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Sample records for acute optic neuritis

  1. Acute Optic Neuritis: Prognosis for the Development of Multiple Sclerosis.

    Science.gov (United States)

    1979-12-01

    The literature was reviewed in regard to acute optic neuritis : prognosis for the development of multiple sclerosis, with specific reference to our...development of multiple sclerosis in patients affected with acute optic neuritis . This finding leads us to conclude that an incidence of 13% to 17...calculated on life tables) most accurately represents the risk that our flyers who are afflicted with optic neuritis will later develop multiple sclerosis. (Author)

  2. The optic nerve sheath on MRI in acute optic neuritis

    Energy Technology Data Exchange (ETDEWEB)

    Hickman, S.J. [University College London, NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, London (United Kingdom); Moorfields Eye Hospital, Department of Neuro-Ophthalmology, London (United Kingdom); Miszkiel, K.A. [National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); Plant, G.T. [Moorfields Eye Hospital, Department of Neuro-Ophthalmology, London (United Kingdom); Miller, D.H. [University College London, NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, London (United Kingdom)

    2005-01-01

    Optic nerve sheath dilatation or gadolinium-enhancement on magnetic resonance imaging in acute optic neuritis have been previously reported but have been thought to be rare occurrences. This study recruited 33 patients with acute unilateral optic neuritis. All had their optic nerves imaged with fat-saturated fast spin-echo (FSE) imaging, and 28 had imaging before and after triple-dose gadolinium-enhanced fat-saturated T{sub 1}-weighted imaging. Follow-up imaging was performed on 20 patients (15 following gadolinium). A dilated subarachnoid space at the anterior end of the symptomatic optic nerve on FSE imaging was seen in 15/33 cases. In three of these cases, dilatation was visible on short-term follow-up. Optic nerve sheath enhancement was seen in 21/28 cases acutely: seven at the anterior end of the lesion only, five at the posterior end only and nine at both ends. Optic sheath enhancement was seen in 13 patients on follow-up. This study suggests that optic nerve sheath dilatation on FSE images and optic nerve sheath enhancement on triple-dose gadolinium-enhanced images are common findings in acute optic neuritis. Optic nerve sheath dilatation may be due to inflammation of the optic nerve, with its associated swelling, interrupting the communication between the subarachnoid space of the diseased optic nerve and the chiasmal cistern. Optic nerve sheath enhancement suggests that meningeal inflammation occurs in optic neuritis, in agreement with pathological studies of both optic neuritis and multiple sclerosis. (orig.)

  3. Bilateral optic neuritis in acute human immunodeficiency virus infection

    DEFF Research Database (Denmark)

    Larsen, M; Toft, P.B.; Bernhard, P;

    1998-01-01

    PURPOSE: To report a case of acute viral disease accompanied by bilateral optic neuritis with substantial paraclinical evidence that human immunodeficiency virus was the causative agent. METHODS: Clinical and paraclinical examination. Magnetic resonance imaging. RESULTS: Virus and antibody titers...... as well as reverse lymphocytosis were consistent with acute infection by the human immunodeficiency virus-1. CONCLUSIONS: Human immunodeficiency virus infection should be considered in the differential diagnosis of acute optic neuritis...

  4. Optic Neuritis

    OpenAIRE

    1989-01-01

    Demyelinating optic neuritis is the most common cause of unilateral painful visual loss in the United States. Although patients presenting with demyelinating optic neuritis have favorable long-term visual prognosis, optic neuritis is the initial clinical manifestation of multiple sclerosis in 20% of patients. The Optic Neuritis Treatment Trial (ONTT) has helped stratify the risk of developing multiple sclerosis after the first episode of optic neuritis based on abnormal findings on brain MRI....

  5. HLA typing in acute optic neuritis

    DEFF Research Database (Denmark)

    Frederiksen, J L; Madsen, H O; Ryder, L P

    1997-01-01

    OBJECTIVE: To study the association of brain magnetic resonance imaging (MRI) findings and HLA findings to clarify the relationship between monosymptomatic optic neuritis (ON) and ON as part of clinically definite multiple sclerosis (CDMS). DESIGN: Population-based cohort of patients with ON refe...

  6. 25-Hydroxyvitamin D levels in acute monosymptomatic optic neuritis

    DEFF Research Database (Denmark)

    Pihl-Jensen, Gorm; Frederiksen, Jette Lautrup

    2015-01-01

    Optic neuritis (ON) is a common first symptom of MS and only few studies have thus far investigated vitamin D at this early stage of MS. The objectives of the study were to examine total 25-hydroxyvitamin D levels (25HVITDL) in patients in acute (A) ON and to determine whether 25HVITD levels in AON...

  7. Serial Magnetization Transfer Imaging in Acute Optic Neuritis

    Science.gov (United States)

    Hickman, S. J.; Toosy, A. T.; Jones, S. J.; Altmann, D. R.; Miszkiel, K. A.; MacManus, D. G.; Barker, G. J.; Plant, G. T.; Thompson, A. J.; Miller, D.H.

    2004-01-01

    In serial studies of multiple sclerosis lesions, reductions in magnetization transfer ratio (MTR) are thought to be due to demyelination and axonal loss, with later rises due to remyelination. This study followed serial changes in MTR in acute optic neuritis in combination with clinical and electrophysiological measurements to determine if the MTR…

  8. Optic neuritis

    DEFF Research Database (Denmark)

    Sørensen, Torben Lykke; Roed, H; Sellebjerg, F

    2004-01-01

    To study the involvement of the chemokine receptor CXCR3 and its ligands (CXCL9/Mig, CXCL10/IP-10, CXCL11/ITAC) in optic neuritis (ON).......To study the involvement of the chemokine receptor CXCR3 and its ligands (CXCL9/Mig, CXCL10/IP-10, CXCL11/ITAC) in optic neuritis (ON)....

  9. Association of race/ethnicity with visual outcomes following acute optic neuritis: an analysis of the Optic Neuritis Treatment Trial.

    Science.gov (United States)

    Moss, Heather E; Gao, Weihua; Balcer, Laura J; Joslin, Charlotte E

    2014-04-01

    IMPORTANCE Retrospective studies have demonstrated disparate outcomes following acute optic neuritis in individuals of African descent compared with individuals of white race/ethnicity. However, published analyses of the prospectively collected Optic Neuritis Treatment Trial (ONTT) data identified no association between worse visual outcomes and black race/ethnicity. OBJECTIVES To investigate the associations of age, sex, and race/ethnicity with visual outcomes following acute optic neuritis through application of longitudinal data analysis techniques to the ONTT data set. DESIGN Secondary analysis of the ONTT (a prospective randomized controlled trial) data set. Our models included effects of treatment (placebo, oral prednisone, or intravenous methylprednisolone), time, and treatment × time interaction, as well as demographic covariates of age, sex, and race/ethnicity. SETTING AND PARTICIPANTS The ONTT data were collected at multiple centers in the United States. Patients of black (n = 58) and white (n = 388) race/ethnicity with acute optic neuritis who enrolled in the ONTT within 8 days of symptom onset were included in analyses. MAIN OUTCOMES AND MEASURES The contrast sensitivity and visual acuity (logMAR) in the affected eye were modeled using 2-stage mixed-effects regression techniques. All available follow-up data from baseline to 15 to 18 years were included. RESULTS The data identified no relationship of age, sex, or treatment with contrast sensitivity or visual acuity outcomes. Race/ethnicity was significantly related to contrast sensitivity (P optic neuritis, with black race/ethnicity being associated with worse scores for both. CONCLUSIONS AND RELEVANCE Race/ethnicity seems to be associated with contrast sensitivity and visual acuity outcomes in affected eyes following acute optic neuritis. To our knowledge, this is the largest cohort of black race/ethnicity with acute optic neuritis to be studied and represents the first evidence from a

  10. [Optic neuritis].

    Science.gov (United States)

    Wilhelm, H; Heine, C; Tonagel, F

    2014-11-01

    Optic neuritis is a frequent neuro-ophthalmological disease in which the diagnosis can be based on just a few symptoms and findings. It is not only important to differentiate from other optic nerve disorders but also to recognise special types of optic neuritis, which is mostly only possible during the course of the disease. This article presents a review of the current state in diagnosis and therapy from the authors' personal point of view.

  11. Changes in the retinal veins in acute optic neuritis

    DEFF Research Database (Denmark)

    Engell, T; Sellebjerg, F; Jensen, C

    1999-01-01

    OBJECTIVE: To investigate patients with acute optic neuritis (ON) for changes of the retinal veins. MATERIAL AND METHODS: Seventy-six patients with acute ON were extensively neuro-ophthalmologically examined. RESULTS: Multiple sclerosis (MS) was found in 41 patients of whom 1 had periphlebitis...... retinae (PR) and 2 had venous sheathing (VS). Probable MS was found in 15 patients without prior symptoms of MS. One had PR and VS, and 2 had VS. Twenty patients had mono-symptomatic ON, none had retinal changes. CONCLUSION: Changes of the retinal veins should alert the clinician to a probable diagnosis...

  12. Retinal nerve fiber layer thickness is associated with lesion length in acute optic neuritis

    DEFF Research Database (Denmark)

    Kallenbach, K; Simonsen, Helle Juhl; Sander, B;

    2010-01-01

    BACKGROUND: Acute optic neuritis occurs with and without papillitis. The presence of papillitis has previously been thought to imply an anterior location of the neuritis, but imaging studies seeking to test this hypothesis have been inconclusive. METHODS: This prospective observational cohort study...... included 41 patients with unilateral optic neuritis and 19 healthy volunteers. All patients were evaluated and examined within 28 days of onset of symptoms. The peripapillary retinal nerve fiber layer thickness (RNFLT), an objective quantitative measure of optic nerve head edema, was measured by optical...... in the development of optic nerve head edema in optic neuritis....

  13. Acute Optic Neuritis | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available on the Trial E.1 Medical condition or disease under investigation E.1.1Medical condition(s) being investigated Acute... Optic Neuritis E.1.1.1Medical condition in easily understood language Acute Optic Neuritis E.1.1.2T

  14. Cortical neuroplasticity in patients recovering from acute optic neuritis

    DEFF Research Database (Denmark)

    Korsholm, Kirsten; Madsen, Kristoffer Hougaard; Frederiksen, Jette L.

    2008-01-01

    Patients with optic neuritis (ON) undergo cortical and subcortical neuroplasticity as revealed by functional magnetic resonance imaging (fMRI). However, the effect of the heterogeneity of scotomas his not been adequately addressed previously. We introduce a new method of modelling scotomas in f......MRI, to reveal a clearer pattern of neuroplasticity, across a mixed patient population. A longitudinal fMRI-study of visual function in 19 ON patients examined at four timepoints between presentation and 6 months was performed. Four different models were compared. The first model included the four different...... Cortical neuroplasticity during recovery. Moreover, inferences from the fourth model can be extended to the general Population of patients recovering from ON. In Conclusion, we present a method of accommodating subject-specific differences between patients with acute ON by inclusion of an HMD...

  15. The investigation of acute optic neuritis: a review and proposed protocol.

    Science.gov (United States)

    Petzold, Axel; Wattjes, Mike P; Costello, Fiona; Flores-Rivera, Jose; Fraser, Clare L; Fujihara, Kazuo; Leavitt, Jacqueline; Marignier, Romain; Paul, Friedemann; Schippling, Sven; Sindic, Christian; Villoslada, Pablo; Weinshenker, Brian; Plant, Gordon T

    2014-08-01

    Optic neuritis is an inflammatory optic neuropathy that affects many patients with multiple sclerosis (MS) at some point during their disease course. Differentiation of acute episodes of MS-associated optic neuritis from other autoimmune and inflammatory optic neuropathies is vital for treatment choice and further patient management, but is not always straightforward. Over the past decade, a number of new imaging, laboratory and electrophysiological techniques have entered the clinical arena. To date, however, no consensus guidelines have been devised to specify how and when these techniques can be most rationally applied for the diagnostic work-up of patients with acute optic neuritis. In this article, we review the literature and attempt to formulate a consensus for the investigation of patients with acute optic neuritis, both in standard care and in research with relevance to clinical treatment trials.

  16. Acute disseminated encephalomyelitis without optic neuritis followed by optic neuritis in a child due to the sudden cessation of steroid therapy.

    Science.gov (United States)

    Ryu, Won Yeol; Sohn, Eun Jung; Kwon, Yoon Hyung; Jeung, Woo Jin; Ahn, Hee Bae; Park, Woo Chan; Rho, Sae Heun

    2014-01-01

    Acute disseminated encephalitis (ADEM) is an autoimmune demyelinating disorder of the central nervous system that usually occurs in children after viral infection or vaccination. It is not uncommon for ADEM to be accompanied by optic neuritis. However, ADEM followed by optic neuritis is a rare. We report the case of a 6-year-old girl who initially presented with ADEM (without optic neuritis) due to a live measles, mumps, and rubella vaccine and was treated with intravenous high-dose corticosteroids. After steroid therapy, she recovered neurologically and was not prescribed any medication, including an oral steroid taper, for use after discharge. Three weeks later, she developed unilateral optic neuritis and was again treated with steroid therapy. This is a rare case of ADEM without optic neuritis in a child, followed by optic neuritis due to the sudden cessation of steroid therapy. Further studies and follow-ups are needed to determine whether ADEM followed by optic neuritis can be considered a specific clinical form of this disorder.

  17. Chemical shift selective magnetic resonance imaging of the optic nerve in patients with acute optic neuritis

    DEFF Research Database (Denmark)

    Larsson, H B; Thomsen, C; Frederiksen, J

    1988-01-01

    of the 16 patients, abnormalities were seen. In one patient with bilateral symptoms, signal hyperintensity and swelling of the right side of the chiasm were found. In another patient the optic nerve was found diffusely enlarged with only a marginally increased signal in the second echo. In the third patient......Optic neuritis is often the first manifestation of multiple sclerosis (MS). Sixteen patients with acute optic neuritis and one patient with benign intracranial hypertension (BIH) were investigated by magnetic resonance imaging, using a chemical shift selective double spin echo sequence. In 3...... an area of signal hyperintensity and swelling was seen in the left optic nerve. In the patient with BIH the subarachnoid space which surrounds the optic nerves was enlarged. Even using this refined pulse sequence, avoiding the major artefact in imaging the optic nerve, the chemical shift artefact, lesions...

  18. A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis

    DEFF Research Database (Denmark)

    Roed, H.G; Langkilde, Annika Reynberg; Sellebjerg, F;

    2005-01-01

    OBJECTIVE: To investigate if IV immunoglobulin (IVIG) treatment in the acute phase of optic neuritis (ON) could improve visual outcome and reduce MRI disease activity 6 months after onset of ON. METHODS: Sixty-eight patients with ON were randomized within 4 weeks from onset of symptoms. Thirty...... during follow-up. CONCLUSIONS: There was no effect of IV immunoglobulin (IVIG) on long-term visual function following acute optic neuritis, nor was there an effect of IVIG treatment in reducing latency on visual evoked potentials and thus preserving function of axons of the optic nerve...

  19. Chemical shift selective magnetic resonance imaging of the optic nerve in patients with acute optic neuritis

    Energy Technology Data Exchange (ETDEWEB)

    Larsson, H.B.W.; Thomsen, C.; Frederiksen, J.; Henriksen, O.; Olesen, J.

    Optic neuritis is often the first manifestion of multiple sclerosis (MS). Sixteen patients with acute optic neuritis and one patient with benign intracranial hypertension (BIH) were investigated by magnetic resonance imaging, using a chemical shift selective double spin echo sequence. In 3 of the 16 patients, abnormalities were seen. In one patient with bilateral symptoms, signal hyperintensity and swelling of the right side of the chiasm were found. In another patient the optic nerve was found diffusely enlarged with only a marginally increased signal in the second echo. In the third patient an area of signal hyperintensity and swelling was seen in the left optic nerve. In the patient with BIH the subarachnoid space which surrounds the optic nerves was enlarged. Even using this refined pulse sequence, avoiding the major artefact in imaging the optic nerve, the chemical shift artefact, lesions were only shown in 3/16 (19%) of the patients with optic neuritis. Nevertheless, the presented chemical shift selective double spin echo sequence may be of great value for detection of retrobulbar lesions.

  20. DEMYELINATING OPTIC NEURITIS IN CHILDREN

    OpenAIRE

    Alper, Gulay; Wang, Li

    2008-01-01

    Acute demyelinating optic neuritis in children can occur in isolation or be associated with acute disseminated encephalomyelitis, multiple sclerosis or neuromyelitis optica. Clinical features, neuroimaging, cerebrospinal fluid findings and long term prognosis were reviewed in 26 children diagnosed with optic neuritis at the first presentation of demyelinating disease. The risk factors for the subsequent diagnosis of multiple sclerosis were analyzed. The mean duration of follow-up was 6.2 year...

  1. Gd-DTPA-enhanced lesions in the brain of patients with acute optic neuritis

    DEFF Research Database (Denmark)

    Christiansen, P; Frederiksen, J L; Henriksen, O

    1992-01-01

    The cerebral hemispheres of 19 patients with acute monosymptomatic optic neuritis (AMON) were investigated using magnetic resonance imaging (MRI) and Gadolinium-DTPA (Gd-DTPA). Using T1-weighted and T2-weighted imaging sequences it was disclosed that 14 of 19 patients had lesions...

  2. Systemic T-cell activation in acute clinically isolated optic neuritis

    DEFF Research Database (Denmark)

    Roed, Hanne; Frederiksen, Jette; Langkilde, Annika Reynberg;

    2005-01-01

    We examined untreated 60 patients with acute monosymptomatic optic neuritis (ON). Patients examined early after onset showed increased expression of HLA-DR and CD45R0 on CD4 and CD8 T cells. Expression of HLA-DR on CD4 T cells was higher in patients without IgG oligoclonal bands. Expression of HLA...

  3. Optic neuritis and acute anterior uveitis associated with influenza A infection: a case report

    Directory of Open Access Journals (Sweden)

    Nakagawa H

    2017-01-01

    Full Text Available Hayate Nakagawa, Hidetaka Noma, Osamu Kotake, Ryosuke Motohashi, Kanako Yasuda, Masahiko Shimura Department of Ophthalmology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan Background: A few reports have described ocular complications of influenza A infection, such as impaired ocular movement, parasympathetic ocular nerve, keratitis, macular lesion, and frosted branch angiitis. We encountered a rare case of acute anterior uveitis and optic neuritis associated with influenza A infection. Case presentation: A 70-year-old man presented with symptoms of upper respiratory tract infection. A rapid diagnostic test showed a positive result for influenza A. At the same time, he developed ocular symptoms including blurred vision with optic disk edema and hemorrhage in the left eye, and bilateral red eyes. Multiplex polymerase chain reaction performed on aqueous humor sample detected no viral infection. Visual field testing with a Goldmann perimeter showed central and paracentral scotomas in the left eye. In addition to antiviral agent (oseltamivir phosphate 75 mg, the patient was prescribed topical prednisolone acetate ophthalmic suspension eye drops every 5 hours and high-dose intravenous methylprednisolone 1,000 mg daily for 3 days. Two months later, his best-corrected visual acuity improved to 20/50 with regression of visual field defects in his left eye. Conclusion: We report a case of bilateral acute anterior uveitis and unilateral optic neuritis concomitant with influenza A infection. Topical and systemic corticosteroids were effective to resolve acute anterior uveitis and neuritis. Analysis of aqueous humor sample suggested that acute anterior uveitis and optic neuritis in this case were not caused by influenza A virus infection per se but by autoimmune mechanism. Keywords: optic neuritis, anterior uveitis, influenza virus, multiplex polymerase chain reaction

  4. Diffusion fMRI detects white-matter dysfunction in mice with acute optic neuritis.

    Science.gov (United States)

    Lin, Tsen-Hsuan; Spees, William M; Chiang, Chia-Wen; Trinkaus, Kathryn; Cross, Anne H; Song, Sheng-Kwei

    2014-07-01

    Optic neuritis is a frequent and early symptom of multiple sclerosis (MS). Conventional magnetic resonance (MR) techniques provide means to assess multiple MS-related pathologies, including axonal injury, demyelination, and inflammation. A method to directly and non-invasively probe white-matter function could further elucidate the interplay of underlying pathologies and functional impairments. Previously, we demonstrated a significant 27% activation-associated decrease in the apparent diffusion coefficient of water perpendicular to the axonal fibers (ADC⊥) in normal C57BL/6 mouse optic nerve with visual stimulation using diffusion fMRI. Here we apply this approach to explore the relationship between visual acuity, optic nerve pathology, and diffusion fMRI in the experimental autoimmune encephalomyelitis (EAE) mouse model of optic neuritis. Visual stimulation produced a significant 25% (vs. baseline) ADC⊥ decrease in sham EAE optic nerves, while only a 7% (vs. baseline) ADC⊥ decrease was seen in EAE mice with acute optic neuritis. The reduced activation-associated ADC⊥ response correlated with post-MRI immunohistochemistry determined pathologies (including inflammation, demyelination, and axonal injury). The negative correlation between activation-associated ADC⊥ response and visual acuity was also found when pooling EAE-affected and sham groups under our experimental criteria. Results suggest that reduction in diffusion fMRI directly reflects impaired axonal-activation in EAE mice with optic neuritis. Diffusion fMRI holds promise for directly gauging in vivo white-matter dysfunction or therapeutic responses in MS patients.

  5. Serial Diffusion Tensor Imaging of the Optic Radiations after Acute Optic Neuritis.

    Science.gov (United States)

    Kolbe, Scott C; van der Walt, Anneke; Butzkueven, Helmut; Klistorner, Alexander; Egan, Gary F; Kilpatrick, Trevor J

    2016-01-01

    Previous studies have reported diffusion tensor imaging (DTI) changes within the optic radiations of patients after optic neuritis (ON). We aimed to study optic radiation DTI changes over 12 months following acute ON and to study correlations between DTI parameters and damage to the optic nerve and primary visual cortex (V1). We measured DTI parameters [fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD)] from the optic radiations of 38 acute ON patients at presentation and 6 and 12 months after acute ON. In addition, we measured retinal nerve fibre layer thickness, visual evoked potential amplitude, optic radiation lesion load, and V1 thickness. At baseline, FA was reduced and RD and MD were increased compared to control. Over 12 months, FA reduced in patients at an average rate of -2.6% per annum (control = -0.51%; p = 0.006). Change in FA, RD, and MD correlated with V1 thinning over 12 months (FA: R = 0.450, p = 0.006; RD: R = -0.428, p = 0.009; MD: R = -0.365, p = 0.029). In patients with no optic radiation lesions, AD significantly correlated with RNFL thinning at 12 months (R = 0.489, p = 0.039). In conclusion, DTI can detect optic radiation changes over 12 months following acute ON that correlate with optic nerve and V1 damage.

  6. Serial Diffusion Tensor Imaging of the Optic Radiations after Acute Optic Neuritis

    Directory of Open Access Journals (Sweden)

    Scott C. Kolbe

    2016-01-01

    Full Text Available Previous studies have reported diffusion tensor imaging (DTI changes within the optic radiations of patients after optic neuritis (ON. We aimed to study optic radiation DTI changes over 12 months following acute ON and to study correlations between DTI parameters and damage to the optic nerve and primary visual cortex (V1. We measured DTI parameters [fractional anisotropy (FA, axial diffusivity (AD, radial diffusivity (RD, and mean diffusivity (MD] from the optic radiations of 38 acute ON patients at presentation and 6 and 12 months after acute ON. In addition, we measured retinal nerve fibre layer thickness, visual evoked potential amplitude, optic radiation lesion load, and V1 thickness. At baseline, FA was reduced and RD and MD were increased compared to control. Over 12 months, FA reduced in patients at an average rate of −2.6% per annum (control = −0.51%; p=0.006. Change in FA, RD, and MD correlated with V1 thinning over 12 months (FA: R=0.450, p=0.006; RD: R=-0.428, p=0.009; MD: R=-0.365, p=0.029. In patients with no optic radiation lesions, AD significantly correlated with RNFL thinning at 12 months (R=0.489, p=0.039. In conclusion, DTI can detect optic radiation changes over 12 months following acute ON that correlate with optic nerve and V1 damage.

  7. Retinal nerve fiber layer thickness is associated with lesion length in acute optic neuritis

    DEFF Research Database (Denmark)

    Kallenbach, K; Simonsen, Helle Juhl; Sander, B

    2010-01-01

    included 41 patients with unilateral optic neuritis and 19 healthy volunteers. All patients were evaluated and examined within 28 days of onset of symptoms. The peripapillary retinal nerve fiber layer thickness (RNFLT), an objective quantitative measure of optic nerve head edema, was measured by optical...... coherence tomography and the length and location of the inflammatory optic nerve lesion were evaluated using MRI. RESULTS: Ophthalmoscopically, 34% of the patients had papillitis. The retinal nerve fiber layer in affected eyes (mean 123.1 microm) was higher during the acute phase than that of fellow eyes...... (mean 98.1 microm, p eyes (mean 97.1 microm, p

  8. Effector and regulatory T cells in patients with acute optic neuritis

    DEFF Research Database (Denmark)

    Tsakiri, Anna; Kjærsgaard, Erik; Grigoriadis, Nikolaos;

    2012-01-01

    Optic neuritis (ON) is an autoimmune acute demyelinating disease of the optic nerve and may occur in patients with confirmed multiple sclerosis (MS) or as a clinically isolated syndrome. T lymphocytes play a central role in the pathogenesis of MS. The phenotype of different T cell subsets is usua...... is usually characterized by the expression of distinct cell surface receptors such as CD45RA, CD45RO, CCR7, CD27 and CD28. The aim of this study was to characterize the phenotype of distinct subsets of CD4 and CD8 T cells in patients with isolated ON....

  9. Atypical Optic Neuritis.

    Science.gov (United States)

    Gaier, Eric D; Boudreault, Katherine; Rizzo, Joseph F; Falardeau, Julie; Cestari, Dean M

    2015-12-01

    Classic demyelinative optic neuritis is associated with multiple sclerosis and typically carries a good prognosis for visual recovery. This disorder is well characterized with respect to its presentation and clinical features by baseline data obtained through the optic neuritis treatment trial and numerous other studies. Atypical optic neuritis entails clinical manifestations that deviate from this classic pattern of features. Clinical signs and symptoms that deviate from the typical presentation should prompt consideration of less common etiologies. Atypical features to consider include lack of pain, simultaneous or near-simultaneous onset, lack of response to or relapse upon tapering from corticosteroids, or optic nerve head or peripapillary hemorrhages. The most important alternative etiologies to consider and the steps towards their respective diagnostic evaluations are suggested for these atypical features.

  10. Optic nerve diffusion tensor imaging after acute optic neuritis predicts axonal and visual outcomes.

    Science.gov (United States)

    van der Walt, Anneke; Kolbe, Scott C; Wang, Yejun E; Klistorner, Alexander; Shuey, Neil; Ahmadi, Gelareh; Paine, Mark; Marriott, Mark; Mitchell, Peter; Egan, Gary F; Butzkueven, Helmut; Kilpatrick, Trevor J

    2013-01-01

    Early markers of axonal and clinical outcomes are required for early phase testing of putative neuroprotective therapies for multiple sclerosis (MS). To assess whether early measurement of diffusion tensor imaging (DTI) parameters (axial and radial diffusivity) within the optic nerve during and after acute demyelinating optic neuritis (ON) could predict axonal (retinal nerve fibre layer thinning and multi-focal visual evoked potential amplitude reduction) or clinical (visual acuity and visual field loss) outcomes at 6 or 12 months. Thirty-seven patients presenting with acute, unilateral ON were studied at baseline, one, three, six and 12 months using optic nerve DTI, clinical and paraclinical markers of axonal injury and clinical visual dysfunction. Affected nerve axial diffusivity (AD) was reduced at baseline, 1 and 3 months. Reduced 1-month AD correlated with retinal nerve fibre layer (RNFL) thinning at 6 (R=0.38, p=0.04) and 12 months (R=0.437, p=0.008) and VEP amplitude loss at 6 (R=0.414, p=0.019) and 12 months (R=0.484, p=0.003). AD reduction at three months correlated with high contrast visual acuity at 6 (ρ = -0.519, p = 0.001) and 12 months (ρ = -0.414, p=0.011). The time-course for AD reduction for each patient was modelled using a quadratic regression. AD normalised after a median of 18 weeks and longer normalisation times were associated with more pronounced RNFL thinning and mfVEP amplitude loss at 12 months. Affected nerve radial diffusivity (RD) was unchanged until three months, after which time it remained elevated. These results demonstrate that AD reduces during acute ON. One month AD reduction correlates with the extent of axonal loss and persistent AD reduction at 3 months predicts poorer visual outcomes. This suggests that acute ON therapies that normalise optic nerve AD by 3 months could also promote axon survival and improve visual outcomes.

  11. Gd-DTPA-enhanced lesions in the brain of patients with acute optic neuritis

    DEFF Research Database (Denmark)

    Christiansen, P; Frederiksen, J L; Henriksen, O

    1992-01-01

    The cerebral hemispheres of 19 patients with acute monosymptomatic optic neuritis (AMON) were investigated using magnetic resonance imaging (MRI) and Gadolinium-DTPA (Gd-DTPA). Using T1-weighted and T2-weighted imaging sequences it was disclosed that 14 of 19 patients had lesions and that enhance......The cerebral hemispheres of 19 patients with acute monosymptomatic optic neuritis (AMON) were investigated using magnetic resonance imaging (MRI) and Gadolinium-DTPA (Gd-DTPA). Using T1-weighted and T2-weighted imaging sequences it was disclosed that 14 of 19 patients had lesions...... and that enhancement was seen in seven patients. It is known that patients with AMON and silent lesions in the CNS have a highly increased risk of developing multiple sclerosis (MS) later on. If it is accepted that a silent lesion in patients with AMON does represent a multiple sclerosis (MS) plaque......, and that an enhancing silent lesion represents an acute MS lesion, we may hypothesize that the disease process ultimately leading to MS starts long before the first symptom or sign ever appears. It would seem that at least half of the silent lesions in the cerebral hemispheres of patients with AMON had existed before...

  12. Safety and efficacy of opicinumab in acute optic neuritis (RENEW)

    DEFF Research Database (Denmark)

    Cadavid, Diego; Balcer, Laura J; Galetta, Steven L

    2017-01-01

    participants and all study staff, including the central readers, were masked to treatment assignment apart from the pharmacist responsible for preparing the study treatments and the pharmacy monitor at each site. The primary endpoint was remyelination at 24 weeks, measured as recovery of affected optic nerve...... conduction latency using full-field visual evoked potential (FF-VEP) versus the unaffected fellow eye at baseline. Analysis was by intention-to-treat (ITT); prespecified per-protocol (PP) analyses were also done. This study is registered with ClinicalTrials.gov, number NCT01721161. FINDINGS: The study...... at week 32. The overall incidence (34 [83%] of 41 in each group) and severity of adverse events (two [5%] of 41 severe adverse events with placebo vs three [7%] of 41 with opicinumab) were similar between groups and no significant effects on brain MRI measures were noted in either group (mean T2 lesion...

  13. Optic nerve diffusion tensor imaging after acute optic neuritis predicts axonal and visual outcomes.

    Directory of Open Access Journals (Sweden)

    Anneke van der Walt

    Full Text Available BACKGROUND: Early markers of axonal and clinical outcomes are required for early phase testing of putative neuroprotective therapies for multiple sclerosis (MS. OBJECTIVES: To assess whether early measurement of diffusion tensor imaging (DTI parameters (axial and radial diffusivity within the optic nerve during and after acute demyelinating optic neuritis (ON could predict axonal (retinal nerve fibre layer thinning and multi-focal visual evoked potential amplitude reduction or clinical (visual acuity and visual field loss outcomes at 6 or 12 months. METHODS: Thirty-seven patients presenting with acute, unilateral ON were studied at baseline, one, three, six and 12 months using optic nerve DTI, clinical and paraclinical markers of axonal injury and clinical visual dysfunction. RESULTS: Affected nerve axial diffusivity (AD was reduced at baseline, 1 and 3 months. Reduced 1-month AD correlated with retinal nerve fibre layer (RNFL thinning at 6 (R=0.38, p=0.04 and 12 months (R=0.437, p=0.008 and VEP amplitude loss at 6 (R=0.414, p=0.019 and 12 months (R=0.484, p=0.003. AD reduction at three months correlated with high contrast visual acuity at 6 (ρ = -0.519, p = 0.001 and 12 months (ρ = -0.414, p=0.011. The time-course for AD reduction for each patient was modelled using a quadratic regression. AD normalised after a median of 18 weeks and longer normalisation times were associated with more pronounced RNFL thinning and mfVEP amplitude loss at 12 months. Affected nerve radial diffusivity (RD was unchanged until three months, after which time it remained elevated. CONCLUSIONS: These results demonstrate that AD reduces during acute ON. One month AD reduction correlates with the extent of axonal loss and persistent AD reduction at 3 months predicts poorer visual outcomes. This suggests that acute ON therapies that normalise optic nerve AD by 3 months could also promote axon survival and improve visual outcomes.

  14. Optic nerve magnetisation transfer ratio after acute optic neuritis predicts axonal and visual outcomes.

    Science.gov (United States)

    Wang, Yejun; van der Walt, Anneke; Paine, Mark; Klistorner, Alexander; Butzkueven, Helmut; Egan, Gary F; Kilpatrick, Trevor J; Kolbe, Scott C

    2012-01-01

    Magnetisation transfer ratio (MTR) can reveal the degree of proton exchange between free water and macromolecules and was suggested to be pathological informative. We aimed to investigate changes in optic nerve MTR over 12 months following acute optic neuritis (ON) and to determine whether MTR measurements can predict clinical and paraclinical outcomes at 6 and 12 months. Thirty-seven patients with acute ON were studied within 2 weeks of presentation and at 1, 3, 6 and 12 months. Assessments included optic nerve MTR, retinal nerve fibre layer (RNFL) thickness, multifocal visual evoked potential (mfVEP) amplitude and latency and high (100%) and low (2.5%) contrast letter acuity. Eleven healthy controls were scanned twice four weeks apart for comparison with patients. Patient unaffected optic nerve MTR did not significantly differ from controls at any time-point. Compared to the unaffected nerve, affected optic nerve MTR was significantly reduced at 3 months (mean percentage interocular difference = -9.24%, p = 0.01), 6 months (mean = -12.48%, p<0.0001) and 12 months (mean = -7.61%, p = 0.003). Greater reduction in MTR at 3 months in patients was associated with subsequent loss of high contrast letter acuity at 6 (ρ = 0.60, p = 0.0003) and 12 (ρ = 0.44, p = 0.009) months, low contrast letter acuity at 6 (ρ = 0.35, p = 0.047) months, and RNFL thinning at 12 (ρ = 0.35, p = 0.044) months. Stratification of individual patient MTR time courses based on flux over 12 months (stable, putative remyelination and putative degeneration) predicted RNFL thinning at 12 months (F(2,32) = 3.59, p = 0.02). In conclusion, these findings indicate that MTR flux after acute ON is predictive of axonal degeneration and visual disability outcomes.

  15. Optic nerve magnetisation transfer ratio after acute optic neuritis predicts axonal and visual outcomes.

    Directory of Open Access Journals (Sweden)

    Yejun Wang

    Full Text Available Magnetisation transfer ratio (MTR can reveal the degree of proton exchange between free water and macromolecules and was suggested to be pathological informative. We aimed to investigate changes in optic nerve MTR over 12 months following acute optic neuritis (ON and to determine whether MTR measurements can predict clinical and paraclinical outcomes at 6 and 12 months. Thirty-seven patients with acute ON were studied within 2 weeks of presentation and at 1, 3, 6 and 12 months. Assessments included optic nerve MTR, retinal nerve fibre layer (RNFL thickness, multifocal visual evoked potential (mfVEP amplitude and latency and high (100% and low (2.5% contrast letter acuity. Eleven healthy controls were scanned twice four weeks apart for comparison with patients. Patient unaffected optic nerve MTR did not significantly differ from controls at any time-point. Compared to the unaffected nerve, affected optic nerve MTR was significantly reduced at 3 months (mean percentage interocular difference = -9.24%, p = 0.01, 6 months (mean = -12.48%, p<0.0001 and 12 months (mean = -7.61%, p = 0.003. Greater reduction in MTR at 3 months in patients was associated with subsequent loss of high contrast letter acuity at 6 (ρ = 0.60, p = 0.0003 and 12 (ρ = 0.44, p = 0.009 months, low contrast letter acuity at 6 (ρ = 0.35, p = 0.047 months, and RNFL thinning at 12 (ρ = 0.35, p = 0.044 months. Stratification of individual patient MTR time courses based on flux over 12 months (stable, putative remyelination and putative degeneration predicted RNFL thinning at 12 months (F(2,32 = 3.59, p = 0.02. In conclusion, these findings indicate that MTR flux after acute ON is predictive of axonal degeneration and visual disability outcomes.

  16. Abnormal MRI in acute optic neuritis and follow-up of patients with regard to multiple sclerosis

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    Soltanzadeh A

    1997-09-01

    Full Text Available Twenty cases of isolated optic neuritis (15 female, 5 male were studied and followed for several months to years after the initial attack. The mean age of patients was 23 years (range: 15-29 years. The most frequent clinical manifestations were decreased visual acuity and blurred vision. A complete neurological examination was performed. In 15 cases (75% the initial brain MRI was abnormal. In fourteen cases, other signs of multiple sclerosis presented in one month to eight years following the initial attack of optic neuritis; eleven of the latter cases had an abnormal initial MRI. Acute optic neuritis can be considered a presenting feature of multiple sclerosis, particulary in the presence of an abnormal brain MRI.

  17. Calpain inhibitor attenuated optic nerve damage in acute optic neuritis in rats

    Science.gov (United States)

    Das, Arabinda; Guyton, M. Kelly; Smith, Amena; Wallace, Gerald; McDowell, Misty L.; Matzelle, Denise D.; Ray, Swapan K.; Banik, Naren L.

    2012-01-01

    Optic neuritis (ON), which is an acute inflammatory autoimmune demyelinating disease of the central nervous system (CNS), often occurs in multiple sclerosis (MS). ON is an early diagnostic sign in most MS patients caused by damage to the optic nerve leading to visual dysfunction. Various features of both MS and ON can be studied following induction of experimental autoimmune encephalomyelitis (EAE), an animal model of MS, in Lewis rats. Inflammation and cell death in the optic nerve, with subsequent damage to the retinal ganglion cells in the retina, are thought to correlate with visual dysfunction. Thus, characterizing the pathophysiological changes that lead to visual dysfunction in EAE animals may help develop novel targets for therapeutic intervention. We treated EAE animals with and without the calpain inhibitor calpeptin (CP). Our studies demonstrated that the Ca2+-activated neutral protease calpain was upregulated in the optic nerve following induction of EAE at the onset of clinical signs (OCS) of the disease and these changes were attenuated following treatment with CP. These reductions correlated with decreases in inflammation (cytokines, iNOS, COX-2, NF-κB), and microgliosis (i.e. activated microglia). We observed that calpain inhibition reduced astrogliosis (reactive astroglia) and expression of aquaporin 4 (AQP4). The balance of Th1/Th2 cytokine production and also expression of the Th1-related CCR5 and CXCR3 chemokine receptors influence many pathological processes and play both causative and protective roles in neuron damage. Our data indicated that CP suppressed cytokine imbalances. Also, Bax:Bcl-2 ratio, production of tBid, PARP-1, expression and activities of calpain and caspases, and internucleosomal DNA fragmentation were attenuated after treatment with CP. Our results demonstrated that CP decreased demyelination [loss of myelin basic protein (MBP)] and axonal damage [increase in dephosphorylated neurofilament protein (de-NFP), and also

  18. [Optic neuritis after a bee sting].

    Science.gov (United States)

    Zambrano-Infantino, Rosanna de Carmen; Piñieríia-Gonsálvez, Jean Félix; Montaño, César; Rodríguez, Carlos

    2013-06-01

    Optic neuritis is an acute inflammation of the optic nerve and, in its atypical form, is caused by inflammation of the optic nerve as part of infectious, immune, granulomatous, or contiguity processes. Hymenoptera stings (bees, wasps and ants) have been associated with different clinical presentations, ranging from local events to systemic manifestations, such as anaphylaxis, glomerulonephritis and central nervous system involvement (ischemic vascular lesions, optic neuritis and demyelinating lesions). This is a report of the case of a 62-year-old woman that after three days of being stung by a bee in the left lower eyelid, showed decreased visual acuity of both eyes and central scotoma, concomitant bilateral headache and eye pain, exacerbated by eye movements. The ophthalmological examination showed that visual acuity was decreased and the bilateral fundus examination revealed blurred optic disks edges. Hyperintense thickening of the left optic nerve was observed with an ocular MRI. Due to the clinical manifestations and epidemiological history, the diagnosis of bilateral optic neuritis was established. Treatment with pulses of 1 g/daily of methylprednisolone was initiated, for three days, with clinical improvement within 24 hours after receiving the first dose. Since 1960, cases of optic neuritis associated with hymenoptera stings have been documented, which take the form of anterior optic neuritis. A case of a patient who presented clinical features of bilateral optic neuritis after been stung by a bee, with a good clinical outcome after treatment with methylprednisolone is reported.

  19. HLA typing in acute optic neuritis. Relation to multiple sclerosis and magnetic resonance imaging findings

    DEFF Research Database (Denmark)

    Frederiksen, J.L.; Madsen, H.O.; Ryder, L.P.

    1997-01-01

    OBJECTIVE: To study the association of brain magnetic resonance imaging (MRI) findings and HLA findings to clarify the relationship between monosymptomatic optic neuritis (ON) and ON as part of clinically definite multiple sclerosis (CDMS). DESIGN: Population-based cohort of patients with ON refe...

  20. Calpain Inhibition Attenuates Apoptosis of Retinal Ganglion Cells in Acute Optic Neuritis

    Science.gov (United States)

    Smith, Amena W.; Das, Arabinda; Guyton, M. Kelly; Ray, Swapan K.; Rohrer, Baerbel

    2011-01-01

    Purpose. Optic neuritis (ON), inflammation of the optic nerve, is strongly associated with the pathogenesis of multiple sclerosis (MS) and is initiated by the attack of autoreactive T cells against self-myelin antigens, resulting in demyelination, degeneration of retinal ganglion cells (RGCs), and cumulative visual impairment. Methods. Experimental autoimmune encephalomyelitis (EAE) was induced in Lewis rats on day 0, and animals received daily intraperitoneal injections of calpain inhibitor (calpeptin) or vehicle from day 1 until killed. Retinal cell death was analyzed by DNA fragmentation, and surviving ganglion cells were quantified after double labeling of retinal tissue with TUNEL and Brn3a. The expression of apoptotic and inflammatory proteins was determined by Western blotting. Results. It was demonstrated that calpain inhibition downregulates expression of proapoptotic proteins and the proinflammatory molecule nuclear factor-kappa B (NF-κB) in the retina of Lewis rats with acute EAE. Immunofluorescent labeling revealed that apoptotic cells in the RGC layer of vehicle-treated EAE animals were Brn3a positive, and a moderate dose of calpeptin dramatically reduced the frequency of apoptotic RGCs. Conclusions. These results suggest that calpain inhibition might be a useful supplement to immunomodulatory therapies such as corticosteroids in ON, due to its neuroprotective effect on RGCs. PMID:21613375

  1. Relationship between cerebrospinal fluid biomarkers for inflammation, demyelination and neurodegeneration in acute optic neuritis.

    Directory of Open Access Journals (Sweden)

    Signe Modvig

    Full Text Available BACKGROUND: Various inflammatory biomarkers show prognostic potential for multiple sclerosis (MS-risk after clinically isolated syndromes. However, biomarkers are often examined singly and their interrelation and precise aspects of their associated pathological processes remain unclear. Clarification of these relationships could aid the appropriate implementation of prognostic biomarkers in clinical practice. OBJECTIVE: To investigate the interrelation between biomarkers of inflammation, demyelination and neurodegeneration in acute optic neuritis and to assess their association to measures of MS risk. MATERIAL AND METHODS: A prospective study at a tertiary referral centre from June 2011 to December 2012 of 56 patients with optic neuritis as a first demyelinating symptom and 27 healthy volunteers. Lumbar puncture was performed within 28 (median 16 days of onset. CSF levels of CXCL13, matrix metalloproteinase (MMP-9, CXCL10, CCL-2, osteopontin and chitinase-3-like-1, myelin basic protein (MBP and neurofilament light-chain (NF-L were determined. MS-risk outcome measures were dissemination in space (DIS of white matter lesions on cerebral MRI, CSF oligoclonal bands and elevated IgG-index. RESULTS: IN THE INTERRELATION ANALYSIS THE BIOMARKERS SHOWED CLOSE CORRELATIONS WITHIN TWO DISTINCT GROUPS: Biomarkers of leukocyte infiltration (CXCL13, MMP-9 and CXCL10 were strongly associated (p<0.0001 for all. Osteopontin and chitinase-3-like-1 were also tightly associated (p<0.0001 and correlated strongly to tissue damage markers (NF-L and MBP. The biomarkers of leukocyte infiltration all associated strongly with MS-risk parameters, whereas CHI3L1 and MBP correlated with MRI DIS, but not with CSF MS-risk parameters and osteopontin and NF-L did not correlate with any MS-risk parameters. CONCLUSIONS: OUR FINDINGS SUGGEST TWO DISTINCT INFLAMMATORY PROCESSES: one of leukocyte infiltration, represented by CXCL13, CXCL10 and MMP-9, strongly associated with and

  2. Clinical observation of alprostadil combined with glucocorticoids on acute optic neuritis

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    Ke-Shun Fan

    2015-09-01

    Full Text Available AIM: To study the clinical effect of alprostadil combined with glucocorticoids in the treatment of acute optic neuritis(AON.METHODS: Seventy patients(70 eyeswith AON from January, 2012 to June, 2014 were randomly divided into two groups. 35 patients in observation group were used 10ug alprostadil with 10mL normal saline(NSby intravenous injection, once/d for 7d/one treatment course, and 10mL NS was used by intravenous injection in 35 patients of control group. Besides, the two groups were treated with the combined therapy as follows: 20mg methylprednisolone was injected periglomerularly beside the eyeballs, once /3d for 3 times; 800~1 000mg of methylprednisolone through intravenous drip for 3d, once/d; after 3d, oral administration of prednisone acetate for 1wk, 1mg/(kg·d; after 1wk, the dose decreased to 5mg/wk until withdraw. Simultaneously, oral administration of ranitidine capsules, calcium carbonate and vitamin D3 tablets were combined in the supportive treament. The differences of curative effect between two groups were comparatively analyzed.RESULTS: In the observation group, 25 eyes(71.4%were markedly effective, 7 eyes(20.0%were valid and 3 eyes(8.6%were invalid, and the total effective rate was 91.4%. In the control group, 15 eyes(42.9%were markedly effective, 14 eyes(40.0%were valid and 6 eyes(17.1%were invalid, and the total effective rate was 82.9%. The difference of total effective rate between the two groups was not statistically significant(P=0.477, but there was a significant difference in markedly effective rate between the two groups(χ2=5.833, P=0.016.CONCLUSION: Alprostadil combined with glucocorticoids is effective for AON, and it is worth of advocation.

  3. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

  4. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L;

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

  5. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L.;

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion...

  6. Current options for the treatment of optic neuritis

    Directory of Open Access Journals (Sweden)

    Pula JH

    2012-07-01

    Full Text Available John H Pula,1 Christopher J MacDonald21Division of Neuro-ophthalmology, University of Illinois College of Medicine at Peoria, Peoria; 2University of Illinois College of Medicine at Urbana-Champaign, Champaign, IL, USAAbstract: Optic neuritis can be defined as typical (associated with multiple sclerosis, improving independent of steroid treatment, or atypical (not associated with multiple sclerosis, steroid-dependent improvement. Causes of atypical optic neuritis include connective tissue diseases (eg, lupus, vasculitis, sarcoidosis, or neuromyelitis optica. In this manuscript, updated treatment options for both typical and atypical optic neuritis are reviewed. Conventional treatments, such as corticosteroids, therapeutic plasma exchange, and intravenous immunoglobulin therapy are all discussed with commentary regarding evidence-based outcomes. Less commonly used treatments and novel purported therapies for optic neuritis are also reviewed. Special scenarios in the treatment of optic neuritis – pediatric optic neuritis, acute demyelinating encephalomyelitis, and optic neuritis occurring during pregnancy – are specifically examined.Keywords: optic neuritis, optic neuropathy, treatment, neuroophthalmology

  7. Optic neuritis in neuromyelitis optica.

    Science.gov (United States)

    Levin, Marc H; Bennett, Jeffrey L; Verkman, A S

    2013-09-01

    Neuromyelitis optica (NMO) is an autoimmune demyelinating disease associated with recurrent episodes of optic neuritis and transverse myelitis, often resulting in permanent blindness and/or paralysis. The discovery of autoantibodies (AQP4-IgG) that target aquaporin-4 (AQP4) has accelerated our understanding of the cellular mechanisms driving NMO pathogenesis. AQP4 is a bidirectional water channel expressed on the plasma membranes of astrocytes, retinal Müller cells, skeletal muscle, and some epithelial cells in kidney, lung and the gastrointestinal tract. AQP4 tetramers form regular supramolecular assemblies at the cell plasma membrane called orthogonal arrays of particles. The pathological features of NMO include perivascular deposition of immunoglobulin and activated complement, loss of astrocytic AQP4, inflammatory infiltration with granulocyte and macrophage accumulation, and demyelination with axon loss. Current evidence supports a causative role of AQP4-IgG in NMO, in which binding of AQP4-IgG to AQP4 orthogonal arrays on astrocytes initiates complement-dependent and antibody-dependent cell-mediated cytotoxicity and inflammation. Immunosuppression and plasma exchange are the mainstays of therapy for NMO optic neuritis. Novel therapeutics targeting specific steps in NMO pathogenesis are entering the development pipeline, including blockers of AQP4-IgG binding to AQP4 and inhibitors of granulocyte function. However, much work remains in understanding the unique susceptibility of the optic nerves in NMO, in developing animal models of NMO optic neuritis, and in improving therapies to preserve vision.

  8. [Optic neuritis: diagnosis, treatment and clinical implications].

    Science.gov (United States)

    Steffen, Heimo; Tabibian, David

    2015-12-16

    Optic neuritis is one of the most important causes of visual loss in young and middle aged adults. The prognosis in terms of functional outcome is good. The diagnosis of optic neuritis is a clinical one. Steroids can shorten the recovery time but do not change the long term functional outcome. The MRI is the most important investiga- tion to assess an associated risk of multiple sclerosis. Optic cohe- rence tomography (OCT) contribute additional details to course and functional outcome of optic neuritis. In the future the OCT may additionally contribute to the relationship between optic neuritis and possible associated multiple sclerosis.

  9. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD. PMID:27936193

  10. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis.

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD.

  11. Baseline Magnetic Resonance Imaging of the Optic Nerve Provides Limited Predictive Information on Short-Term Recovery after Acute Optic Neuritis

    Science.gov (United States)

    Berg, Sebastian; Kaschka, Iris; Utz, Kathrin S.; Huhn, Konstantin; Lämmer, Alexandra; Lämmer, Robert; Waschbisch, Anne; Kloska, Stephan; Lee, De-Hyung; Doerfler, Arnd; Linker, Ralf A.

    2015-01-01

    Background In acute optic neuritis, magnetic resonance imaging (MRI) may help to confirm the diagnosis as well as to exclude alternative diagnoses. Yet, little is known on the value of optic nerve imaging for predicting clinical symptoms or therapeutic outcome. Purpose To evaluate the benefit of optic nerve MRI for predicting response to appropriate therapy and recovery of visual acuity. Methods Clinical data as well as visual evoked potentials (VEP) and MRI results of 104 patients, who were treated at the Department of Neurology with clinically definite optic neuritis between December 2010 and September 2012 were retrospectively reviewed including a follow up within 14 days. Results Both length of the Gd enhancing lesion (r = -0.38; p = 0.001) and the T2 lesion (r = -0.25; p = 0.03) of the optic nerve in acute optic neuritis showed a medium correlation with visual acuity after treatment. Although visual acuity pre-treatment was little but nonsignificantly lower if Gd enhancement of the optic nerve was detected via orbital MRI, improvement of visual acuity after adequate therapy was significantly better (0.40 vs. 0.24; p = 0.04). Intraorbitally located Gd enhancing lesions were associated with worse visual improvement compared to canalicular, intracranial and chiasmal lesions (0.35 vs. 0.54; p = 0.02). Conclusion Orbital MRI is a broadly available, valuable tool for predicting the improvement of visual function. While the accurate individual prediction of long-term outcomes after appropriate therapy still remains difficult, lesion length of Gd enhancement and T2 lesion contribute to its prediction and a better short-term visual outcome may be associated with detection and localization of Gd enhancement along the optic nerve. PMID:25635863

  12. Baseline magnetic resonance imaging of the optic nerve provides limited predictive information on short-term recovery after acute optic neuritis.

    Directory of Open Access Journals (Sweden)

    Sebastian Berg

    Full Text Available BACKGROUND: In acute optic neuritis, magnetic resonance imaging (MRI may help to confirm the diagnosis as well as to exclude alternative diagnoses. Yet, little is known on the value of optic nerve imaging for predicting clinical symptoms or therapeutic outcome. PURPOSE: To evaluate the benefit of optic nerve MRI for predicting response to appropriate therapy and recovery of visual acuity. METHODS: Clinical data as well as visual evoked potentials (VEP and MRI results of 104 patients, who were treated at the Department of Neurology with clinically definite optic neuritis between December 2010 and September 2012 were retrospectively reviewed including a follow up within 14 days. RESULTS: Both length of the Gd enhancing lesion (r = -0.38; p = 0.001 and the T2 lesion (r = -0.25; p = 0.03 of the optic nerve in acute optic neuritis showed a medium correlation with visual acuity after treatment. Although visual acuity pre-treatment was little but nonsignificantly lower if Gd enhancement of the optic nerve was detected via orbital MRI, improvement of visual acuity after adequate therapy was significantly better (0.40 vs. 0.24; p = 0.04. Intraorbitally located Gd enhancing lesions were associated with worse visual improvement compared to canalicular, intracranial and chiasmal lesions (0.35 vs. 0.54; p = 0.02. CONCLUSION: Orbital MRI is a broadly available, valuable tool for predicting the improvement of visual function. While the accurate individual prediction of long-term outcomes after appropriate therapy still remains difficult, lesion length of Gd enhancement and T2 lesion contribute to its prediction and a better short-term visual outcome may be associated with detection and localization of Gd enhancement along the optic nerve.

