1/24. Bilateral optic disk edema and blindness as initial presentation of acute lymphocytic leukemia.PURPOSE: To report bilateral optic disk edema and blindness as the unusual initial presentation of acute lymphocytic leukemia (ALL) in an adult. methods: A 19-year-old man presented with a history of headaches, back pain, and 10 days of worsening vision that progressed to blindness. Ocular examination revealed light perception acuity in the right eye and no light perception in the left eye. Fundus examination revealed bilateral profound optic disk edema, tortuous vessels, and retinal hemorrhages. Acute lymphocytic leukemia was diagnosed with complete blood count and bone marrow biopsy. head computed tomography and magnetic resonance imaging, were normal. Lumbar puncture revealed normal opening pressure. Ocular ultrasonography showed bilateral optic nerve enlargement. DESIGN: Interventional case report and literature review. ESULTS: The presumptive diagnosis of leukemic infiltration of the optic nerves was made, and urgent radiotherapy, intrathecal methotrexate, and intravenous daunorubicin were instituted. visual acuity improved to hand motions in the right eye. CONCLUSIONS: Acute lymphocytic leukemia can rarely present in adults as visual changes due to leukemic optic nerve infiltration. radiation treatment should be considered as an urgent treatment modality for this rare condition.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/24. Microvascular changes in the retrobulbar optic nerve in idiopathic intracranial hypertension.PURPOSE: To examine the microvascular changes in the retrobulbar optic nerve in idiopathic intracranial hypertension (PTC). methods: Both optic nerves from a 29-year-old man with a two year history of PTC were examined histologically and morphometrically. A semi-automated image analysis system and paraphenylenediamine (PPD) stain were employed to resolve sufficiently the microvascular images for counts and measurement. RESULTS: There were 150 vessels distributed in the optic nerves which revealed the following: The average lumen of the vessels in outer sectors were larger than those of the inner sector vessels (168.17 microns 2 vs. 46.99 microns 2; p = 0.0338; OD; and 251.96 microns 2 vs. 130.02 microns 2; p = 0.029; OS) while in the normal control optic nerve the outer and inner area lumens were reversed in size-differential, but this did not show a statistical difference. The thickness of the PTC optic nerve vessel walls in the outer sectors was also greater than that of the walls in the inner sectors (4.95 microns vs. 2.67 microns; p = 0.013; OD and 5.25 microns vs. 3.34 microns; p = 0.019; OS); the same measurements in the normal optic nerve showed a reversed ratio, which was opposite that of the experimental group and but not statistically different. CONCLUSION: This pattern of microvascular changes is consistent with the selective axonal loss in the peripheral area of each optic nerve as much more severe than that in the inner sectors.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
3/24. Ischemic optic neuropathy in a female carrier with Fabry's disease.We report ocular findings of a patient with anterior ischemic optic neuropathy (AION) and cilioretinal artery occlusion in a female carrier of Fabry's disease. fluorescein angiography revealed delayed filling of the upper and temporal part of peripapillary choroidal vessels and capillaries of the right optic disk and late filling of the cilioretinal artery. CT scanning was performed several times in early stages and demonstrated thickening of the intraorbital optic nerve due to ischemic edema. About 5 months later, the fellow eye showed optic disk edema, an early sign of AION, and was treated by systemic corticosteroid and urokinase whereby AION did not progress.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/24. retinal vasculitis due to secondary syphilis.BACKGROUND: retinal vasculitis is one of the manifestations of ocular syphilis. CASE: A 29-year-old man was referred to our hospital with the complaint of sudden visual loss in the left eye lasting more than three weeks. OBSERVATIONS: Ophthalmoscopic examination showed retinal hemorrhages, edema, and sheathing of large retinal arteries and veins. fluorescein angiography revealed extensive occlusion of the affected retinal arteries, veins, and capillaries. Little evidence of uveitis or vitritis was observed. The fluorescent treponemal antibody-absorption test was positive, and the treponema pallidum hemagglutination titer was 1:10,240. The treatment with penicillin was effective, leading to resolution of the retinal hemorrhages and edema, although occlusion of the retinal vessels persisted. CONCLUSIONS: Vascular occlusion occurred simultaneously in large retinal arteries, arterioles, and capillaries as well as in segments of retinal veins, resulting in irreversible changes in the vascular walls.