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1. |
Does Early Immunotherapy Reduce the Conversion of Ocular Myasthenia Gravis to Generalized Myasthenia Gravis? |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 249-250
Mark Kupersmith,
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ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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2. |
Immunotherapy of Ocular Myasthenia Gravis Reduces Conversion to Generalized Myasthenia Gravis |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 251-255
Jared Mee,
Mark Paine,
Edward Byrne,
John King,
Katrina Reardon,
Justin O'Day,
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摘要:
BackgroundSeveral retrospective studies have suggested that immunotherapy, including prednisolone, azathioprine and thymectomy, reduces progression of ocular myasthenia gravis to generalized myasthenia gravis. This study examines the effect of immunotherapy on generalization rates in ocular myasthenia patients who are acetylcholine receptor (AChR) antibody-positive.MethodsRetrospective record review of 34 patients from three university-based hospitals with neurology and neuro-ophthalmology services in Australia. In all patients, positive AChR antibodies were recorded, the initial symptoms were purely ocular, and all had at least 2 years of follow-up. The patients who developed generalized myasthenia gravis were compared with those who remained purely ocular.ResultsThere were 21 patients who developed generalized myasthenia gravis. Of these 21, only 2 (9.5%) had received prior immunotherapy. Among the 13 patients whose symptoms remained purely ocular, 10 (76.9%) had received prior immunotherapy.ConclusionsIn this study, most of the patients who progressed from ocular myasthenia to generalized myasthenia had not received prior immunotherapy. This study adds weight to the call for a prospective trial of early immunotherapy in patients with ocular myasthenia.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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3. |
Interferon-&agr;–Associated Bilateral Simultaneous Ischemic Optic Neuropathy |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 256-259
Yoav Vardizer,
Yifat Linhart,
Anat Loewenstein,
Hanna Garzozi,
Nail Mazawi,
Anat Kesler,
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摘要:
The authors describe one patient with essential thrombocytosis and one with chronic hepatitis C infection who developed bilateral simultaneous anterior ischemic optic neuropathy within 3 months of starting treatment with interferon-&agr;. One patient had several typical risk factors for conventional AION; the other did not. These cases are the fourth and fifth reported examples of this phenomenon. Interferon-&agr; treatment may cause or aggravate the risk of developing anterior ischemic optic neuropathy. Vulnerable patients should be advised of this potential complication, assisted in reducing risk factors, and monitored for optic nerve and retinal vascular complications.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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4. |
Laser Pointer Visual Field Screening |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 260-263
Michael Lee,
Laura Balcer,
Nicholas Volpe,
Grant Liu,
Gui Ying,
Steven Galetta,
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摘要:
BackgroundSensitivity of confrontation visual field (CVF) screening is low unless defects are significant. We compared the sensitivity of laser pointer visual field screening (LVF) with conventional CVF for identifying eyes with abnormal automated perimetry.MethodsNinety consecutive patients presenting for HVF prospectively underwent a masked comparison of CVF and LVF testing (175 eyes) from April to May 2000. LVF was performed using a laser pointer target projected onto a tangent screen. Points were tested in random fashion on either side of the vertical and horizontal meridians, near central fixation, around the blind spot, and in each quadrant. Single and double simultaneous finger counting was used to test CVF.ResultsLVF demonstrated significantly greater sensitivity as compared with CVF (73% versus 31%,P= 0.001) in identifying field defects found on HVF. Specificities for LVF and CVF were 82% and 99%, respectively. The average testing times per eye were 0.5 minute for CVF, 1.5 minutes for LVF, and 8.0 minutes for HVF.ConclusionsIn this cohort, laser visual field testing was significantly more sensitive than confrontation testing. It may represent an effective, time-efficient tool for visual field screening.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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5. |
Posner-Schlossman Syndrome and Nonarteritic Anterior Ischemic Optic Neuropathy |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 264-267
Inci Irak,
Bradley Katz,
Norm Zabriskie,
Paul Zimmerman,
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摘要:
A 41-year-old woman with acute OD pain and decreased visual acuity presented with anterior uveitis, an intraocular pressure of 56 mm Hg, an open angle, ipsilateral nerve fiber bundle visual field defects, and optic nerve edema. With control of intraocular pressure and uveitis, visual acuity improved to 20/25, visual field defects persisted, and optic disc pallor developed. She has remained stable over 23 months of follow-up. This case represents a concurrence of glaucomatocyclitic crisis (Posner-Schlossman syndrome, PSS) and nonarteritic ischemic optic neuropathy (NAION). Although this combination occurs rarely, patients with PSS and other risk factors for NAION, including an optic disc that lacks a physiologic cup, should be protected against NAION by prophylactic treatment with ocular antihypertensive medications.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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6. |
