Eyeball Research Articles

Axial length association with corneoscleral sagittal height and scleral asymmetry.

To determine how corneoscleral geometry changes with axial length and to assess the usefulness of including the sagittal configuration of the anterior segment when predicting the axial length. An observational study was performed including 96 healthy subjects (96 eyes). Axial length was calculated from optical biometry (IOL Master 500). Corneal curvature and scleral sagittal height parameters at 13, 14 and 15 mm were obtained automatically using corneoscleral topography (eye surface profiler; ESP). In addition, corneal and scleral sagittal heights at numerous locations (21 radii: 0-10 mm from the corneal apex at 12 angles: 0-330°) were calculated using the raw height data extracted from the ESP. The relationships between axial length and the study parameters were analysed using Pearson correlation analysis. The equations for the prediction of axial length were obtained by fitting multiple linear regression models. The temporal-nasal scleral asymmetry at 13-, 14- and 15-mm chord lengths was significantly correlated with axial length (r2 ≤ 0.26; p < 0.001). Significant inverse correlations were found between the temporal scleral sagittal height and axial length (r2 ≤ 0.28; p ≤ 0.02). The nasal scleral sagittal height was not associated with axial length. Three significant multiple linear regression models were fitted based on spherical equivalent, corneal radius and scleral asymmetry at 13 (r2 = 0.79; p < 0.001), 14 (r2 = 0.80; p < 0.001) and 15 (r2 = 0.80; p < 0.001) mm chord lengths. Larger ocular globes show reduced temporal-nasal scleral asymmetry, mainly due to the lower sagittal height of the temporal sclera. Thus, the geometry of the temporal scleral may be a factor of interest during myopia progression.

Autofluorescence-based tissue characterization enhances clinical prospects of light-sheet-microscopy

Light sheet fluorescence microscopy (LSFM) is a transformative imaging method that enables the visualization of non-dissected specimen in real-time 3D. Optical clearing of tissues is essential for LSFM, typically employing toxic solvents. Here, we test the applicability of a non-hazardous alternative, ethyl cinnamate (ECi). We comprehensively characterized autofluorescence (AF) spectra in diverse murine tissues—ocular globe, knee, and liver—employing LSFM under various excitation wavelengths (405–785 nm) to test the feasibility of unstained samples for diagnostic purposes, in particular regarding percutaneous biopsies, as they constitute to most harvested type of tissue sample in clinical routine. Ocular globe structures were best discerned with 640 nm excitation. Knee tissue showed complex variation in AF spectra variation influenced by tissue depth and structure. Liver exhibited a unique AF pattern, likely linked to vasculature. Hepatic tissue samples were used to demonstrate the compatibility of our protocol for antibody staining. Furthermore, we employed machine learning to augment raw images and segment liver structures based on AF spectra. Radiologists rated representative samples transferred to the clinical assessment software. Learning-generated images scored highest in quality. Additionally, we investigated an actual murine biopsy. Our study pioneers the application of AF spectra for tissue characterization and diagnostic potential of optically cleared unstained percutaneous biopsies, contributing to the clinical translation of LSFM.

Optic Nerve Sheath Measurement on Ultrasound: A Novel Diagnostic Test for Giant Cell Arteritis.

Optic nerve sheath enhancement on magnetic resonance imaging has been reported in patients with giant cell arteritis (GCA), with or without visual manifestations. Whether similar findings can be documented on ultrasound is unknown. Optic nerve ultrasound is a point-of-care, easy to learn, rapid, and noninvasive technique. This study aims to investigate whether optic nerve sheath diameter (ONSD) measured on ultrasound is useful in the diagnosis of active, new-onset GCA. A single-center, diagnostic accuracy study was performed from June to November 2022 on consecutive eligible patients referred for suspected GCA. Optic nerve ultrasound was performed on both eyes. The ONSD (includes the optic nerve and its sheath) and optic nerve diameter (OND) were measured 3 mm behind the ocular globe. The presence or absence of GCA was confirmed clinically 6 months later. Multivariable linear regression, adjusting for age and sex, was used to determine the association between optic nerve ultrasound measures and final GCA diagnosis. Thirty participants were enrolled, including nine participants with a final diagnosis of GCA. Mean ± SD ONSD was 5.98 ± 1.17 mm in patients with GCA and 4.02 ± 0.99 mm in patients without GCA. Mean ONSD was greater by 1.26 mm in patients with GCA (95% confidence interval 0.30-2.21 mm, P = 0.01) compared with those without GCA, adjusting for age and sex. Mean ± SD OND was 2.97 ± 0.46 mm in patients with GCA and 2.47 ± 0.58 mm in patients without GCA. There was no evidence of an association between GCA diagnosis and OND. Patients with GCA had a significantly greater ONSD on ultrasound than patients without GCA. Optic nerve ultrasound may represent a novel, rapid, bedside diagnostic test for GCA. A large prospective study is required to confirm these findings and evaluate whether ONSD can be used as a disease activity biomarker in GCA.

Update on Factors Contributing to Traumatic Glaucoma Following Ocular Contusion and Globe Perforation

Update on Factors Contributing to Traumatic Glaucoma Following Ocular Contusion and Globe Perforation

Realistic 3D human saccades generated by a 6-DOF biomimetic robotic eye under optimal control.

We recently developed a biomimetic robotic eye with six independent tendons, each controlled by their own rotatory motor, and with insertions on the eye ball that faithfully mimic the biomechanics of the human eye. We constructed an accurate physical computational model of this system, and learned to control its nonlinear dynamics by optimising a cost that penalised saccade inaccuracy, movement duration, and total energy expenditure of the motors. To speed up the calculations, the physical simulator was approximated by a recurrent neural network (NARX). We showed that the system can produce realistic eye movements that closely resemble human saccades in all directions: their nonlinear main-sequence dynamics (amplitude-peak eye velocity and duration relationships), cross-coupling of the horizontal and vertical movement components leading to approximately straight saccade trajectories, and the 3D kinematics that restrict 3D eye orientations to a plane (Listing's law). Interestingly, the control algorithm had organised the motors into appropriate agonist-antagonist muscle pairs, and the motor signals for the eye resembled the well-known pulse-step characteristics that have been reported for monkey motoneuronal activity. We here fully analyse the eye-movement properties produced by the computational model across the entire oculomotor range and the underlying control signals. We argue that our system may shed new light on the neural control signals and their couplings within the final neural pathways of the primate oculomotor system, and that an optimal control principle may account for a wide variety of oculomotor behaviours. The generated data are publicly available at https://data.ru.nl/collections/di/dcn/DSC_626870_0003_600.

Human Eye Ball Gazing and Face Based Ultra Digital Security System using AI

Abstract: The "Eye Ball Gazing and Face-Based Ultra Digital Security System" invents a remarkable surveillance mechanism by fusing recognition of faces with eye ball movement monitoring. It gathers and safely retains people's unique visages and eyeball peering patterns uponparticipation. It sets up an authentication system with multiple factors that bolsters security and cuts the chance of unlicensed entry if access is requested. This novel solution to the continually evolving requirements of technological safety distinguishes real-time eye-ball peering information with recorded sequences, besides ensuring human facial features. Sophisticated facial identification and eye motion monitoring techniques are put together in the "Eye Ball Gazing and Face-Based Ultra Digital Security System" to produce an effective validation structure in the realm of digital safety. When a person signs up, the tool confidentially saves distinct facial traits and eyeball staring movements. Upon access request, the documented data is cross-referenced with actual time eyeball gazing sequences, and recognition offacial features is utilized to confirm ID in addition.The simultaneous use of both of these methods oflogin minimizes the possibility of inappropriate entry and improves confidentiality, which requiresa multi-step verification procedure. In the current age of technology, this groundbreaking solution guarantees top-notch security and accessibility control.

Clinico-haematobiochemical and cardiac alterations in Trypanosoma evansi infected buffaloes of Andhra Pradesh, India.

The present research aimed to document the incidence, clinical signs, haematological, and serum biochemical alterations, as well as electrocardiography and echocardiography findings in 62 buffaloes (selected from a total of 240) infected with Trypanosoma evansi. The study spanned one year, from January 2022 to December 2022. Morphological identification of Trypanosoma evansi was done by the presence of a centrally positioned nucleus with a small sub-terminal kinetoplast at the posterior position through microscopic examination of Giemsa stained peripheral blood smears. The incidence of trypanosomosis were determined to be 26% (62/240) using stained blood smear examination and 41% (98/240) through polymerase chain reaction assay. Clinical signs exhibited by buffaloes with trypanosomosis included the lack of rumination (94%; 58/62), anorexia (90%; 56/62), emaciation (87%; 54/62), loss of milk yield (84%; 52/62), ocular discharges (82%; 51/62), depressed demeanour (81%; 50/62), sunken eye balls (61%; 38/62), fever (60%; 37/62), scleral congestion (56%; 35/62) and intermittent fever (42%; 26/62). Cardiovascular clinical findings in affected buffaloes included tachycardia (44%; 27/62), cardiac arrhythmia (24%; 15/62), cardiac murmurs (19%; 12/62) and muffled heart sounds (18%; 11/62). In the present study, buffaloes with trypanosomosis exhibited significant reduction in haemoglobin (p = 0.008), packed cell volume (p = 0.004), total erythrocyte count (p = 0.003), mean corpuscular volume (p = 0.042), total leucocyte count (p = 0.048) and absolute neutrophil count (p = 0.012); a significant increase in absolute eosinophil count (p = 0.011) and absolute monocyte count (p = 0.008) compared to the apparently healthy buffaloes. Additionally significant decrease in albumin (p = 0.001), A/G ratio (p = 0.007), calcium (p = 0.008), glucose (p = 0.007), phosphorous (p = 0.048), sodium (p = 0.008), potassium (p = 0.041) and chloride (p = 0.046) were observed in buffaloes with trypanosomosis compared to healthy ones. Buffaloes with trypanosomosis also showed significant increase in globulin (p = 0.004), aspartate aminotransferase (p = 0.008), bilirubin (p = 0.034), blood urea nitrogen (p = 0.071), creatinine (p = 0.029), cholesterol (p = 0.046), lactate dehydrogenase (p = 0.009), gamma-glutamyl transferase (p = 0.004) and creatine kinase-myoglobin binding levels (p = 0.005). Electrocardiography explorations in buffaloes with trypanosomosis revealed sinus tachycardia, low voltage QRS complex, ST segment elevation, wide QRS complex, sinus arrhythmia, sinus bradycardia, wandering pace maker, first degree atrio ventricular block, biphasic T wave and tall T wave. Echocardiography examination unveiled cardiac chamber dilatation, ventricular wall thickening and indications of pericarditis/cardiac tamponade. Necropsy was carried on the dead buffaloes during the study period disclosed severely congested blood vessels on epicardial surface, endocardial haemorrhages, and presence of pericardial fluid. Histopathological examination of the heart revealed hyaline degeneration, haemorrhages in the cardiac muscles and varying degrees of degenerative changes. Additionally, the pericardium displayed increased thickness due to presence of more elastic fibres, fibroblast cells in the myocardium, discontinuity of muscle layers, vascular congestion, perivascular mono nuclear cell infiltration and augmented thickness of the endocardium with fibroblast cell proliferation. The study's conclusion highlights cardiac alterations as secondary complications in buffaloes infected with Trypanosoma evansi. Further investigations are recommended to elucidate therapeutic modifications and refine the treatment paradigm.

Urgent Management of Penetrating Ocular Injury: A Case Report and Review of the Literature.

Ocular globe injury is a severe ophthalmic emergency that requires immediate attention in the emergency department. In this case report, we present a 35-year-old male who suffered a penetrating ocular injury and globe rupture caused by a nail puncture. The patient presented with severe pain and visual loss and was treated with tetanus vaccination, empirical antibiotics, and pain control, followed by an urgent orbital computed tomography (CT) scan and consultation with an ophthalmologist. The CT scan revealed a retained nail in the ocular space, and an urgent operation was performed to repair the eyeball rupture, remove the intraocular foreign body, and perform an anterior vitrectomy. The patient was discharged 6 days after the operation with a visual acuity of 20/400 and an ocular trauma score of 34. This case highlights the importance of initial emergency physician decision-making and the need for a thorough history-taking and examination when encountering penetrating ocular injuries.

A Sustainable Retinal Drug Co-Delivery for Boosting Therapeutic Efficacy in wAMD: Unveiling Multifaceted Evidence and Synergistic Mechanisms.

