1/90. On the visual disturbances associated with massive basal aneurysms.When massive basal aneurysms compromise the anterior visual pathways the resulting disturbances of vision are diverse and a firm clinical diagnosis is difficult. Because of the rarity of the condition, a critical analysis of the visual defects was made in five personally studied patients with large anterior basal aneurysms in an effort to clarify the clinical features of the disorder. These observations were related to those reported in larger series of patients by Jefferson and Bull. This study gives support to the opinion that the commonest visual defect seen with massive basal aneurysms is impairment of visual acuity, followed next in frequency by bitemporal hemianopia, and then by junction scotoma.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
2/90. Toxic optic neuropathy after concomitant use of melatonin, zoloft, and a high-protein diet.melatonin is a neuromodulating hormone found in the pineal gland and retina. It is involved in light-dark circadian rhythms and mediates retinal processes in a manner antagonistic to that of dopamine. Zoloft (sertraline) is an antidepressant drug that blocks the reuptake of serotonin at the neural synapse. serotonin is the natural precursor of melatonin. A 42-year-old woman sought treatment for visual acuity loss, dyschromatopsia, and altered light adaptation. Neuro-ophthalmologic examination was otherwise normal except for evolving bilateral cecocentral scotomas. She had taken Zoloft for 4 years and began a high-protein diet with melatonin supplementation 2 weeks before onset of visual symptoms. visual acuity and color vision improved within 2 months after melatonin and the high-protein diet were discontinued. Combined use of melatonin, Zoloft, and a high-protein diet may have resulted in melatonin/dopamine imbalance in the retina, manifesting as a toxic optic neuropathy. physicians and patients should be alerted to this potential drug interaction.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
3/90. Cilioretinal artery occlusion during coronary catheterization.PURPOSE: To report on a patient with cilioretinal artery occlusion during cardiac catheterization. methods: A 51-year-old man complained of blurred vision in the left eye immediately following cardiac catheterization. visual acuity was 6/12 and the eye had a dense central scotoma. RESULTS: Mild retinal whitening of the posterior pole and segmented filling of the cilio-retinal artery established the diagnosis of cilioretinal artery occlusion. Immediate paracentesis was performed. Two weeks later, a tiny central scotoma could be observed and visual acuity was 6/6. CONCLUSIONS: cardiac catheterization may result in retinal infarction. awareness to any visual symptoms, immediate diagnosis and prompt intervention may prevent permanent visual impairment.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
4/90. coffee and doughnut maculopathy: a cause of acute central ring scotomas.AIMS: To report the clinical features of five patients with non-progressive central ring scotomas of acute onset associated with excellent retained visual acuity. methods: Complete neuro-ophthalmological examinations were performed. visual fields were performed by tangent screen, Goldmann, or Humphrey perimetry. In some cases further testing was carried out including fundus photography, fluorescein angiography, ERG, VEP, and neuroimaging. RESULTS: The patients were three women and two men whose ages ranged from 25 to 57 years. Four patients were heavy caffeine consumers while the fifth patient experienced an episode of hypotension. Vision loss was acute in all cases. The onset of vision loss was bilateral/simultaneous in three cases, bilateral/sequential in one case, and unilateral in one case. All affected eyes retained visual acuities of 20/25 or better. Colour vision was subnormal in three of four cases. Visual field defects were characterised by a central ring scotoma having an outer diameter less than 10 degrees. Fundus examination demonstrated temporal optic nerve pallor in three patients (five of 10 affected eyes) and reddish, petaloid macular lesions in one patient. Good visual acuity was maintained for the duration of follow up in all five patients. CONCLUSION: Central ring scotomas with excellent retained visual acuity may present as an acute, bilateral syndrome in patients who are heavy caffeine consumers. The configuration of visual field loss and its location, combined with the presence of temporal pallor in five eyes, suggest that the defect localises to the inner layers of the macula. While these cases could be considered an expansion of the clinical spectrum of acute macular neuroretinopathy, some may represent a distinct entity.- - - - - - - - - - ranking = 2keywords = vision (Clic here for more details about this article) |
