摘要:

Objective:To study the effects of sildenafil on blue‐on‐yellow and white‐on‐white Humphrey visual field (HVF).Materials and Methods:Healthy subjects, ages 20 to 38 years, were prospectively randomized to active drug (n = 5) or placebo (n = 3) groups. Blue‐on‐yellow and white‐on‐white HVF testing was performed before and 1 hour after masked dosing of sildenafil 200 mg or placebo. Changes in mean deviation (MD) were compared between groups.Results:Three of three placebo and four of five sildenafil subjects had no change on HVF. One of five sildenafil subjects had a decrease in MD of 17.9 dB and 4.7 dB on blue‐on‐yellow and white‐on‐white HVF testing, respectively. This subject reported more systemic side effects than other subjects.Conclusions:Sildenafil has no effect on HVF testing in most persons; however, sildenafil caused an acute abnormality of HVF testing in one subject, who experienced pronounced nonvisual systemic symptoms; this effect was greater on blue‐on‐yellow than white‐on‐white HVF.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;The purpose of this article is to describe a 75‐year‐old patient with an acute central retinal artery occlusion after a local anesthetic with adrenaline on nasal mucosa. The local anesthetic was used in removing Jackson tubes from the left lacrimal canal. Occlusion of the central retinal artery related to nasal operations is a rare complication. In previous reports, retinal artery occlusions have been noted in connection with nasal submucosal injections of anesthetic and epinephrine. In our case, the use of anesthetic and adrenaline was superficial.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Cervical manipulation, specifically chiropractic manipulation, is an important cause of vertebrobasilar and occasionally carotid distribution strokes. Neuro‐ophthalmologic findings are a common and at times relatively isolated feature of cervical manipulation‐induced stroke. A case of chiropractic‐induced occipital lobe infarction with homonymous hemianopsia is reported, and the literature regarding neuro‐ophthalmologic findings is reviewed.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;A 74‐year‐old man experienced vertical diplopia. Two years earlier, he was diagnosed with a squamous cell carcinoma of the periorbital frontal skin, with perineural spread involving the ophthalmic division of the right trigeminal nerve and the right facial nerve. The clinical findings were consistent with a right fourth cranial nerve palsy. Computerized tomography and magnetic resonance imaging demonstrated a discrete mass involving the belly of the right superior oblique muscle. An anterior orbitotomy and biopsy demonstrated a mass extending into the belly of the superior oblique muscle. Histology revealed an infiltrating squamous cell carcinoma. The possibility of perineural, direct, or metastatic spread to the superior oblique muscle should be considered in a patient with a history of squamous cell carcinoma of the head and neck. The authors believe this case to be the first report of superior oblique underaction due to involvement of the muscle by squamous cell carcinoma, presumably because of perineural spread. Diagnosis was made possible by neuroimaging and histopathology. There was good short‐term resolution of the patient's diplopia after radiotherapy.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Multiple myeloma and plasmacytoma are rare causes of mass lesions at the skull base and cavernous sinus. Sixth nerve palsy, in isolation or in combination with other cranial neuropathies, may occur rarely as the initial presenting feature of multiple myeloma. We report the neuro‐ophthalmologic, radiologic, and pathologic findings for two patients who developed sixth nerve palsies as an initial manifestation of intracranial plasmacytoma and multiple myeloma. One patient presented with an isolated sixth nerve palsy in the setting of multiple vasculopathic risk factors. Treatable skull base lesions, including plasmacytoma and multiple myeloma, must be considered in patients with sixth nerve palsies, especially among those who demonstrate a progressive course or multiple cranial neuropathies.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objective:We postulated that an alteration in endogenous vitamin A (retinol) metabolism plays a causal role in the pathogenesis of idiopathic intracranial hypertension (IIH).Materials and Methods:Serum retinol was determined by a fluorometric method from 40 control subjects and 58 patients with idiopathic intracranial hypertension (IIH). Retinol binding protein (RBP) was also assayed by quantitative radial immunodiffusion in 17 control subjects and 30 patients with IIH.Results:Mean retinol values were higher in the IIH group compared with the control group, but did not reach a significant level. However, seven of 30 patients with IIH had high RBP levels, but none of the control subjects did.Conclusion:This data suggests that IIH is associated with an abnormality in vitamin A metabolism that is linked to its transport system.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objectives:To review the presenting symptoms and ophthalmic findings of 57 patients with cavernous carotid aneurysms of giant size (≥2.5‐cm diameter).Materials and Methods:Hospital charts of 57 patients with giant cavernous carotid aneurysms who presented to University Hospital in London, Ontario, Canada between 1961 and 1993 were reviewed. All patients were proven by cerebral angiography to have unruptured giant cavernous carotid aneurysms.Results:Forty‐six patients (81%) were women (mean age, 54 years). The most common presenting symptoms were diplopia (89%), retroorbital pain (61%), headache (19%), diminished or blurred vision (14%), and photophobia (4%). The most common clinical sign was partial or complete ophthalmoplegia (93%). Trigeminal nerve involvement was found in 37% of patients. Other clinical signs included ptosis, decreased visual acuity, proptosis, and visual field defects.Conclusions:This study characterizes a large group of patients with giant cavernous carotid aneurysms seen over a 30‐year period at a single institution. As in previous studies, diplopia and retroorbital pain were the most common symptoms. The high incidence of ophthalmoplegia observed in this study may be explained by a greater compressive and/or ischemic effect of giant aneurysms compared with their smaller counterparts.

ISSN:1070-8022    

出版商:OVID    

年代:2001

数据来源: OVID