  13. Neuritis óptica inflamatoria Inflammatory optic neuritis

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    T. Ayuso

    2009-08-01

    Full Text Available La neuritis óptica inflamatoria (NO es la causa más frecuente de pérdida visual aguda en adultos jóvenes. Aunque el pronóstico visual es excelente en la mayoría de los casos, muchos pacientes desarrollarán otra patología como esclerosis múltiple en la evolución posterior. La historia natural de la NO ha sido estudiada en múltiples trabajos en los últimos años; uno de los más importantes es el Optic Neuritis Treatment Trial. La Resonancia Magnética tiene un papel fundamental en el diagnóstico etiológico de la NO y en la predicción del riesgo de conversión a esclerosis múltiple. Recientemente se han incorporado nuevas técnicas exploratorias como la tomografia de coherencia óptica, útil para el diagnóstico y pronóstico; se han identificado biomarcadores séricos que ayudan en el diagnóstico de otras patologías de naturaleza autoinmune que producen NO. Un mejor conocimiento de los datos clínicos y exploratorios de la NO típica permitirá un estudio diagnóstico más rápido y certero. El tratamiento de la NO con esteroides debe ser individualizado teniendo en cuenta que no modifican el pronóstico a largo plazo y en pacientes con alto riesgo de conversión a esclerosis múltiple debe plantearse terapia inmunomoduladora. Este trabajo revisa los datos existentes en la literatura referentes a las manifestaciones clínicas, el diagnóstico etiológico y diferencial y tratamiento de la NO inflamatoria.Inflammatory Optic Neuritis (ON is the most frequent cause of acute visual loss in young adults. Although the visual prognosis is excellent in the majority of cases, many patients develop pathology, such as multiple sclerosis, in its subsequent evolution. The natural history of ON has been studied in numerous works in recent years; one of the most important of which is Optic Neuritis Treatment Trial. Magnetic Resonance plays a fundamental role in the etiological diagnosis of ON and in predicting the risk of conversion into

  14. Clinical and pathological features of acute optic neuritis in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jia-ying; SHEN Xu-zhong; SUN Li; LU Zhao-zeng; YE Wen

    2013-01-01

    Background The incentives and the factors that affect the onset and outcome of optic neuritis (ON) are not very clear.The aim of this study is to define and get a comprehensive understanding of the clinical profile of ON,and to identify the factors that were related to the prognosis of the patients.Methods Medical records of patients with diagnosis of ON at Huashan Hospital,Fudan University between March 2008 and June 2011 were reviewed.Clinical features,ophthalmologic and neurologic assessments,neuroimaging studies,laboratory examinations,visual recovery,and final outcome of the patients were evaluated by the authors.Results Records of 50 patients (32 females and 18 males),aged 15-56 years,were reviewed,in which 22% patients had a previous onset of ON.Maximal visual deficit was severe in 72.5% (<20/200).Abnormal rates of hormone levels and rheumatoid indicators were found in 54.2% and 25.0%.ANA test returned positive in 40%,oligoclonal banding (OCB)was identified in 31.3%,and Serum neuromyelitis optica (NMO)-lgG studies were abnormal in 25% of the patients.Neuroimaging abnormalities associated with ON were documented in six patients.Three of the 50 patients have been diagnosed with multiple sclerosis,and two with NMO.Visual acuity was 20/20 or better in 26.1% and 20/100 or worse in 39.1% affected eyes at the last visit.Poor visual acuity at onset is the main factor that would affect the final outcome of vision (P <0.05).Conclusions Vision defects of this group of patients were severe.Females had a higher incidence of ON than males.Hormone levels,rheumatoid indicators and immune parameters may be related to the onset of ON.The severe reduction of visual acuity at onset may be related to the poor outcome of vision in ON patients.

  15. Retinal atrophy correlates with fMRI response in patients with recovered optic neuritis

    DEFF Research Database (Denmark)

    Fuglø, D; Kallenbach, K; Tsakiri, A;

    2011-01-01

    We wanted to investigate if retinal nerve fiber layer thickness (RNFLT) measured by optical coherence tomography (OCT) might be a good marker of acute and chronic changes in the afferent visual pathway following acute optic neuritis (ON).......We wanted to investigate if retinal nerve fiber layer thickness (RNFLT) measured by optical coherence tomography (OCT) might be a good marker of acute and chronic changes in the afferent visual pathway following acute optic neuritis (ON)....

  16. Clinical analysis on 12 cases of syphilitic optic neuritis

    Directory of Open Access Journals (Sweden)

    Lin LI

    2016-08-01

    Full Text Available Objective To explore the clinical characteristics and pathophysiological mechanism of syphilitic optic neuritis.  Methods The clinical signs and symptoms, laboratory tests, electrophysiological examinations, imaging features, treatment and prognosis of 12 cases with syphilitic optic neuritis admitted in our hospital from January 2014 to March 2016 were retrospectively analyzed.  Results The main clinical manifestation was vision loss in 12 patients (18 eyes, with acute or subacute onset, monocular attack or one after other. Degrees of visual loss differed among these patients. They also presented visual field defect and ocular fundus changes. Cerebrospinal fluid (CSF examination showed increased white blood cell and protein. Rapid plasma reagin (RPR assay and Treponema pallidum hemagglutination assay (TPHA in serum were positive. RPR assay/toluidine red unheated serum test (TRUST and TPHA in CSF were positive. Visual-evoked potential (VEP showed prolonged latency and declined amplitude of P100 wave. MRI revealed optic atrophy, abnormal signs in medial orbital part or overall length of optic nerve. The vision was improved after intravenous injection of aqueous penicillin and muscular injection of benzathine benzylpenicillin.  Conclusions Neurosyphilis is a rare cause of optic neuritis. Differential diagnosis should be paid attention on syphilitic optic neuritis from idiopathic optic neuritis and ischemic optic neuropathy. Serologic test and CSF examination will be helpful for a clear diagnosis. Besides, early diagnosis and standard therapy are essential for vision recovery. DOI: 10.3969/j.issn.1672-6731.2016.07.007

  17. Longitudinally extensive optic neuritis in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Pula, John H; Kattah, Jorge C; Keung, Bonnie; Wang, Huaping; Daily, Jennifer

    2014-10-15

    Neuomyelitis optica, sarcoid, and multiple sclerosis can all cause optic neuritis. Further means of distinguishing the causes of optic neuritis among these etiologies would be valuable for the clinician. This is a retrospective, cohort study from a single university based hospital and neuro-ophthalmology clinic. Blinded interpretation of orbit MRIs was performed on patients with acute optic neuritis from multiple sclerosis (n=25), sarcoid (n=5) and neuromyelitis optica spectrum disorder (n=6). A length of >40 mm anterior visual pathway enhancement distinguished neuromyelitis optica spectrum disorder from multiple sclerosis (p=0.0376). No statistically significant differences were found for presence of pain or papillitis, however there was a trend for bilateral involvement and chiasmal involvement in neuromyelitis optica spectrum disorder compared to multiple sclerosis. In acute optic neuritis, enhancing anterior visual pathway lesion length >40 mm helps differentiate neuromyelitis optica spectrum disorder from multiple sclerosis. This degree of involvement can be considered longitudinally extensive optic neuritis. Further characterization is necessary as this degree of enhancement occurs in other clinical syndromes besides neuromyelitis optica. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Optical coherence tomography segmentation reveals ganglion cell layer pathology after optic neuritis.

    Science.gov (United States)

    Syc, Stephanie B; Saidha, Shiv; Newsome, Scott D; Ratchford, John N; Levy, Michael; Ford, E'tona; Crainiceanu, Ciprian M; Durbin, Mary K; Oakley, Jonathan D; Meyer, Scott A; Frohman, Elliot M; Calabresi, Peter A

    2012-02-01

    Post-mortem ganglion cell dropout has been observed in multiple sclerosis; however, longitudinal in vivo assessment of retinal neuronal layers following acute optic neuritis remains largely unexplored. Peripapillary retinal nerve fibre layer thickness, measured by optical coherence tomography, has been proposed as an outcome measure in studies of neuroprotective agents in multiple sclerosis, yet potential swelling during the acute stages of optic neuritis may confound baseline measurements. The objective of this study was to ascertain whether patients with multiple sclerosis or neuromyelitis optica develop retinal neuronal layer pathology following acute optic neuritis, and to systematically characterize such changes in vivo over time. Spectral domain optical coherence tomography imaging, including automated retinal layer segmentation, was performed serially in 20 participants during the acute phase of optic neuritis, and again 3 and 6 months later. Imaging was performed cross-sectionally in 98 multiple sclerosis participants, 22 neuromyelitis optica participants and 72 healthy controls. Neuronal thinning was observed in the ganglion cell layer of eyes affected by acute optic neuritis 3 and 6 months after onset (P optica, with and without a history of optic neuritis, when compared with healthy controls (P optica and a history of optic neuritis exhibited the greatest reduction in ganglion cell layer thickness. Results from our in vivo longitudinal study demonstrate retinal neuronal layer thinning following acute optic neuritis, corroborating the hypothesis that axonal injury may cause neuronal pathology in multiple sclerosis. Further, these data provide evidence of subclinical disease activity, in both participants with multiple sclerosis and with neuromyelitis optica without a history of optic neuritis, a disease in which subclinical disease activity has not been widely appreciated. No pathology was seen in the inner or outer nuclear layers of eyes with optic

  19. A population-based prospective study of optic neuritis

    DEFF Research Database (Denmark)

    Soelberg, K; Jarius, S; Skejoe, Hanne Pernille Bro

    2017-01-01

    BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study was ...

  20. Longitudinally extensive optic neuritis in pediatric patients.

    Science.gov (United States)

    Graves, Jennifer; Kraus, Verena; Soares, Bruno P; Hess, Christopher P; Waubant, Emmanuelle

    2015-01-01

    Extensive optic nerve demyelinating lesions on magnetic resonance imaging (MRI) in adults could indicate a diagnosis other than multiple sclerosis with worse prognosis such as neuromyelitis optica. We report the frequency of longitudinally extensive lesions in children with first events of optic neuritis. Subjects had brain or orbit MRI within 3 months of onset and were evaluated at the University of California, San Francisco, Pediatric Multiple Sclerosis Center. Lesion length, determined by T2 hyperintensity or contrast enhancement, was blindly graded as absent, focal or longitudinally extensive (at least 2 contiguous segments of optic nerve). Of 25 subjects, 9 (36%) had longitudinally extensive optic neuritis. Extensive lesions were not associated with non-multiple sclerosis versus multiple sclerosis diagnosis (P = 1.00). No association between age and lesion extent was observed (P = .26). Prospective studies are needed to determine if longitudinally extensive optic neuritis can predict visual outcome.

  1. Optic neuritis as onset manifestation of multiple sclerosis

    DEFF Research Database (Denmark)

    Sørensen, T L; Frederiksen, J L; Brønnum-Hansen, Henrik;

    1999-01-01

    To determine the predictive value on survival of optic neuritis (ON) as onset manifestation of MS.......To determine the predictive value on survival of optic neuritis (ON) as onset manifestation of MS....

  2. Association of Optic Neuritis and Hipoparathyroidism

    OpenAIRE

    Mosquera Klinger, Gabriel Alonso; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Beltrán Carrascal, Elkin; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Grizales, Ana María; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Gómez, Claudia Milena; Hospital Universitario San Ignacio

    2013-01-01

    This article presents a case of a 70 year-old-man with a history of thyroid cancer, that during the previous year had undergone total thyroidectomy, and presented hypoparathyroidism as a post-surgical complication. The patient has 15 days of clinical symptoms of progressive loss of visual acuity in the right eye, also clinical and imaging findings compatible with right eye optic neuritis. During hospital stay, a diagnosis of optic neuritis was made and other common causes of optic neutiris in...

  3. Ipsilateral Uveitis and Optic Neuritis in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Eric Thouvenot

    2012-01-01

    Full Text Available Background. Uveitis is 20 times more frequent in multiple sclerosis (MS patients than in the general population. Methods. A retrospective study of local multiple sclerosis (n=700 and uveitis cohorts (n=450 described the ophthalmological and neurological characteristics of patients with multiple sclerosis and uveitis. Results. Uveitis and multiple sclerosis were associated in seven patients. The time intervals between diagnoses of MS and uveitis ranged from 6 months to 15 years. Analysis of the patients’ characteristics revealed that multiple sclerosis was associated with an older age of onset than usually expected, that is, 39 years. Uveitis was bilateral in three cases and mainly posterior (5/10. Five patients presented with acute optic neuritis (two in one eye and three in both eyes. All eyes presenting with acute optic neuritis were also affected by uveitis (P=0.02, though not simultaneously. Conclusion. The ipsilateral association between optic neuritis and uveitis in this series of patients with multiple sclerosis may suggest a reciprocal potentiation between optic neuritis and uveitis in multiple sclerosis.

  4. [Optic neuritis in juvenile idiopathic arthritis patient].

    Science.gov (United States)

    Lourenço, Daniela M R; Buscatti, Izabel M; Lourenço, Benito; Monti, Fernanda C; Paz, José Albino; Silva, Clovis A

    2014-01-01

    Optic neuritis (ON) was rarely reported in juvenile idiopathic arthritis (JIA) patients, particularly in those under anti-tumor necrosis factor alpha blockage. However, to our knowledge, the prevalence of ON in JIA population has not been studied. Therefore, 5,793 patients were followed up at our University Hospital and 630 (11%) had JIA. One patient (0.15%) had ON and was reported herein. A 6-year-old male was diagnosed with extended oligoarticular JIA, and received naproxen and methotrexate subsequently replaced by leflunomide. At 11 years old, he was diagnosed with aseptic meningitis, followed by a partial motor seizure with secondary generalization. Brain magnetic resonance imaging (MRI) and electroencephalogram showed diffuse disorganization of the brain electric activity and leflunomide was suspended. Seven days later, the patient presented acute ocular pain, loss of acuity for color, blurred vision, photophobia, redness and short progressive visual loss in the right eye. A fundoscopic exam detected unilateral papilledema without retinal exudates. Orbital MRI suggested right ON. The anti-aquaporin 4 (anti-AQP4) antibody was negative. Pulse therapy with methylprednisolone was administered for five days, and subsequently with prednisone, he had clinical and laboratory improvement. In conclusion, a low prevalence of ON was observed in our JIA population. The absence of anti-AQP4 antibody and the normal brain MRI do not exclude the possibility of demyelinating disease associated with chronic arthritis. Therefore, rigorous follow up is required.

  5. Pituitary Apoplexy Presented with Optic Neuritis

    Directory of Open Access Journals (Sweden)

    Mahsa Owji

    2013-07-01

    Full Text Available The patient is a 40-years-old woman presented with visual loss in the right eye since two days ago. The patient complained of headache with gradual onset in the right parietal area since 2 years ago. The headache pattern did not alter.The left eye was normal but the vision in the right eye was 50 cm finger counting. Marcus Gunn pupil could be observed during swinging-flashlight test in the right eye. According to these findings, the first diagnosis was optic neuritis which was corroborated with visual evoked potential (the latency of P100 was 122. According to magnetic resonance imaging (MRI, there was a big cystic tumor in sella turcica extended to the suprasellar region (Figure 1-A. It had a large liquid component. Optic chiasm was under pressure and was displaced (Figure 1-B. A faint enhancement was seen after the injection (Figure 1-C.The patient was operated with the transnasal-transsphenoidal approach. Blood and fibrin were among the small monomorphic round cells andfibro-connective tissue of the pituitary gland. Considering the bleeding inside the pituitary tumor, the final diagnosis was pituitary apoplexy. After recovery from the operation the symptoms were removed.Pituitary apoplexy presents with headache, loss of vision, ophthalmoplegia, and mental alterations which is caused by infarction or sudden bleeding inside the pituitary tumor.1In our review of literature, 3 patients afflicted with pituitary apoplexy presented with optic neuritis were reported.In a study conducted by Petersen et al., all three patients referred to them suffered from unilateral visual loss and headache. They were examined with the early diagnosis of optic neuritis. After taking a Brain Computerized tomography (CT scan, pituitary adenoma together with the formation of cyst were detected in patients. After transsphenoidal adenomectomy, the patient regained full vision. Therefore, the correct diagnosis of these patients, who had been incorrectly diagnosed with

  6. Detection of optic nerve lesions in optic neuritis using frequency-selective fat-saturation sequences

    Energy Technology Data Exchange (ETDEWEB)

    Miller, D.H. (NMR Research Unit, National Hospital for Neurology and Neurosurgery, London (United Kingdom)); MacManus, D.G. (NMR Research Unit, National Hospital for Neurology and Neurosurgery, London (United Kingdom)); Bartlett, P.A. (St. Mary' s Hospital, London (United Kingdom)); Kapoor, R. (NMR Research Unit, National Hospital for Neurology and Neurosurgery, London (United Kingdom)); Morrissey, S.P. (NMR Research Unit, National Hospital for Neurology and Neurosurgery, London (United Kingdom)); Moseley, I.F. (NMR Research Unit, National Hospital for Neurology and Neurosurgery, London (United Kingdom))

    1993-02-01

    MRI was performed on seven patients with acute optic neuritis, using two sequences which suppress the signal from orbital fat: frequency-selective fat-saturation and inversion recovery with a short inversion time. Lesions were seen on both sequences in all the symptomatic optic nerves studied. (orig.)

  7. [Recurrent inflammatory optic neuritis and neuromyelitis optica].

    Science.gov (United States)

    de Sèze, J; Arndt, C

    2010-12-01

    Inflammatory optic neuritis (ON) represents a frequent clinical situation in neurology and ophthalmology. When MRI and CSF analysis are normal, ON is considered idiopathic with a suspected viral etiology. However, in several cases either a recurrence or a myelitis may occur. In the first case, it is relapsing inflammatory optic neuritis (RION) and in the second case it is neuromyelitis optica (NMO). Nevertheless, predictive criteria of a recurrence or an extension of the disease to spinal cord remains unknown, excepted for anti-NMO IgG antibodies which are probably highly specific for a future evolution to NMO. In the present paper, the authors successively present the two clinical situations (RION and NMO) and attempt to summarize diagnostic and prognostic criteria.

  8. [A case of Charles Bonnet syndrome following syphilitic optic neuritis].

    Science.gov (United States)

    Ogata, Hidenori; Shigeto, Hiroshi; Torii, Takako; Kawamura, Nobutoshi; Ohyagi, Yasumasa; Kira, Jun-ichi

    2011-08-01

    Charles Bonnet syndrome refers to visual hallucinations in patients with visual acuity loss or visual field loss without dementia. We report a case of Charles Bonnet syndrome following syphilitic optic neuritis. A 62-year-old man was admitted to our hospital suffering acute bilateral visual loss in a few months. On admission, he was almost blind and his optic discs were found to be atrophic on fundoscopy. In addition to increased cell counts and protein concentration in cerebrospinal fluid (CSF), serum and CSF rapid plasma reagin tests were positive. A diagnosis of syphilitic optic neuritis was made and he was treated with intravenous penicillin G (24 million units per day for 14 days) without any recovery. After treatment finished, he began to experience complex, vivid, elaborate and colored visual hallucinations. He recognized these visions as unreal and felt distressed by them. No cognitive impairment was observed on several neuropsychological tests. We diagnosed the patient as suffering from Charles Bonnet syndrome. Brain MRI revealed diffuse mild atrophy of the cerebral cortex and multiple T2 high signal intensity lesions in the deep cerebral white matter. Single photon emission computed tomography revealed decreased regional cerebral blood flow in bilateral medial occipital lobes. Administration of olanzapine resulted in a partial remission of visual hallucinations. Charles Bonnet syndrome following syphilitic optic neuritis is rare. In the present case, visual loss and dysfunction of bilateral medial occipital lobes may have triggered the visual hallucinations, which were alleviated by olanzapine.

  9. Long echo time STIR sequence MRI of optic nerves in optic neuritis

    Energy Technology Data Exchange (ETDEWEB)

    Onofrj, M. [Dept. of Neurology, State Univ. of Chieti, Ospedale ex-Pediatrico (Italy); Tartaro, A. [Dept. of Radiology, State Univ. of Chieti (Italy); Thomas, A. [Dept. of Neurology, State Univ. of Chieti, Ospedale ex-Pediatrico (Italy); Gambi, D. [Dept. of Neurology, State Univ. of Chieti, Ospedale ex-Pediatrico (Italy); Fulgente, T. [Dept. of Neurology, State Univ. of Chieti, Ospedale ex-Pediatrico (Italy); Delli Pizzi, C. [Dept. of Radiology, State Univ. of Chieti (Italy); Bonomo, L. [Dept. of Radiology, State Univ. of Chieti (Italy)

    1996-01-01

    MRI of the optic nerves was obtained in 13 patients with acute optic neuritis and 13 with a previous optic neuritis (ON), assessed by clinical features, visual fields and visual evoked potentials. Results of the conventional short tau inversion recovery (STIR) sequence obtained with a short echo time (STE-STIR; 22 ms) were compared with those of a long echo time (LTE-STIR: 80 ms) sequence. The conventional STE-STIR sequence revealed lesions in the optic nerves in 78.5% of acute and 58.8% of previous ON. The LTE-STIR sequence showed abnormalities in 92.8% of acutely symptomatic nerves and 94.1% of nerves with previous ON. The optic nerve lesions appeared significantly longer with the LTE-STIR sequence than with the conventional STE-STIR sequences, in both acute and previous ON. (orig.)

  10. Evaluation of Retinal Nerve Fiber Layer and Ganglion Cell Complex in Patients with Optic Neuritis or Neuromyelitis Optica Spectrum Disorders Using Optical Coherence Tomography in a Chinese Cohort

    OpenAIRE

    Guohong Tian; Zhenxin Li; Guixian Zhao; Chaoyi Feng; Mengwei Li; Yongheng Huang; Xinghuai Sun

    2015-01-01

    We evaluate a cohort of optic neuritis and neuromyelitis optica (NMO) spectrum disorders patients in a territory hospital in China. The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) were measured using spectral-domain OCT after 6 months of acute onset. The results showed that both the peripapillary RNFL and macular GCC were significantly thinner in all optic neuritis subtypes compared to controls. In addition, the recurrent optic neuritis and NMO group...

  11. The observation and nursing of acute optic neuritis patients cured with compound anisodine%复方樟柳碱辅助治疗急性视神经炎的观察和护理

    Institute of Scientific and Technical Information of China (English)

    冯英; 郝廷静

    2016-01-01

    Summarize the nursing of acute optic neuritis patients cured with compound anisodine,which include mental nursing,nursing dur-ing and after the procedure,health education.Believe that targeted effective nursing should be given by nursers for acute optic neuritis patients cured with compound anisodine,which helps to improve patients’good prognosis.%总结了复方樟柳碱治疗急性视神经炎患者的护理措施,包括心理护理、操作中护理、操作后护理以及健康指导。认为在用复方樟柳碱辅助治疗视神经炎的同时实施有目的、有计划的护理干预,是提高患者预后的关键。

  12. Optic neuritis associated with influenza B virus meningoencephalitis.

    Science.gov (United States)

    Vianello, F A; Osnaghi, S; Laicini, E A; Milani, G P; Tardini, G; Cappellari, A M; Lunghi, G; Agostoni, C V; Fossali, E F

    2014-11-01

    Various postinfectious neurological manifestations have been described associated to influenza viruses. Optic neuritis is a serious, often reversible disease reported among several infectious diseases and vaccines complications. We report a case of optic neuritis following an influenza B virus infection in a 10-year-old male.

  13. Treatment options for atypical optic neuritis

    Directory of Open Access Journals (Sweden)

    Amina Malik

    2014-01-01

    Full Text Available Context: Optic neuritis (ON is defined as inflammation of the optic nerve and can have various etiologies. The most common presentation in the US is demyelinating, or "typical" ON, usually associated with multiple sclerosis. This is in contrast to "atypical" causes of ON, which differ in their clinical presentation, management, and prognosis. These atypical cases are characterized by lack of eye pain, exudates, and hemorrhages on exam, very severe, bilateral or progressive visual loss, or with failure to recover vision. Aims: The aim was to describe the clinical presentations of atypical ON and their treatments. Settings and Design: Review article. Materials and Methods: Literature review. Results: Types of atypical ON identified include neuromyelitis optica, autoimmune optic neuropathy, chronic relapsing inflammatory optic neuropathy, idiopathic recurrent neuroretinitis, and optic neuropathy associated with systemic diseases. Atypical ON usually requires corticosteroid treatment and often will require aggressive immunosuppression. Conclusions: Unlike demyelinating ON, atypical ON requires treatment to preserve vision.

  14. Post-Plasmodium vivax malaria cerebellar ataxia and optic neuritis: A new form of delayed cerebellar ataxia or cerebellar variant of acute disseminated encephalomyelitis?

    Directory of Open Access Journals (Sweden)

    Gaurav M Kasundra

    2015-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is commonly seen after viral and bacterial infections, immunization, and Plasmodium falciparum (PF malaria. Plasmodium vivax (PV rarely causes ADEM. We report a 14-year-old female patient who presented with acute onset bilateral cerebellar ataxia and optic neuritis, 2 weeks after recovery from PV. Magnetic resonance imaging showed bilateral cerebellar hyperintensities suggestive of ADEM. No specific viral etiology was found on cerebrospinal fluid examination. Patient responded well to treatment without any sequelae. Thus, PV too is an important cause of ADEM along with PF. Two of the previously reported cases had co-infection with falciparum malaria. The only other two reported cases, as also this patient, are from Asia. A geographical or racial predisposition needs to be evaluated. Also, a possibility of post-PV delayed cerebellar ataxia, which is classically described post-PF infection, may be considered as it may be clinically, radiologically, and prognostically indistinguishable from a milder presentation of ADEM.

  15. Bilateral Optic Neuritis After Bee Sting

    Directory of Open Access Journals (Sweden)

    Yusuf Türkyılmaz

    2014-01-01

    Full Text Available Corneal edema, hyphema, lens dislocation, iris atrophy, cataract and glaucoma cases due to bee sting are frequently reported. Optic neuropathy developing after a bee sting is rarely reported. A 46-year-old man applied to our clinic with visual loss. He had a history of transient loss of consciousness and bilateral severe visual loss after a bee sting 10 days ago. His first diagnosis was myocardial infarction and coronary angiography was applied in a private hospital; the angiography was found normal. In our clinic, his best-corrected visual acuity was 0.5 in the right eye and 0.7 in the left eye. The diagnosis was bilateral optic neuritis, and 64 mg/day oral methylprednisolone treatment was applied. Visual acuity improved to 1.0 in both eyes 39 days later. Optic neuritis due to bee sting is a rare case that can cause severe visual loss and responds well to systemic corticosteroid treatment. (Turk J Ophthalmol 2014; 44: 72-4

  16. Herpetic optic neuritis associated with herpetic keratitis.

    Science.gov (United States)

    Sáenz-Francés, F; Calvo-González, C; Jiménez-Santos, M; Méndez-Hernández, C; Fernandez-Vidal, A M; Martínez-de-la-Casa, J M; García-Sánchez, J; García-Feijoó, J

    2007-01-01

    To report a case of herpetic optic neuritis associated with herpetic keratitis. A 65 year old woman presented with oedema in the nasal sector of his right papilla. Blood biochemistry, a haemogram, erythrocyte sedimentation rate and C-reactive protein were all normal. The patient was diagnosed as having a non-arteritic anterior ischaemic optic neuropathy. One week later slit lamp examination showed diffuse stromal corneal oedema and a dendritic lesion in the nasal zone of the corneal epithelium. Serology for varicela-zoster virus was positive. Treatment was started with valacyclovir given orally and topical acyclovir ointment. A week later, the optic disc swelling and corneal lesions had resolved. The precise mechanism through which the papilla and cornea were successively affected in our patient is unclear but the sensitive innervation of both these structures is provided by the nasal branch of the nasociliary nerve and the spread of herpes via this nerve could affect both sites.

  17. Clinical profile of Malay children with optic neuritis.

    Science.gov (United States)

    Shatriah, Ismail; Adlina, Abdul-Rahim; Alshaarawi, Salem; Wan-Hitam, Wan-Hazabbah

    2012-05-01

    Limited data are available on optic neuritis in Asian children. Clinical profiles tend to vary with different races. We aimed to determine the clinical manifestations, visual outcomes, and etiologies of optic neuritis in Malaysian children, and discuss the literature of optic neuritis in Asian children. A retrospective study involving 14 children with optic neuritis was performed at Hospital Universiti Sains Malaysia between July 2005 and January 2010 (follow-up, 18-60 months). Clinical features, laboratory results, possible etiologies, and visual acuity after 1 year were studied. Females were predominant (mean age at presentation, 11.1 years). All patients manifested bilateral involvement. Swollen optic discs were observed in 92.9% of eyes; 60.7% of patients demonstrated a visual acuity of 6/60 (or 20/200) or worse on presentation, whereas 14.3% remained at 6/60 (or 20/200) or worse, 1 year after their attack. Cecocentral scotoma comprised the most common visual field defect. Infection contributed to 50.0% of cases; 14.3% progressed to multiple sclerosis during follow-up, with no evidence of recurrent optic neuritis. The clinical profiles and etiologies of optic neuritis in Malay children differ slightly compared with other optic neuritis studies of Asian children. The frequency of progression to multiple sclerosis is relatively lower.

