1/10. optic neuritis in children.PURPOSE: To describe the clinical characteristics of optic neuritis in children, including final visual acuity and development of multiple sclerosis (MS). methods: charts were reviewed of all patients < 15 years of age who presented with optic neuritis to the Bascom Palmer eye Institute or the Miami Children's Hospital between 1986 and 1998. RESULTS: Fifteen patients were identified. There was a slight female predilection in the study group (60%), with a mean age of 9.8 years at presentation. A preceding febrile illness within 2 weeks of visual symptoms was reported in 66% of patients. Initial visual acuity ranged from 20/15 to no light perception. Involvement was bilateral in 66% of patients, and disc swelling was present in 64% of involved eyes. Of the patients who underwent magnetic resonance imaging, 33% had focal demyelinating lesions in the brain, and 63% of affected nerves were enlarged or enhanced with gadolinium. Eleven patients were treated with intravenous steroids. Final visual acuity was > or = 20/40 in 58.3% of eyes. Thirty percent of the patients had vision of finger counting or worse. Four (26%) patients developed MS. The mean age of patients with MS was 12 years, compared with 9 years in children who did not develop MS. patients with unilateral involvement had an excellent visual prognosis (100% > 20/40), but a higher rate of development of MS (75%). Two patients had positive serology for lyme disease. CONCLUSIONS: optic neuritis presents differently in children than in adults. Children typically have bilateral involvement with papillitis following an antecedent viral illness. Although visual prognosis is poorer in children than adults, the development of MS is less common in children. Children who present with unilateral involvement have a better visual prognosis; however, they also develop MS at a greater frequency than children with bilateral involvement. patients who developed MS were, on average, older at presentation with optic neuritis than those who did not develop MS.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
2/10. A suprasellar meningioma simulating atypical retrobulbar optic neuritis.A 39-year-old female came with the chief complaint of acute decrease of left eye vision for the past 2 weeks. No history of systemic diseases or headache was complained. The visual acuity of the left eye was "hand motion", and rapidly responded to methylprednisolone therapy in 3 days. On tapering oral prednisolone, the visual acuity decreased again from 20/20 to light perception in the left eye. The magnetic resonance image (MRI) study showed a large suprasellar mass. The patient underwent craniotomy and removal of the tumor successfully, and the pathological report turned out to be a meningioma. The visual acuity of the left eye remained poor after the surgery. In conclusion, neuroimaging study is necessary in every case of presumed retrobulbar optic neuritis which shows atypical course. Early detection of a brain tumor may save the vision of the patient.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
3/10. Bilateral optic neuritis in pregnancy.A 25-year old primigravida at 11-weeks period of amenorrhoea presented with bilateral optic neuritis following Varicella Zoster viral (VZV) infection. She was serologically positive for systemic lupus erythematosus but negative for virus. The exact pathogenesis of the patient's severe optic neuritis, adduction and neurological deficit was unknown. The initiation of high dose steroids for optic neuritis was a big clinical dilemma in a pregnant patient with viral infection. The patient was treated with high dose steroids after three days of commencement of antiviral treatment. At 6 months after presentation, her visual acuity in the right eye was 6/36 with perception to light in the left.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
4/10. Bilateral optic neuritis in a child following Epstein-Barr virus infection.A rare case of bilateral optic neuritis is presented in a child with no light perception. Ophthalmic examination revealed dilated pupils without reaction to the light, swollen optic discs with small peripapillary hemorrhages in both eyes. serology revealed evidence of recent Epstein-Barr virus infection. After treatment with high dose of corticosteroid visual acuity gradually improved. After four months visual acuity was normal despite complete pallor of the optic disc. Ebstein-Barr virus infection should be considered in the differential diagnosis of bilateral optic neuritis in a child with severe bilateral visual loss.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
5/10. The spectrum of optic nerve disease in human immunodeficiency virus infection.We studied four patients with hiv-associated optic neuropathies. One had syphilitic optic perineuritis, which responded promptly and completely to penicillin therapy. The second had cytomegalovirus papillitis and visual acuity subsequently deteriorated to no light perception. The third showed varicella zoster optic neuritis, which improved after intravenous acyclovir treatment. The fourth patient developed cryptococcal retrobulbar neuritis and died shortly thereafter. Optic neuropathy was among the initial symptoms of hiv infection in two of the four cases.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
6/10. Reversible blindness in optic neuritis associated with influenza vaccination.A patient is reported in whom bilateral optic neuritis developed following an influenza vaccination. From complete blindness (absence of light perception) in one eye, the patient's vision returned to normal following steroid treatment.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
7/10. optic neuritis and systemic lymphoma.A 26-year-old man with stage IV poorly differentiated lymphocytic lymphoma complained of visual loss of two weeks' duration. Examination revealed visual acuity of light perception in the right eye secondary to optic neuritis and other tests revealed the presence of lymphomatous leptomeningeal infiltration. Combined treatment with intrathecal methotrexate, prednisone, and whole brain radiation resulted in rapid long-lasting recovery of visual function of the right eye. The cerebrospinal fluid contained a large amount of thymus-derived lymphocytes and the subsequent clinical course observed with characteristic of T-cell or malignant lymphoblastic lymphoma.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
8/10. optic neuritis--etiology?A 44-year-old otherwise healthy woman was referred to washington University with previous diagnoses of para planitis and retrobulbar neuritis, and with a current complaint of markedly decreased vision (light perception only) in the right eye. Among the findings at the time of this evaluation were posterior uveitis and evidence of optic neuropathy and of a disordered immune system. The patient responded to pulsed high-dose corticosteroid therapy. A subsequent similar episode in the left eye also was resolved with such treatment. Dr. Burde describes the case in detail and asks Drs. Keltner, Gittinger and Miller to offer diagnoses. Their answers vary considerably.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
9/10. Favorable visual outcome in cryptococcal meningitis.PURPOSE: To describe an unusual, favorable visual outcome in a patient with lupus erythematosus and cryptococcal meningitis and to present bilateral superior oblique muscle paresis. methods: Case report. A 15-year-old girl with lupus erythematosus and cryptococcal meningitis had bilateral superior oblique paresis, bilateral optic nerve head swelling, and increased intracranial pressure. She developed a visual acuity of no light perception in the right eye. RESULTS: Treatment with oral fluconazole, acetazolamide, and dexamethasone, as well as repeated lumbar punctures to reduce intracranial pressure, was followed by recovery to a visual acuity of 20/20 in both eyes and normal ocular motility. CONCLUSION: With appropriate treatment, visual loss associated with cryptococcal meningitis may have a favorable outcome.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
10/10. Reversible bilateral simultaneous papillitis with no light perception.This 14-year-old patient with bilateral simultaneous papillitis experienced no light perception in either eye for 24 hours and had a complete recovery of central and peripheral vision 3 weeks later. fluorescein angiography confirmed the diagnosis. Although her hospital work-up was negative except for a mildly elevated CSF protein, it seems most likely that this was a postviral syndrome based on the bilaterality, rapid recovery of vision, and the age group.- - - - - - - - - - ranking = 5keywords = perception (Clic here for more details about this article) |
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