attack.

Case of Optic Atrophy from Neuritis and Gastric Attacks

Case of Optic Atrophy from Neuritis and Gastric Attacks

A Case of Optic Atrophy

A Case of Optic Atrophy