  18. Inflammatory Optic Neuritis: From Multiple Sclerosis to Neuromyelitis Optica.

    Science.gov (United States)

    de Seze, Jérôme

    2013-01-01

    Inflammatory optic neuritis represents a frequent clinical situation in neurology and ophthalmology. In those parts of the world where multiple sclerosis is common, it is the condition most discussed as the cause of optic neuritis. However, the risk for conversion from optic neuritis to multiple sclerosis is evaluated at only around 50% after 15 years of follow-up. The risk is higher in cases in whom abnormalities typical of multiple sclerosis are found on magnetic resonance imaging of the brain and oligoclonal bands found on cerebrospinal fluid protein electrophoresis with no corresponding bands in serum. When these investigations are normal, optic neuritis is usually considered as "idiopathic" with a suspected viral aetiology, but in some cases, a systemic disease such as sarcoidosis, systemic lupus erythematosis, or Sjögren syndrome may be diagnosed. In rare cases, either recurrent optic neuritis or myelitis may occur without any evidence for multiple sclerosis. In the first case, it corresponds to a recently characterised disorder referred to as chronic relapsing inflammatory optic neuropathy and in the second case to a recently better identified entity, neuromyelitis optica. In the present paper, the differential diagnosis of inflammatory optic neuritis is presented from multiple sclerosis to infectious optic neuritis, systemic disease, and neuromyelitis optica.

  19. MR imaging of optic neuritis using short TI IR

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Kohichi; Uehara, Masako; Ashikaga, Ryuichirou; Inoue, Masaaki; Shindou, Hiroshi; Mabuchi, Nobuhisa; Yoshioka, Hiroyasu; Hamada, Tatsumi; Ishida, Osamu (Kinki Univ., Osaka (Japan). School of Medicine)

    1990-12-01

    We evaluated the ability of MRI using short TI inversion recovery (STIR) to diagnose optic neuritis. Eleven patients with previous or recent attack of optic neuritis were studied with MRI at 0.5 tesla. STIR images revealed high signal regions in 7 of 12 symptomatic and 5 of 10 asymptomatic nerves. Three of five asymptomatic nerves with high intensity were pertinent to the cases with past attack and seemed to reflect the demyelinating change. The other two nerves were pertinent to the cases without past attack and seemed to show occult lesions. We consider that STIR is useful in detection of optic nerve lesions associated with optic neuritis. (author).

  20. Optic neuritis following Varicella zoster vaccination: report of two cases.

    Science.gov (United States)

    Han, Sang Beom; Hwang, Jeong-Min; Kim, Ji-Soo; Yang, Hee Kyung

    2014-09-03

    Two women presented at our clinic with vision blurring following Varicella zoster virus (VZV) vaccination, 3 weeks and 1 week ago. Ophthalmologic examination and magnetic resonance imaging revealed bilateral and unilateral optic neuritis, respectively. One patient had a history of optic neuritis in the fellow eye 33 years ago without recurrence since then. Both patients completely recovered after treatment with high dose intravenous methylprednisolone followed by a tapered dose of oral prednisolone. This is the first report of optic neuritis occurring in relation to VZV vaccination.

  1. Optic Neuritis Associated with Myelodysplastic Syndrome Accompanied by Eosinophilic Crisis.

    Science.gov (United States)

    Nagasaki, Joji; Nishimoto, Mitsutaka; Nakamae, Hirohisa; Nakane, Takahiko; Koh, Hideo; Yoshimoto, Kumiko; Shiraki, Kunihiko; Hino, Masayuki

    2015-01-01

    Myelodysplastic syndrome (MDS) was diagnosed in a 64-year-old man. Three months later, he presented with right-sided visual loss. A diagnosis of optic neuritis caused by both ischemic and non-ischemic changes was established. Concurrently, prominent eosinophilia was seen in both the peripheral blood and bone marrow. A partial improvement of visual loss was obtained concomitant with a rapid decrease of the eosinophils after treatment with corticosteroids. Optic neuritis related to MDS is a rare condition and its etiology has not yet been identified. We herein report a case of optic neuritis associated with MDS and accompanied by an eosinophilic crisis.

  2. Current options for the treatment of optic neuritis

    OpenAIRE

    Pula JH; MacDonald CJ

    2012-01-01

    John H Pula,1 Christopher J MacDonald21Division of Neuro-ophthalmology, University of Illinois College of Medicine at Peoria, Peoria; 2University of Illinois College of Medicine at Urbana-Champaign, Champaign, IL, USAAbstract: Optic neuritis can be defined as typical (associated with multiple sclerosis, improving independent of steroid treatment), or atypical (not associated with multiple sclerosis, steroid-dependent improvement). Causes of atypical optic neuritis include connective tissue di...

  3. Electrophysiological evidence for heterogeneity of lesions in optic neuritis.

    Science.gov (United States)

    Klistorner, Alexander; Graham, Stuart; Fraser, Clare; Garrick, Raymond; Nguyen, Tan; Paine, Michael; O'Day, Justin; Grigg, John; Arvind, Hemamalini; Billson, Frank A

    2007-10-01

    To examine the natural history of multifocal visual evoked potentials (mfVEPs) within 12 months of the first episode of optic neuritis (ON) in patients with possible multiple sclerosis (MS). Twenty-seven patients with a first episode of ON, no previous demyelinating events, and MRI lesions consistent with demyelination were examined with mfVEP. Changes in amplitude and latency of mfVEP were analyzed at 1, 3, 6, and 12 months after an acute attack. Five of 27 patients had persistent loss of amplitude after 12 months of follow-up. This loss was most marked centrally. Amplitude recovered in the remaining 22 patients at 1 month, but delayed latency, which was also most marked centrally, persisted. Of these, two distinct subgroups were identified: six patients with no improvement in latency and 16 patients with significant latency recovery over the 12 months of follow-up, suggesting remyelination. Conversion to MS was highest in the group with severe amplitude loss, followed by the group with no latency recovery. The conversion rate was lowest in the group of patients with latency improvement. Distinct patterns of disease evolution were identified using mfVEP in patients with first episode of optic neuritis and at high risk for MS, supporting the concept of heterogeneity of early lesions in MS.

  4. Visual function in optic neuritis in relation to multiple sclerosis : an electrophysiological and psychophysical study

    NARCIS (Netherlands)

    J.C. van der Poel (Johanna Catarina)

    1985-01-01

    textabstractThe purpose of the present study is to assess the predictive value of visual function in ON patients with regard to the development of MS. For this purpose, idiopathic optic neuritis patients were seen during the acute stage of the attack and after improvement of visual acuity. Visual fu

  5. Visual function in optic neuritis in relation to multiple sclerosis : an electrophysiological and psychophysical study

    NARCIS (Netherlands)

    J.C. van der Poel (Johanna Catarina)

    1985-01-01

    textabstractThe purpose of the present study is to assess the predictive value of visual function in ON patients with regard to the development of MS. For this purpose, idiopathic optic neuritis patients were seen during the acute stage of the attack and after improvement of visual acuity. Visual fu

  6. A sphenoid sinus mucocele simulating as retro bulbar optic neuritis

    Science.gov (United States)

    Gupta, Anoop Kishore; Menon, Vimla; Sharma, Pradeep; Saxena, Rohit; Kumaran, Senthil

    2012-01-01

    A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis. However, magnetic resonance imaging (MRI) showed lesion consistent with sphenoid sinus mucocele. Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field. A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms. PMID:22569385

  7. Optic neuritis: Experience from a south Indian demyelinating disease registry

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    Lekha Pandit

    2012-01-01

    Full Text Available Background: Natural history of optic neuritis (OPN has not been studied in India. Aim: To study consecutive patients with optic neuritis as the initial manifestation of the neurologic disease and with disease duration of 3 or more years registered in the Mangalore Demyelinating Disease Registry. Materials and Methods: The study included 59 patients with a primary diagnosis of optic neuritis (confirmed by either an ophthalmologist or a neurologist or both. All the patients were investigated and followed-up in the clinic. Results: During the follow-up of the 59 patients, 29 (49% patients developed multiple sclerosis (MS; 3 (5% patients neuromyelitis optica (NMO; and 13 (22% patients chronic relapsing inflammatory optic neuritis (CRION, while the remaining 14 (24% did not either progress or relapse, monophasic OPN. An initial abnormal magnetic resonance imaging predicted conversion to MS in all 7 patients who had imaging at onset. Patients with NMO were left with significant residual visual loss distinguishing NMO from MS. In this large series of patients with CRION, nearly 50% of patients had deterioration in vision while steroids were being tapered. Long-term immunosuppression was essential for maintaining good visual outcome in both NMO and CRION. Conclusions: Optic neuritis in India appears similar to that in the West with nearly 50% developing MS in the long term.

  8. Gypenosides might have neuroprotective and immunomodulatory effects on optic neuritis.

    Science.gov (United States)

    Li, Kaijun; Du, Yi; Fan, Qian; Tang, Cheng-Ye; He, Jian-Feng

    2014-05-01

    Optic neuritis is a common disease in young adults, inducing apoptosis of retinal ganglion cells, which leads to varying degree of visual function damages, even blindness. As the standard treatment, methylprednisolone pulse therapy can only promote the recovery of visual acuity but not prevent retinal ganglion cell degeneration. It cannot help improve the ultimate visual outcome. Both inflammatory response and endogenous oxidative stress play crucial roles in the progression of optic neuritis. The combination of immunomodulatory and antioxidant is expected to improve the prognosis of the disease by preventing the apoptosis of retinal ganglion cells. Triterpenoids (oleanolic acid derived) were reported to have the dual capacity of simultaneously repressing production of pro-inflammatory mediators and exerting neuroprotective effects through induction of anti-oxidant genes in experimental optic neuritis. Gypenosides with an aglycone mainly of dammarane-type tetracyclic triterpenoids, also has the dual capacity of immune regulation and antioxidation. Both gypenosides and oleanolic acid were reported to have similar roles in hepatoprotection. Beside, gypenosides were reported to have the capacity of modulating the activation of immune cells and the expression of cytokines. In addition, gypenosides showed neuroprotective effect against oxidative injury in dopaminergic neurons and mouse model of Parkinson's disease. Accordingly, we propose that gypenosides have potential neuroprotective and immunomodulatory effects on optic neuritis through antioxidation and immune regulation. The application of gypenosides might prevent the apoptosis of retinal ganglion cells and improve the ultimate visual outcome in patients with optic neuritis.

  9. Clinical observation of cobamamide in the treatment for acute optic neuritis%腺苷钴胺治疗急性视神经炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    盖春柳; 底煜; 徐晓鹤

    2013-01-01

    Objective To observe the clinical effect of cobamamide in the treatment for acute optic neuritis. Methods 41 patients(57 eyes )with acute optic neuritis were randomly divided into two groups: cobamamide group ( 22 cases,31 eyes )and Vit B12 group( 19 cases,26 eyes ). Patients of the two groups were treated with cobamamide (1.5 mg,once daily )or Vit B12( 0. 5 mg,once daily )respectively,and high-dose glucocorticoid hormone was used simultaneously, the course was 15 d. Visual acuity, effect and the improvement of VEP were compared between the two groups before and after treatment. Results There was no significant difference in total effective rate between the two groups( P > 0. 05 ). The significant efficiency rate of cobamamide group was higher than that of Vit B12 group( P 0.05),显效率差异有统计学意义(P<0.05).结论 急性视神经炎早期大剂量激素联合腺苷钴胺肌注综合治疗作用明显,临床效果优于Vit B12,对视功能的恢复作用较好.

  10. Early Onset Optic Neuritis Following Measles-Rubella Vaccination

    Directory of Open Access Journals (Sweden)

    Siamak Moradian

    2008-12-01

    Full Text Available

    PURPOSE: To report two cases of optic neuritis with onset less than 24 hours following measles-rubella (MR vaccination. CASE REPORT: Two teenage patients developed acute optic neuritis 6 to 7 hours after MR booster vaccination. The first patient demonstrated bilateral papillitis and severe visual loss but improved significantly with pulse intravenous steroid therapy with methylprednisolone 500 mg/day. The second patient had unilateral retrobulbar optic neuritis and demonstrated excellent visual recovery without intervention. CONCLUSION: Acute optic neuritis is a rare complication of MR vaccination and may occur early after immunization.

  1. Prospective Study on Retinal Nerve Fibre Layer Thickness Changes in Isolated Unilateral Retrobulbar Optic Neuritis

    Directory of Open Access Journals (Sweden)

    Gordon S. K. Yau

    2013-01-01

    Full Text Available Purpose. To investigate the retinal nerve fibre layer (RNFL thickness after unilateral acute optic neuritis using optical coherence tomography (OCT. Patients and Methods. This prospective cohort study recruited consecutive patients with a first episode of isolated, unilateral acute optic neuritis. RNFL thickness and visual acuity (VA of the attack and normal fellow eye were measured at presentation and 3 months in both the treatment and nontreatment groups. Results. 11 subjects received systemic steroids and 9 were treated conservatively. The baseline RNFL thickness was similar in the attack and fellow eye (P≥0.4. At 3 months, the attack eye had a thinner temporal (P=0.02 and average (P=0.05 RNFL compared to the fellow eye. At 3 months, the attack eye had significant RNFL thinning in the 4 quadrants and average thickness (P≤0.0002 compared to baseline. The RNFL thickness between the treatment and nontreatment groups was similar at baseline and 3 months (P≥0.1. Treatment offered better VA at 3 months (0.1 ± 0.2 versus 0.3 ± 0.2 LogMAR, P=0.04. Conclusion. Generalized RNFL thinning occurred at 3 months after a first episode of acute optic neuritis most significantly in the temporal quadrant and average thickness. Visual improvement with treatment was independent of RNFL thickness.

  2. Bilateral optic neuritis in pediatric systemic lupus erythematosus associated with antiphospholipid antibodies and neuromyelitis optica immunoglobulin.

    Science.gov (United States)

    Wei, Wenxin; Zerfoss, Erica; Ashker, Lamees; Cantore, William A

    2010-05-21

    The authors report a case of a 16-year-old girl with a history of systemic lupus erythematosus who developed bilateral acute optic neuritis. Systemic lupus erythematosus can present with a vast array of neurological and ophthalmic complications, with optic neuritis being a rare but devastating manifestation and the major cause of blindness in these patients. The patient presented with an acute unilateral visual deficit that progressed to bilateral visual loss with no light perception over the course of days. Treatment included high-dose steroids, cyclophosphamide, intravenous immunoglobulin, and eventually rituximab. Furthermore, the patient was also seropositive for both antiphospholipid and neuromyelitis optica antibodies, which can have implications on prognosis and treatment options.

  3. Comparative study of MRI and diffusion tensor imaging in acute optic neuritis%急性视神经炎的 MRI 和扩散张量成像对比研究

    Institute of Scientific and Technical Information of China (English)

    宛四海; 肖新兰; 张雪林; 潘璜

    2009-01-01

    Objective To study the sensitivity and diagnostic value of MR diffusion tensor imaging ( DTI) for acute optic neuritis.Methods DTI data of optic nerve were obtained in 16 patients with acute optic neuritis and 16 healthy subjects.The MRI manifestations and quantity parameters of DTI such as the fractional anisotropy(FA), the mean diffusivity(MD), and the eigenvalue were analyzed.The statistical analysis was conducted with one-way ANOVA.Results Acute optic neuritis showed isointense on T1 WI,and hyperintense on T2 WI, FLAIR T2 WI and fat suppressed sequences, but the sensitivity were low at 37.9%(11/29), 51.7%(15/29) and 58.6%(17/29),respectively.DTI, however, was very sensitive in showing acute optic neuritis which were hypointense on FA and ( directionally encoded color ) DEC maps and its sensitivity was 100%( 29/29 ) .Compared with unaffected contralateral nerves [ 0.59 ±0.01, ( 0.92 ± 0.17) ×10 -3 mm2/s,(2.02 ±0.09) ×10 -3 mm2/s and(0.71 ±0.13) ×10 -3 mm2/s,respectively)] and control groups[(0.59 ±0.07,(0.94 ±0.10) ×10 -3 mm2/s,(1.93 ±0.19) ×10 -3 mm2/s and(0.67 ± 0.10) ×10 -3 mm2/s,respectively],acute optic neuritis showed a significant reduction of FA value (0.34 ± 0.05) and elevation of MD value ( 1.46 ±0.18 ) ×10-3 mm2/s, eigenvalue λ∥( 2.33 ±0.16 ) × 10 -3 mm2/s and eigenvalue λ⊥(1.37 ±0.13) ×10 -3 mm2/s(F=162.106,152.693,39.897,291.591, respectively;P<0.01).Conclusion DTI is a sensitive technique for optic nerve imaging in vivo, and has important value for clinical application of acute optic neuritis.%目的:探讨MR DTI对急性视神经炎诊断的敏感度及其应用价值。方法16例临床诊断为急性视神经炎的患者和16名正常健康志愿者,分别行视神经常规MRI和DTI,分析其影像表现,计算DTI定量参数视神经的各向异性分数( FA)、平均扩散率( MD)、本征值,并采用单因素方差分析进行统计学分析。结果急性视神经炎在T1 WI为等信号,T2 WI

  4. Neuromyelitis optica with simultaneous occurrence of optic neuritis and transverse myelitis.

    Directory of Open Access Journals (Sweden)

    Jayasree Sankunni NAIR

    2012-10-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory demyelinating disease that preferentially affects the optic nerves and spinal cord. It has a worldwide distribution and distinctive clinical, neuroimaging and laboratory findings that distinguish it from multiple sclerosis. In most cases there is a long interval between the optic neuritis and myelitis but approximately 10 to 20% can have near simultaneous occurrence of both. We report a case of NMO presenting with symptoms and signs of optic neuritis and transverse myelitis which was later confirmed by neuroimaging and laboratory findings. The acute attack was treated with pulse therapy of corticosteroid and subsequently the patient was maintained on Azathioprine and tapering dose of oral steroid. This case highlights a neurological disorder that is increasing in prominence and may become more relevant in our region with increased diagnostic utility of antibody testing.

  5. Optic neuritis in pediatric population: a review in current tendencies of diagnosis and management.

    Science.gov (United States)

    Pérez-Cambrodí, Rafael José; Gómez-Hurtado Cubillana, Aránzazu; Merino-Suárez, María L; Piñero-Llorens, David P; Laria-Ochaita, Carlos

    2014-01-01

    Optic neuritis is an inflammation of the optic nerve and may be related to different systemic conditions. The clinical presentation of this pathology usually includes sudden loss of visual acuity (VA) which may be unilateral or bilateral, visual field restriction, pain with eye movements, dyschromatopsia, a relative afferent pupillary defect and optic disk swelling. Optic neuritis in children has specific clinical features and a better prognosis than in adulthood. Although usually appears an underlying viral disease, the main concern for practitioners is the relationship of optic neuritis with multiple sclerosis. In addition to the classical techniques as magnetic resonance imaging (MRI), current tendencies of diagnosis for eye practitioners include new imaging devices as optical coherence tomography (OCT), useful to show a thinning of the retinal fibers layer (RFL) after the inflammatory episode. Regarding the management of these patients, short-term intravenous steroid dosages seem to be the best option to treat acute attacks characterized by a very poor bilateral VA. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  6. Elevated Neutrophil Lymphocyte Ratio in Recurrent Optic Neuritis

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    Hande Guclu

    2015-01-01

    Full Text Available Purpose. To demonstrate the relation between optic neuritis (ON and systemic inflammation markers as neutrophil lymphocyte ratio (N/L ratio, platelet count, mean platelet volume (MPV, and red cell distribution width (RDW and furthermore to evaluate the utilization of these markers to predict the frequency of the ON episodes. Methods. Forty-two patients with acute ON and forty healthy subjects were enrolled into the study. The medical records were reviewed for age, sex, hemoglobin (Hb, Haematocrit (Htc, RDW, platelet count, MPV, white blood cell count (WBC, neutrophil and lymphocyte count, and neutrophil lymphocyte ratio (N/L ratio. Results. The mean N/L ratio, platelet counts, and RDW were significantly higher in ON group (p=0.000, p=0.048, and p=0.002. There was a significant relation between N/L ratio and number of episodes (r=0.492, p=0.001. There was a statistically significant difference for MPV between one episode group and recurrent ON group (p=0.035. Conclusions. Simple and inexpensive laboratory methods could help us show systemic inflammation and monitor ON patients. Higher N/L ratio can be a useful marker for predicting recurrent attacks.

  7. Mucocele After Orbital Fracture Repair Masquerading as Optic Neuritis.

    Science.gov (United States)

    Park, Jongyeop; Kim, Jinhyun; Choi, Jinsu; Kim, Hochang

    2016-06-01

    The authors report a patient of mucocele formation after orbital wall fracture repair masquerading as optic neuritis.A 38-year-old man with a history of medial orbital wall fracture repair with an alloplastic implant 10 years previously, presented with left visual disturbance and mild ocular pain with movement of the left eye of 3-day duration, and a relative afferent papillary defect in his left eye. He reported having cold symptoms 2 weeks before presentation. His symptoms were typical of retrobulbar optic neuritis. Under suspicion of optic neuritis, computed tomography and magnetic resonance imaging were performed and revealed a large cyst in the sphenoid sinus and ethmoid sinus, just behind the alloplastic implant, that was compressing the medial rectus muscle and optic nerve of the left eye. The patient underwent endoscopic marsupialization of the cyst. Subsequent histologic examinations revealed a cyst lined with ciliated pseudostratified columnar epithelium. The patient had an uncomplicated postoperative course and the visual disturbance resolved. For patients who present solely with optic neuropathy after orbital fracture repair, it is important to be vigilant of potentially rare cause, mucocele formation.

  8. Disease Activity and Conversion into Multiple Sclerosis after Optic Neuritis Is Treated with Erythropoietin

    Directory of Open Access Journals (Sweden)

    Kurt-Wolfram Sühs

    2016-09-01

    Full Text Available Changes in cerebral lesion load by magnetic resonance imaging (MRI in patients from a double-blind, placebo-controlled, phase II study on erythropoietin in clinically isolated optic neuritis (ClinicalTrials.gov, NCT00355095 were analyzed. Therefore, patients with acute optic neuritis were assigned to receive either 33,000 IU of recombinant human erythropoietin (IV daily for three days, or a placebo, as an add-on to methylprednisolone. Of 35 patients, we investigated changes in cerebral lesion load in MRIs obtained at baseline and at weeks 4, 8, and 16. In 5 of the 35 patients, we found conversion into multiple sclerosis (MS based on MRI progression only. These five patients had received the placebo. Another five patients showed MRI progression together with relapses. Three of these patients had received erythropoietin, and two the placebo. Yet, analyzing the change in absolute numbers of periventricular, juxtacortical, and infratentorial lesions including gadolinium-enhancing lesions, there were no significant differences between the groups. Although effective in terms of retinal nerve fiber layer protection, erythropoietin treatment of acute isolated optic neuritis did not influence further evolution of MRI lesions in the brain when comparing absolute numbers. However, early conversion from clinically isolated syndrome to MS assessed by MRI activity seemed to occur more frequently in the placebo-treated group.

  9. Disease Activity and Conversion into Multiple Sclerosis after Optic Neuritis Is Treated with Erythropoietin

    Science.gov (United States)

    Sühs, Kurt-Wolfram; Papanagiotou, Panagiotis; Hein, Katharina; Pul, Refik; Scholz, Kerstin; Heesen, Christoph; Diem, Ricarda

    2016-01-01

    Changes in cerebral lesion load by magnetic resonance imaging (MRI) in patients from a double-blind, placebo-controlled, phase II study on erythropoietin in clinically isolated optic neuritis (ClinicalTrials.gov, NCT00355095) were analyzed. Therefore, patients with acute optic neuritis were assigned to receive either 33,000 IU of recombinant human erythropoietin (IV) daily for three days, or a placebo, as an add-on to methylprednisolone. Of 35 patients, we investigated changes in cerebral lesion load in MRIs obtained at baseline and at weeks 4, 8, and 16. In 5 of the 35 patients, we found conversion into multiple sclerosis (MS) based on MRI progression only. These five patients had received the placebo. Another five patients showed MRI progression together with relapses. Three of these patients had received erythropoietin, and two the placebo. Yet, analyzing the change in absolute numbers of periventricular, juxtacortical, and infratentorial lesions including gadolinium-enhancing lesions, there were no significant differences between the groups. Although effective in terms of retinal nerve fiber layer protection, erythropoietin treatment of acute isolated optic neuritis did not influence further evolution of MRI lesions in the brain when comparing absolute numbers. However, early conversion from clinically isolated syndrome to MS assessed by MRI activity seemed to occur more frequently in the placebo-treated group. PMID:27706045

  10. Permeability of the blood-brain barrier predicts conversion from optic neuritis to multiple sclerosis

    DEFF Research Database (Denmark)

    Cramer, Stig P; Modvig, Signe; Simonsen, Helle Juhl

    2015-01-01

    Optic neuritis is an acute inflammatory condition that is highly associated with multiple sclerosis. Currently, the best predictor of future development of multiple sclerosis is the number of T2 lesions visualized by magnetic resonance imaging. Previous research has found abnormalities in the per...... reflecting cellular permeability of the blood-brain barrier, whereas T2 lesion count may more reflect the length of the subclinical pre-relapse phase.See Naismith and Cross (doi:10.1093/brain/awv196) for a scientific commentary on this article.......Optic neuritis is an acute inflammatory condition that is highly associated with multiple sclerosis. Currently, the best predictor of future development of multiple sclerosis is the number of T2 lesions visualized by magnetic resonance imaging. Previous research has found abnormalities...... years after optic neuritis onset. Logistic regression analysis showed that baseline permeability in normal-appearing white matter significantly improved prediction of multiple sclerosis conversion (according to the 2010 revised McDonald diagnostic criteria) within 2 years compared to T2 lesion count...

  11. Evaluating the Use of Optical Coherence Tomography in Optic Neuritis

    Directory of Open Access Journals (Sweden)

    Fiona Costello

    2011-01-01

    Full Text Available Optic neuritis (ON is an inflammatory optic nerve injury, which is strongly associated with multiple sclerosis (MS. Axonal damage in the optic nerve manifests as retinal nerve fiber layer (RNFL deficits, which can be readily quantified with optical coherence tomography (OCT. The RNFL represents the most proximal region of the afferent visual pathway; and, as such, is a unique region of the central nervous system (CNS because it lacks myelin. Changes in retinal integrity can be correlated with reliable and quantifiable visual outcomes to provide a structural-functional paradigm of CNS injury. Because the eye provides a unique “view” into the effects of CNS inflammation, the ON “system model” may provide greater understanding about disease mechanisms, which underpin disability in MS. This review addresses the applications of OCT in study of ON patients, with specific reference to the published reports to date. The future role of OCT is discussed, both in terms of the potential gains and certain challenges associated with this evolving technology.

