1/3. ophthalmic artery occlusion secondary to radiation-induced vasculopathy.A 35-year-old man with neurofibromatosis type 1 (NF1) had a left ophthalmic artery occlusion that caused no light perception OS 28 years after having been treated with external beam radiation therapy for a presumed glioma of the right optic nerve and chiasm. Clinical and imaging findings were consistent with radiation-induced cerebral vasculopathy. This ophthalmic complication has never been reported, despite the common occurrence of severe carotid-ophthalmic artery junction stenosis after radiation in NF1 patients. Even though modern radiation techniques limit collateral damage, this modality should be used with discretion in NF1 patients, given the vulnerability of their immature cerebral vasculature to radiation.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
2/3. Total blindness from presumed optic nerve melanocytoma.PURPOSE: To describe total blindness secondary to presumed optic nerve melanocytoma. DESIGN: Interventional case report. methods: A 12-year-old African-American girl, who developed loss of light perception secondary to a pigmented lesion of the optic disk, underwent transvitreal fine-needle aspiration biopsy (FNAB) of the lesion. RESULTS: Cytopathology revealed cells with features of melanocytoma and melanophages but no cells compatible with melanoma. The patient is being followed without treatment. CONCLUSIONS: optic nerve melanocytoma can cause total blindness in the affected eye. Although it has limitations, FNAB can assist in diagnosis and management of melanocytoma with visual loss.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
3/3. role for surgery as adjuvant therapy in optic nerve sheath meningioma.PURPOSE: To describe a role for optic nerve decompression as adjuvant surgical therapy in the management of optic nerve sheath meningioma in patients with severe, progressive visual loss and optic disc edema before or after radiation therapy. methods: Interventional case report. RESULTS: Two patients with unilateral optic nerve sheath meningioma had progressive visual loss (20/200 and no light perception) and disc edema. The first had previously undergone fractionated stereotactic radiotherapy and the second subsequently was treated with fractionated stereotactic radiotherapy after decompression surgery. After excision of a dural window and biopsy of the tumor from the nerve sheath, visual acuity improved to 20/25 and 20/200, respectively, both coinciding with resolution of disc edema. CONCLUSIONS: In patients with optic nerve sheath meningioma with severe disc edema and rapid vision loss, surgery may serve an important but restricted, adjuvant role to radiation therapy under special conditions.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |