Optical coherence tomography as a useful adjunct in the early detection of meningioma with optic nerve compression.

A 48-year-old woman presented with persistent clouding vision in her lower field in the right eye for 5 months. A small retinal hemorrhage was initially reported. Her visual acuity was 20/30 in the right eye and 20/20 in the left, with normal color vision and pupil response. Fundus examination did not reveal any retinal hemorrhage. Although optical coherence tomography (OCT) showed normal macula and retinal nerve fiber layers in both eyes, asymmetric thinning of the ganglion cell inner plexiform layer was found in the superior macula of the right eye in ganglion cell analysis (GCA). Visual field examination revealed a subtle inferonasal scotoma. Compressive optic neuropathy (CON) was suspected. The visual evoked potential test revealed delayed P100 latency. A tuberculum sellae meningioma was found with right medial optic canal extension. The visual acuity of the right eye returned to 20/25 after decompression surgery. OCT can be used to differentiate between retinopathy and optic neuropathy. GCA can help in the early detection of CON and achieve a good visual outcome after surgery.

Optical coherence tomography features in a case of Type I sialidosis.

A 15-year-old boy presented with progressive myoclonic epilepsy and unbalance gaits for 4 years. Slit lamp examination showed a punctate cataract and funduscopic examination revealed bilateral macular cherry-red spots. Macular scan of spectral domain optical coherence tomography (SD-OCT) showed hyperreflectivity of the inner retinal layer and apparent hyperreflectivity of the photoreceptor layers in the foveal region. The clinical presentations were consistent with a Type I sialidosis which led to genetic analysis and revealed NEU1 mutation in this patient. He was under regular follow-up by ophthalmologist and neurologist. Sialidosis is a rare lysosomal storage disease resulting from a deficiency of alpha-N-acetyl neuraminidase caused by a mutation in the NEU1 gene. This results in abnormal intracellular accumulation of sialyloligosaccharides in brain neurons and ganglion cells of the retina. SD-OCT is a useful tool in detecting macular cherry-red spot and has a role in evaluating the extent of ganglion cell damage. It can aid in the differential diagnosis and long-term follow-up of the neurological metabolic disorders.

Bilateral optic neuritis related to chronic inflammatory demyelinating polyneuropathy.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a condition that mainly affects the peripheral nervous system; however, the central nervous system has also been involved in rare cases. Herein, we describe the case of a 33-year-old man with CIDP who presented with progressively blurred vision and pain with eye movement in both eyes for 1 month. Ocular examination revealed reduced visual acuities of 0.15 (oculus unitas or OU) and unremarkable fundi (OU). Furthermore, bitemporal visual field defects and prolonged visually evoked potentials were evident. Brain magnetic resonance imaging revealed nothing remarkable along the optic nerve and chiasm. These findings were compatible with the diagnosis of bilateral optic neuritis. The patient's symptoms and visual acuity improved after 5 days of intravenous (IV) corticosteroid pulse therapy, which was subsequently replaced by oral prednisolone therapy with a tapering schedule. The patient's visual acuity returned to 1.0 (OU) 6 months after treatment. However, bilateral optic neuritis recurred in 7 months while the patient was on oral prednisolone and azathioprine. IV corticosteroid pulse therapy was subsequently reinitiated and the patient's visual acuity returned gradually to 1.0 (OU). Bilateral optic neuritis is a rare manifestation of CIDP. It responded well to IV corticosteroid therapy in our case.

Resveratrol modulates mitochondria dynamics in replicative senescent yeast cells.

Mitochondria form a reticulum network dynamically fuse and divide in the cell. The balance between mitochondria fusion and fission is correlated to the shape, activity and integrity of these pivotal organelles. Resveratrol is a polyphenol antioxidant that can extend life span in yeast and worm. This study examined mitochondria dynamics in replicative senescent yeast cells as well as the effects of resveratrol on mitochondria fusion and fission. Collecting cells by biotin-streptavidin sorting method revealed that majority of the replicative senescent cells bear fragmented mitochondrial network, indicating mitochondria dynamics favors fission. Resveratrol treatment resulted in a reduction in the ratio of senescent yeast cells with fragmented mitochondria. The readjustment of mitochondria dynamics induced by resveratrol likely derives from altered expression profiles of fusion and fission genes. Our results demonstrate that resveratrol serves not only as an antioxidant, but also a compound that can mitigate mitochondria fragmentation in replicative senescent yeast cells.

Clinical prospective study of visual function in patients with acute optic neuritis.

