11/357. Ocular toxicity of systemic medications: a case series.BACKGROUND: There are many visually threatening conditions that may result from long-term use of systemic medications. Many of these adverse side effects can be greatly reduced or prevented with close monitoring of patients. In view of current knowledge, updated clinical guidelines for appropriate monitoring of ocular toxicity from systemic medications need to be developed for the eye care practitioner. CASE review: There have been many reports of ocular toxicity from isoniazid, thioridazine, steroids, and amiodarone therapy. Clinical cases illustrating possible adverse ocular side effects are presented, which include INH-induced optic neuropathy, phenothiazine-induced retinopathy, steroid-induced glaucoma, and vortex epitheliopathy secondary to amiodarone. CONCLUSION: Optometrists should be aware of the potential for ocular side effects from systemic medications. Eye care guidelines for monitoring ocular side effects from thioridazine, INH, steroids, and amiodarone use are suggested.- - - - - - - - - - ranking = 1keywords = optic (Clic here for more details about this article) |
12/357. HSV-1--induced acute retinal necrosis syndrome presenting with severe inflammatory orbitopathy, proptosis, and optic nerve involvement.OBJECTIVE: To present a unique case in which orbital inflammation, proptosis, and optic neuritis were the initial symptoms of acute retinal necrosis (ARN). The clinical presentation of ARN, as well as the currently recommended diagnostic procedures and guidelines for medical treatment of ARN, are summarized. DESIGN: Interventional case report. TESTING: polymerase chain reaction (PCR) techniques were made on the vitreous for cytomegalovirus, Epstein-Barr virus, herpes simplex virus (HSV), varicella zoster virus, and toxoplasmosis. A full laboratory evaluation was made together with HLA-typing and serologic tests measuring convalescent titers for HSV and other micro-organisms. magnetic resonance imaging scan, computed tomography (CT) scan, and fluorescein angiographic examination were performed. The patient was treated with acyclovir and oral prednisone. MAIN OUTCOME MEASURES: The patient was evaluated for initial and final visual acuity and for degree of proptosis, periocular edema, and vitreitis. RESULTS: The first symptoms and signs of ARN were eye pain, headache, proptosis, and a swollen optic nerve on CT scan. Other than increased c-reactive protein, all blood samples were normal. PCR was positive for HSV-type I in two separate vitreous biopsies. The patient had the strongly ARN-related specificity HLA-DQ7. CONCLUSIONS: This is the first report of HSV-induced ARN presenting with inflammatory orbitopathy and optic neuritis. polymerase chain reaction for HSV-1 was positive more than 4 weeks after debut of symptoms, which is a new finding. The combination of severe vitreitis and retinal whitening, with or without proptosis, should alert the clinician to the possibility of herpes infection and treatment with intravenous acyclovir started promptly.- - - - - - - - - - ranking = 708.60207264505keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
13/357. Retrobulbar optic neuritis and rhegmatogenous retinal detachment in a fourteen-year-old girl with retinitis pigmentosa sine pigmento.A 14-year-old girl complained of a sudden decrease in right visual acuity. The patient had night blindness, a mottled retina but no pigments, extinguished scotopic electroretinographic response, central scotoma in the right eye and rhegmatogenous retinal detachment. She had initially received laser photocoagulation around the retinal tear and then corticosteroid therapy, cryoretinopexy and segmental buckling. Her right visual acuity increased to 1.0. The association of retinitis pigmentosa sine pigmento, retrobulbar optic neuritis and rhegmatogenous retinal detachment, as demonstrated in our patient, may be uncommon.- - - - - - - - - - ranking = 1759.6914070129keywords = optic neuritis, neuritis, optic, retrobulbar (Clic here for more details about this article) |
14/357. Melanocytoma of the left optic nerve head and right retrobulbar optic neuropathy compressed by a tuberculum sellae meningioma.A 40-year-old woman had a highly pigmented, slightly elevated tumor on the left optic disc. She had no visual disturbance in the left eye. The tumor was stationary for 5 years. At age 45 years, she complained of decreased visual acuity in the right eye. magnetic resonance imaging showed a right-shifted homogeneous lesion at the tuberculum sellae. Histopathologic study of the excised lesion revealed interlacing bundles of spindle-shaped fibroblast-like cells with whorl formation. We believe that a relationship between melanocytoma of the optic nerve head and a tuberculum sellae meningioma may exist rather than a chance occurrence, as previously suggested by others.- - - - - - - - - - ranking = 12.744901601161keywords = optic, retrobulbar (Clic here for more details about this article) |
15/357. Adrenal cortical carcinoma metastatic to the brain in a child.A 9-year-old girl presented with profoundly decreased vision in both eyes and bilateral optic disc swelling. magnetic resonance imaging showed a large intraventricular mass. Excisional biopsy diagnosed metastatic adrenal cortical carcinoma (ACC). This is, to the best of our knowledge, the first reported case of ACC metastatic to the brain in a child. It also illustrates the importance of differentiating optic neuritis from papilledema in children.- - - - - - - - - - ranking = 352.80103632253keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
16/357. cysticercosis of the optic nerve.cysticercosis of the optic nerve has been reported only twice in the literature. A case of optic nerve cysticercosis in a 50-year-old woman with atypical optic neuritis is reported. Computerized tomography showed a thickened left optic nerve with a ring-enhancing lesion containing an eccentric nodule. An enzyme-linked immunosorbent assay test for cysticercosis further established the diagnosis. The patient was treated with oral prednisolone and albendazole, with no improvement in vision.- - - - - - - - - - ranking = 358.80103632253keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
17/357. Paediatric chiasmal neuritis--typical of post-Epstein-Barr virus infection?A case of chiasmal neuritis with bilateral, asymmetric optic nerve involvement is presented. association with recent Epstein-Barr virus infection is suggested. The clinical picture, possible aetiological factors, and causative relation to Epstein-Barr virus are presented.- - - - - - - - - - ranking = 720.29797514434keywords = neuritis, optic (Clic here for more details about this article) |
18/357. Postpartum optic neuritis: etiologic and pathophysiologic considerations.The clinical course of four patients with visual loss in the postpartum period due to acute optic neuritis is described. Factors that disclosed the underlying etiology and expression of disease are discussed. The clinical records of four women examined and managed for visual loss after uncomplicated pregnancies and term deliveries were reviewed. Neurodiagnostic examination, treatment modalities, and outcomes were assessed. These four women with varied and confounding medical histories, all with optic neuropathy, eventually were demonstrated to harbor demyelinating disease. Although visual loss in the postpartum period evokes differential diagnostic considerations, the authors' experience suggests that puerperal immune-mediated changes are responsible for activation of optic neuritis associated with relapsing multiple sclerosis.- - - - - - - - - - ranking = 2111.8062179352keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
19/357. Bisected macula following retrobulbar steroid injection.A case of bilateral accidental globe penetration during administration of retrobulbar steroid for bilateral optic neuritis is discussed. One eye with bisected macula was managed successfully by vitrectomy, internal gas tamponade, and postoperative laser to the edges of the retinal tear. The fellow eye was blind due to central retinal artery occlusion.- - - - - - - - - - ranking = 355.23216332398keywords = optic neuritis, neuritis, optic, retrobulbar (Clic here for more details about this article) |
20/357. subacute sclerosing panencephalitis presenting as optic neuritis.subacute sclerosing panencephalitis (SSPE) is a rare progressive neurologic disease affecting both grey and white matter of the brain in children and young adults. One such case which involved the visual system is described here.- - - - - - - - - - ranking = 1407.2041452901keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
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