Spontaneous Improvement of Visual Acuity in a 13-Year-Old Boy with Neuromyelitis Optica Spectrum Disorder.

Ophthalmic and MRI evaluations of a 13-year-old boy who reported loss of visual acuity in his right eye demonstrated the presence of unilateral optic neuritis. After serological tests showed positivity for anti-aquaporin 4 antibody, he was diagnosed with neuromyelitis optica spectrum disorder. Encephalopathy and myelitis were not observed. Since his unilateral optic neuritis was considered to reflect mild disease activity, only follow-up observations were performed. Visual acuity and central scotoma improved 1 week after the first examination. In the absence of any specific treatments, good visual acuity has remained for 20 months, with no relapse of optic neuritis.

Long-Term Course Following Vitreous Surgery for Epiretinal Membrane.

BACKGROUND AND OBJECTIVE: To follow the long-term course of visual acuity (VA) and central retinal thickness (CRT) over at least a 3-year follow-up after vitreous surgery in patients with epiretinal membrane (ERM). PATIENTS AND METHODS: This study examined 43 eyes of patients who underwent 23- or 25-gauge vitreous surgery for ERM. RESULTS: There was significant improvement of the VA at 3 months after surgery compared with baseline, with the improvements maintained for 5 years (analysis of variance [ANOVA]; P < .05). There was a significant decrease in the mean CRT from 1 month up to 5 years (ANOVA; P < .05). There was also a significantly worse mean VA found for cases exhibiting an outer retinal layer disorder before surgery. CONCLUSION: Disorders of the outer layer of the retina before surgery have an influence on the VA outcome, with changes sometimes occurring even after the long-term postoperative follow-ups. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e105-e111.].

Age-related macular degeneration affects the optic radiation white matter projecting to locations of retinal damage.

We investigated the impact of age-related macular degeneration (AMD) on visual acuity and the visual white matter. We combined an adaptive cortical atlas and diffusion-weighted magnetic resonance imaging (dMRI) and tractography to separate optic radiation (OR) projections to different retinal eccentricities in human primary visual cortex. We exploited the known anatomical organization of the OR and clinically relevant data to segment the OR into three primary components projecting to fovea, mid- and far-periphery. We measured white matter tissue properties-fractional anisotropy, linearity, planarity, sphericity-along the aforementioned three components of the optic radiation to compare AMD patients and controls. We found differences in white matter properties specific to OR white matter fascicles projecting to primary visual cortex locations corresponding to the location of retinal damage (fovea). Additionally, we show that the magnitude of white matter properties in AMD patients' correlates with visual acuity. In sum, we demonstrate a specific relation between visual loss, anatomical location of retinal damage and white matter damage in AMD patients. Importantly, we demonstrate that these changes are so profound that can be detected using magnetic resonance imaging data with clinical resolution. The conserved mapping between retinal and white matter damage suggests that retinal neurodegeneration might be a primary cause of white matter degeneration in AMD patients. The results highlight the impact of eye disease on brain tissue, a process that may become an important target to monitor during the course of treatment.

Anti-aquaporin-4 antibody-positive familial neuromyelitis optica in mother and daughter.

BACKGROUND: Cases of anti-aquaporin (AQP)-4 antibody-positive familial neuromyelitis optica (NMO) in mothers and daughters are described. PARTICIPANTS: The demographic, clinical, neuroimaging, and anti-AQP-4 antibody status were investigated in four patients from two Asian families with anti-AQP-4 antibody-positive NMO. OBSERVATIONS: NMO was diagnosed in both mothers and daughters using the latest diagnostic criteria. All patients were anti-AQP-4 antibody-positive, and only one had an autoimmune background. The Japanese family presented with a poor visual outcome due to multiple occurrences of optic neuritis, whereas the Korean family presented with a good visual outcome. Disease onset occurred at different ages, even within the same family. CONCLUSIONS: These cases may enhance the understanding of the genetic contribution to NMO. Our findings suggest that familial history must be carefully examined in patients with NMO.