BACKGROUND/PURPOSE: To investigate the clinical features and visual outcomes of acute optic neuritis in adult patients. METHODS: We prospectively collected ninety-nine adult patients, who were found to have acute optic neuritis between 2005 and 2007 at National Taiwan University Hospital. A total of 30 cases, aged ranging from 21 to 55 years old (average 36.4 ± 9.9), that followed up at least 6 months were enrolled in our study. Baseline clinical features and visual function results were analyzed. RESULTS: The mean follow-up period was 15.6 months. Twenty three (76.7%) cases were female. Twenty-seven cases were unilateral involved, one was simultaneously bilateral involved and two was sequentially bilateral involved. In total 33 affected eyes, ocular or periocular pain was noted in 14 eyes (69.7%). Optic disc swelling was noted in 5 eyes (15.2%). A total of 6 cases had recurrent episodes, and two of them were diagnosed with multiple sclerosis thereafter. At 6-month follow up, 24 eyes (72.7%) had good visual recovery (better than 20/40). Only 2 eyes (6%) had severe visual loss (<20/1000). Optic disc pale was detected in 72.7% of the eyes during follow up. CONCLUSION: Visual recovery was observed in most eyes with acute optic neuritis, although disc pale detectable. Patients with recurrent optic neuritis had worse visual outcome. There was a low association of optic neuritis with multiple sclerosis in our patients.

The effect of interferon beta-1a on optic neuritis relapse in patients with multiple sclerosis.

BACKGROUND: To evaluate the clinical effect of interferon beta-1a on optic neuritis (ON) relapse in patients with multiple sclerosis (MS) in Taiwan. METHODS: Data were collected from 23 MS patients with ON at National Taiwan University Hospital between January 1, 1993 and February 1, 2007. Twenty-three MS patients with ON received interferon beta-1a (Rebif) 44 microg via subcutaneous injection three times weekly. All patients received corticosteroids pulse therapy followed by oral prednisolone for acute ON. The annual relapse rate (ARR) of ON in these MS patients before and after the use of interferon beta-1a (Rebif) was the main clinical parameter of outcome in this study. RESULTS: The ARR of ON was lower in the posttreatment period than in the pretreatment period (P = 0.0068). Thirteen patients (56.5%) had improved final visual acuity (>2 lines), and the other ten patients (43.5%) had stable final visual outcome (-2 lines < X < 2 lines). In addition, no recurrence of ON was noted in 15 patients (65.2%) during the posttreatment period. CONCLUSIONS: The use of interferon beta-1a 44 microg via subcutaneous injection three times weekly did not increase the ON attacks in MS patients receiving this treatment. In addition, beneficial effects were found with the use of interferon beta-1a on these patients.

Anterior ischemic optic neuropathy associated with pegylated interferon therapy for chronic hepatitis C.

PURPOSE: To report a case of anterior ischemic optic neuropathy (AION) associated with the combined therapy of pegylated interferon alpha (PEG-IFNalpha) and ribavirin. METHODS: Case report. RESULTS: A 57-year-old male with chronic hepatitis C, treated with PEG-IFNalpha -2b and ribavirin for 6 months, noted sudden onset of painless blurred vision in his right eye. The initial visual acuity decreased to 20/60 in the right eye. Fundoscopy of right eye revealed optic disc edema with disc hemorrhage. Visual field examination disclosed inferior altitudinal defect. Relative afferent pupillary defect with poor color vision function was also noted in the right eye. Visual evoked potential demonstrated decreased amplitude in the right eye. A marked resolution of disc edema and improvement of visual acuity to 20/20 were noted at 6 weeks follow-up. CONCLUSIONS: AION may occur in combined treatment of PEG-IFNalpha -2b and ribavirin for chronic hepatitis C. Patients who are candidates for this treatment should be informed about its possible occurrence.

Optic neuropathy and sixth cranial nerve palsy caused by compression from a dolichoectatic basilar artery.

A 53-year-old man with progressive visual loss in the right eye and diplopia manifested dysfunction of the right optic nerve and the right sixth cranial nerve. MRI revealed a markedly enlarged and tortuous basilar artery, its proximal portion compressing the right sixth cranial nerve at the exit from the pons and its distal portion elevating and compressing the right optic nerve. This is the first report of optic neuropathy and sixth cranial nerve palsy caused by a dolichoectatic basilar artery.

Optic neuritis secondary to Angiostrongylus cantonensis infection.

PURPOSE: To describe a case of optic neuritis secondary to Angiostrongylus cantonensis infection. METHOD: Case report of a patient with eosinophilic meningitis secondary to A. cantonensis infection. The patient developed a sudden decrease in visual acuity with a visual field defect and color vision loss in his left eye. Both visual evoked potential and clinical manifestations suggested the diagnosis of optic neuritis (os). RESULT: After two weeks of larvicidal drugs and steroid treatment, the patient's visual acuity and color vision had dramatically improved. CONCLUSION: Optic neuritis may occur in patients with A. cantonensis meningitis. Treatment with a combination of steroid and larvicidal agents may be beneficial to these patients.