Sustainable retinal codelivery poses significant challenges technically, although it is imperative for synergistic treatment of wet age-related macular degeneration (wAMD). Here, a microemulsion-doped hydrogel (Bor/PT-M@TRG) is engineered as an intravitreal depot composing of temperature-responsive hydrogel (TRG) and borneol-decorated paeoniflorin (PF) & tetramethylpyrazine (TMP)-coloaded microemulsions (Bor/PT-M). Bor/PT-M@TRG, functioning as the "ammunition depot", resides in the vitreous and continuously releases Bor/PT-M as the therapeutic "bullet", enabling deep penetration into the retina for 21 days. A single intravitreal injection of Bor/PT-M@TRG yields substantial reductions in choroidal neovascularization (CNV, a hallmark feature of wAMD) progression and mitigates oxidative stress-induced damage in vivo. Combinational PF&TMP regulates the "reactive oxygen species/nuclear factor erythroid-2-related factor 2/heme oxygenase-1" pathway and blocks the "hypoxia inducible factor-1α/vascular endothelial growth factor" signaling in retina, synergistically cutting off the loop of CNV formation. Utilizing fluorescence resonance energy transfer and liquid chromatography-mass spectrometry techniques, they present compelling multifaceted evidence of sustainable retinal codelivery spanning formulations, ARPE-19 cells, in vivo eye balls, and ex vivo section/retina-choroid complex cell levels. Such codelivery approach is elucidated as the key driving force behind the exceptional therapeutic outcomes of Bor/PT-M@TRG. These findings highlight the significance of sustainable retinal drug codelivery and rational combination for effective treatment of wAMD.

Linking cerebral hemodynamics and ocular microgravity-induced alterations through an in silico-in vivo head-down tilt framework

Head-down tilt (HDT) has been widely proposed as a terrestrial analog of microgravity and used also to investigate the occurrence of spaceflight-associated neuro-ocular syndrome (SANS), which is currently considered one of the major health risks for human spaceflight. We propose here an in vivo validated numerical framework to simulate the acute ocular-cerebrovascular response to 6° HDT, to explore the etiology and pathophysiology of SANS. The model links cerebral and ocular posture-induced hemodynamics, simulating the response of the main cerebrovascular mechanisms, as well as the relationship between intracranial and intraocular pressure to HDT. Our results from short-term (10 min) 6° HDT show increased hemodynamic pulsatility in the proximal-to-distal/capillary-venous cerebral direction, a marked decrease (-43%) in ocular translaminar pressure, and an increase (+31%) in ocular perfusion pressure, suggesting a plausible explanation of the underlying mechanisms at the onset of ocular globe deformation and edema formation over longer time scales.

Pistol: Pupil Invisible Supportive Tool in the Wild

This paper is an in the wild evaluation of the eye tracking tool Pistol. Pistol supports Pupil Invisible projects and other eye trackers (Dikablis, Emke GmbH, Look, Pupil, and many more) in offline mode. For all eye tracking recordings, Pistol is able to compute pupil and iris ellipse, eye aperture, eye lids, 3D eye ball, optical vector estimation, and eye movement types. For Pupil Invisible projects, it also supports the detection of a special marker and allows the 2D and 3D gaze estimation mapped on the scene camera. In this extended journal paper for Pistol we focus on challenging in the wild situations, such as reflections on glasses, eye tracking during sport, changing lightning conditions, and this for two eye trackers. The tool Pistol can be downloaded here Link

Perforating Ocular Sickle Knife Trauma: a Case report

Introduction : Perforating ocular injury can lead to disability or even mortality. Most individuals sustaining eye injuries are male in young age. This is a report of an extreme case when a sickle knife stabbed in the right eye of a young male cause perforating of the eyeball.&#x0D; Case Illustration : Seventeen years old young male presented to Emergency Room of Sukabumi Regional Public Hospital with pain and bleeding in his right eye an hour before. He had been hacked during a brawls. There was a wound in the right supraorbita area and a big sickle knife stuck in the head and tear the eye ball. Visual acuity was no light perception in his right eye. Anterior segment examination of the right eye revealed perforated sclera and cornea. X-ray examination showed fracture of the roof of the right orbit and a metal object had stuck into the Orbits. The sickle knife extraction, enucleation and superior orbit reconstruction of the right eye was done.&#x0D; Discussion : Identification of wounds caused by sharp metal foreign body is very important for the subsequent treatment of injuries. If the eyeball cannot be preserved, then enucleation can't be avoided. In this case, hard impact of sharp object around of the eye are also cause fracture of superior orbital rim. Reconstruction of the orbital roof using titanium and micro screws given the most stable and effective results.&#x0D; Conclusion : Removing a metal foreign body and anatomical defect management is important for a good outcome.

