Neuroanatomical insights into neuro-ophthalmic presentations of skull base meningiomas: Pathways to precision medicine - A meta-analysis.

Background: Skull base meningiomas are intricately related to neuro-ophthalmic functions and have been related to direct influences on both the afferent and efferent visual pathways due to close contacts with crucial neurovascular structures. The present article reviews the neuro-ophthalmic presentations of these tumors, necessitating the need for precise anatomic information for the delivery of customized diagnostic and therapeutic approaches. Methods: A literature review was conducted using PubMed and Scopus, focusing on terms related to skull base meningiomas and their neuro-ophthalmic impacts. The review included recent and seminal articles to assess advances in understanding and managing these tumors from an anatomical perspective. Results: The findings underscore the diversity in neuro-ophthalmic manifestations based on the meningioma's location, affecting visual pathways differently. For instance, meningiomas in the optic nerve sheath typically lead to isolated optic neuropathy and are often managed with radiation therapy. In contrast, those extending from the sphenoid wing require more aggressive approaches like open surgery. This review highlights how the tumor's location dictates the choice of treatment, ranging from conservative management to multidisciplinary surgical interventions. Conclusion: Proper recognition of the sites of skull base meningiomas results in a treatment tailored to provide therapy aimed explicitly at neuro-ophthalmic outcomes related to the site of the tumors. This approach will not only help to treat effectively but also avoid a wide range of complications and, in turn, increase the effectiveness of the treatment results that a patient will receive. Future studies should aim to refine these anatomical insights toward further advancements in modes of treatment.

Enhancing neuro-ophthalmic surgical education: The role of neuroanatomy and 3D digital technologies - An overview.

Background: Neuro-ophthalmology, bridging neurology and ophthalmology, highlights the nervous system's crucial role in vision, encompassing afferent and efferent pathways. The evolution of this field has emphasized the importance of neuroanatomy for precise surgical interventions, presenting educational challenges in blending complex anatomical knowledge with surgical skills. This review examines the interplay between neuroanatomy and surgical practices in neuro-ophthalmology, aiming to identify educational gaps and suggest improvements. Methods: A literature search across databases such as PubMed, Scopus, and Web of Science was conducted, focusing on the implications of neuroanatomy in neuro-ophthalmic surgery education and practice. The review synthesizes insights from both recent and foundational studies to highlight current understandings and future research directions, particularly in educational approaches. Results: Findings indicate that 3D digital modeling and virtual reality have significantly enhanced neuroophthalmic surgical education by providing immersive and engaging learning experiences. For instance, detailed 3D brain atlases offer comprehensive resources for understanding the central nervous system's normal and pathological states. Although studies show that 3D and traditional 2D methods achieve similar post-test results, 3D methods notably improve engagement and motivation, suggesting a shift toward more interactive learning environments. Conclusion: Integrating both traditional and innovative educational tools is crucial for the progression of neuro-ophthalmic surgical training. This balance helps overcome educational hurdles and better prepare future surgeons. Continuous research and collaboration are essential to refine educational strategies, ultimately aiming to enhance patient care in neuro-ophthalmology.

Effect of aging and lifestyle on healthy macular photoreceptors and retinal pigment epithelium-Bruch membrane complex thickness.

OBJECTIVES: Investigate how aging and some lifestyle factors correlate with changes in macular photoreceptor and retinal pigment epithelium-Bruch membrane complex layers thickness in a sample of healthy population by using OCT segmentation technique. SUBJECTS AND METHODS: A cross-sectional study conducted at the ophthalmology department in the Medical City in Baghdad. All participants underwent an interview of medical history and lifestyle habits. Maculae of all participants were scanned using spectral domain optical coherence tomography, followed by manual segmentation of retinal layers. RESULTS: The study included 152 healthy participants (152 eyes), their mean age was 57.3 ± 6.7 years, gender distribution was 82(53.9%) males and 70(46.1%) females. There was a decrement in retinal pigment epithelium-Bruch membrane layer thickness at central subfield (500 µm radius from fovea minimum) by - 0.178 µm/year (p = 0.019), inner macula (500-1500 µm radius from fovea minimum) by - 0.263 µm/year (p = 0.002), outer macula (1500-3000 µm radius from fovea minimum) by - 0.225 µm/year (p = 0.015) with no statistically significant effect on photoreceptor thickness. Physical activity and smoking had statistically no significant effect on these layers thickness, however smokers had higher photoreceptor thickness at fovea minimum and central subfield. Body mass index increase by one kg/m2 correlated with a decrement in photoreceptor layer thickness by - 0.108 µm (p = 0.007). CONCLUSION: Aging process affected the retinal pigment epithelium-Bruch membrane complex and photoreceptor layer thickness in a healthy population, and this process can be slowed down by avoiding some lifestyles which aggravate these changes like obesity.

Ophthalmic Injuries Related to Maxillofacial Trauma Due to Urban Warfare.

: Midfacial trauma commonly causes ocular injuries of varying degrees. Eye injuries account for approximately 10% of all battle injuries. Severity of injuries may range from a subconjunctival haemorrhage to optic nerve injury and globe laceration and rupture. AIM OF STUDY: Is to evaluate the associated ophthalmic injuries in maxillofacial trauma due to war and to emphasize the need for proper ophthalmic examination to exclude and manage any associated ophthalmic injuries. MATERIALS AND METHODS: A total of 66 patients with maxillofacial trauma due to war were considered in this study and underwent classification of the fractures to know patterns of fractures and to specify the ophthalmic injuries which might be associated with each fracture. Referral to ophthalmologist was considered to determine the exact nature of ophthalmic injuries. Results by a maxillofacial surgeon and ophthalmologist were evaluated. RESULTS: Midfacial trauma particularly those associated with zygomatic bone fracture was highly significant due to blast and bullets can lead to serious ophthalmic injuries. This was related to 57% of ophthalmic injuries. The related ocular injuries which were subconjunctival hemorrhage and the rupture or lacerated eye globe found to be highly significant war injuries while the preretinal hemorrhage and diplopia were significant. CONCLUSION: A thorough proper ophthalmic examination should be carried out for every patient with these fractures and suspected cases should be placed under close observation so that immediate and active treatment can be taken if necessary.