  12. Differential Diagnosis for Multiple Sclerosis-related Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    Yan Zhang; Xiaolei Liang; Shihui Wei; Hongyang Li

    2015-01-01

    Purpose:.To analyze clinical features and main causes of multiple sclerosis-related optic neuritis (MS-ON), providing evidence for the differential diagnosis of MS-ON. Methods: Clinical data were collected from 527 patients, 123 males and 404 females, diagnosed with MS-ON between June 2008 and June 2013. Visual acuity, optometry, visual field, slit-lamp microscopy, indirect ophthalmoscopy (20D), opti-cal coherence tomography (OCT) and magnetic resonance imaging (MRI) were performed. Venous blood was sampled for detection of autoimmune antibodies and Aquaporin (AQP-4). Results:.Fifty nine cases were diagnosed with neuromyelitis optica-related optic neuritis. (NMO-ON),.27 Sjogren's syn-drome-related optic neuropathy,.22 tumors,.21 anterior is-chemic optic neuropathy, 15 radiation-induced optic neuropa-thy, 14 optic neuropathy-related infection, 17 genetic eye dis-eases and 10 open angle glaucoma. Among168 MS-ON pa-tients undergoing optic nerve MRI,90 cases (53.57%) had a lesion 30 mm in two (1.19%). Conclusion:.MS-ON is more commonly misdiagnosed with NMO-ON and Sjogren's syndrome, when compared to optic neuropathy, tumors and ischemic optic neuropathy.

  13. Management of optic neuritis and impact of clinical trials: an international survey

    DEFF Research Database (Denmark)

    Biousse, Valérie; Calvetti, Olivier; Drews-Botsch, Carolyn D

    2009-01-01

    OBJECTIVE: 1) To evaluate the management of acute isolated optic neuritis (ON) by ophthalmologists and neurologists; 2) to evaluate the impact of clinical trials; 3) to compare these practices among 7 countries. METHODS: A survey on diagnosis and treatment of acute isolated ON was sent to 5,443 n...... ON patients according to the best evidence from clinical research. This confirms that evaluation of the impact of major clinical trials ("translational T2 clinical research") is essential when assessing the effects of interventions designed to improve quality of care....

  14. The clinical studay on visual function changes in multiple sclerosis with acute optic neuritis%以急性视神经炎首发的多发性硬化视神经功能障碍分析

    Institute of Scientific and Technical Information of China (English)

    夏朝霞; 蓝育青; 王梅; 肖剑晖; 彭蔚; 郭慧

    2008-01-01

    目的 探讨以急性视神经炎(acute optic neuritis,AON)为首发的多发性硬化(multiple sclerosis,MS)视神经功能的改变特点,及时治疗并尽大可能恢复视神经功能.方法 对每例以视神经炎为首发的MS患者行视力、眼底、视野及视诱发电位检查,部分患者行CT或者MRI,脑脊液测定和寡克隆区带检查.采用χ2检验与t检验对患者视神经功能改变的特点进行分析.结果 (1)视神经功能检查:所有患者均有视力下降;不同程度的视神经萎缩、视神经乳头水肿表现;客观检查显示视野损害、视诱发电位、色觉异常;与无伴AON的MS患者进行比较,在视力下降及视神经乳头水肿方面差异均有统计学意义;视诱发电位检查均存在异常,表现在P100潜伏期延长,AON组异常率为63.6%~72.7%,无伴AON的MS组为21.4%~28.5%,两组相比差异有显著性意义(P<0.05).(2)脑脊液免疫球蛋白检查:视神经炎鞘内IgG合成率低于无伴AON组(P<0.01).(3)所有患者经大剂量肾上腺素糖皮质激素及时治疗后,视力恢复到0.5以上者约31.2%~36.3%.结论 AON是MS的最常见症状之一,视神经炎与MS视神经脊髓炎型的视神经损害发生频率高且程度重,迫切需要对AON患者进行早期诊断,并及时给予大剂量肾上腺素糖皮质激素治疗.%Objective To studay the visual functional disorders of multiple sclerosis with optic neuritis and treat them early to remedy visual function effectively. Methods Visual acuity, funduscopy,visual evoked potentials (VEP), visual field defect, CT and/or MRI were assessed in cases of MS with optic neuritis and MS without optic neuritis patients. CSF determinations and oligoclomal bands were assessed in part of them, by x2 and t test. Results (1)Abnomal visual function test results were commonly observed in patients on visual acuity, optic atrophy, papilledema, visual field defect, VEP. Patients with AON had visual acuity less than 0.1 (P<0

  15. Is the incidence of optic neuritis rising? Evidence from an epidemiological study in Barcelona (Spain), 2008-2012.

    Science.gov (United States)

    Martínez-Lapiscina, E H; Fraga-Pumar, E; Pastor, X; Gómez, M; Conesa, A; Lozano-Rubí, R; Sánchez-Dalmau, B; Alonso, A; Villoslada, Pablo

    2014-04-01

    It is currently believed that the incidence rate of optic neuritis (ON) ranges between 0.56 and 5.1 cases per 100,000 person-years. However, since these figures were generated, they have not been updated and there are suggestions that the incidence of ON is on the rise. When designing new therapies and clinical trials for ON, and to improve the management this disease, it is important to have accurate epidemiological data. Thus, we set out to obtain the prevalence and incidence rates of ON in Barcelona (Spain) from 2008 to 2012, by a retrospective evaluation of electronic hospital records at the Hospital Clinic of Barcelona (population of 300,000 in the catchment area) matching the following ICD-9-CM codes as search terms: 377.3-optic neuritis; 377.30-optic neuritis, unspecific; 377.31-optic papillitis; 377.32-retrobulbar neuritis, acute; 377.39-other optic neuritis and "optic neuropathy". Demographic and clinical data were collected from records with a confirmed diagnosis of ON, including cases of idiopathic ON, multiple sclerosis, neuromyelitis optica and CRION. The prevalence of acute ON on 31 December 2012 was 2.75 cases per 100,000 people. The mean annual prevalence of acute ON during the 2008-2012 period was 7.87 cases per 100,000 person-year and the mean annual incidence rate was 5.36 cases per 100,000 person-years. The incidence of ON in Barcelona during 2008-2012 was higher than previously reported. This increase may reflect the evolution of diagnostic criteria, the use of a referral-center approach instead of a population-based approach, increased awareness of demyelinating diseases, latitude-related factors and possibly a true increase in its incidence.

  16. Multifocal visual evoked potential in optic neuritis, ischemic optic neuropathy and compressive optic neuropathy

    Directory of Open Access Journals (Sweden)

    Manju Jayaraman

    2014-01-01

    Full Text Available Purpose: To investigate the effect of optic neuritis (ON, ischemic optic neuropathy (ION and compressive optic neuropathy (CON on multifocal visual evoked potential (mfVEP amplitudes and latencies, and to compare the parameters among three optic nerve disorders. Materials and Methods: mfVEP was recorded for 71 eyes of controls and 48 eyes of optic nerve disorders with subgroups of optic neuritis (ON, n = 21 eyes, ischemic optic neuropathy (ION, n = 14 eyes, and compressive optic neuropathy (CON, n = 13 eyes. The size of defect in mfVEP amplitude probability plots and relative latency plots were analyzed. The pattern of the defect in amplitude probability plot was classified according to the visual field profile of optic neuritis treatment trail (ONTT. Results: Median of mfVEP amplitude (log SNR averaged across 60 sectors were reduced in ON (0.17 (0.13-0.33, ION (0.14 (0.12-0.21 and CON (0.21 (0.14-0.30 when compared to controls. The median mfVEP relative latencies compared to controls were significantly prolonged in ON and CON group of 10.53 (2.62-15.50 ms and 5.73 (2.67-14.14 ms respectively compared to ION group (2.06 (-4.09-13.02. The common mfVEP amplitude defects observed in probability plots were diffuse pattern in ON, inferior altitudinal defect in ION and temporal hemianopia in CON eyes. Conclusions: Optic nerve disorders cause reduction in mfVEP amplitudes. The extent of delayed latency noted in ischemic optic neuropathy was significantly lesser compared to subjects with optic neuritis and compressive optic neuropathy. mfVEP amplitudes can be used to objectively assess the topography of the visual field defect.

  17. Capreomycin-induced optic neuritis in a case of multidrug resistant pulmonary tuberculosis

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    Magazine Rahul

    2010-01-01

    Full Text Available A patient of multidrug-resistant pulmonary tuberculosis was prescribed an anti-tubercular regimen containing capreomycin. Patient developed optic neuritis 3 months after starting treatment. Investigations did not reveal any specific cause for this ocular condition and on discontinuing capreomycin his vision recovered. We conclude that capreomycin is the cause of reversible optic neuritis in our case.

  18. Initial Pattern of Optic Nerve Enhancement in Korean Patients with Unilateral Optic Neuritis

    Science.gov (United States)

    Son, Dae Yong; Park, Kyung-Ah; Seok, Su Sie; Lee, Ju-Yeun

    2017-01-01

    Purpose The purpose of this study was to demonstrate whether the pattern of optic nerve enhancement in magnetic resonance imaging (MRI) can help to differentiate between idiopathic optic neuritis (ON), neuromyelitis optica (NMO), and multiple sclerosis (MS) in unilateral ON. Methods An MRI of the brain and orbits was obtained in patients with acute unilateral ON. Patients with ON were divided into three groups: NMO, MS, and idiopathic ON. The length and location of the abnormal optic nerve enhancement were compared for ON eyes with and without NMO or MS. The correlation between the pattern of optic nerve enhancement and the outcome of visual function was analyzed. Results Of the 36 patients with ON who underwent an MRI within 2 weeks of the onset, 19 were diagnosed with idiopathic ON, 9 with NMO, and 8 with MS. Enhancement of the optic nerve occurred in 21 patients (58.3%) and was limited to the orbital segment in 12 patients. Neither the length nor the location of the optic nerve enhancement was significantly correlated with visual functions other than contrast sensitivity or the diagnosis of idiopathic ON, MS, or NMO. Patients with greater extent of optic nerve sheath enhancement and more posterior segment involvement showed higher contrast sensitivity. Conclusions Our data revealed that the pattern of optic nerve enhancement was not associated with diagnosis of idiopathic ON, NMO, or MS in Korean patients with unilateral ON. We believe further studies that include different ethnic groups will lead to a more definitive answer on this subject. PMID:28243026

  19. Recurrent optic neuritis: clues from a long-term follow up study of recurrent and bilateral optic neuritis patients

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    Asli Kurne

    2010-03-01

    Full Text Available Asli Kurne1, Rana Karabudak1, Gul Yalcin-Cakmakli1, Yasemin Gursoy-Ozdemir1, Pinar Aydin3, Ayse Ilksen-Colpak1, Sevda Lule2, Tulay Kansu11Department of Neurology, 2Institute of Neurological Sciences and Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey; 3Special Eye Clinic, Ankara, TurkeyBackground and aim: Optic neuritis (ON can be recurrent, with unilateral or bilateral presentation. Diagnosis of recurrent cases may be challenging. In this study long-term follow-up of recurrent and/or bilateral ON patients is reported in an effort to guide differential diagnosis and treatment.Methods: The study included 474 optic neuropathy patients. Of these, 70 patients with recurrent unilateral or bilateral, and nonrecurrent bilateral ON were assessed. The characteristics of each ON attack, laboratory and magnetic resonance imaging (MRI findings, associated diseases and response to treatment were noted for each patient. Most of the patients were reevaluated in the outpatient clinic. Seven patients were investigated for neuromyelitis optica (NMO-immunoglobulin G (IgG seropositivity.Results: Forty-seven patients had recurrent unilateral ON and 23 had bilateral ON. Mean follow-up was 7.55 years. Final diagnoses for recurrent unilateral group were multiple sclerosis (MS (n = 29, chronic relapsing inflammatory optic neuritis (CRION (n = 11, NMO (n = 4, or autoimmune thyroid disease (n = 3; and for bilateral ON group, MS (n = 4, vasculitis (n = 13, postinfectious ON (n = 4, and sarcoidosis (n = 2. Three patients were positive for NMO antibodies.Conclusion: Based on the data collected, we conclude when recurrent ON causes moderate to severe visual loss in the absence of cranial MRI findings typical of MS, other diagnoses should be considered, including NMO.Keywords: optic neuritis, recurrent, bilateral, multiple sclerosis, neuromyelitis optica

  20. Permeability of the blood–brain barrier predicts conversion from optic neuritis to multiple sclerosis

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    Modvig, Signe; Simonsen, Helle J.; Frederiksen, Jette L.; Larsson, Henrik B. W.

    2015-01-01

    Optic neuritis is an acute inflammatory condition that is highly associated with multiple sclerosis. Currently, the best predictor of future development of multiple sclerosis is the number of T2 lesions visualized by magnetic resonance imaging. Previous research has found abnormalities in the permeability of the blood–brain barrier in normal-appearing white matter of patients with multiple sclerosis and here, for the first time, we present a study on the capability of blood–brain barrier permeability in predicting conversion from optic neuritis to multiple sclerosis and a direct comparison with cerebrospinal fluid markers of inflammation, cellular trafficking and blood–brain barrier breakdown. To this end, we applied dynamic contrast-enhanced magnetic resonance imaging at 3 T to measure blood–brain barrier permeability in 39 patients with monosymptomatic optic neuritis, all referred for imaging as part of the diagnostic work-up at time of diagnosis. Eighteen healthy controls were included for comparison. Patients had magnetic resonance imaging and lumbar puncture performed within 4 weeks of onset of optic neuritis. Information on multiple sclerosis conversion was acquired from hospital records 2 years after optic neuritis onset. Logistic regression analysis showed that baseline permeability in normal-appearing white matter significantly improved prediction of multiple sclerosis conversion (according to the 2010 revised McDonald diagnostic criteria) within 2 years compared to T2 lesion count alone. There was no correlation between permeability and T2 lesion count. An increase in permeability in normal-appearing white matter of 0.1 ml/100 g/min increased the risk of multiple sclerosis 8.5 times whereas having more than nine T2 lesions increased the risk 52.6 times. Receiver operating characteristic curve analysis of permeability in normal-appearing white matter gave a cut-off of 0.13 ml/100 g/min, which predicted conversion to multiple sclerosis with a

  1. Permeability of the blood-brain barrier predicts conversion from optic neuritis to multiple sclerosis.

    Science.gov (United States)

    Cramer, Stig P; Modvig, Signe; Simonsen, Helle J; Frederiksen, Jette L; Larsson, Henrik B W

    2015-09-01

    Optic neuritis is an acute inflammatory condition that is highly associated with multiple sclerosis. Currently, the best predictor of future development of multiple sclerosis is the number of T2 lesions visualized by magnetic resonance imaging. Previous research has found abnormalities in the permeability of the blood-brain barrier in normal-appearing white matter of patients with multiple sclerosis and here, for the first time, we present a study on the capability of blood-brain barrier permeability in predicting conversion from optic neuritis to multiple sclerosis and a direct comparison with cerebrospinal fluid markers of inflammation, cellular trafficking and blood-brain barrier breakdown. To this end, we applied dynamic contrast-enhanced magnetic resonance imaging at 3 T to measure blood-brain barrier permeability in 39 patients with monosymptomatic optic neuritis, all referred for imaging as part of the diagnostic work-up at time of diagnosis. Eighteen healthy controls were included for comparison. Patients had magnetic resonance imaging and lumbar puncture performed within 4 weeks of onset of optic neuritis. Information on multiple sclerosis conversion was acquired from hospital records 2 years after optic neuritis onset. Logistic regression analysis showed that baseline permeability in normal-appearing white matter significantly improved prediction of multiple sclerosis conversion (according to the 2010 revised McDonald diagnostic criteria) within 2 years compared to T2 lesion count alone. There was no correlation between permeability and T2 lesion count. An increase in permeability in normal-appearing white matter of 0.1 ml/100 g/min increased the risk of multiple sclerosis 8.5 times whereas having more than nine T2 lesions increased the risk 52.6 times. Receiver operating characteristic curve analysis of permeability in normal-appearing white matter gave a cut-off of 0.13 ml/100 g/min, which predicted conversion to multiple sclerosis with a sensitivity of

  2. Management of optic neuritis and impact of clinical trials: an international survey

    DEFF Research Database (Denmark)

    Biousse, Valérie; Calvetti, Olivier; Drews-Botsch, Carolyn D

    2009-01-01

    OBJECTIVE: 1) To evaluate the management of acute isolated optic neuritis (ON) by ophthalmologists and neurologists; 2) to evaluate the impact of clinical trials; 3) to compare these practices among 7 countries. METHODS: A survey on diagnosis and treatment of acute isolated ON was sent to 5...... more frequently presented to ophthalmologists, and were subsequently referred to neurologists or subspecialists. Evaluation and management of ON varied among countries, mostly because of variations in healthcare systems, imaging access, and local guidelines. A brain MRI was obtained for 70...... countries, steroids were often prescribed to improve visual outcome or to decrease the long-term risk of multiple sclerosis. INTERPRETATION: Although recent clinical trials have changed the management of acute ON around the world, many neurologists and ophthalmologists do not evaluate and treat acute...

  3. Normal Caloric Responses during Acute Phase of Vestibular Neuritis

    Science.gov (United States)

    Lee, Sun-Uk; Park, Seong-Ho; Kim, Hyo-Jung; Koo, Ja-Won

    2016-01-01

    Background and Purpose We report a novel finding of caloric conversion from normal responses into unilateral paresis during the acute phase of vestibular neuritis (VN). Methods We recruited 893 patients with a diagnosis of VN at Dizziness Clinic of Seoul National University Bundang Hospital from 2003 to 2014 after excluding 28 patients with isolated inferior divisional VN (n=14) and those without follow-up tests despite normal caloric responses initially (n=14). We retrospectively analyzed the neurotological findings in four (0.5%) of the patients who showed a conversion from initially normal caloric responses into unilateral paresis during the acute phase. Results In those four patients, the initial caloric tests were performed within 2 days of symptom onset, and conversion into unilateral caloric paresis was documented 1–4 days later. The clinical and laboratory findings during the initial evaluation were consistent with VN in all four patients except for normal findings in bedside head impulse tests in one of them. Conclusions Normal findings in caloric tests should be interpreted with caution during the acute phase of suspected VN. Follow-up evaluation should be considered when the findings of the initial caloric test are normal, but VN remains the most plausible diagnosis. PMID:26932259

  4. Parallel changes in structural and functional measures of optic nerve myelination after optic neuritis.

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    Anneke van der Walt

    Full Text Available Visual evoked potential (VEP latency prolongation and optic nerve lesion length after acute optic neuritis (ON corresponds to the degree of demyelination, while subsequent recovery of latency may represent optic nerve remyelination. We aimed to investigate the relationship between multifocal VEP (mfVEP latency and optic nerve lesion length after acute ON.Thirty acute ON patients were studied at 1, 3, 6 and 12 months using mfVEP and at 1 and 12 months with optic nerve MRI. LogMAR and low contrast visual acuity were documented. By one month, the mfVEP amplitude had recovered sufficiently for latency to be measured in 23 (76.7% patients with seven patients having no recordable mfVEP in more than 66% of segments in at least one test. Only data from these 23 patients was analysed further.Both latency and lesion length showed significant recovery during the follow-up period. Lesion length and mfVEP latency were highly correlated at 1 (r = 0.94, p = <0.0001 and 12 months (r = 0.75, p < 0.001. Both measures demonstrated a similar trend of recovery. Speed of latency recovery was faster in the early follow-up period while lesion length shortening remained relatively constant. At 1 month, latency delay was worse by 1.76 ms for additional 1mm of lesion length while at 12 months, 1mm of lesion length accounted for 1.94 ms of latency delay.A strong association between two putative measures of demyelination in early and chronic ON was found. Parallel recovery of both measures could reflect optic nerve remyelination.

  5. Parallel changes in structural and functional measures of optic nerve myelination after optic neuritis.

    Science.gov (United States)

    van der Walt, Anneke; Kolbe, Scott; Mitchell, Peter; Wang, Yejun; Butzkueven, Helmut; Egan, Gary; Yiannikas, Con; Graham, Stuart; Kilpatrick, Trevor; Klistorner, Alexander

    2015-01-01

    Visual evoked potential (VEP) latency prolongation and optic nerve lesion length after acute optic neuritis (ON) corresponds to the degree of demyelination, while subsequent recovery of latency may represent optic nerve remyelination. We aimed to investigate the relationship between multifocal VEP (mfVEP) latency and optic nerve lesion length after acute ON. Thirty acute ON patients were studied at 1, 3, 6 and 12 months using mfVEP and at 1 and 12 months with optic nerve MRI. LogMAR and low contrast visual acuity were documented. By one month, the mfVEP amplitude had recovered sufficiently for latency to be measured in 23 (76.7%) patients with seven patients having no recordable mfVEP in more than 66% of segments in at least one test. Only data from these 23 patients was analysed further. Both latency and lesion length showed significant recovery during the follow-up period. Lesion length and mfVEP latency were highly correlated at 1 (r = 0.94, p = <0.0001) and 12 months (r = 0.75, p < 0.001). Both measures demonstrated a similar trend of recovery. Speed of latency recovery was faster in the early follow-up period while lesion length shortening remained relatively constant. At 1 month, latency delay was worse by 1.76 ms for additional 1mm of lesion length while at 12 months, 1mm of lesion length accounted for 1.94 ms of latency delay. A strong association between two putative measures of demyelination in early and chronic ON was found. Parallel recovery of both measures could reflect optic nerve remyelination.

  6. In vivo detection of experimental optic neuritis by pupillometry.

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    Shindler, Kenneth S; Revere, Karen; Dutt, Mahasweta; Ying, Gui-Shuang; Chung, Daniel C

    2012-07-01

    Optic neuritis is an inflammatory demyelination of optic nerve often occurring in multiple sclerosis (MS) patients. Mice with experimental autoimmune encephalomyelitis (EAE), an MS model, develop optic neuritis, but it is detected histologically after sacrifice, limiting the ability to monitor progression or treatment in vivo. We examined whether pupillary light responses measured by pupillometry can identify eyes with optic neuritis in EAE mice. C57BL/6 mice were exposed to unilateral light flashes of increasing intensity at 10 s intervals (4.7, 37, and 300 μW/cm(2)). Pupillary responses were recorded with a commercially available pupillometer. EAE was then induced by immunization with myelin oligodendrocyte glycoprotein. Pupillometry was repeated up to 17 days post-immunization, and responses were correlated with optic nerve inflammation. By day 17 post-immunization, 90% of EAE eyes had optic nerve inflammation. EAE eyes had significantly reduced pupillary constriction compared to control eyes. Mice exhibited more than a 25% decrease in pupillary constriction in at least one eye by days 13-15 post-immunization. In some eyes, pupil responses decreased prior to onset of detectable inflammation. Results show that pupillometry detects decreased optic nerve function in experimental optic neuritis, even in the absence of histological detection. Measuring pupillary constriction allows in vivo identification and functional assessment of eyes with optic neuritis that will be useful in evaluating potential therapies over time. Furthermore, results demonstrate that decreased visual function occurs early in optic neuritis, before optic nerve inflammation reaches its peak level.

  7. [Current status and progress in diagnosis and treatments of pediatric optic neuritis].

    Science.gov (United States)

    Chen, Lanlan; Jiang, Libin

    2014-12-01

    Pediatric optic neuritis (ON) is different from its adult counterpart in terms of epidemiology, etiology, clinical manifestations, and prognosis. Although adult optic neuritis was well described in treatments by the Optic Neuritis Treatment Trial (ONTT), there is no universal agreement on the treatments in a pediatric population. Since there is an inadequate knowledge about pediatric ON in our nation, we compared the clinical manifestations of pediatric ON with its adult population, reviewed the existing understanding of the relationship between pediatric ON and various diseases of CNS, and summarized the current treatments, expecting to provide useful reference in clinic.

  8. Axonal transport rate decreased at the onset of optic neuritis in EAE mice.

    Science.gov (United States)

    Lin, Tsen-Hsuan; Kim, Joong Hee; Perez-Torres, Carlos; Chiang, Chia-Wen; Trinkaus, Kathryn; Cross, Anne H; Song, Sheng-Kwei

    2014-10-15

    Optic neuritis is frequently the first symptom of multiple sclerosis (MS), an inflammatory demyelinating neurodegenerative disease. Impaired axonal transport has been considered as an early event of neurodegenerative diseases. However, few studies have assessed the integrity of axonal transport in MS or its animal models. We hypothesize that axonal transport impairment occurs at the onset of optic neuritis in experimental autoimmune encephalomyelitis (EAE) mice. In this study, we employed manganese-enhanced MRI (MEMRI) to assess axonal transport in optic nerves in EAE mice at the onset of optic neuritis. Axonal transport was assessed as (a) optic nerve Mn(2+) accumulation rate (in % signal change/h) by measuring the rate of increased total optic nerve signal enhancement, and (b) Mn(2+) transport rate (in mm/h) by measuring the rate of change in optic nerve length enhanced by Mn(2+). Compared to sham-treated healthy mice, Mn(2+) accumulation rate was significantly decreased by 19% and 38% for EAE mice with moderate and severe optic neuritis, respectively. The axonal transport rate of Mn(2+) was significantly decreased by 43% and 65% for EAE mice with moderate and severe optic neuritis, respectively. The degree of axonal transport deficit correlated with the extent of impaired visual function and diminished microtubule-associated tubulins, as well as the severity of inflammation, demyelination, and axonal injury at the onset of optic neuritis.

  9. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

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    Stella Maris Costa Castro

    2013-07-01

    Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  10. Familial Mediterranean fever associated with optic neuritis, successfully treated with anti-interleukin 1 agents.

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    Başaran, Özge; Kavuncu, Sevim; Güven, Alev; Uncu, Nermin; Acar-Çelikel, Banu; Çakar, Nilgün

    2016-01-01

    Familial Mediterranean fever (FMF) is an inherited periodic auto-inflammatory disease characterized by recurrent attacks of fever, synovitis and serositis. Ophthalmological manifestations of FMF are extremely rare. Here we described a boy who has been followed-up for FMF and attended with a loss of vision during the course of the disease. He was diagnosed with optic neuritis. As the other etiologies were excluded his optic neuritis was attributed to the underlying auto inflammatory process. After pulse steroid therapy, his symptoms improved and a complete remission occurred. Afterwards he had two more optic neuritis attacks. Thereafter anti-interleukin 1 (IL-1) drugs were introduced and he did not develop further attacks of both optic neuritis and FMF. This case presentation highlights the possible association between FMF and optic nerve involvement.

  11. Diagnostic implication of magnetic resonance imaging using STIR sequences in optic neuritis

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    Igarashi, Yasuo; Hashimoto, Masato; Ohyachi, Hiroaki; Nakamura, Yasushi; Ohguro, Hiroshi; Ohtsuka, Kenji; Nakagawa, Takashi (Sapporo Medical Coll. (Japan))

    1994-10-01

    We evaluated 23 patients with optic neuritis by magnetic resonance imaging (MRI) using STIR sequences. The series comprised 5 cases of multiple sclerosis and 18 of unknown etiology. Abnormal high-intensity area was observed in the optic nerve in at least one slice. The slices showing a high signal intensity averaged 3.4 in number. The abnormal finding was most frequent at 15 mm posterior to the eyeglobe in papillitis and retrobulbar optic neuritis. The incidence of abnormal finding was more frequent in papillitis than in retrobulbar neuritis. The high-intensity signal in the optic nerve was not correlated with the latency of major positivity of pattern-reversal VEPs and was rather associated with the clinical course and outcome of optic neuritis. (author).