MSV-net: Multi-scale visual-inspired network for short-term electricity price forecasting

In electricity price forecast, deep networks have shown promising due to their strong nonlinear modeling capability but corresponding design tricks are not convincible, reflecting the situation that biologically-inspired networks in time-series analysis are still not enough explored. To this end, this paper proposes a multi-scale visual-inspired network with three explored modules, namely MSV-Net, for electricity price forecasting. In particular, through simulating both the ocular globe and neurons in signal conversion and further enhancement, the multi-scale feature extraction module captures the overall and specific time-scale features via multiple convolutional kernels and especially highlights the core features via self-attention mechanisms. Through imitating the left and right hemispheres in analyzing and producing complementary visual information, the dual-stream collaboration module adopts the convolutional layer and gated recurrent unit to extract and integrate time-dependent relationships in parallel, thus improving the model stability. Through simulating the higher visual region in understanding complex environments, the forecasting module is introduced to forecast the electricity price. The layer-by-layer collaboration of the above three modules guarantees the effectiveness of the MSV-Net. Moreover, four comprehensive evaluation metrics are explored to assess the forecasting performance in peak, low, and normal samples. Experiments and discussions under two electricity price datasets show that the MSV-Net has satisfactory forecasting accuracy and stability, in improving average mean absolute percent error of 31.59 % and 25.15 % for two datasets compared with 12 baselines, and shows extensible in other energy forecasting fields.

Orbital pleomorphic sarcoma: A case report

Aims/Purpose: To report a case involving an undifferentiated pleomorphic sarcoma localized in the orbit.Methods: Case report and literature review.Results: Undifferentiated pleomorphic sarcomas (UPS) are one of the least common types within all malignant sarcomas, with their incidence reaching 5–10% of the cases. Within this group of UPS, tumours involving the head and neck have an even lower incidence (approximately 3 to 5%). We report the case of an 86 year old male with a history of cardiovascular disease, presenting with a painless lesion in his right eye. The orbit CT reported a soft tissue lesion in contact with the right ocular globe, lacrimal gland and extraconal fat. At examination the patient registered best corrected visual acuity right eye (OD) no light perception right eye and left eye (OS) 20/50. At slit lamp examination OD is not evaluable due to corneal compromise. OS anterior segment and posterior pole with no alterations. Immunohistochemistry was negative for P40, desmine, CD34, SOX‐10 and cytokeratin cocktail. S100 had weak and patchy staining. These results led to a giant cell pleomorphic sarcoma diagnosis, histological grade 3. The patient underwent urgent orbital exenteration, with an adequate postsurgical evolution and oncology follow up.Conclusions: The diagnosis of an UPS is based on exclusion, due to their heterogeneous nature, with histological characteristics that overlap with other malignant mesenchymal neoplasms, mainly with metastatic sarcomatoid carcinoma and melanoma. These tumours are characterized by their rapid growth and potential for metastasis, especially in the lungs. Treatment includes surgical resection, sometimes combined with adjuvant chemotherapy. Strict periodic checkups are essential, since local recurrence is frequent (between 19 to 31%), with most cases occurring within the first 24 months.

NETRA TARPANA: LITERATURE REVIEW

Netra (eye ball) is an important sense organ. Inspite of remarkable progress and advances in the field of modern ophthalmology, there is some limitations. Modern medicine doesn’t have any definite treatment for the particular problem of the eye. Most of the inflammatory eye diseases are managed well in western system of medicine. However, neurological diseases of the eye as well as degenerative conditions of the eye are resistant to even advanced new generation procedures. Thousands of patients in India alone are affected by neurological and degenerative conditions of the eye. Although modern medical science has made tremendous and remarkable progress and advance in the field of ophthalmology in recent times, the importance of ayurvedic treatment in the diseases of eyes cannot be ignored. Ayurveda, the ancient system of medicine gives valuable guide lines not only in treatment aspects but also in preventive line. There is a great need to find out an ocular procedure for prevention and treatment of eye diseases having no or least adverse effect. Tarpana karma is one of the local therapeutic procedures which if promptly used shows objective evidences of excellent responses. In this article there is a review on netra tarpana karma, their indications, contraindications and possible mode of action is discussed.

