11/25. Delayed visual deterioration after pituitary surgery--a review introducing the concept of vascular compression of the optic pathways.BACKGROUND: Delayed visual deterioration after pituitary surgery has been attributed to secondary empty sella syndrome and downward herniation of the optic nerves and chiasm, but the pathophysiological basis of this condition is still a matter of debate. review: According to the literature, prior radiation therapy, previous visual impairment and transcranial surgery constitute risk factors for delayed visual deterioration. radiation-induced vascular changes and/or strangulation of the optic nerves or chiasm are thought to compromise local blood flow. Downward herniation of the optic pathways was present in the majority of cases, but did not correlate with visual symptoms and signs, while dense scarring of the chiasm was a reproducable finding in all surgically explored cases. Indentations in the upper margin of the optic nerves or chiasm caused by the A1 segments of the anterior cerebral arteries have been reported repeatedly. As perichiasmal scarring constitutes the most consistent finding, the intimate relationship between artery and nerve with consecutive pulsatile pressure may constitute a causative factor in delayed visual dysfunction after pituitary surgery. The authors therefore introduce the concept of vascular compression, which is illustrated with a personal case of a successful decompression procedure with teflon interposition between the A1 segment and the non-herniated optic nerve to treat visual loss eight months following removal of a hemorrhagic pituitary adenoma. CONCLUSIONS: Clinicians should be aware that surgical exploration via a transcranial approach is indicated in cases of progressive visual loss late after pituitary surgery, no matter whether downward displacement of the optic pathways is present on imaging studies or not. Special attention should be paid intra-operatively to the dissection of the intimate relationship between the anterior cerebral arteries and the optic nerves and chiasm.- - - - - - - - - - ranking = 1keywords = optic (Clic here for more details about this article) |
12/25. Giant intrasellar arachnoid cyst manifesting as adrenal insufficiency due to hypothalamic dysfunction--case report--.A 67-year-old man first noticed loss of pubic and axillary hair in 1992 and then a visual field defect in 2001. He experienced loss of consciousness attributed to hyponatremia in April 2002. magnetic resonance imaging showed a giant intrasellar cystic mass, 40 mm in diameter, that had compressed the optic chiasm. The patient complained of chronic headache, and neurological examination revealed bitemporal hemianopsia. Preoperative endocrinological examination indicated adrenal insufficiency, and hypothyroidism due to hypothalamic dysfunction. The patient underwent endonasal transsphenoidal surgery. The cyst membrane was opened and serous fluid was drained. Histological examination identified the excised cyst membrane as arachnoid membrane. The patient's headaches resolved postoperatively, but the bitemporal hemianopsia and endocrinological function were unchanged. This arachnoid cyst associated with hypothalamic dysfunction might have been caused by an inflammatory episode in the suprasellar region.- - - - - - - - - - ranking = 0.090909090909091keywords = optic (Clic here for more details about this article) |
13/25. New ways to look at an old problem.A 32-year-old man presented with optic neuritis (papillitis). A discussion of optic neuritis, the role of magnetic resonance imaging, and possible treatment options are presented. The role of optical coherence tomography in following patients with optic neuritis is discussed.- - - - - - - - - - ranking = 13.57703139745keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
14/25. Bilateral visual loss complicating liposuction in a patient with idiopathic intracranial hypertension.A 34-year-old obese woman developed blurred vision in both eyes soon after large-volume liposuction of the dorsum and gluteus region bilaterally associated with abdominal dermolipectomy. An ophthalmic examination revealed severe bilateral visual loss and pallid optic disc edema. The patient gave a history of transient obscurations of vision in the past. neuroimaging studies were non-revealing, but a lumbar puncture disclosed a markedly elevated intracranial pressure. The patient was diagnosed as having had bilateral ischemic optic neuropathy superimposed on pre-existing idiopathic intracranial hypertension (IIH). acetazolamide treatment was used. Some visual improvement occurred, and optic disc edema evolved into severe optic disc pallor. This case shows that visual loss from optic disc infarction may be a devastating complication of high-volume liposuction in patients with underlying IIH. Because liposuction is frequently performed on obese patients, physicians should screen for signs and symptoms of IIH before undertaking this procedure.- - - - - - - - - - ranking = 0.45454545454545keywords = optic (Clic here for more details about this article) |
15/25. Adalimumab-associated optic neuritis.We present, to our knowledge, the first published cases of optic neuritis associated with adalimumab, a medication in the class of anti-tumor necrosis factor-alpha (TNF-alpha) antagonists. Approved in recent years by the FDA, adalimumab (Humira, Abbott laboratories; Abbott Park, IL) is a recombinant monoclonal antibody that targets and blocks the physiologic effects of TNF. Other TNF antagonists have had associations with optic neuritis and demyelinating events.- - - - - - - - - - ranking = 26.972244613081keywords = optic neuritis, neuritis, optic (Clic here for more details about this article) |