5/90. Single isolated cotton-wool spots.The presence of isolated cotton-wool spots in normal fundi may indicate serious systemic disease. In this presentation 4 patients were examined for blurred vision or scotomas with sudden onset. Two of them were pregnant. Funduscopic examination revealed soft-appearing white spots in the temporal arcades in 3 patients and in the papillomacular bundle in 1 patient. Due to the lack of other fundus lesions 3 of the patients were initially treated for toxoplasmosis. The patients were seronegative for typical viral (hiv), antinuclear antibodies, bacterial infections, or toxoplasmosis. blood pressures, glycosylated hemoglobin and blood counts were in the normal range. At the follow-up examinations subjective symptoms had improved and the spots disappeared or were smaller and showed more distinct borders, and no new lesions were detected. These cases suggest that isolated cotton-wool spots may occur without serious systemic disease in otherwise healthy subjects and the spots may be misinterpreted as acute inflammatory retinochoroidal lesions.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
6/90. Scanning laser entoptic perimetry for the screening of macular and peripheral retinal disease.OBJECTIVE: To determine the effectiveness of scanning laser entoptic perimetry as a noninvasive platform for screening for retinal damage in visually asymptomatic patients within the central 120 degrees (diameter) of vision. DESIGN: A masked study comparing entoptic perimetry with fundus photographs. SETTING: The Shiley eye Center and the AIDS Ocular research Unit at the University of california, San Diego. patients: Fifty-eight patients recruited during ophthalmologic visits for treatment or follow-up of ocular disease. MEASUREMENTS: For each testing session, we compared the presence of a disturbance in the entoptic stimulus with the presence of retinal disease within the central 120 degrees of vision, centered on the fovea. RESULTS: Scanning laser entoptic perimetry has a sensitivity and specificity of more than 90%, a positive predictive value of 100%, and a negative predictive value of 89% for screening retinal lesions within the central 120 degrees diameter of vision. CONCLUSION: Scanning laser entoptic perimetry may be an effective and inexpensive screening test for diagnosing retinal disease in hospitals and community clinics. Arch Ophthalmol. 2000;118:1205-1210- - - - - - - - - - ranking = 3keywords = vision (Clic here for more details about this article) |
7/90. Compressive optic neuropathy caused by renal osteodystrophy. Case report.Compressive optic neuropathy with acute or chronic vision loss has been associated with various skull base tumors, aneurysms, graves disease, trauma, and, less commonly, fibrous dysplasia and osteopetrosis. The authors present a case of acute visual deterioration in a 25-year-old woman who had massive calvarial hypertrophy with optic canal stenosis secondary to renal osteodystrophy (uremic leontiasis ossea [ULO]: bighead disease). Significant visual field restoration was achieved with high-dose corticosteroids followed by optic nerve decompression. This is the first case report of cranial neuropathy associated with ULO.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
8/90. Ring scotomata in fundus flavimaculatus.Ring scotomata were associated with fundus flavimaculatus in six patients. The demonstration of ring scotomata in patients with fundus flavimaculatus helps to explain persistent visual complaints that may exist in the presence of normal central visual acuity. In many instances, ring scotomata cannot be predicted on the basis of the ophthalmoscopic findings. The presence of ring scotomata appears to be an ominous finding, even when associated with normal central visual acuity, for in three of our patients it preceded loss of central vision by 1 1/2 to four years.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
9/90. Retinal ischemia in diabetic retinopathy.Eight patients with proliferative diabetic retinopathy developed extensive retinal arteriolar and capillary obstruction. ophthalmoscopy showed many white, thread-like retinal arterioles associated with capillary and venous dilatation. Widespread retinal arteriolar and capillary nonperfusion was demonstrated by fluorescein angiography. Ischemic maculopathy resulted in severe loss of visual acuity in some eyes. The severe degree of retinal ischemia was accompanied by optic disc pallor and neovascularization and a high incidence of rubeosis iridis with neovascular glaucoma. patients with this variety of diabetic retinopathy have a poor prognosis of retaining useful vision.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
10/90. Antirecoverin antibody in the aqueous humor of a patient with cancer-associated retinopathy.PURPOSE: To describe a patient with cancer-associated retinopathy (CAR) in whom antirecoverin antibody was found in the aqueous humor.DESIGN: Interventional case report.methods: A 65-year-old man underwent resection of adenocarcinoma of the lung in June 1991 and noted deterioration of vision 10 months later. Goldmann perimetry revealed a ring-like scotoma in each eye, and the electroretinogram was nonrecordable. aqueous humor and peripheral venous blood were collected for Western blot analysis from this patient and three other patients during surgery for age-related cataract.RESULTS: We found antirecoverin antibody within the aqueous humor and serum in the patient with CAR. In contrast, such imunoreactivities were not observed in specimens from the control patients.CONCLUSION: These observations strongly suggest that antirecoverin antibody penetrates into the aqueous humor and vitreous cavity beyond the blood-retina barrier in CAR.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
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