Solitary Intracranial Extra-osseous Plasmacytoma Presenting with Ophthalmic Signs |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 268-271
Suzanne Brannan,
Bethan Matthews,
Vijay Savant,
Ray Brown,
Timothy Matthews,
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摘要:
Solitary plasmacytomas rarely develop in the skull, meninges, or brain. Ophthalmic signs as the initial manifestations of solitary intracranial plasmacytoma have rarely been described. We report the neuro-ophthalmologic, imaging, and pathologic findings for two patients. One patient presented with optic neuropathy, the second with bilateral sixth nerve palsies. Plasmacytoma is a treatable intracranial tumor that should be considered in the differential diagnosis of patients who present with optic neuropathy or sixth nerve palsy.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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7. |
Siegrist Streaks in Giant Cell Arteritis |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 272-273
Dustin Coupal,
Anil Patel,
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摘要:
A patient who presented with symptoms of giant cell arteritis was found to have a right ophthalmic artery occlusion. One month after initial evaluation, the peripheral retina demonstrated multiple linear bands of chorioretinal atrophy known as Siegrist streaks. Although most commonly described in the setting of acute hypertension, Siegrist streaks also occur in patients with giant cell arteritis.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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8. |
Retinal Vascular Abnormalities in Neurofibromatosis Type 1 |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 274-275
Panagiotis Karadimas,
Efterpi Hatzispasou,
Evrydiki Bouzas,
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摘要:
Microvascular retinal abnormalities, presenting in a corkscrew configuration, have been very recently described in patients with neurofibromatosis type 1 (NF-1). We report one more patient with NF-1 who had distinctive corkscrew retinal vessels superior and inferior to the fovea. This patient further supports the existence of a true association between this recently described retinal finding and NF-1.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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9. |
Rocky Mountain Spotted Fever as a Cause of Macular Star Figure |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 276-278
Michael Vaphiades,
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摘要:
An 86-year-old woman with a history of tick bites in the previous months developed subnormal visual acuity in both eyes, keratic precipitates, anterior chamber and vitreous cells, optic disc edema, retinal hemorrhages, and retinal arteriolar sheathing. She had no fever or skin rash. Three weeks later, binocular macular star figures appeared. Brain imaging was negative; cerebrospinal fluid disclosed a lymphocytic pleocytosis and elevated protein. The serumRickettsia rickettsiiantibody test was markedly positive, establishing a diagnosis of Rocky Mountain Spotted Fever (RMSF) as the cause of the ophthalmic findings. Despite treatment with oral doxycycline, these findings improved only modestly. Although neuroretinitis has been previously described in RMSF, macular star has not been documented.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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10. |
The Multifocal Visual Evoked Potential |
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Journal of Neuro-Ophthalmology,
Volume 23,
Issue 4,
2003,
Page 279-289
Donald Hood,
Jeffrey Odel,
Bryan Winn,
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摘要:
With the multifocal technique, visual evoked potentials (VEPs) can be recorded simultaneously from many regions of the visual field. For the multifocal VEP (mfVEP), the patient views a display that typically contains 60 sectors, each with a checkerboard pattern. The display covers about the same retinal area as the 24–2 Humphrey visual field (HVF). However, due to the scaling of the sectors of the mfVEP display, the fields are sampled differently by the mfVEP and HVF. To assess local defects in the visual field, the mfVEP responses must be compared with normal controls. These comparisons require relatively sophisticated analyses and software. Whereas the mfVEP can be recorded relatively easily with the same equipment used to record multifocal electroretinograms (mfERGs), the software needed to perform the analysis is not yet widely available. The mfVEP is valuable for ruling out non-organic visual loss, diagnosing and following patients with optic neuritis/multiple sclerosis, evaluating patients with unreliable or questionable HVFs, and following disease progression. When combined with the mfERG, diseases of the outer retina (before the retinal ganglion cells) can be distinguished from diseases of the ganglion cells and/or optic nerve. The difficulties encountered in recording and analyzing mfVEP responses are greater than those involved in full-field VEP testing. Thus, in its current form, the mfVEP is best recorded and interpreted by ophthalmologists and electrophysiologists experienced with the technique. However, this technique is developing rapidly; advances in commercial hardware and software are expected in the near future.
ISSN:1070-8022
出版商:OVID
年代:2003
数据来源: OVID
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