Subject(s)
Frontal Sinus , Mucocele/complications , Oculomotor Nerve Diseases/etiology , Paranasal Sinus Diseases/complications , Aged , Diplopia/etiology , Female , Humans , Magnetic Resonance Imaging , Mucocele/diagnosis , Mucocele/surgery , Oculomotor Nerve Diseases/diagnosis , Oculomotor Nerve Diseases/surgery , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/surgery , Tomography, X-Ray ComputedABSTRACT
PURPOSE: The authors retrospectively analyzed changes in the retinal nerve fiber layer in patients with idiopathic intracranial hypertension and studied their relation to visual field loss to determine the clinical usefulness of retinal nerve fiber analysis in the clinical management of patients with papilledema. METHODS: Retinal nerve fiber layer photographs and visual fields from 36 eyes of 21 patients with papilledema due to idiopathic intracranial hypertension were analyzed for abnormalities in a masked fashion. RESULTS: Nerve fiber layer changes were found in 67% of eyes studied. Superior areas within the nerve fiber layer were affected 5.4 times more frequently than inferior regions. Visual field loss was more prevalent in eyes with diffuse nerve fiber layer loss (89%) than in eyes with slit defects (29%). The location of the nerve fiber layer changes correlated with corresponding areas of visual field loss. Nerve fiber layer changes were as common in mild to moderate as in atrophic papilledema; however, slit defects predominated in patients with mild to moderate papilledema, and diffuse loss predominated in atrophic papilledema. CONCLUSIONS: Changes in the retinal nerve fiber layer observed in patients with idiopathic intracranial hypertension provide objective information regarding the status of their optic nerve and may improve their clinical management.
Subject(s)
Nerve Fibers/pathology , Optic Nerve/pathology , Pseudotumor Cerebri/complications , Retina/pathology , Vision Disorders/pathology , Visual Fields , Adolescent , Adult , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Papilledema/etiology , Photography , Retrospective Studies , Vision Disorders/etiology , Visual Field TestsABSTRACT
Periodic alternating gaze is a rarely reported phenomenon. We have observed two cases that are unique in their early onset at birth and infancy. Multiple congenital defects of the posterior cranial fossa were present on MRI in both cases. A prominent abnormality shared by both was absence of normal structures in the region of the inferior cerebellar vermis. Periodic alternating gaze appears to be associated with pathologic changes in the hindbrain in these and other reported cases.
Subject(s)
Brain/abnormalities , Eye Movements/physiology , Brain/physiopathology , Female , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging , Male , PeriodicityABSTRACT
Hypertropia following trauma to the trochlea is rare. The more widely recognized response of the trochlea to trauma is hypotropia or acquired Brown syndrome. We observed three cases of hypertropia following penetrating trauma to the trochlea. Each had computerized tomography and/or magnetic resonance imaging to assist in the understanding of the mechanism of the observed superior oblique dysfunction. The clinical course of these cases was variable. Awareness of the damaged trochlea's capacity to respond as a hypertropic as well as a hypotropic syndrome will allow for improved management of these unusual patients.