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/24. The pseudopapilledema of neonatal-onset multisystem inflammatory disease.PURPOSE: To report a rare case of neonatal-onset multisystem inflammatory disease with serial photographs to characterize the optic nerve findings. DESIGN: Observational case report. methods: A 6-year-old girl with neonatal-onset multisystem inflammatory disease, who had received systemic corticosteroid therapy for 5 years, had bilateral fibrillar opacities that surrounded the optic disks and extended into the peripapillary nerve fiber layer and vessels. A magnetic resonance imaging examination and lumbar puncture revealed elevated intracranial pressure. RESULTS: The elevated intracranial pressure returned to normal following a corticosteroid taper. optic disk photographs, taken 4 years earlier, were subsequently obtained. The optic disk appearance had remained unchanged over the 4-year period, consistent with a pseudopapilledema. CONCLUSION: The optic disk appearance is not consistent with papilledema from increased intracranial pressure. The optic disk findings, in conjunction with the underlying inflammatory syndrome, suggest an infiltrative etiology for the atypical optic nerve findings in neonatal-onset multisystem inflammatory disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/24. Foster Kennedy syndrome and optociliary shunt vessels in a patient with an olfactory groove meningioma.A 48-year-old woman complained of acute loss of vision in her right eye. Ophthalmoscopically, the right optic disk appeared pale, and abnormally dilated vessels were noted on the disk. The left optic disk was reddish and swollen. fluorescein angiography revealed abnormal vessels on the right optic disk that might be venous. The patient had right-sided anosmia. Computed tomography and magnetic resonance imaging showed a lesion in the frontal lobe that was deviated to the right and attached to the olfactory groove. A histopathologic study of the excised specimen disclosed a meningioma. We believe that this patient with olfactory groove meningioma represents a rare case of Foster Kennedy syndrome and optociliary shunt vessels.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
7/24. Papilloedema in Behcet's disease: value of MRI in diagnosis of dural sinus thrombosis.Behcet's disease is a multisystem disease characterised by the clinical triad of oral ulcers, genital ulcers and uveitis. nervous system involvement is frequent and occasionally precedes other manifestations. Behcet's disease is not frequently considered in the differential diagnosis of papilloedema. We report four cases of Behcet's disease in which papilloedema occurred with or without dural sinus thrombosis. MRI is of great value in the investigation of such patients as it can demonstrate venous sinus thrombosis non-invasively or suggest the diagnosis by showing the associated parenchymal lesions secondary to small vessel pathology.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/24. Pseudodrusen of the optic disc. papilledema simulating buried drusen of the optic nerve head.The distinction between true papilledema and pseudopapilledema rests on characteristics of the optic disc when examined ophthalmoscopically. Buried disc drusen frequently simulate papilledema and often result in misdirected diagnostic maneuvers in search of a cause for presumed intracranial hypertension. When an elevated optic disc exhibits an irregular, "lumpy, bumpy" border, a diagnosis of buried drusen of the optic nerve is usually made. We report a case with papilledema secondary to increased intracranial pressure in which the margins of the swollen optic disc presented this lumpy, bumpy border characteristic of buried drusen. The lumpy character of the disc border disappeared with resolution of the papilledema, and ultrasonography demonstrated the absence of any buried drusen. Other characteristics of papilledema, including extension of the disc swelling into the peripapillary nerve fiber layer, telangiectasia of the superficial vessels of the optic disc, and obscuration of the retinal vessels as they crossed the margins of the optic disc, provided strong evidence of true papilledema and remain the most reliable findings allowing a distinction between true papilledema and pseudopapilledema.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/24. Shiny multifocal chorioretinitis with papillitis.We report a case of unilateral inflammation involving the retinal pigment epithelium-choriocapillaris complex and the optic disc, characterized by multiple, small, shiny, yellowish-white subretinal lesions involving the midperiphery of the retina and associated with optic disc edema. These lesions showed hypofluorescence in the early transit phase of the fluorescein angiogram and leakage in the late phase. Perivascular staining of the retinal vessels and diffuse optic disc leakage were also present. A benign course associated with marked visual improvement and resolution of the inflammatory lesions occurred.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/24. Alteration of the blood-retina barriers in cases of viral retinitis.This paper presents three cases of serologically documented viral retinitis, and the great value of fluorescein angiography in outlining the structural abnormalities and the site of the lesions. Of our series in the case of influenza retinitis, the fluoroangiographic findings showed dye leakage from retinal vessels in the posterior pole. The dye leakage did not appear completely in the sites of macular edema. This edema was similar to the clinical appearance of cotton-wool spots and was arranged in a star-like pattern. One of the cases of cytomegalovirus retinitis (Case 3), a previously healthy adult with dysfunction of the cellular immune system, seems to be a further example of an inflammation in the inner retina presenting cotton-wool spots at the early stage. Case 2, a previously healthy adult, fulfilled the criteria for Vogt-Koyanagi-Harada syndrome. The patient had serologically documented cytomegalovirus infection with dysfunction of the cellular immune system. The fluorescein angiographic examination showed alteration both in the inner and outer blood-retina barriers as it is characteristic in cases of Harada syndrome. The cytomegalovirus infection might be assumed to play a role in the clinical picture as well as in the etiology of this disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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