  12. A rare case report on ethambutol induced optic neuritis

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    Gopineni Divya

    2015-02-01

    Full Text Available Ethambutol (EMB is one of the first-line drugs in the treatment of tuberculosis. EMB induced ocular toxicity is a rare side-effect that observed as either dose or duration related effect and reversible on therapy discontinuation. We report a rare case of EMB-induced optic neuritis, even though the dose and duration are not related to it. After withdrawal of the drug, we observed there is a recovery and mapping of the central visual field showed only slight enlargement of the blind spot in the right eye. If there is no vision improvement, but ocular toxicity is not severe, isoniazid should also be stopped. [Int J Basic Clin Pharmacol 2015; 4(1.000: 172-174

  13. An unusual case of bilateral multifocal retinal pigment epithelial detachment with methanol-induced optic neuritis.

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    Ranjan, Ratnesh; Kushwaha, Rajnath; Gupta, Ramesh Chandra; Khan, Perwez

    2014-03-01

    To describe an unusual case of methanol-induced optic neuritis with bilateral multifocal extrafoveal serous retinal pigment epithelial (RPE) detachment. Single case report. A 40-year-old male presented with acute bilateral loss of vision and history of consumption of adulterated alcohol. On examination, his vision was perception of light in the right eye and finger counting at 1-ft distance in the left eye. Pupillary reactions were sluggish. The optic discs were normal. An elevated lesion with subretinal serous fluid was present over macula adjacent to superior major vessel arcade in the right eye, which was confirmed as a large extrafoveal RPE detachment on fluorescein angiography. There were two more small RPE detachments in the right eye as well as in the left eye. All RPE detachments were extrafoveal in location. The patient was managed medically with intravenous methylprednisolone (1 g) in 500 ml of ringer lactate for three consecutive days. After three doses, visual acuity of both eyes was recorded as 20/20. We herein report an unusual case of bilateral multifocal extrafoveal serous RPE detachment in a patient of methanol-induced optic neuritis. RPE detachments may be due to the toxic effect of methanol metabolites.

  14. Functional MRI Examination of Visual Pathways in Patients with Unilateral Optic Neuritis

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    Giulia Mascioli

    2012-01-01

    Full Text Available The relations between brain areas involved in vision were explored in 8 patients with unilateral acute optic neuritis using functional magnetic resonance imaging (fMRI and diffusion tensor imaging (DTI. In all patients monocular stimulation of affected and unaffected eye elicited significantly different activation foci in the primary visual cortex (V1, whereas the foci evoked in the middle temporal visual area (area V5 were similar in size and in delay of blood-oxygen-level-dependent response. DTI analysis documented lower white matter anisotropy values and reduced fibre reconstruction in the affected compared with the unaffected optic nerves. The preserved activation of area V5 observed in all our patients is an interesting finding that suggests the notion of a different sensitivity of the optic pathways to inflammatory changes.

  15. Interrelationship of optical coherence tomography and multifocal visual-evoked potentials after optic neuritis.

    Science.gov (United States)

    Klistorner, Alexander; Arvind, Hemamalini; Garrick, Raymond; Graham, Stuart L; Paine, Mark; Yiannikas, Con

    2010-05-01

    Acute optic neuritis (ON) is often followed by recovery of visual function. Although this recovery is mainly attributable to resolution of the acute inflammation, the redistribution of ion channels along the demyelinated membrane, and subsequent remyelination, part of it may be the result of neural plasticity. In the present study, the interrelationship was examined between structural (retinal nerve fiber layer [RNFL] thickness) and functional (amplitude of multifocal visual evoked potentials [mfVEPs]) measures of the integrity of the visual pathway in the postacute stage of ON, to determine whether there was any evidence of ongoing neural reorganization. Twenty-five subjects with acute unilateral ON underwent serial RNFL thickness measurement and mfVEP recording. The inter-eye asymmetry of both measures was analyzed. In the period between 6 and 12 months, the subjects were considered free of optic disc edema, and that period was used to analyze the structure-function relationship. Twenty control subjects were also examined. There were significant but opposite changes in RNFL thickness and mfVEP amplitude. The average asymmetry of RNFL thickness between affected and fellow eyes increased from 17.5 +/- 11.5 to 21.1 +/- 12.8 microm (P = 0.0003), indicating progressive axonal loss, whereas mfVEP amplitude asymmetry decreased from 46.6 +/- 32.4 to 38.3 +/- 31.1 nV (P = 0.0015), indicating continuous functional recovery. In comparison to the 6-month results, the mfVEP amplitude in the ON eye improved by 17.8%, whereas RNFL thickness decreased by 20.8%. The result remained unchanged regardless of the degree of optic nerve remyelination. The finding of structural-functional discrepancy at the postinflammatory stage may support the concept that neural plasticity contributes to functional recovery after acute ON.

  16. Comprehensive review of ocular angiostrongyliasis with special reference to optic neuritis.

    Science.gov (United States)

    Feng, Ying; Nawa, Yukifumi; Sawanyavisuth, Kittisak; Lv, Zhiyue; Wu, Zhong-Dao

    2013-12-01

    Angiostrongyliasis, caused by Angiostrongylus cantonensis infection, is a food-borne parasitic disease. Its larvae evoke eosinophilic inflammation in the central nervous system, but can also cause pathological changes in the eyes. Among ocular angiostrongyliasis cases, the incidence of optic neuritis is low and only few sporadic reports exist. Some patients with optic neuritis developed obvious hypopsia or even vision loss, which would seriously influence the quality of life of patients. Prompt treatment of optic neuritis caused by A. cantonensis is the key factor for minimizing the incidence of serious complications of this disease. In this review, we first provide a comprehensive overview of ocular angiostrongyliasis, and then focus on the clinical features of optic neuritis caused by A. cantonensis.

  17. Multifocal visual evoked potential analysis of inflammatory or demyelinating optic neuritis.

    Science.gov (United States)

    Fraser, Clare L; Klistorner, Alexander; Graham, Stuart L; Garrick, Raymond; Billson, Francis A; Grigg, John R

    2006-02-01

    To determine the sensitivity of multifocal visual evoked potentials (mVEP) in optic neuritis of an inflammatory or demyelinating nature. Cross-sectional study. Sixty-four patients participated who had a confirmed diagnosis of optic neuritis (ON) (past and acute). Based on the McDonald multiple sclerosis (MS) criteria, 25 patients (27 eyes with ON) were deemed to have isolated optic neuritis and thus not have MS (i.e., the not-MS group), and 19 patients (24 eyes with ON) had a diagnosis of MS (i.e., the MS group). The remaining 20 patients (25 eyes with ON) were at a high risk of MS, but diagnostic evaluation was equivocal, and thus were classified as the possible MS group. A control group of 20 normal patients was enrolled. The mVEP test was performed using the Accumap. All ON patients had recent magnetic resonance imaging scans of the brain and spinal cord. Multifocal visual evoked potentials amplitude and latency values were analyzed within each group and were compared with the normal controls. No abnormality was recorded on mVEP in the control group. Of all the ON eyes, 74 (97.3%) were abnormal on mVEP testing. Amplitude values were abnormal in 92.6% of not-MS eyes, 92.0% of possible MS eyes, and 100% of those with MS, and latency was abnormal in 33.3%, 76.0%, and 100%, respectively. There was a significant difference in the mVEP latency z-scores among all ON groups (P<0.01; Kruskal-Wallis test). Although distribution graphs of latency z-scores in the not-MS and MS groups had single peaks and were clearly separate from each other, the latency z-score distribution within the possible MS group in postacute patients was bimodal, with each peak corresponding to the distribution of the not-MS and MS group, respectively. The mVEP latency z-scores had a sensitivity and specificity of 100% in detecting patients with ON due to MS when compared with normal patients. The mVEP test is a sensitive and specific tool for detecting optic neuritis. There was a significant

  18. Neuroprotective effect of melatonin in experimental optic neuritis in rats.

    Science.gov (United States)

    Aranda, Marcos L; González Fleitas, María F; De Laurentiis, Andrea; Keller Sarmiento, María I; Chianelli, Mónica; Sande, Pablo H; Dorfman, Damián; Rosenstein, Ruth E

    2016-04-01

    Optic neuritis (ON) is an inflammatory, demyelinating, and neurodegenerative condition of the optic nerve, which might induce permanent vision loss. Currently, there are no effective therapies for this disorder. We have developed an experimental model of primary ON in rats through a single microinjection of 4.5 μg of bacterial lipopolysaccharide (LPS) into the optic nerve. Since melatonin acts as a pleiotropic therapeutic agent in various neurodegenerative diseases, we analyzed the effect of melatonin on LPS-induced ON. For this purpose, LPS or vehicle were injected into the optic nerve from adult male Wistar rats. One group of animals received a subcutaneous pellet of 20 mg melatonin at 24 hr before vehicle or LPS injection, and another group was submitted to a sham procedure. Melatonin completely prevented the decrease in visual evoked potentials (VEPs), and pupil light reflex (PLR), and preserved anterograde transport of cholera toxin β-subunit from the retina to the superior colliculus. Moreover, melatonin prevented microglial reactivity (ED1-immunoreactivity, P Melatonin completely prevented the increase in nitric oxide synthase 2, cyclooxygenase-2 levels (Western blot) and TNFα levels, and partly prevented lipid peroxidation induced by experimental ON. When the pellet of melatonin was implanted at 4 days postinjection of LPS, it completely reversed the decrease in VEPs and PLR. These data suggest that melatonin could be a promising candidate for ON treatment.

  19. Transgenic inhibition of astroglial NF-κB protects from optic nerve damage and retinal ganglion cell loss in experimental optic neuritis

    Directory of Open Access Journals (Sweden)

    Brambilla Roberta

    2012-09-01

    Full Text Available Abstract Background Optic neuritis is an acute, demyelinating neuropathy of the optic nerve often representing the first appreciable symptom of multiple sclerosis. Wallerian degeneration of irreversibly damaged optic nerve axons leads to death of retinal ganglion cells, which is the cause of permanent visual impairment. Although the specific mechanisms responsible for triggering these events are unknown, it has been suggested that a key pathological factor is the activation of immune-inflammatory processes secondary to leukocyte infiltration. However, to date, there is no conclusive evidence to support such a causal role for infiltrating peripheral immune cells in the etiopathology of optic neuritis. Methods To dissect the contribution of the peripheral immune-inflammatory response versus the CNS-specific inflammatory response in the development of optic neuritis, we analyzed optic nerve and retinal ganglion cells pathology in wild-type and GFAP-IκBα-dn transgenic mice, where NF-κB is selectively inactivated in astrocytes, following induction of EAE. Results We found that, in wild-type mice, axonal demyelination in the optic nerve occurred as early as 8 days post induction of EAE, prior to the earliest signs of leukocyte infiltration (20 days post induction. On the contrary, GFAP-IκBα-dn mice were significantly protected and showed a nearly complete prevention of axonal demyelination, as well as a drastic attenuation in retinal ganglion cell death. This correlated with a decrease in the expression of pro-inflammatory cytokines, chemokines, adhesion molecules, as well as a prevention of NAD(PH oxidase subunit upregulation. Conclusions Our results provide evidence that astrocytes, not infiltrating immune cells, play a key role in the development of optic neuritis and that astrocyte-mediated neurotoxicity is dependent on activation of a transcriptional program regulated by NF-κB. Hence, interventions targeting the NF-κB transcription

  20. Clinical Observation and Nursing Experience of Adverse Reactions in Acute Retrobulbar Optic Neuritis Patients Treated With High-dose Methylprednisolone Pulse Therapy%大剂量甲泼尼龙冲击疗法治疗急性球后视神经炎病情观察及不良反应的护理体会

    Institute of Scientific and Technical Information of China (English)

    韩点; 金鑫; 王建忠; 刘淑娟; 田茹; 于凤辉

    2015-01-01

    Objective To explore the clinical observation methods and care measures for adverse reactions in acute retrobulbar optic neuritis patients treated with high-dose methylprednisolone therapy.MethodsA retrospective review was conducted among the 40 cases(46 eyes)of patients with acute retrobulbar optic neuritis.Results The total effective rate of al patients was 92.5%. Other than two cases had high blood glucose, there were no severe adverse reactions in the patients.Conclusion High-dose methylprednisolone pulse therapy has sure clinical effects in the treatment of acute retrobulbar optic neuritis. Close observation and good care against adverse reactions are significant protective measures for promoting clinical effects,reducing adverse reactions and improving prognosis.%目的 探讨大剂量甲泼尼龙冲击疗法治疗急性球后视神经炎的临床观察及不良反应的护理措施.方法 对40例(46只眼)急性球后视神经炎的患者资料进行性总结.结果 全部患者治疗的总有效率为92.5%,除2例出现高血糖外,其他患者未出现严重不良反应.结论 大剂量甲泼尼龙冲击疗法治疗急性球后视神经炎疗效确切,严密观察病情,做好护理工作是提高治疗效果、减少不良反应、改善预后的重要保障.

  1. Lesion Activity on Brain MRI in a Chinese Population with Unilateral Optic Neuritis.

    Science.gov (United States)

    Lai, Chuntao; Chang, Qinglin; Tian, Guohong; Wang, Jiawei; Yin, Hongxia; Liu, Wu

    2015-01-01

    Longitudinal studies have shown that brain white matter lesions are strong predictors of the conversion of unilateral optic neuritis to multiple sclerosis (MS) in Caucasian populations. Consequently brain MRI criteria have been developed to improve the prediction of the development of clinically definite multiple sclerosis (CDMS). In Asian populations, optic neuritis may be the first sign of classical or optic-spinal MS. These signs add to the uncertainty regarding brain MRI changes with respect to the course of unilateral optic neuritis. The aim of this study was to examine the association between brain lesion activity and conversion to CDMS in Chinese patients with unilateral optic neuritis. A small prospective cohort study of 40 consecutive Chinese patients who presented with unilateral optic neuritis was conducted. Brain lesion activity was recorded as the incidence of Gd-enhanced lesions and new T2 lesions. Brain lesions on MRI that were characteristic of MS were defined according to the 2010 revisions of the McDonald criteria. The primary endpoint was the development of CDMS. We found that nineteen patients (48%) had brain lesions that were characteristic of MS on the initial scan. One of these patients (3%) had Gd-enhanced brain lesions. A significantly lower percentage of the patients (10%, poptic neuritis; however, these patients exhibit low lesion activity. The predictive value of brain lesion activity for CDMS requires investigation in additional patients.

  2. Recovery from optic neuritis: an ROI-based analysis of LGN and visual cortical areas

    DEFF Research Database (Denmark)

    Korsholm, Kirsten; Madsen, Kristoffer Hougaard; Frederiksen, Jette L

    2007-01-01

    and neuronal plasticity in the cortical and subcortical visual pathways. To assess where recovery takes place along the visual pathway, visual activation was studied in the lateral geniculate nucleus (LGN), the main thalamic relay nucleus in the visual pathway and in three areas of the visual cortex......: the lateral occipital complexes (LOC), V1 and V2. We conducted a longitudinal functional magnetic resonance imaging (fMRI) study of regions of interest (ROI) of activation in LGN and visual cortex in 19 patients with acute ON at onset, 3 and 6 months from presentation. With fMRI we measured the activation......Optic neuritis (ON) is the first clinical manifestation in approximately 20% of patients with multiple sclerosis (MS). The inflammation and demyelination of the optic nerve are characterized by symptomatic visual impairment and retrobulbar pain, and associated with decreased visual acuity...

  3. Leber's hereditary optic neuropathy masquerading as optic neuritis with spontaneous visual recovery.

    Science.gov (United States)

    Hsu, Tsui-Kang; Wang, An-Guor; Yen, May-Yung; Liu, Jorn-Hon

    2014-01-01

    We report a case of Leber's hereditary optic neuropathy (LHON) masquerading as optic neuritis with late visual recovery. A 28-year-old man had gradual visual loss in both eyes for two weeks. Visual acuity was 0.4 in the right eye and 0.7 in the left. Fundus examination revealed hyperaemic discs in each eye. Fluorescein angiography revealed dye leakage at both optic discs in the late phase. Static perimetry (Humphrey 30-2) revealed bilateral relative central scotomata. Magnetic resonance imaging of the optic nerves was normal and his lumbar puncture showed normal opening pressure. He received steroid pulse therapy for three days. Nevertheless, vision in his right eye deteriorated to 0.1 one month later and left vision worsened to 0.05 six months later. Fifteen months after onset, his vision began to improve. At 21 months, his vision recovered to 0.9 R and 1.0 L. Peripheral blood DNA sequencing revealed 14484 mutation of mitochondrial DNA (mtDNA). Visual recovery can occur in patients with Leber's hereditary optic neuropathy with mtDNA 14484 mutation. LHON could be misdiagnosed as optic neuritis in some cases. Molecular examination of mtDNA mutation can confirm the diagnosis of LHON in clinically controversial patients. We should keep in mind the diagnosis of LHON when optic neuritis shows poor response to pulse therapy.

  4. [Optic neuritis--immunological approach to elucidate pathogenesis and develop innovative therapy].

    Science.gov (United States)

    Kezuka, Takeshi

    2013-03-01

    The pathogenesis of optic neuritis developed rapidly from the end of the 19th century to the beginning of the 20th century accompanying progress in morpho-anatomy and physiology. Thereafter, the pathology of the disease continues to be clarified with the advances in medicine and clinical peripheral devices. The analysis of optic neuritis is about to enter a new phase, triggered by the advent of molecular immunology and genetic engineering. This article describes the results of recent studies on the pathogenetic mechanism of optic neuritis and the potential of utilizing these new findings in the development of novel therapies. Studies revealed that optic neuritis associated with anti-aquaporin(AQP) 4 antibodies is refractory to steroid therapy and causes injuries to the optic nerve-optic chiasma-optic tract, resulting in a broad array of visual field abnormalities. Especially, the disease becomes severe in individuals who possess anti-AQP4 antibodies that target astrocytes, together with anti-myelin oligodendrocyte glycoprotein (MOG) antibodies that target myelin oligodendrocytes. Furthermore, measurement of glial fibrillary acidic protein (GFAP) levels in cerebrospinal fluid may be useful in the diagnosis of anti-AQP4 antibody positive optic neuritis. Studies using experimental autoimmune optic neuritis (EAON) models demonstrate two patterns: a pattern of myelin oligodendrocyte damage as in optic neuritis associated with multiple sclerosis, and a pattern of astrocyte damage as in anti-AQP4 antibody positive optic neuritis, which in optic neuritis associated with anti-AQP4 antibodies, incites IgG deposits in the optic nerve to damage astrocytes. In multiple sclerosis-associated optic neuritis models, visual acuity decreases first, followed by deposition of complements in the optic nerve and infiltration of microglia and inflammatory cells. Thereafter, the number of axons decreases and latency of visually evoked potential (VEP) is prolonged. The implication of these

  5. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    DEFF Research Database (Denmark)

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

    2002-01-01

    The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size...... a reduced blood oxygenation level dependent (BOLD) signal increase and a greater asymmetry in the visual cortex, compared with controls. The volume of visual cortical activation was significantly correlated to the result of the contrast sensitivity test. The BOLD signal increase correlated significantly...... of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...

  6. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    DEFF Research Database (Denmark)

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

    2002-01-01

    to both the results of the contrast sensitivity test and to the Snellen visual acuity. Our results indicate that fMRI is a useful method for the study of ON, even in cases where the visual acuity is severely impaired. The reduction in activated volume could be explained as a reduced neuronal input......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size...... of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...

  7. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease

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    Patrick Scott

    2016-05-01

    Full Text Available Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1 disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*. The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status.

  8. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease.

    Science.gov (United States)

    Scott, Patrick; Bruwer, Zandre; Al-Kharusi, Khalsa; Meftah, Douja; Al-Murshedi, Fathiya

    2016-05-01

    Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1) disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*). The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status.

  9. Clinical profile and neuroimaging in pediatric optic neuritis in Indian population: A case series

    Directory of Open Access Journals (Sweden)

    Rutika Khadse

    2017-01-01

    Full Text Available Purpose of the study: The purpose of this study was to report clinical features, neuroimaging, and visual outcome in pediatric optic neuritis (ON in Indian population. Materials and Methods: This is a retrospective study of children up to the age of 16 years, diagnosed with ON, that presented at pediatric and neuroophthalmology clinic of a tertiary eye care center, in South India, within the period of 2010–2015. Results: We identified 62 eyes of 40 children diagnosed as ON within the study period. The mean age was 11.15 ± 3.24 years (1–15 years with mean follow-up of 13 months. In this series, there was female preponderance (67%. Mean logarithm of the minimum angle of resolution visual acuity at presentation was 1.14 ± 0.93, which after treatment recovered to 0.10 ± 0.26 at final visit (P < 0.001. Involvement was bilateral in 22 children (55% and recurrent in 3 eyes of 3 children. Preceding febrile illness was reported in seven cases (18%. Four (10% cases were diagnosed as multiple sclerosis (MS, one with neuromyelitis optica , and one with acute disseminated encephalomyelitis. One case was associated with tuberculous meningitis, 1 with septicemia, and 1 with bilateral maxillary sinusitis. Neuroimaging studies of optic nerve in 14 children demonstrated isolated optic nerve enhancement. Magnetic resonance imaging brain revealed white matter T2 hyperintense lesions separate from optic nerve in ten cases, of which four cases were diagnosed as MS. Conclusions: Bilateral presentation was common, association with MS was low. Papillitis was more frequent than retrobulbar neuritis and prognosis was good in pediatric ON in Indian population.

  10. Visual evoked potential(VEP)findings and comparison study of VEP and MRI in acute optic neuritis%急性视神经炎的视觉诱发电位表现及与磁共振成像的对比研究

    Institute of Scientific and Technical Information of China (English)

    刘东伟; 陶黎明; 许育新; 鲍宁; 刘贺婷; 邢媛

    2012-01-01

    Objective To investigate the VEP findings in diagnosing acute optic neuritis and the relationship be -tween VEP and MRI. Methods VEP was performed in forty patients (61 eyes) of acute optic neuritis (including papilitis and retrobulbar neuritis ) and the results were analyzed compared with MRI. Results Thirty-four(54 eyes) out of 40 pa-tients were successfully performed on P-VEP . Out of the 50 eyes ,47 eyes presented the increased implicit time of P100 wave and 14 eyes presented reduced amplitudes of P100 wave. There are 5 eyes performed P-VEP not typically. Six pa-tients (7 eyes) of F-VEP presented increased implicit time of P2 wave. Out of the 40 patients, 5 patients presented thick-ened optic nerves ,6 patients had abnormal cerebral white matter signal and ischemic lesions , infarction, malacia, age-relat-ed brain changes. Conclusion VEP is helpful in early diagnosis of acute optic neuritis . VEP combined with MRI can im-prove the diagnostic accuracy of acute optic neuritis .%目的 探讨急性视神经炎患者的视觉诱发电位(visual evoked potential,VEP)表现及其与磁共振成像(MRI)的对比分析.方法 对40例(61只眼)诊断为急性视神经炎(包括视神经乳头炎和球后视神经炎)患者VEP资料进行分析,并与MRI结果 进行对比分析.结果 40例中34例行P-VEP检查,成功获得检查结果 共54只眼,其中50只眼主要表现为P100波潜伏期延迟(47只眼),振幅下降(14只眼),有4只眼记录不到典型P100波,6例(7只眼)F-VEP主要表现为P2波潜伏期延迟;头颅MRI有5例表现为单侧或双侧视神经增粗,6例表现为脑白质异常信号和/或脑白质脱髓鞘改变以及大脑皮层下缺血灶、梗死灶、软化灶、老年性脑改变.VEP检查阳性率明显高于头颅MRI.结论 VEP有助于急性视神经炎的早期诊断,VEP结合MRI能提高急性视神经炎诊断的准确率.

  11. Evidence favoring the involvement of CC chemokine receptor (CCR) 5 in T-lymphocyte accumulation in optic neuritis

    DEFF Research Database (Denmark)

    Sørensen, Torben Lykke; Ransohoff, R M; Jensen, J;

    2003-01-01

    To define the relationships between levels of chemokine receptor (CCR)5+ T-cells in blood and cerebrospinal fluid (CSF) of optic neuritis (ON) and control patients (CON).......To define the relationships between levels of chemokine receptor (CCR)5+ T-cells in blood and cerebrospinal fluid (CSF) of optic neuritis (ON) and control patients (CON)....

  12. Relationship between serum bilirubin levels and optic neuritis

    Institute of Scientific and Technical Information of China (English)

    DENG Juan; LIANG Xue-mei; ZHANG Xiu-lan; LING Shi-qi; YANG Ting-ting; LI Min; PENG Fu-hua

    2013-01-01

    Background Bilirubin is the end product of heme catabolism and has strong antioxidant properties.Serum bilirubin levels are reported to be reduced in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO).The pathophysiology of optic neuritis (ON) resembles that of MS; however,the role of endogenous bilirubin in ON is unclear.The aim of this study is to measure serum bilirubin levels in patients with ON,and to investigate the correlation between ON and serum antioxidant status of bilirubin.Methods Serum levels of bilirubin were measured in 42 patients with ON,50 patients with multiple sclerosis (MS),48 patients with neuromyelitis optica (NMO) and 48 healthy control subjects.Results Serum total bilirubin (Tbil),direct bilirubin (Dbil) and indirect bilirubin (Ibil) levels in patients with ON were significantly lower than those in the healthy controls.However,no statistical significance was found between levels in the ON and MS,ON and NMO,and MS and NMO groups.In patients with ON,serum Tbil,Dbil,and Ibil levels were lower in those with recurrence or those with ON for a longer duration (>1 year).Moreover,Tbil,Dbil,and Ibil concentrations were lower in patients with papillitis than in those with retrobulbar type ON,but the differences were not statistically significant.Conclusions Low antioxidant status may exist in patients with ON.But serum levels of Tbil,Dbil,and Ibil did not correlate with clinical presentations,such as recurrence,duration of disease and subtypes of ON.Low antioxidant status already existed in MS or NMO patients before systemic symptoms appeared.

  13. Visual outcome after intravenous dexamethasone therapy for idiopathic optic neuritis in an Indian population: A clinical case series

    Directory of Open Access Journals (Sweden)

    Sethi Harinder

    2006-01-01

    Full Text Available Purpose: To evaluate the clinical profile, response to dexamethasone treatment and visual function outcome in Indian patients with acute optic neuritis. Materials and Methods: We conducted an observational study of patients with acute optic neuritis who were treated with intravenous dexamethasone (100 mg in 250 ml of 5% dextrose over 1-2 hours daily, for three consecutive days and had completed at least two years of follow-up. Parameters assessed included visual acuity, contrast sensitivity, color vision, visual fields, relative afferent pupillary defect (RAPD and visually evoked potentials. Out of 40 patients studied, 26 patients (33 eyes had all visual function parameters assessed. Twenty three patients (28 eyes had completed two years of follow-up and were included for statistical analysis. Results: Improvement in visual acuity was statistically significant for distance after 24 hours of the first dose ( P = < 0.001 and for near vision after 24 hours of the second dose ( P = 0.006; improvement in color and contrast sensitivity was statistically significant 24 hours after the third dose ( P = < 0.001 for color vision and P = 0.013 for contrast sensitivity. Significant improvement in RAPD and visual fields were seen by 1 month ( P = 0.005. Recurrence was seen in 4 eyes of 4 patients. No serious side effects were observed. At two years, 82.14% (23 out of 28 eyes had visual acuity > 20/40. Conclusion: Treatment with intravenous pulsed dexamethasone led to rapid recovery of vision in acute optic neuritis, without any serious side effects.

  14. Multiphasic disseminated encephalomyelitis followed by optic neuritis in a child with gluten sensitivity.

    Science.gov (United States)

    Ching, B H; Mohamed, A R; Khoo, T B; Ismail, H I H M

    2015-08-01

    Multiphasic disseminated encephalomyelitis (MDEM) followed by optic neuritis (ON) has been described as a new entity in recent years. Gluten encephalopathy has also been recognized as a neurological manifestation of celiac disease. Accurate diagnosis of both is important due to the therapeutic implications. We report a girl presenting with recurrent encephalopathic polyfocal demyelinating episodes followed by optic neuritis, and a clinical history suggestive of gluten sensitivity. She had persistently high ESR, neutrophilia, and tested positive for anti-MOG (myelin oligodendrocyte glycoprotein) antibody. She responded well to methylprednisolone in each relapse, and achieved remission for a year after azathioprine was added.

