摘要:

Mutations in the genetic material of mitochondria have been described in patients with a range of neuro- ophthalmological and neuromuscular disorders. Many cases of Leber's hereditary optic neuropathy are caused by a single point mutation, for example, and Kearns- Sayre syndrome, chronic external ophthalmoplegia, and other mitochondrial cytopathies are frequently associated with large-scale deletions of mitochondrial genes. A knowledge of the role of the mitochondrial genome and of the precise nature of these mutations is important in understanding the etiology of such diseases and is already leading to more effective therapy.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We reviewed the neuro-ophthalmic findings in 177 subjects with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex who underwent an eye examination in one center from January 1984 to May 1989. The findings included ocular motor nerve palsies (five cases), papilledema (two cases), cytomegalovirus optic neuritis (two cases), cortical blindness (one case), conjugate gaze palsy (one case), and altitudinal visual field defect (one case). These findings were attributed to central nervous system toxoplasmosis (four cases) or lymphoma (one case), cryptococcal meningitis (two cases), systemic cytomegalovirus infections (two cases), and herpes simplex encephalitis (one case). Of 177 patients, 61 patients were tested for syphilis. Twenty-six patients had positive rapid plasma reagin titers, and 28 had positive fluorescent treponemal antibody-absorbed tests. Human immunodeficiency virus-infected individuals need to be screened routinely for syphilis.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 68-year-old man developed the sudden onset of transient obscurations of vision in the right eye in November 1988. Two weeks later he noted floaters, photophobia, and blurred vision in the left eye. He presented with unilateral optic disc edema in the right eye. The left eye showed anterior uveitis but a normal optic disc. He was found to be violently seroreactive forTreponema palliduminfection and was also human immunodeficiency virus (HIV) seropositive. Ultrasonography confirmed the presence of a solid thickening of the anterior optic nerve sheath in the right eye. An interesting and dramatic response to penicillin therapy occurred. This is the first instance of a gumma or solid syphiloma of the optic nerve documented by ophthalmic ultrasonography.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A patient with a 30-year history of blindness in the right eye developed progressive temporal visual loss in the left eye. Examination showed right optic atrophy with optociliary shunts and left band atrophy. These clinical findings suggested that the visual deficit was caused by a right optic nerve sheath meningioma that had grown intracranially to involve the chiasm. Magnetic resonance imaging and surgical exploration revealed a perioptic meningioma extending from the orbit through the optic canal and over the tuberculum sellae. The tumor did not impinge on the optic chiasm or the left optic nerve. The chiasm was compressed by a thrombosed giant right internal carotid artery aneurysm.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 49-year-old woman with a 6-year history of headaches was found to have a pale right optic disc with narrowed retinal arterioles and a congested left optic disc. Her visual acuity was 20/20 in each eye with normal visual fields in May 1983. These findings were attributed to a previous attack of nonarteretic anterior ischemic optic neuropathy (AION). She had a normal neurologic examination and a normal head computed tomographic (CT) scan performed 2 years prior to her initial ophthalmologic evaluation. She was followed over the next 2 years without change in her fundus examination. In December 1987, after a generalized tonic-clonic seizure, she was found to have a large right frontoparietal mass without direct impingement on the optic nerves, or chiasm on neuroradiological studies. At this time she developed marked papilledema in the left eye with a pale optic disc in the right eye remaining unchanged. Histopathological diagnosis of malignant glioma was made. Two diseases, ischemic optic neuropathy and glioma, in one patient represents a bizzare example of the pseudo-Foster Kennedy syndrome.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 60-year-old woman developed embolic occlusion of a branch retinal artery following septic cavernous sinus thrombosis. Two days later it was followed by loss of light perception due to embolic or vasculitic ischemic optic neuropathy. Recurrent emboli from a focus of carotid arteritis in cavernous sinus thrombosis may be responsible for visual loss in such eyes.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 20-year-old woman presented with bilateral ptosis, total ophthalmoplegia, cerebellar symptoms, and hyporeflexia, indicating Fisher's syndrome. She had been diagnosed with infectious mononucleosis 2 months previously. Increased Epstein-Barr virus (EBV) titer was noted, and the Epstein-Barr virus-associated nuclear antigen (EBNA) became positive during the clinical course. Apparent light-near dissociation of the pupils was noted and accommodation was intact. During pharmacological tests with topical application to the eye by sympathomimetic or parasympathomimetic drugs, the pupils showed no supersensitivity, indicating possible central disorder. Enhanced ptosis was noted in each eye and this condition was aggravated by manually lifting the eyelids. The recovery latency time of this enhanced ptosis was 180 ms, indicating a central polysynaptic process to possibly be the cause. Although this condition is considered specifically associated with peripheral neural or muscle diseases, the present case would indicate a central disorder as a possible mechanism.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We report a case of a 47-year-old woman with rheumatoid arthritis who developed ocular myasthenia gravis during penicillamine treatment. Her serum contained elevated titers of acetylcholine receptor antibodies, and her symptoms resolved 8 weeks after discontinuation of penicillamine. We review the clinical and laboratory features of this syndrome of penicillamine-induced myasthenia gravis and discuss its pathophysiology and treatment.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 69-year-old diabetic patient taking oral hypoglycemic drugs and with no systemic complications presented a right peripheral facial palsy, and 2 months later a complete right external ophthalmoplegia with sparing of the pupillary function. Clinical, radiologic, and other laboratory investigation ruled out compressive, infectious, and inflammatory etiology. Four months later, after achieving good metabolic control, there was almost complete recovery of the ophthalmoplegia without signs of aberrant regeneration of the third nerve. Diabetes is proposed as the etiology of this case. A possible anatomic substrate is presented to explain the findings.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A patient with olivopontocerebellar atrophy presented with an asymmetric parkinsonian syndrome consisting of right limb rigidity, bradykinesia, masked facies, and a hypophonic, monotonous voice. Right limb clumsiness suggested corticospinal tract involvement. Gait was slightly wide based, but no other cerebellar or brainstem signs were present. Eye movements were characteristic of parkinsonism with low-gain pursuit and hypometric rightward saccades. Saccadic velocity and the vestibular ocular reflex were within normal limits. There was no pathologic nystagmus or saccadic dysmetria. Magnetic resonance imaging showed cerebellar and lower brainstem atrophy virtually diagnostic of olivopontocerebellar atrophy. Olivopontocerebellar atrophy may present uncommonly with asymmetric parkinsonian features, including parkinsonian eye movement abnormalities.

ISSN:0272-846X    

出版商:OVID    

年代:1990

数据来源: OVID