ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Given the ever-increasing number of drugs available for the treatment of a variety of ocular and systemic disorders, it is not surprising that neuro-ophthalmologic complications are being recognized with increasing frequency. In this chapter, we describe both previously unreported (or rarely described) neuro-ophthalmologic complications produced by well known medications and neuro-ophthalmologic complications produced by new medications. The medications discussed include antidepressants, antiepileptic medications, topical antiglaucoma medications, and chemotherapeutic/immunosuppressive agents. Most of the side effects produced by these medications affect visual sensory function; however, some produce disturbances of ocular motility and alignment. Some of these effects are related directly to drug toxicity, whereas others are related to secondary effects of the drug. The heterogeneity of the pathogenesis of side effects from these drugs explains why some of the side effects are reversible, whereas others are not.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Stroke is the second most common cause of death worldwide, exceeded only by heart disease. Epidemiologic studies have greatly enhanced our understanding of the factors that increase stroke risk. There have also been many recent developments in the understanding of the various etiologies of stroke as well as specific new treatments. The characteristic sudden onset and rapid tissue damage make stroke particularly challenging to treat. The most promising therapy for acute ischemic stroke is the use of a thrombolytic agent. This has been the focus of recent large trials and remains a challenging treatment for cerebral ischemic stroke as well as for retinal artery occlusion. Because neuro-ophthalmic symptoms and signs such as vision loss and diplopia are common in patients with stroke, patients are often seen by ophthalmologists prior to their primary care physicians or neurologists. The ophthalmologist should be aware of some of the new diagnostic and therapeutic issues in the management of patients with acute ischemic stroke. This review emphasizes some of the controversial topics published during the past few years.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Movement disorders are a diverse group of neurologic disorders that share in common the frequent development of clinical abnormalities in ocular motility or visual perception. This article reviews the recent literature pertaining to the neuro-ophthalmologic advances in the basal ganglia disorders (Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, multiple system atrophy, and Huntington disease), the spinocerebellar ataxias and episodic ataxias, amyotrophic lateral sclerosis, benign essential blepharospasm, hemifacial spasm, and Tourette syndrome.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Polymorphism in mitochondrial DNA necessitates careful scrutiny of potentially pathogenic mutations to establish their true pathogenic significance. Research on Leber hereditary optic neuropathy continues to provide insights into the pathogenesis of mitochondrial disease. Interest in the retinal manifestations of mitochondrial disease has highlighted the macular dystrophy of the 3243 mutation, particularly in association with the syndrome of maternally inherited diabetes and deafness. Mitochondrial encephalopathies present in a number of ways, but imaging predominantly shows abnormalities of myelin and grey-matter nuclei. The mitochondrial myopathies provide insights into interactions between nuclear and mitochondrial DNA mutations and parallels between mitochondrial diseases and aging.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The phacomatoses are a group of disorders that feature multiple hamartomas of the central and peripheral nervous system, eye, skin, and viscera. Most of these disorders have a well-defined Mendelian pattern of inheritance because of a mutation in a single gene which has been identified. In other instances, no clear patterns of inheritance or genetic susceptibility have been recognized. The combination of ocular and central nervous system manifestations in patients with phacomatoses makes neuro-ophthalmologic evaluation particularly important in diagnosis and management. This review provides an overview of the phacomatoses with emphasis on recent reports of significance to neuro-ophthalmology.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Experimental models of human diseases have affected the design and direction of both basic and clinical research into understanding the pathogenesis and treatments of demyelinating disease, stroke, and hereditary disorders of the central nervous system. However, in spite of major advances in molecular research that have linked Leber Hereditary Optic Neuropathy to mutations in mitochondrial DNA, there has been relatively little focus in applying basic scientific methodologies to optic neuropathies other than glaucoma. The relative absence of detailed scientific knowledge about the basic mechanisms involved in the pathogenesis of optic nerve injury has contributed to the use of empiric therapies for neuro-ophthalmic optic neuropathies. Over the past decade major clinical trials, such as the Optic Neuritis Treatment Trial and Ischemic Optic Neuropathy Decompression Trial, have proven that currently available treatment options for demyelinating and ischemic optic neuropathies are ineffective and can even be harmful. Although the pathogenesis of visual failure in demyelinating, ischemic, and hereditary optic neuropathies appears diverse, a final common pathway for irreparable optic nerve injury may exist. This article reviews several models of experimental optic neuropathies that may aid in the development of novel treatments for neuro-ophthalmic disorders of the optic nerve during the 21st century.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A new paradigm emerges: visual field defects after optic nerve or brain injury are partially reversible. Using high-resolution visual field tests, areas of residual vision can be identified which are characterized by impaired vision (relative defect) with some residual capacities. By repetitively stimulating these partially damaged areas with daily computer-based visual restitution training it is now possible to enlarge the visual field. Average border shifts of 5° (range, 0 to 20°) have been found in clinical trials, and training is effective even when started years after the injury. Visual restitution training is useful for the treatment of patients with stroke, head injury, or partial optic nerve damage, as long as the patient presents some residual vision. The improved vision is maintained in most patients after training is discontinued. Brain plasticity is likely to provide the substrate for restoration of vision, opening new opportunities to treat partial blindness, which has been considered irreversible.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Vogt-Koyanagi-Harada (VKH) disease affects primarily persons who are Asian, Latino, Native American, or Asian Indian. Women appear to be affected more commonly than men, and VKH disease may occur at all ages, including childhood. Experimental data continue to support an autoimmune etiology for VKH disease, directed most probably against an antigenic component of the melanocyte, possibly tyrosinase or a tyrosinase-related protein. The clinical diagnosis of VKH disease continues to be based on physical findings. Newer imaging modalities such as magnetic resonance imaging, indocyanine green angiography, and digital image analysis have not added appreciably to our understanding of the condition. First-line therapy consists of high-dose corticosteroids, with use of corticosteroid–sparing agents for resistant or recalcitrant disease. Complications are the main cause of reversible and irreversible vision loss, with subretinal fibrosis and choroidal neovascular membranes having particularly poor prognoses.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID