摘要:

ObjectiveTo determine the hemodynamlc abnormalities that result in visual acuity loss because of retinal or choroidal dysfunction associated with arteriovenous shunts (AVS) that involve the cavernous sinus.MethodsRetrospective study of the records of 250 patients with either a carotid cavernous fistula or dural arteriovenous malformation revealed a total of 10 patients with vision loss secondary to retinopathy (group I) or choroidal effusion (group II). The cerebral angiograms of these 10 patients and 10 additional patients with visual dysfunction due to elevated intraocular pressure (group III) were evaluated to determine whether the three groups could be distinguished by a specific vasculopathic pattern. Particular attention was given to the extent of thrombosis in the ophthalmic venous system and cavernous sinus.ResultsThere were angiographic signs of severe thrombosis in the ophthalmic vein in nine patients and in the cavernous sinus in seven patients ipsilateral to the retinal or choroidal lesion. In contrast, in group III, severe thrombosis in the ipsilateral ophthalmic vein and in the cavernous sinus occurred in one and two patients, respectively. Closure of the AVS improved the visual acuity in 1 of 4 patients in group I and in 4 of 5 patients in group II, and normalized the intraocular pressure in all patients.ConclusionsOphthalmic vein thrombosis, rather than arterialization of the venous system or an arterial “steal,” is the principal cause of retinal or choroidal dysfunction associated with AVS to the cavernous sinus. Following AVS closure, visual recovery is more frequent with choroidal effusion or detachment rather than with retinopathy.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Anterior ischemic optic neuropathy (AION) is a condition more commonly found in later life. We present a case of unilateral AION in a 13-year-old boy with small discs and ipsilateral optic nerve head drusen.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A case of bilateral retrobulbar optic neuritis with profound visual loss is described. Magnetic resonance imaging (MRI) with fat-saturation suppression and gadolinium enhancement done 15 days after the onset of symptoms demonstrated bilateral posterior optic nerve disease in a pattern similar to that seen in previously reported cases. However, subsequent retrospective review of an MRI study done at a different hospital during the first week of disease demonstrated a single focus of gadolinium enhancement within the body of the chiasm. This observation suggests that bilateral demyelination of the posterior optic nerves may begin as a single focus of chiasmal disease that then spreads to involve the proximal portions of the optic nerves.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Ocular manifestations of an acquired cytomegalovirus (CMV) infection are often associated with the patient being in an immunocompromised state. In the vast majority of cases, the affliction appears as a necrotic retinitis; an isolated optic nerve lesion is seen less frequently. To date, only two cases of CMV retinitis and one case of bilateral acute retinal necrosis have been reported in healthy individuals. We describe a 32-year-old healthy woman who developed bilateral papillitis. Tests were positive for acute CMV infection but negative for an immunocompromised state. We changed the antiviral therapy from acyclovir to foscarnet in association with corticosteroids, and resolution of the papillitis and recovery of visual acuity were obtained.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A 68-year-old woman presented with diplopia. Fluctuations of dysfunction of lateral rectus muscles in both eyes were detected on consecutive examinations. The diagnosis of ocular myasthenia was proposed. After the initiation of therapy, the patient complained of disturbing micropsia. The micropsia and diplopia were relieved by occlusion of one eye or by a base-out prism over one of the patient's eyeglass lenses. Mechanisms of micropsia are discussed.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Six patients with unilateral epiretinal membrane of the macula perceived the spontaneous Pulfrich psychophysical stereo-illusion, suggesting a relative conduction delay on the side of the membrane. In three of these patients, visual-evoked potential studies were also obtained and confirmed an absolute conduction delay in the anterior pathway on the side of the epiretinal membrane in two patients and an absence of the P 100 wave on the side of the epiretinal membrane in the third patient. It is important to recognize that the Pulfrich psychophysical stereo-illusion can be spontaneously perceived in macula disease, and therefore, the test may not always distinguish optic nerve from macula disease. Key Words: Epiretinal membrane—Pulfrich stereoillusion—Visual-evoked potentials—Optic nerve.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Superior oblique myokymia (SOM) is an uncommon ocular motility disorder characterized by intermittent uniocular vertical or torsional oscillations with periodic remissions and exacerbations. Although generally idiopathic in origin, isolated case reports have documented its association with intracranial pathology. We present a case of superior oblique myokymia associated with a dural arteriovenous fistula.

ISSN:1070-8022    

出版商:OVID    

年代:1996

数据来源: OVID