Ruthenium brachytherapie and sandwich therapy for medium sized uveal melanomas

Aims/Purpose: Brachytherapy using ruthenium is an established procedure for the treatment of uveal melanomas, the most common malignant primary intraocular tumour in adults. The supplementary use of transpupillary thermotherapy (TTT) with brachytherapy is known as sandwich therapy. Due to the rarity of uveal melanomas, long‐term outcome of large cohorts treated by ruthenium brachytherapy with and without TTT is of special clinical and scientific interest.Methods: Based on a retrospective longitudinal study, patients with uveal melanoma who received treatment using ruthenium brachytherapy at the Department of Ophthalmology from 1994 to 2021, were analysed. The evaluation includes tumour height, visual acuity, radiation data, side effects, local recurrence, bulbus preservation and occurrence of metastasis.Results: Overall, 150 patients with medium sized uveal melanoma (tumour height &gt;3.0 and ≤7.0 mm) who received ruthenium brachytherapy were included. The mean age of patients at diagnosis was 63.5 ± 12.9 years (median 65), the proportion of women was 60.0%. Tumours were located centrally in 48.7% of cases; ciliary body involvement was seen in 4%. Additive transpupillary thermotherapy (TTT) was performed in 70.7% of cases as part of a sandwich therapy. After therapy and a mean follow‐up of 68.0 ± 58.3 years tumours height was significantly reduced from 4.5 ± 1.1 to 1.4 ± 1.6 mm (p &lt; 0.001). Visual acuity showed deterioration from 0.25 ± 0.43 to 1.0 ± 0.85 logMAR (p &lt; 0.001) due to the large proportion of centrally located tumours. In 29.9% of cases no side effects requiring therapy occurred. Within the remaining cases cataracta complicata (41.3%) and radiation retinopathy (30.0%) were observed. Local tumour control was achieved in 86.0% of patients, in 91.3% of cases the ocular globe was preserved. Metastatic free survival was seen in 86.4% of patients.Conclusions: Brachytherapy using ruthenium plaque with and without TTT represents a safe procedure in the treatment of uveal melanomas over the last three decades.

Eye ball sensor controlled wheel chairs for disabled patients

Eye ball sensor controlled wheel chairs for disabled patients

Grzybicze zapalenia rogówki

Fungal keratitis are important problem in ophthalmology. The most often isolated ethiologic factors are Candida species, Fusarium species and Aspergillus species. Microbiological diagnostics of mycotic infections is long-lasting and has low susceptibility. Effectiveness of antifungal therapy is limited by pathogenes resistance and specific pharmacokinetics of medications used in therapy of eye ball infections.

Implementation of Image Enhancement and Edge Detection Algorithm on Diabetic Retinopathy (DR) Image Using FPGA

Diabetic retinopathy (DR) is an ocular ailment that may lead to loss of vision and eventual blindness among individuals diagnosed with diabetes. The blood vessels of the retina, a layer of light-sensitive tissue located at the posterior aspect of the ocular globe, are adversely impacted. The identification of DR entails the utilization of retinal fundus images. The detection of any form of abnormality in the eye through raw fundus images poses a significant challenge for medical practitioners. Hence, it is imperative to engage in the processing of fundus images. This paper delineates several image processing techniques for DR images, including but not limited to, manipulation of brightness levels, application of negative transformation, and utilization of threshold operations. It focuses on elucidating the enhancement techniques that pertain to DR images, which aim to optimize the visual quality of said images in order to facilitate more facile disease detection. The process of detecting edges within DR images is also executed by Sobel edge detection algorithm. In order to successfully execute the aforementioned algorithms, expedient and contemporaneous systems are favored to account for the intricacies of the image processing calculations. The exclusive utilization of software techniques in order to fulfill the prerequisites of advanced algorithms presents a significant challenge, owing to the multifarious processes that are involved in their computation, coupled with an exigent requirement for high processing speeds. The proposed model is utilized to articulate a proficient model for the design and execution of field programable gate array (FPGA)-based image enhancement processes along with the Sobel edge detection algorithm upon DR images. Finally, a Internet Protocol chip is developed that can combine multiple image enhancement operations into a single framework with less complexity.

Infiltrative Optic Neuropathy in a Patient with Gastric Carcinoma: Case Report and State of the Art

Introduction: Metastatic tumors to the optic disc are a rare event. Infiltration of the optic nerve head is usually a unilateral process with characteristic funduscopic features. Loss of vision is its main symptom. Neuroimaging should be performed in every patient suspected of infiltrative optic neuropathy. The patient should be referred for appropriated chemotherapy for the systemic cancer plus external ocular irradiation. Case Presentation: The case of a 75-year-old man with progressive vision loss in his left eye is presented. Among his medical background a gastric adenocarcinoma (GAC) with multiple liver metastases is highlighted. The exploration showed an optic nerve head invaded by chalky whitish infiltrates, associated to flameshaped hemorrhages along the vascular arcades; the magnetic resonance imaging (MRI) demonstrated signal enhancement of the posterior region of the left ocular globe, affecting the optic nerve head. Orbital radiotherapy was ruled out due to patient’s systemic situation. Discussion: Metastases and optic nerve infiltration should be suspected in every oncologic patient who develops optic neuropathy. Though a rare condition with poor systemic prognosis, patients should be studied and offered orbital radiotherapy in order to stabilize the ocular progression.