  15. Unilateral Optic Neuritis: A Rare Complication after Measles-Mumps-Rubella Vaccination in a 30-Year-Old Woman

    Directory of Open Access Journals (Sweden)

    Chiara De Giacinto

    2016-01-01

    Full Text Available Purpose. To report a case of unilateral optic neuritis following Measles-Mumps-Rubella (MMR vaccination. Methods. A 30-year-old female developed unilateral optic neuritis five days after a Measles-Mumps-Rubella (MMR booster vaccination. The patient displayed unilateral involvement, with severe visual loss. However, visual acuity improved significantly after four days of intravenous steroid therapy with 500 mg/day of methylprednisolone. Conclusions. Optic neuritis is one of the rare complications associated with the mumps, measles, and rubella vaccine. It may be a toxic reaction to the nonviral component of the vaccine, but the exact etiology is unknown. Postvaccination neuritis is generally bilateral and usually affects children. In adults, unilateral optic neuritis is usually correlated with multiple sclerosis (MS.

  16. Multifocal VEP and OCT in optic neuritis: a topographical study of the structure-function relationship.

    Science.gov (United States)

    Klistorner, Alexander; Arvind, H; Nguyen, T; Garrick, R; Paine, M; Graham, S; O'Day, J; Yiannikas, C

    2009-04-01

    To investigate topographical relationship between amplitude of multifocal visual evoked potentials (mfVEP) and retinal nerve fibre layer (RNFL) thickness following acute optic neuritis (ON). Fifty patients with a clinical diagnosis of acute unilateral ON between 6 and 36 months prior to the study and 25 age-matched controls underwent mfVEP testing (Accumap V 2.1, ObjectiVision Pty Ltd, Sydney, Australia) and OCT imaging (fast RNFL protocol, Stratus, software version 3.0, Carl Zeiss Meditec, Inc., Dublin, CA). RNFL thickness and mfVEP amplitude were measured for upper, temporal and lower retinal sectors and corresponding areas of the visual field in affected eyes of ON patients and control eyes. Inter-eye asymmetry coefficients for both RNFL thickness and mfVEP amplitude were calculated for each zone, and corresponding coefficients were correlated between each other. There was highly significant reduction of RNFL thickness and mean mfVEP amplitude in all three retinal sectors of the affected eye. Largest reduction of RNFL thickness was noticed in temporal sector and of mfVEP amplitude in corresponding central part of the visual field. RNFL thickness correlated highly with amplitude of the mfVEP derived from corresponding areas of the visual field in all three zones. We demonstrated strong topographical associations between structural and functional measures of optic nerve integrity in patients with ON.

  17. Loss of Nrf2 exacerbates the visual deficits and optic neuritis elicited by experimental autoimmune encephalomyelitis

    Science.gov (United States)

    Larabee, Chelsea M.; Desai, Shruti; Agasing, Agnieshka; Georgescu, Constantin; Wren, Jonathan D.; Axtell, Robert C.

    2016-01-01

    Purpose Optic neuritis, inflammation of the optic nerve, is experienced by most patients with multiple sclerosis (MS) and is typically characterized by episodes of acute, monocular vision loss. These episodes of inflammation can lead to damage or degeneration of the retinal ganglion cells (RGCs), the axons of which comprise the optic nerve. Experimental autoimmune encephalomyelitis (EAE) is a well-established model of MS in which mice are immunized to produce a neuroautoimmunity that recapitulates the cardinal hallmarks of human disease, namely, inflammation, demyelination, and neurodegeneration of the brain, spinal cord, and optic nerve. Inflammation-associated oxidative stress plays a key role in promoting spinal cord damage in EAE. However, the role of oxidative stress in optic neuritis and the associated visual deficits has not been studied. To address this gap in research, we sought to determine how a deficiency in the master antioxidant transcription factor (using nuclear factor-E2-related factor [Nrf2]-deficient mice) affects visual pathology in the EAE model. Methods EAE was induced in 8-week-old wild-type (WT) and Nrf2 knockout (KO) mice by immunization against the myelin oligodendrocyte glycoprotein (MOG) peptide antigen. Motor deficits were monitored daily, as was visual acuity using the established functional optokinetic tracking (OKT) assay. Mice were euthanized 21 days post-immunization for histological analyses. The optic nerves were paraffin-embedded and stained with hematoxylin and eosin (H&E) or immune cell type–specific antibodies to analyze inflammatory infiltrates. The retinas were flatmounted and stained with an RGC-specific antibody, and the RGCs were counted to assess neurodegeneration. T-helper (Th) cell-associated cytokines were measured in spleens with enzyme-linked immunosorbent assay (ELISA). Immune analyses of healthy, non-EAE mice were characterized with flow cytometry to assess the baseline immune cell profiles. Results Female Nrf2

  18. Lesion length of optic neuritis impacts visual prognosis in neuromyelitis optica.

    Science.gov (United States)

    Akaishi, Tetsuya; Nakashima, Ichiro; Takeshita, Takayuki; Mugikura, Shunji; Sato, Douglas Kazutoshi; Takahashi, Toshiyuki; Nishiyama, Shuhei; Kurosawa, Kazuhiro; Misu, Tatsuro; Nakazawa, Toru; Aoki, Masashi; Fujihara, Kazuo

    2016-04-15

    The visual acuity prognoses of patients with neuromyelitis optica (NMO) are worse than those with optic neuritis (ON) caused by other diseases. Predicting the prognoses of ON at the time of onset is important for selecting treatments for NMO patients. Twenty-three consecutive anti-aquaporin-4 autoantibody-positive NMO patients who presented with ON and had contrast-enhanced optic MRIs in the acute phase of their first ON episode were examined. Optical coherence tomographies (OCTs) were also examined for 22 of them. The visual acuity at the final follow-up, as assessed with the logMAR scale more than three years after ON onset, served as the outcome measure. These variables were also collected from 12 patients with serum anti-myelin oligodendrocyte glycoprotein antibody (anti-MOG-Ab). The strongest predictor of visual prognosis was the axial ON lesion length in the acute phase (R=0.747, p<0.0001), which was not observed in patients with anti-MOG-Ab. Specifically, the ON lesion length within the intra-orbit and canalicular segments exhibited the strongest correlation with visual prognosis (R=0.783, p<0.0001). The ON onset age was also correlated with visual prognosis (R=0.435, p=0.0338). OCT data in the chronic phase also showed a correlation with visual prognosis, but they were much weaker than the ON lesion length in the acute phase. The ON lesion length in the acute phase was an important predictor of the visual prognoses of NMO patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. A simple computer program to quantify red desaturation in patients with optic neuritis.

    Science.gov (United States)

    Almog, Yehoshua; Gepstein, Raz; Nemet, Arie Y

    2014-08-01

    Red desaturation is a subjective, sensitive test for patients with optic nerve disease. There is no quantitative clinical test to measure the severity of color desaturation. The current study introduces a simple PowerPoint presentation for quantification of red desaturation in patients with optic neuritis. A Microsoft Office PowerPoint presentation was designed. A red square is shown on each half of the screen. The degree of desaturation on one side is increased in each successive slide. The patient holds a black cardboard divider between his/her eyes, such that each eye can see one-half of the screen. The patient uses the mouse to forward through the slides, thereby gradually increasing the desaturation of the red square presented to the normal eye until it matches the color of the red square seen with the tested eye. Desaturation is graded by the number of slide changes needed until subjective equal color between the eyes is perceived. The test was presented to normal volunteers and to patients with optic neuritis. The difference in saturation levels between the right and the left eyes in patients with optic neuritis vs controls was compared. A total of 83 patients were included. Patients with optic neuritis had significantly increased desaturation compared to controls (6.17 ± 3.3 vs 0.24 ± 2.8 respectively; p < 0.0001). This test is easy to create and efficiently quantifies the severity of red desaturation.

  20. Calcium influx and calpain activation mediate preclinical retinal neurodegeneration in autoimmune optic neuritis.

    Science.gov (United States)

    Hoffmann, Dorit B; Williams, Sarah K; Bojcevski, Jovana; Müller, Andreas; Stadelmann, Christine; Naidoo, Vinogran; Bahr, Ben A; Diem, Ricarda; Fairless, Richard

    2013-08-01

    Optic neuritis is a common manifestation of multiple sclerosis, an inflammatory demyelinating disease of the CNS. Recently, the neurodegenerative component of multiple sclerosis has come under focus particularly because permanent disability in patients correlates well with neurodegeneration; and observations in both humans and multiple sclerosis animal models highlight neurodegeneration of retinal ganglion cells as an early event. After myelin oligodendrocyte glycoprotein immunization of Brown Norway rats, significant retinal ganglion cell loss precedes the onset of pathologically defined autoimmune optic neuritis. To study the role calcium and calpain activation may play in mediating early degeneration, manganese-enhanced magnetic resonance imaging was used to monitor preclinical calcium elevations in the retina and optic nerve of myelin oligodendrocyte glycoprotein-immunized Brown Norway rats. Calcium elevation correlated with an increase in calpain activation during the induction phase of optic neuritis, as revealed by increased calpain-specific cleavage of spectrin. The relevance of early calpain activation to neurodegeneration during disease induction was addressed by performing treatment studies with the calpain inhibitor calpeptin. Treatment not only reduced calpain activity but also protected retinal ganglion cells from preclinical degeneration. These data indicate that elevation of retinal calcium levels and calpain activation are early events in autoimmune optic neuritis, providing a potential therapeutic target for neuroprotection.

  1. Lymphocyte Proliferation Response to S Antigen in Patients with Uveitis and Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    PeixianRen; XiuzhenYan

    1995-01-01

    Purpose:To evaluate the autoimmunity which may play a major role in the etiolo-gy of certain forms of uveitis and optic neuritis.Methods:lymphocyte proliferation response to retinal soluble antigen in vitro by gy of certain forms of uveitis and optic neuritis.Methods:Lymphocyte proliferation response toretinal soluble antigen in vitro by incoperation3H-thymidine withDNA was tested in 115patients with anterior u-veitis,posterior/pan-uveitis,optic neuritis,and 50volunteers with unrelated diseases such as congenital ptosis,strabismus,or completely healthy persons as control.Results:The positive rate of lymphocyte stimulation was34%(18/53)in anteri-or uveitis,41.5%(17/41)in posterior/pan-uveitis,and57.1%(12/21)in optic euritis,The results in the experimental groups were significantly different from those of the control group(x2=14.76,P<0.05,x2=19.14P<0.005,x2=26.38,P<0.005,respectively).Conclusion:The autoimmunity plays a role in the patogenesis in certain forms of uveitis and optic neuritis,Such immune responses may be secondary to the expo-sition or release of retinal antigens by various causes,leading to activation or augmentation of meager or low-affinity S antigen specific lymphocytes which may preexist in the circulation and starting the pathogenic autoimmune process.Eye Science 1995;11:120-123.

  2. Hyperacute Corticosteroid Treatment of Optic Neuritis at the Onset of Pain May Prevent Visual Loss: A Case Series

    Directory of Open Access Journals (Sweden)

    G. T. Plant

    2011-01-01

    Full Text Available Aim. To show that high-dose corticosteroids may prevent visual loss in patients with optic neuritis (ON treated at the prodromal, hyperacute, phase of retrobulbar pain. Method. Prospective case series: patients were recruited with a history of ON associated with pain. The patients were advised to report immediately to the investigators should the pain recur in either eye. Where possible, orbital magnetic resonance imaging (MRI was performed to confirm a recurrence of ON and treatment with high-dose corticosteroids was commenced. Visual function and the patient’s subjective account were monitored. Results. Eight patients (including cases of MS, CRION and NMO presented in the hyperacute phase. MRI confirmed optic nerve inflammation in 5/5. Treatment was commenced immediately, and, in all cases, no visual loss ensued. Conclusion. MRI can be used to confirm acute optic neuritis prior to visual loss in the hyperacute phase. We suggest that treatment with high-dose corticosteroids may abort the attack and prevent loss of vision in patients with ON who are treated at the onset of pain. This has potential implications for the management of acute ON and also for our understanding of the pathogenesis and potential therapeutic targets in the neuroinflammatory conditions associated with ON.

  3. Neither retinal nor brain atrophy can be shown in patients with isolated unilateral optic neuritis at the time of presentation

    DEFF Research Database (Denmark)

    Kallenbach, Klaus; Sander, Birgit; Tsakiri, Anna;

    2011-01-01

    BACKGROUND: Acute monosymptomatic optic neuritis (ON) may be the earliest manifestation of multiple sclerosis (MS). Atrophy has been shown to be a prominent feature of MS with great impact on disability. OBJECTIVES: The objectives of this study were to evaluate retinal and brain atrophy and possi......BACKGROUND: Acute monosymptomatic optic neuritis (ON) may be the earliest manifestation of multiple sclerosis (MS). Atrophy has been shown to be a prominent feature of MS with great impact on disability. OBJECTIVES: The objectives of this study were to evaluate retinal and brain atrophy...... and possible associations at the earliest possible stages of MS. METHODS: In a prospective observational cohort study we included 60 untreated patients with monosymptomatic ON and 19 healthy volunteers. Unaffected fellow eyes were examined with optical coherence tomography (OCT) and normalized brain volumes...... were calculated based on MRI. Additionally, visual evoked potentials (VEPs) were recorded. RESULTS: Neither OCT measurements nor brain volume measures revealed signs of localized or generalized atrophy in patients compared with healthy volunteers. Stratification of patients into high risk based...

  4. Optic neuritis caused by canine distemper virus in a Jack Russell terrier.

    Science.gov (United States)

    Richards, Tara R; Whelan, Nick C; Pinard, Chantale L; Alcala, Fernanda Castillo; Wolfe, Katheryn C

    2011-04-01

    An atypical case of canine distemper (CD) was diagnosed in a vaccinated healthy adult dog. The patient was presented circling, seizuring, and blind. Postmortem examination resulted in a diagnosis of CD. Optic neuritis was diagnosed, a finding not previously described in the context of CD virus infection presenting solely with neurological signs.

  5. CSF abnormalities can be predicted by VEP and MRI pathology in the examination of optic neuritis

    DEFF Research Database (Denmark)

    Vinter, Matilda Degn; Nielsen, Signe Modvig; Larsson, Henrik B W

    2012-01-01

    Optic neuritis (ON) is linked to multiple sclerosis (MS). The presence of white matter lesions on cerebral magnetic resonance imaging (MRI) predicts the risk of MS after ON with considerable accuracy. Oligoclonal bands (OCB) are present in 95 % of MS patients, and a lumbar puncture can also be va...

  6. Optic neuritis in a traveler returning from Dominican Republic to Spain with dengue virus infection.

    Science.gov (United States)

    Ramos, José M; Tello, Antonio; Alzamora, Antonio; Ramón, María Luisa

    2015-01-01

    A search of medical literature will show that dengue infection is rarely linked to optic neuritis. Here we report the development of loss of vision in a female traveler who returned to Spain from the Caribbean after acquiring a dengue infection. © 2014 International Society of Travel Medicine.

  7. Tumor necrosis factor alpha gene polymorphism in multiple sclerosis and optic neuritis

    DEFF Research Database (Denmark)

    Fugger, L; Morling, N; Sandberg-Wollheim, M

    1990-01-01

    The NcoI tumor necrosis factor (TNF alpha) polymorphism was studied in relapsing/remitting multiple sclerosis and monosymptomatic optic neuritis. The frequency of the NcoI marker phenotypes did not differ between healthy controls and the two disease groups. No extra or missing DNA fragments were...

  8. Animal model of human disease with optic neuritis: neuropapillitis in a rat model infected with Angiostrongylus cantonensis.

    Science.gov (United States)

    Feng, Ying; Zeng, Xin; Li, Wei-hua; Wang, Wen-cong; Ou-Yang, Li-si; Sun, Xi; Lv, Zhiyue; Wu, Zhong-Dao

    2014-11-01

    Human Angiostrongylus cantonensis (A. cantonensis) is a food-borne parasitic disease and can cause optic neuritis. Increasing clinical angiostrongyliasis cases with optic neuritis have been reported, but the pathogenesis has not been fully understood until now. Here, we applied rats with A. cantonensis infection as an animal model to study the pathogenesis of optic neuritis caused by the infection. We observed that the optic disk of experimental rats appeared hyperemic, the retina vein became thick, and the visual evoked potential (VEP) latency was prolonged. There were obvious inflammatory cell infiltration in the retina and optic nerve adventitia followed with obvious optic nerve fiber demyelination and retina ganglion swelling. We also evaluated the effect of dexamethasone combined with albendazole on optic neuritis of rats infected with A. cantonensis. The results showed it had no obvious effect to prevent progressive visual deterioration for optic neuritis caused by A. cantonensis. The studies provided evidence that the pathogenesis of optic neuritis in infected rats was correlated to optic nerve demyelination and ganglion cell damage caused by optic nerve inflammation, and the common therapy to this disease was not so effective. Based on the above results, it may be necessary to combine neuroprotective agents with common therapy to treat and protect optic nerve and ganglion cells from their secondary injury.

  9. Aquaporin 4 antibody [NMO Ab] status in patients with severe optic neuritis in India.

    Science.gov (United States)

    Ambika, Selvakumar; Balasubramanian, Mahalakshmi; Theresa, Lily; Veeraputhiran, Akila; Arjundas, Deepak

    2015-12-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system that causes attacks of optic neuritis and transverse myelitis. The discovery of a specific serum marker for NMO-IgG antibody [aquaporin 4 antibody/AQP4 Ab] has revolutionised the treatment of demyelinating diseases. Severe vision loss can be seen in optic neuritis (ON) associated with both multiple sclerosis (MS) and NMO. Identifying this antibody in optic neuritis patients can help us to establish the likelihood of these patients developing NMO (Jarius et al. Neurol Sci 298:158-162, 2010). It is important to differentiate these two entities as the treatment strategies of MS and NMO are different. To the best of our knowledge, there is no published literature regarding the importance of identifying this antibody in severe optic neuritis in Indian patients. Hence we decided to screen our severe optic neuritis patients for this AQP4 Ab. To investigate the presence of aquaporin 4 antibody and determine its prognostic value for visual and neurological outcome, in patients with bilateral and recurrent [severe] ON without any previous neurological manifestations presenting to a neuro-ophthalmology clinic in India. Single centre, prospective study. 40 patients (27 female patients and 13 male) with severe optic neuritis [patients with no visual improvement by 4 weeks from onset of vision loss] who presented either as recurrent attacks or as bilateral and severe optic neuritis between January 2010 and June 2011 were enrolled. Clinical features, visual outcome and sequential neurological events were compared between the seropositive and the seronegative groups. Aquaporin 4 antibodies were detected from serum using ELISA technique and IIF technique. Presence of this antibody in the serum was considered to be seropositive status and patients who did not have this antibody were considered seronegatives. AQP4 antibodies were detected in 8 of the 40 patients with severe ON (20 %).The

  10. Detection of optic nerve atrophy following a single episode of unilateral optic neuritis by MRI using a fat-saturated short-echo fast FLAIR sequence

    Energy Technology Data Exchange (ETDEWEB)

    Hickman, S.J. [Inst. of Neurology, Univ. College London (United Kingdom); Dept. of Neuro-Ophthalmology, Moorfields Eye Hospital, London (United Kingdom); Brex, P.A.; Silver, N.C.; Barker, G.J.; Miller, D.H. [Inst. of Neurology, Univ. College London (United Kingdom); Brierley, C.M.H.; Compston, D.A.S. [Cambridge Centre for Brain Repair, Cambridge (United Kingdom); Scolding, N.J. [Inst. of Clinical Neurosciences, Frenchay Hospital, Bristol (United Kingdom); Moseley, I.F. [Lysholm Radiological Dept., National Hospital for Neurology and Neurosurgery, London (United Kingdom); Plant, G.T. [Dept. of Neuro-Ophthalmology, Moorfields Eye Hospital, London (United Kingdom)

    2001-02-01

    We describe an MRI technique for quantifying optic nerve atrophy resulting from a single episode of unilateral optic neuritis. We imaged 17 patients, with a median time since onset of optic neuritis of 21 months (range 3-81 months), using a coronal-oblique fat-saturated short-echo fast fluid-attenuated inversion-recovery (sTE fFLAIR) sequence. The mean cross-sectional area of the intraorbital portion of the optic nerves was calculated by a blinded observer from five consecutive 3 mm slices from the orbital apex forwards using a semiautomated contouring technique and compared with data from 16 controls. The mean optic nerve area was 11.2mm{sup 2} in the affected eye of the patients, 12.9mm{sup 2} in the contralateral eye (P = 0.006 compared to the affected eye) and 12.8mm{sup 2} in controls (P = 0.03 compared to the affected eyes). There was a significant negative correlation between disease duration and the size of the affected optic nerve (r = -0.59, P = 0.012). The measurement coefficient of variation was 4.8 %. The sTE fFLAIR sequence enables measurement of optic nerve area with sufficient reproducibility to show optic nerve atrophy following a single episode of unilateral optic neuritis. The correlation of increasing optic nerve atrophy with disease duration would be consistent with ongoing axonal loss in a persistently demyelinated lesion, or Wallerian degeneration following axonal damage during the acute inflammatory phase. (orig.)

  11. Primary Sjoegren's syndrome initially manifested by optic neuritis: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kadota, Y.; Tokumaru, A.M.; Kohyama, S.; Okizuka, H.; Kaji, T.; Kusano, S. [Department of Radiology, National Defense Medical College, Saitama (Japan); Kamakura, K. [Department of Internal Medicine, National Defense Medical College, Saitama (Japan)

    2002-04-01

    We herein describe the MRI findings in a patient clinically diagnosed with primary Sjoegren's syndrome (SjS) initially manifested by retrobulbar optic neuritis. A 63-year-old woman suddenly had left ocular pain and progressive visual disturbance. MR T2-weighted images revealed hyperintensity in the left optic nerve, with swelling. Contrast-enhanced T1-weighted images showed no abnormal enhancement. Follow-up MRI 6 months after admission revealed no significant changes in the affected optic nerve. To our knowledge, optic neuritis as a complication of SjS has been reported in ten patients [1, 2, 3, 4, 5, 6] and MRI findings in only one of them [6]. We thought MR images were useful for visualizing optic nerve involvement in SjS and observing its course. (orig.)

  12. Magnetisation transfer ratio in optic neuritis is associated with axonal loss, but not with demyelination.

    Science.gov (United States)

    Klistorner, A; Chaganti, J; Garrick, R; Moffat, K; Yiannikas, C

    2011-05-01

    Pathophysiological basis of Magnetisation Transfer Ratio (MTR) reduction in multiple sclerosis still remains a matter of controversy. Optic nerve represents an ideal model to study the consequences of axonal loss and demyelination on MTR since effects of disease on the optic nerve are clinically apparent and potentially quantifiable by objective means. By measuring the latency of multifocal visual evoked potentials (mfVEP) (measure of optic nerve conduction) and Retinal Nerve Fiber Layer (RNFL) thickness (measure of axonal damage) we investigated the effect of neurodegeneration and demyelination on MTR after an episode of optic neuritis (ON). 23 patients with a single unilateral episode of ON and 10 healthy volunteers were enrolled. Orbital MRI including MTR protocol, Optical Coherence Tomography and Multifocal VEP were performed at post-acute stage of ON. Average MTR of affected eye was significantly reduced as compared to the fellow eye and normal controls. There was a highly significant correlation between MTR and measures of axonal loss (RNFL thickness and mfVEP amplitude), which was independent on the level of demyelination. While latency delay also correlated significantly with MTR, correlation became non-significant when adjusted for the degree of axonal loss. There was a significant reduction of MTR in a group of patients with extensive axonal damage, while MTR remained normal in a group of patients with extensive demyelination, but little or no axonal loss. Results of this study indicate that reduction of optic nerve MTR after an episode of ON has a strong association with the degree of axonal damage, but not with demyelination. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  13. A literature review on optic neuritis following vaccination against virus infections.

    Science.gov (United States)

    Stübgen, Joerg-Patrick

    2013-08-01

    Optic neuritis (ON) is a primary inflammation of the optic nerve. ON is mostly idiopathic, and infrequently occurs on the background of systemic autoimmune disease, recent infectious disease or inoculation with mostly adjuvanted vaccines. Published case histories, retrospective reviews and analyses of epidemiological data report on the onset of immune-mediated ON (and other autoimmune disorders) within a defined period (days to weeks) after immunization of patients with probable genetic predisposition. After vaccination, there exists no long-term increased risk to develop ON. The risk for these vaccine-induced adverse events may be enhanced by adjuvants. Patient age distribution reflected immunization schedules and advisories, or patient age groups studied. Vaccination is one of the most important prevention tools in modern medicine, and a discussion on risk-benefit or cost-benefit analysis, and advisory on individual vaccines or vaccination programs falls outside the scope of this review. Despite a great deal of scientific uncertainty, the existence of a possible causal link between vaccines and acute ON should not be totally disregarded.

  14. 糖皮质激素联合复方樟柳碱治疗急性视神经炎临床分析%Clinical evaluation of glucocorticoidon and compound anisodine on acute optic neuritis

    Institute of Scientific and Technical Information of China (English)

    张瑛; 赵蕾

    2011-01-01

    目的 评价甲基强的松龙联合复方樟柳碱(compound anisodine,CA)治疗急性视神经炎(optic neuritis,ON)的效果.方法 对1998年1月至2010年1月在我院收治的44例(58眼)ON患者的病案资料进行回顾性分析.结果 甲基强的松龙治疗ON有效率为57.14%,甲基强的松龙联合CA治疗ON有效率为83.33%,两种治疗方法比较有统计学意义(X2=4.7947,P<0.05).结论 甲基强的松龙联合CA治疗ON的效果优于甲基强的松龙单独治疗组.

  15. Optical coherence tomography in the diagnosis and management of optic neuritis and multiple sclerosis.

    Science.gov (United States)

    Costello, Fiona E; Klistorner, Alexander; Kardon, Randy

    2011-07-01

    Optic neuritis (ON) is an inflammatory optic nerve injury, which is strongly associated with multiple sclerosis (MS). Optical coherence tomography (OCT) has the potential to provide a reliable means of capturing axonal deficits, which can be paired to tests of visual function to provide a structural-functional paradigm of brain injury. In this respect, the eye provides a unique view into the effects of central nervous system inflammation, which may enhance the understanding of disease mechanisms that contribute to neurological disability in MS. This review addresses the published experience with OCT in the diagnosis and treatment of patients with ON and MS, and discusses the applications of OCT in ongoing clinical trials. The potential gains and limitations of spectral-domain OCT as an evolving technology and surrogate marker of axonal brain injury are also discussed. Copyright 2011, SLACK Incorporated.

  16. N-methyl-D-aspartate receptor blockade is neuroprotective in experimental autoimmune optic neuritis.

    Science.gov (United States)

    Sühs, Kurt-Wolfram; Fairless, Richard; Williams, Sarah K; Heine, Katrin; Cavalié, Adolfo; Diem, Ricarda

    2014-06-01

    Optic neuritis is a common clinical manifestation of the chronic inflammatory CNS disease multiple sclerosis that can result in persistent visual impairment caused by degeneration of optic nerve axons and apoptosis of retinal ganglion cells (RGCs). Using a model of experimental autoimmune encephalomyelitis with optic neuritis (Brown Norway rats), we show that administration of the N-methyl-D-aspartate (NMDA) receptor antagonists memantine or MK801 results in RGC protection, axon protection, and reduced demyelination of optic nerves. Calcium imaging revealed that RGC responses to glutamate stimulation predominantly occurred via NMDA receptors and were inhibited by memantine in a dose-dependent manner. In contrast, oligodendrocytes were mainly responsive through the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid/kainate receptor. This suggests that NMDA receptor blockade protected RGCs directly and that the protection was independent of effects on oligodendrocytes. Moreover, increased RGC survival was observed before the onset of optic nerve demyelination--when RGC degeneration had already started. These results indicate an important pathophysiologic role for NMDA receptor-mediated glutamate toxicity during the induction phase of this disease model and highlight a potential target for therapeutic neuroprotection in human optic neuritis.