16/25. A rare cystic non-functioning neuroendocrine pancreatic tumor with an unusual presentation.This report describes a patient with a cystic non-functioning neuroendocrine glucagon cell pancreatic tumor presenting with demyelination of the optical nerve that had initially provoked marked monolateral reduced vision and had led to a suspected diagnosis of multiple sclerosis. Cystic degeneration is uncommon in endocrine pancreatic tumors due to their abundant vascular supply. Very few cases of cystic neuroendocrine non-functioning pancreatic tumors have been reported in the international literature. The presence of atypical neurological symptoms, such as sudden visual impairment, should be taken into account in the differential diagnosis for such tumors. The prognosis is poor, because most of these tumors are malignant and diagnosed at an advanced stage. The three-year disease-free survival of our patient, however, encourages the use of aggressive surgical treatment.- - - - - - - - - - ranking = 0.090909090909091keywords = optic (Clic here for more details about this article) |
17/25. Cortical seeding of a craniopharyngioma after craniotomy: Case report.BACKGROUND: Cortical seeding of a craniopharyngioma has been rarely reported. We present a case that ectopically recurred along the tract of a previous surgical route. methods: A 27-year-old woman presented earlier with a suprasellar craniopharyngioma. A left frontotemporal craniotomy was done with subtotal resection of the tumor because it was strongly adhered to the optic chiasm. Histopathology confirmed the diagnosis of craniopharyngioma. Six months after, the patient presented with decreased visual acuity and diplopia. She was reoperated through the previous craniotomy with a total resection. One year after the second surgery, the patient presented with seizures that were difficult to control. magnetic resonance imaging revealed a contrast-enhancing tumor with cystic and solid components on the left temporal lobe cortex. The primary tumor bed was intact. The patient was reoperated, and the temporal lobe tumor was totally removed. Histologic studies showed an adamantinomatous craniopharyngioma. The patient was free of neurologic abnormalities, and no new lesion was found in the magnetic resonance imaging performed 1 year after the last surgery. CONCLUSIONS: Although craniopharyngiomas exhibit a benign histopathologic pattern, a total resection combined with careful inspection and irrigation of the surgical field is the optimal treatment for preventing local and ectopic recurrences. It is strongly recommended that the concerned patients have a long-term clinical and neuroimaging follow-up.- - - - - - - - - - ranking = 0.090909090909091keywords = optic (Clic here for more details about this article) |
18/25. Low vision rehabilitation of the albino patient.From the eye care professional's point of view, the three most common types of albinism are tyrosinase-negative oculocutaneous albinism, tyrosinase-positive oculocutaneous albinism and ocular albinism. skin and uveal hypopigmentation is variable in this condition depending on the type of albinism. However, all types of albinism lack the necessary uveal pigmentation have subnormal visual acuity. Using low vision rehabilitation techniques such as modifying lighting and providing telescopic optical devices, these patients can experience dramatic improvements in functional visual acuity. This manuscript examines strategic approaches to visual rehabilitation as well as provides a clinical review of the condition.- - - - - - - - - - ranking = 0.090909090909091keywords = optic (Clic here for more details about this article) |
19/25. Visual and neural function in Leber's optic neuropathy.This report details the chronology of vision loss for an 18-year-old Caucasian male with Leber's optic neuropathy. Findings of an oculo-visual assessment with auxiliary in-office tests of visual neural function, results of neurophysiological testing, and rehabilitative therapy with low vision aids are presented. The clinical characteristics of this devastating disorder are reviewed.- - - - - - - - - - ranking = 0.45454545454545keywords = optic (Clic here for more details about this article) |
20/25. Adaptive computer use for a person with visual impairment.A single-subject research design that used multiple baselines across behaviors compared traditional adaptations (e.g., the use of readers) to adapted computer technologies for typical reading activities performed by an adult with severe visual impairment. A Macintosh IIci equipped with software that translated information displayed on the monitor into synthesized speech was paired with a page scanner and optical character recognition software to convert scanned images of printed text into computer documents. These computer technologies were applied to three reading behaviors: proofreading of word-processed documents, reading of printed research articles, and reading of common printed materials such as letters and instruction sheets. The findings demonstrated that the use of adapted computer technology, rather than traditional methods, increased the subject's reading efficiency and frequency. The increased functional independence that occurred as a result of the computer technology improved the subject's patterns of adaptation in reading-related tasks and improved the quality of her life.- - - - - - - - - - ranking = 0.090909090909091keywords = optic (Clic here for more details about this article) |
| <- Previous || Next -> |