ABSTRACT
Giant cell arteritis (GCA) is a common medium to large vessel vasculitis of the elderly that can lead to permanent vision loss. Neuroimaging in GCA may reveal optic nerve sheath enhancement, which is a cardinal finding of optic perineuritis (OPN). The clinical manifestations of GCA can mimic that of other ocular disorders including amiodarone-associated optic neuropathy (AAON). We report a case of biopsy-proven GCA in a patient initially suspected to have AAON. This patient presented with bilateral optic disc oedema in conjunction with subacute predominately monocular vision loss and enhancement of the corresponding optic nerve sheath on neuroimaging. Clinicians should recognise that clinical and neuroimaging findings of GCA can mimic a variety of ocular and orbital pathologies including idiopathic OPN and AAON.
ABSTRACT
PURPOSE: To report a case of bitemporal hemianopsia due to ischemic chiasmopathy after mechanical thrombectomy of a right distal internal carotid artery (ICA) occlusion. OBSERVATIONS: A 60-year-old female presented with left sided weakness and difficulty speaking and was found to have suffered a right internal carotid artery occlusion 10 days after tricuspid valve replacement for severe symptomatic tricuspid valve disease. She underwent mechanical thrombectomy and in hospital and at further follow ups was noted to have a bitemporal hemianopsia, consistent with an ischemic optic chiasmopathy. CONCLUSIONS AND IMPORTANCE: The optic chiasm is vascularized by multiple arteries of the Circle of Willis. As such, ischemic optic chiasmopathy is rare. Clinicians should consider ischemic chiasmopathy following cardiac and other surgical procedures including mechanical thrombectomy of the ICA or its branches.
ABSTRACT
ABSTRACT: Mollaret meningitis (MM) refers to benign recurrent aseptic meningitis usually following herpes simplex virus 2 (HSV-2) infection. Neuro-ophthalmic manifestations associated with MM are rarely reported. We present a case of recurrent HSV-2 meningitis with the neuro-ophthalmic presentation of papilledema and sixth nerve palsy. To our knowledge, this is the first such description in the English language ophthalmic literature.
Subject(s)
Herpes Simplex , Meningitis, Aseptic , Papilledema , Herpes Simplex/complications , Herpes Simplex/diagnosis , Herpesvirus 2, Human , Humans , Meningitis, Aseptic/complications , Meningitis, Aseptic/diagnosis , RecurrenceABSTRACT
ABSTRACT: A 43-year-old woman presented with a right-sided visual field defect in the right eye. The visual acuity was normal and there was a right relative afferent pupillary defect. Formal visual field testing revealed a junctional scotoma of Traquair. The fundus examination showed optic atrophy in the right eye and optical coherence tomography demonstrated unilateral band atrophy. Neuroimaging revealed a sellar and suprasellar cystic pituitary adenoma for which she underwent a transsphenoidal drainage. We demonstrate the clinical and radiographic features of the junctional scotoma of Traquair and describe the differentiating features vs the junctional scotoma.
Subject(s)
Scotoma/diagnostic imaging , Visual Acuity/physiology , Adult , Female , Humans , Magnetic Resonance Imaging , Scotoma/physiopathology , Tomography, Optical Coherence , Visual Field Tests , Visual Fields/physiologySubject(s)
Cryopyrin-Associated Periodic Syndromes/diagnosis , Neurology , Ophthalmology , Optic Disk/diagnostic imaging , Papilledema/etiology , Visual Acuity/physiology , Adult , Aged , Cryopyrin-Associated Periodic Syndromes/complications , Female , Humans , Male , Papilledema/diagnosis , Papilledema/physiopathologyABSTRACT
ABSTRACT: A 70-year-old woman presented with acute awareness of decreased color vision in her right eye. Fundus examination and a flash electroretinography (ERG) were both normal. A multifocal ERG (mfERG) however revealed foveal depression, and thinning of inner nuclear layer was noted on macular optical coherence tomography (OCT), and a diagnosis of resolved paracentral acute middle maculopathy was made. Clinicians should be aware of the complementary role of OCT and mfERG in unexplained acute central visual loss to distinguish retinal from neuro-ophthalmic etiologies. Structural ocular imaging with OCT shows features of inner, middle, and outer retinal localizations to the visual loss.
Subject(s)
Fluorescein Angiography/methods , Fovea Centralis/diagnostic imaging , Macular Degeneration/diagnosis , Optic Nerve Diseases/diagnosis , Tomography, Optical Coherence/methods , Visual Acuity , Visual Fields/physiology , Acute Disease , Aged , Diagnosis, Differential , Female , Fundus Oculi , Humans , Macular Degeneration/physiopathologySubject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Eye Movements/drug effects , Miller Fisher Syndrome/chemically induced , Ophthalmoplegia/etiology , Aged, 80 and over , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/adverse effects , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Humans , Hydroxyethylrutoside , Male , Miller Fisher Syndrome/complications , Miller Fisher Syndrome/diagnosis , Ophthalmoplegia/physiopathology , Skin Neoplasms/diagnostic imagingABSTRACT
Background In this study, we reviewed a select sample of ophthalmology literature to determine if there was a correlation between Altimetric and traditional citation-based and impact factor metrics. We hypothesized that Altmetric score would more closely correlate with impact factor and citations in 2016. Methods Journal Citation Reports for the year 2013 was used to find the 15 highest impact factor ophthalmology journals in 2013. Then Elsevier's Scopus was used to identify the 10 most cited articles from each journal for the years 2013 and 2016. Metrics for all identified articles were collected using the Altmetric Bookmarklet, and date of Twitter account creation was noted for journals with such an account. Altmetric scores, impact factor, and citation counts were tabulated for each article. Pearson's correlation coefficient ( r ) determined correlation of independent variables (number of citations or impact factor) with dependent variable (Altmetric score). For our Twitter analysis, account age was the independent variable and calculated correlation coefficients ( r ) were the dependent variable. Proportion of variance was determined with a coefficient of determination ( R 2 ). Results This study included 300 articles, evenly split between 2013 and 2016. Within the 2013 cohort, three journals had significant positive correlations between citation count and Altmetric score. For the 2016 cohort, both Altmetric score and citation count ( r = 0.583, p < 0.001) and Altmetric score and impact factor ( r = 0.183, p = 0.025) revealed significant positive correlations. In 2016, two journals were found to have significant correlations between Altmetric score and citation number. Neither year revealed a significant correlation between the age of a journal's Twitter profile and the relationship between Altmetric score and citation count. In each year, Twitter accounted for the highest number of mentions. Conclusion The findings suggest that correlation between Altmetric score and traditional quality metric scores may be increasing. Altmetric score was correlated with impact factor and number of citations in 2016 but not 2013. At this time, Altmetrics are best used as an adjunct that is complementary but not an alternative to traditional bibliometrics for assessing academic productivity and impact.
ABSTRACT
ABSTRACT: A 43-year-old woman presented with progressive anosmia, self-neglect, and lethargy for 1 year. Brain MRI demonstrated a mass that was compressing the optic nerve in the right eye and had a significant mass effect and cerebral edema producing increased intracranial pressure. Examination revealed the patient to have a variant of Foster Kennedy syndrome involving ipsilateral compressive optic neuropathy with superimposed optic disc edema and contralateral papilledema.