  17. Efficacy of vision restoration therapy after optic neuritis (VISION study: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schinzel Johann

    2012-06-01

    Full Text Available Abstract Background Optic neuritis is a frequent manifestation of multiple sclerosis. Visual deficits range from a minor impairment of visual functions through to complete loss of vision. Although many patients recover almost completely, roughly 35% of patients remain visually impaired for years, and therapeutic options for those patients hardly exist. Vision restoration therapy is a software-based visual training program that has been shown to improve visual deficits after pre- and postchiasmatic injury. The aim of this pilot study is to evaluate whether residual visual deficits after past or recent optic neuritis can be reduced by means of vision restoration therapy. Methods/design A randomized, controlled, patient- and observer-blinded clinical pilot study (VISION study was designed to evaluate the efficacy of vision restoration therapy in optic neuritis patients. Eighty patients with a residual visual deficit after optic neuritis (visual acuity ≤0.7 and/or scotoma will be stratified according to the time of optic neuritis onset (manifestation more than 12 months ago (40 patients, fixed deficit versus manifestation 2 to 6 months ago (40 patients, recent optic neuritis, and randomized into vision restoration therapy arm or saccadic training arm (control intervention. Patients will be instructed to complete a computer-based visual training for approximately 30 minutes each day for a period of 6 months. Patients and evaluators remain blinded to the treatment allocation throughout the study. All endpoints will be analyzed and P-values  Discussion If vision restoration therapy is shown to improve visual function after optic neuritis, this method might be a first therapeutic option for patients with incomplete recovery from optic neuritis. Trial registration NCT01274702

  18. Cerebrospinal fluid neurofilament light chain levels predict visual outcome after optic neuritis

    DEFF Research Database (Denmark)

    Modvig, Signe; Degn, M; Sander, B

    2016-01-01

    BACKGROUND: Optic neuritis is a good model for multiple sclerosis relapse, but currently no tests can accurately predict visual outcome. OBJECTIVE: The purpose of this study was to examine whether cerebrospinal fluid (CSF) biomarkers of tissue damage and remodelling (neurofilament light chain (NF-L...... cell layer+inner plexiform layer (GC-IPL) thicknesses. RESULTS: CSF NF-L levels at onset predicted inter-ocular differences in follow-up LCVA (β=13.8, p=0.0008), RNFL (β=5.6, p=0.0004) and GC-IPL (β=4.0, p=0.0008). The acute-phase GC-IPL thickness also predicted follow-up LCVA (β=12.9, p=0.0021 for NF-L......, β=-1.1, p=0.0150 for GC-IPL). Complete/incomplete remission was determined based on LCVA from 30 healthy controls. NF-L had a positive predictive value of 91% and an area under the curve (AUC) of 0.79 for incomplete remission. CONCLUSION: CSF NF-L is a promising biomarker of visual outcome after...

  19. Fellow eye changes in optic neuritis correlate with the risk of multiple sclerosis.

    Science.gov (United States)

    Klistorner, A; Arvind, H; Nguyen, T; Garrick, R; Paine, M; Graham, S; Yiannikas, C

    2009-08-01

    Recent studies demonstrate early diffuse central nervous system (CNS) inflammation in patients with multiple sclerosis (MS). The clinically unaffected (fellow) eye of patients with unilateral optic neuritis (ON) may reflect the status of normal-appearing white matter in the CNS, which can be assessed electrophysiologically. To study the relationship between electrophysiological parameters in the fellow eye of ON patients, and risk of conversion to MS. Forty-eight consecutive patients with acute unilateral ON were examined 12 months after ON of which 14 had MS, 19 remained high risk (HR) for MS, and 15 had low risk (LR) for MS according to McDonald's criteria. Twenty-five age-matched controls were also tested. Amplitude and latency of multifocal visual evoked potential (mfVEP) in the fellow eyes of patients at 12 months were analyzed and compared with controls. Average mfVEP amplitude was 240 +/- 35, 232 +/- 36, 181 +/- 38, and 169 +/- 48 nV for controls, LR, HR, and MS groups respectively. Average mfVEP latency for controls, LR, HR, and MS patients was 139.7 +/- 5.5, 141.7 +/- 3.6, 145.9 +/- 8.9, and 152.0 +/- 9.9 ms respectively. The magnitude of latency prolongation and amplitude decline 12 months after the initial episode was proportional to the risk of MS. The prognostic significance of these changes as predictors of subsequent MS should be investigated longitudinally.

  20. 前列地尔联合糖皮质激素治疗急性视神经炎的临床观察%Clinical observation of alprostadil combined with glucocorticoids on acute optic neuritis

    Institute of Scientific and Technical Information of China (English)

    范可顺; 邵新香; 周雷

    2015-01-01

    AIM:To study the clinical effect of alprostadil combined with glucocorticoids in the treatment of acute optic neuritis( AON) . METHODS: Seventy patients (70 eyes) with AON from January, 2012 to June, 2014 were randomly divided into two groups. 35 patients in observation group were used 10ug alprostadil with 10mL normal saline ( NS ) by intravenous injection, once/d for 7d/one treatment course, and 10mL NS was used by intravenous injection in 35 patients of control group. Besides, the two groups were treated with the combined therapy as follows:20mg methylprednisolone was injected periglomerularly beside the eyeballs, once /3d for 3 times; 800 ~ 1 000mg of methylprednisolone through intravenous drip for 3d, once/d; after 3d, oral administration of prednisone acetate for 1wk, 1mg/( kg · d ); after 1wk, the dose decreased to 5mg/wk until withdraw. Simultaneously, oral administration of ranitidine capsules, calcium carbonate and vitamin D3 tablets were combined in the supportive treament. The differences of curative effect between two groups were comparatively analyzed. RESULTS:In the observation group, 25 eyes (71. 4%) were markedly effective, 7 eyes (20. 0%) were valid and 3 eyes (8. 6%) were invalid, and the total effective rate was 91. 4%. In the control group, 15 eyes ( 42. 9%) were markedly effective, 14 eyes ( 40. 0%) were valid and 6 eyes ( 17. 1%) were invalid, and the total effective rate was 82. 9%. The difference of total effective rate between the two groups was not statistically significant (P=0. 477), but there was a significant difference in markedly effective rate between the two groups (χ2=5. 833, P=0. 016). CONCLUSION:Alprostadil combined with glucocorticoids is effective for AON, and it is worth of advocation.%目的:探讨前列地尔联合糖皮质激素综合治疗急性视神经炎的临床疗效。  方法:将我院2012-01/2014-06急性视神经炎住院患者70例70眼随机分组,观察组35例给予前列地尔10μg入10m

  1. Brimonidine suppresses loss of retinal neurons and visual function in a murine model of optic neuritis.

    Science.gov (United States)

    Guo, Xiaoli; Namekata, Kazuhiko; Kimura, Atsuko; Noro, Takahiko; Azuchi, Yuriko; Semba, Kentaro; Harada, Chikako; Yoshida, Hiroshi; Mitamura, Yoshinori; Harada, Takayuki

    2015-04-10

    Optic neuritis is inflammation of the optic nerve and is strongly associated with multiple sclerosis (MS), an inflammatory demyelinating syndrome of the central nervous system. It leads to retinal ganglion cell (RGC) death and can cause severe vision loss. Brimonidine (BMD) is a selective α2-adrenergic receptor agonist that is used clinically for the treatment of glaucoma. BMD lowers intraocular pressure, but recent evidence suggests that its therapeutic efficacy may also mediate through mechanisms independent of modulation of intraocular pressure. In this study, we examined the effects of topical administration of BMD on retinal degeneration during optic neuritis in experimental autoimmune encephalomyelitis (EAE), an animal model of MS. EAE was induced with MOG35-55 in C57BL/6J mice and BMD eyedrops were applied daily. In the EAE retina, the number of RGCs was significantly decreased and this effect was suppressed with BMD treatment. Consistent with histological analyses, the visual impairment observed in EAE mice was inhibited with BMD treatment, indicating the functional significance of the neuroprotective effect of BMD. Furthermore, BMD increased the expression level of basic fibroblast growth factor in the EAE retina, particularly in Müller glial cells and RGCs. Our findings suggest that topical administration of BMD may be available for RGC protection during optic neuritis, as well as for glaucoma.

  2. Unique association of Waldenström macroglobulinemia with optic neuritis and monoclonal T cell expansion.

    Science.gov (United States)

    Morita, Ken; Yoshimi, Akihide; Masuda, Akiko; Ichikawa, Motoshi; Yatomi, Yutaka; Kurokawa, Mineo

    2013-08-01

    Waldenström macroglobulinemia is a lymphoplasmacytic lymphoma characterized by production of the immunoglobulin M (IgM) monoclonal protein. Commonly involved sites are the bone marrow, lymph nodes, and spleen. Lymphoplasmacytic infiltration of the central nervous system (CNS), in contrast, is referred to as Bing-Neel syndrome, and is an extremely rare phenomenon. Here, we present a unique case of Waldenström macroglobulinemia with optic neuritis accompanied by monoclonal expansion of T cells, which recovered after administration of CNS-targeting chemotherapy. Although the underlying causal relationships in this case remain obscure, aberrantly expanded T cells may have contributed to the development of optic neuritis, and we should be reminded that some types of cranial neuropathy in Waldenström macroglobulinemia may be reversible.

  3. Perivascular Enhancement in a Patient with Neuromyelitis Optica Spectrum Disease during an Optic Neuritis Attack.

    Science.gov (United States)

    Pekcevik, Yeliz; Izbudak, Izlem

    2015-01-01

    We present a case with neuromyelitis optica spectrum disease (NMOSD) who had perivascular enhancement during an optic neuritis attack. Cloud-like enhancement, pencil-thin enhancement, and leptomeningeal enhancement have been defined as specific enhancement patterns to neuromyelitis optica (NMO). Perivascular enhancement has not been described before in NMO/NMOSD. This finding suggests that perivascular enhancement may also be seen in NMO/NMOSD patients.

  4. Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

    OpenAIRE

    Merle H; Olindo S; Jeannin S; Hage R; Donnio A; Richer R; Cabre P

    2013-01-01

    Harold Merle,1 Stéphane Olindo,2 Séverine Jeannin,2 Rabih Hage,1 Angélique Donnio,1 Raymond Richer,1 Philippe Cabre2 1Service d'Ophtalmologie, 2Service de Neurologie, Centre Hospitalier Universitaire de Fort de France, Fort-de-France, Martinique, France Purpose: Optic neuritis (ON) observed during neuromyelitis optica (NMO) is in most cases very severe and with poor prognosis. This study's objective was to analyze visual field (VF) abnormaliti...

  5. Parent and medical professional willingness to enroll children in a hypothetical pediatric optic neuritis treatment trial

    Directory of Open Access Journals (Sweden)

    Amy eWaldman

    2011-11-01

    Full Text Available The Optic Neuritis Treatment Trial and subsequent studies have had a tremendous impact on the treatment and prognosis of optic neuritis and multiple sclerosis in adults. The results of these studies have been extrapolated to children; however, pediatric data are sparse. Using the method of prospective preference assessment, the willingness of parents and medical professionals to enroll children in a hypothetical Pediatric Optic Neuritis Treatment Trial was assessed using a mock consent form and questionnaire. A 3-arm trial was proposed: 1 intravenous corticosteroids, 2 high-dose oral corticosteroids, and 3 an oral placebo. The forms were completed by 198 parents and 49 physicians. After reviewing the hypothetical scenario, trial design, risks and benefits, and alternatives to the study, 21% of parents would enroll their children in the trial whereas 98% of medical professionals would enroll their patients. With medical professional recommendation, 43% of parents would enroll their children. The manner in which this hypothetical trial was presented to parents, specifically with respect to the recommendation of their child’s health care team, influenced a parent’s willingness to participate.

  6. The role of Magnetic Resonance Imaging and Visual Evoked Potential in management of optic neuritis

    Science.gov (United States)

    Al-Eajailat, Suha Mikail; Al-Madani Senior, Mousa Victor

    2014-01-01

    Introduction To report our experience in management of patients with optic neuritis. The effects of brain magnetic resonance imaging and visual evoked potential on management were investigated Methods This is a four years clinical trial that included patients presenting with first attack of optic neuritis older than 16 years with visual acuity of less than 6/60 and presentation within first week of illness. Brain magnetic resonance imaging and visual evoked potentials were done for all patients. Patients were classified into three groups. First group received placebo, second received oral steroids and third received intravenous and oral steroids. Primary outcome measure was improvement in visual acuity. Results A total number of 150 patients were enrolled in the study. Ocular pain was seen 127 patients Relative afferent pupillary defect in 142 patients and color vision impairment in 131 patients. Abnormal MRI findings were seen in 84 patients. Pattern reversal VEP was abnormal in all patients. Using oral or intravenous steroid resulted in faster recovery but did not affect the final visual outcome. Recurrence rate was higher in patients with multiple MRI lesions and diminished VEP amplitude. Using intravenous steroids decreased recurrence rate in patients with three and more MRI lesions and non recordable VEP response. Conclusion MRI and pattern reversal VEP are recommended to be done in all patients presenting with optic neuritis. We advise to give intravenous methyl prednisolone in patients with multiple MRI white matter lesions and non recordable VEP at presentation. PMID:25018804

  7. Change of Visual Acuity and Related Factors in Idiopathic Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    Changxian Yi; Linjie Guo; Jiexiong Ou; Hong Yan; Qiang Yu

    2001-01-01

    Purpose : To study the change of visual acuity and related factors in idiopathic optic neuritis. Methods: Retrospectively studying 136 cases (210 eyes) of idiopathic optic neuritis hospitalized in our department during last 5 years. The data was analyzed with the methods of multivariate stepwise regression analysis by SPSS statistic package. Results: The final visual acuity was very strongly related positively to the initial visual acuity at the time point of starting treatment and negatively to the time span beginning the treatment to the time showing improvement, age of patient and the duration from onset of the disorder to the time point of treatment beginning. Conclusions: Promptly right treatment can significantly change the natural course and the final vision of optic neuritis. Severe visual loss, old age, longer time without right therapy and slow improvement after the treatment may indicate an unfavorable final visual recovery. The different dosages of steroid applied in this study was not significant in view of the final visual acuity. Eye Sience 2001; 17: 46 ~ 49.

  8. Aquaporin-4 antibody negative recurrent isolated optic neuritis: clinical evidence for disease heterogeneity.

    Science.gov (United States)

    Waschbisch, A; Atiya, M; Schaub, C; Derfuss, T; Schwab, S; Lee, D H; Müller, M; Linker, R A

    2013-08-15

    Recurrent optic neuritis is frequently observed in multiple sclerosis (MS) and is a typical finding in neuromyelitis optica (NMO). Patients that lack further evidence of demyelinating disease are diagnosed with RION (recurrent isolated optic neuritis) or CRION (chronic relapsing inflammatory neuropathy) if they require immunosuppressive therapy to prevent further relapses. The etiology and disease course of this rare condition are not well defined. We studied a series of 10 patients who presented with recurrent episodes of isolated optic neuritis (ON, n=57) and were followed over a median of 3.5 years. Visual acuity was severely reduced at the nadir of the disease (20/200 to 20/800). All patients had MRI non-diagnostic for MS/NMO and were aquaporin-4 antibody negative. Six patients fulfilled the CRION criteria. In two of these a single ON followed by a long disease-free interval preceded development of CRION for years, suggesting the conversion of an initially "benign" isolated ON into the chronic relapsing course. Cerebrospinal fluid (CSF) analysis revealed mild pleocytosis in 5 patients, identical oligoclonal bands in serum and CSF were observed in 2 patients, while the others remained negative. In conclusion, recurrent ON is a disease entity that requires aggressive glucocorticoid and eventually long-term immunosuppressive therapy to prevent substantial visual impairment.

  9. Current and future potential of retinal optical coherence tomography in multiple sclerosis with and without optic neuritis.

    Science.gov (United States)

    Balk, Lisanne J; Petzold, Axel

    2014-01-01

    Multiple sclerosis (MS) is a disorder characterized by inflammation and neuroaxonal degeneration. The latter is held responsible for the irreversible disability in patients with MS. The eye is a unique window into the brain. With the advent of optical coherence tomography, accurate quantification of retinal layer thickness has become feasible. Neuroaxonal degeneration affecting the retinal layers is structurally and functionally related to pathology in the visual pathways, which is most severe following MS optic neuritis. This is relevant to recognize because MS optic neuritis may mask the subtle thinning of retinal layers associated with global CNS atrophy, which is also related to more global loss of neurological function. Taken together, optical coherence tomography stands at the brink of becoming a validated imaging biomarker for monitoring neurodegeneration in MS and to provide end points for clinical trials.

  10. 血府逐瘀汤联合西药治疗急性感染性视神经炎的效果研究%Efficacy of blood Xuefuzhuyutang combined with western medicine in treatment of acute infectious optic neuritis

    Institute of Scientific and Technical Information of China (English)

    何陈亮; 李永波; 胡振仙; 赵丽珍

    2012-01-01

    目的 研究血府逐瘀汤联合西药治疗急性感染性视神经炎的疗效.方法 选取2006年9月-2011年12月于医院进行治疗的60例急性感染性视神经炎为研究对象,将其随机分为治疗组和对照组各30例,对照组进行西药常规治疗,治疗组则在对照组的基础上加用血府逐瘀汤进行治疗,后将两组患者的总有效率、视野正常率及不良反应发生率进行对比.结果 治疗组的总有效率为100.00%,高于对照组的93.33%,视野正常率为86.67%,高于对照组的66.67%,差异均有统计学意义(P<0.05),而两组不良反应发生率均为16.67%.结论 血府逐瘀汤联合西医治疗急性感染性视神经炎的疗效好、安全性高、临床价值较高.%OBJECTIVE To study the efficacy of blood Xuefuzhuyutang combined with western medicine in the treatment of acute infectious optic neuritis. METHODS A total of 60 patients with acute infectious optic neuritis who enrolled hospital from Sep 2006 to Dec 2011 were selected as the study objects, those objects were divided intothe treatment group and the control group with 30 cases in each, the treatment group was treated with blood Xuefuzhuyutang on the basis of the treatment in the control group; the total effective rate, the rate of the vision restored to normal, and the incidence of the adverse reactions were compared between the two groups. RESULTS The total effective rate of the treatment group was 100. 00%, higher than 93. 33% of the control group; the normal vision rate of the treatment group was 86. 67% , higher than 66. 67% of the control group, the differences were statistically significant (P<0. 05) , the incidence rate of the adverse reactions of both groups were 16. 67%. CONCLUSION The blood Xuefuzhuyutang combined with western medicine is effective and safe in the treatment of acute infectious optic neuritis, 'which has significant clinical value.

  11. Axonal loss and myelin in early ON loss in postacute optic neuritis.

    Science.gov (United States)

    Klistorner, Alexander; Arvind, Hemamalini; Nguyen, Than; Garrick, Raymond; Paine, Mark; Graham, Stuart; O'Day, Justin; Grigg, John; Billson, Francis; Yiannikas, Con

    2008-09-01

    To investigate the relation between retinal nerve fiber layer (RNFL) thickness and latency and amplitude of multifocal visual-evoked potentials (mfVEPs) in the postacute stage of optic neuritis in patients with early or possible multiple sclerosis. Thirty-two patients with clinical diagnosis of unilateral optic neuritis and magnetic resonance imaging lesions typical of demyelination and 25 control subjects underwent mfVEP and optical coherence tomography imaging. Although there was significant reduction of RNFL thickness in the affected eyes (18.7%), a considerably larger decrease was observed for the amplitude of the mfVEPs (39.8%). Latency of the mfVEPs was also significantly delayed in optic neuritis eyes. In fellow eyes, the amplitude of mfVEPs was significantly reduced and the latency prolonged, but RNFL thickness remained unaltered. RNFL thickness correlated highly with the mfVEP amplitude (r = 0.90). There was also strong correlation between optical coherence tomography measure of axonal loss and mfVEP latency (r = -0.66). Although our findings demonstrate strong associations between structural and functional measures of optic nerve integrity, the functional loss was more marked. This fact, together with amplitude and latency changes of the mfVEPs observed in clinically normal fellow eyes, may indicate greater sensitivity of mfVEPs in detecting optic nerve abnormality or the presence of widespread inflammation in the central nervous system, or both. The significant correlation of the mfVEP latency with RNFL thickness suggests a role for demyelination in promoting axonal loss.

  12. Experimental optic neuritis induced by the microinjection of lipopolysaccharide into the optic nerve.

    Science.gov (United States)

    Aranda, Marcos L; Dorfman, Damián; Sande, Pablo H; Rosenstein, Ruth E

    2015-04-01

    Optic neuritis (ON) is a condition involving primary inflammation, demyelination, and axonal injury in the optic nerve which leads to retinal ganglion cell (RGC) loss, and visual dysfunction. We investigated the ability of a single microinjection of bacterial lipopolysaccharide (LPS) directly into the optic nerve to induce functional and structural alterations compatible with ON. For this purpose, optic nerves from male Wistar rats remained intact or were injected with vehicle or LPS. The effect of LPS was evaluated at several time points post-injection in terms of: i) visual pathway and retinal function (visual evoked potentials (VEPs) and electroretinograms, (ERGs), respectively), ii) anterograde transport from the retina to its projection areas, iii) consensual pupil light reflex (PLR), iv) optic nerve histology, v) microglia/macrophage reactivity (by Iba-1- and ED1-immunostaining), vi) astrocyte reactivity (by glial fibrillary acid protein-immunostaining), vii) axon number (by toluidine blue staining), vii) demyelination (by myelin basic protein immunoreactivity and luxol fast blue staining), viii) optic nerve ultrastructure, and ix) RGC number (by Brn3a immunoreactivity). LPS induced a significant and persistent decrease in VEP amplitude and PLR, without changes in the ERG. In addition, LPS induced a deficit in anterograde transport, and an early inflammatory response consisting in an increased cellularity, and Iba-1 and ED1-immunoreactivity in the optic nerve, which were followed by changes in axonal density, astrocytosis, demyelination, and axon and RGC loss. These results suggest that the microinjection of LPS into the optic nerve may serve as a new experimental model of primary ON.

  13. Paraneoplastic autoimmune optic neuritis with retinitis defined by CRMP-5-IgG.

    Science.gov (United States)

    Cross, Shelley A; Salomao, Diva R; Parisi, Joseph E; Kryzer, Thomas J; Bradley, Elizabeth A; Mines, Jonathan A; Lam, Byron L; Lennon, Vanda A

    2003-07-01

    Autoantibodies have defined two paraneoplastic visual disorders related to small-cell lung carcinoma: retinopathy ("CAR"-IgG [23kDa, recoverin]) and optic neuritis collapsin response-mediated protein 5 (CRMP-5-IgG [62kDa]). Among 16 patients with CRMP-5-IgG and optic neuritis (aged 52-74 years; all smokers, 9 women), we documented coexisting retinitis in 5. None had CAR-IgG. Fifteen had subacute vision loss, swollen optic discs, and field defects. Vascular leakage was evident at and remote from the disc; 5/5 tested had abnormal electroretinograms. Nine had striking vitreous cells. Vitrectomy showed reactive lymphocytosis (4/4), predominantly CD4(+) (1/1). Most patients had multifocal neurological accompaniments. Cerebrospinal fluid contained lymphocytes (7-32), elevated protein, multiple oligoclonal immunoglobulin bands, and CRMP-5-IgG. Three patients superficially resembled Devic's disease at presentation. One autopsied patient had predominantly CD8(+) T lymphocytes infiltrating optic nerve and spinal cord. Eleven patients had confirmed small-cell carcinoma; 1 had imaging evidence of lung cancer; 3 had renal or thyroid carcinoma. Full-length CRMP-5 protein was identified in normal retina and optic nerve by Western blot analyses. Photoreceptor cells, retinal ganglion cells, and nerve fibers exhibited CRMP-5-specific immunoreactivity. In summary, CRMP-5-IgG defines a paraneoplastic ophthalmological entity of combined optic neuritis and retinitis with vitreous inflammatory cells. Positive serology obviates the need for vitreous biopsy and expedites the search for cancer.

  14. Optic neuritis and retinal ganglion cell loss in a chronic murine model of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Thomas eQuinn

    2011-08-01

    Full Text Available Multiple sclerosis (MS and its animal model experimental autoimmune encephalomyelitis (EAE are neurodegenerative diseases with characteristic inflammatory demyelination in the central nervous system, including the optic nerve. Neuronal and axonal damage is considered to be the main cause of long-term disability in patients with MS. Neuronal loss, including retinal ganglion cell (RGC apoptosis in eyes with optic neuritis, also occurs in EAE. However, there is significant variability in the clinical course and level of neuronal damage in MS and EAE. The current studies examine the mechanisms and kinetics of RGC loss in C57BL/6 mice immunized with myelin oligodendrocyte glycoprotein to induce a chronic EAE disease. Clinical progression of EAE was scored daily and vision was assessed by optokinetic responses. At various time points, RGCs were counted and optic nerves were examined for inflammatory cell infiltration. Almost all EAE mice develop optic neuritis by day 15 post-immunization; however, RGC loss is delayed in these mice. No RGC loss is detected 25 days post-immunization, whereas RGC numbers in EAE mice significantly and progressively decrease compared to controls from 35-50 days post-immunization. The delayed time course of RGC loss is in stark contrast to that reported in relapsing EAE, as well as in rats with chronic EAE. Results suggest that different clinical disease courses of optic nerve inflammation may trigger distinct mechanisms of neuronal damage, or RGCs in different rodent strains may have variable resistance to neuronal degeneration.

  15. Etiological study on optic neuritis in childhood%儿童视神经炎病因分析

    Institute of Scientific and Technical Information of China (English)

    彭静婷; 张晓君; 崔世磊; 张风; 周海英

    2008-01-01

    Objective To explore underlying causes of presumptive optic neuritis(ON)in children.Methods Retrospective study of continuous cases with presumed diagnosis of optic neuritis in childhood.Results 104 cases(65.8%)met ON criteria in this cohort of children,among which 80 cases(76.9%)were considered as idiopathic demyelinating optic neuritis(IDON).Infectious optic neuritis and inflammatory optic neuropathy were found on 3 cases respectively.The cause of 18 cases remains unknown.Leber hereditary optic neuropathy and non-organic visual acuity loss account most of the 54cases misdiagnosed as optic neuritis.Conclusions As in adult patients,idiopathic demyelinating optic neuritis is the most common pathogeny of optic neuritis in children,while infectious events were more common in children.Leber hereditary optic neuropathy and non-organic visual acuity loss were the most common disease confused with optic neuritis in childhood.Some rare disease in childhood which can causeoptic nerve lesion should also be considered.%目的 了解临床初诊为视神经炎(ON)儿童患者的病因分布和临床特点.方法 收集158例初诊ON的儿童患者详细的眼科和神经内科检查及实验室、影像学检查资料,参照国际认可的标准重新诊断,并与成人ON病因进行比较.结果 104例初诊为ON的儿童患者最后诊断符合ON,占65.8%.其中,80例为特发性脱髓鞘性ON,占76.9%;感染性ON和炎性视神经病各3例,18例病因未明.另54例不符合ON诊断,其中,以Leber遗传性视神经病、非器质性视力下降等较常见.结论 初诊为ON的儿童患者病因分布与成人类似,以特发性脱髓鞘性ON最为常见.Leber遗传性视神经病和非器质性视力下降是儿童患者中最常见的与ON混淆的疾病.

  16. UNILATERAL OPTIC NEURITIS AND CENTRAL RETINAL VASCULITIS DUE TO OCULAR SYPHILIS.

    Science.gov (United States)

    Khan, Murtaza S; Kuruppu, Dulanji K; Popli, Tanav A; Moorthy, Ramana S; Mackay, Devin D

    2017-08-14

    Report a case of concurrent unilateral optic neuritis and central retinal artery occlusion as the presenting signs of syphilis. A case report of a 22-year-old man with progressive unilateral vision loss. With no known previous history of syphilis, genital lesions, or other extraocular manifestations, the patient presented with pain with eye movements and decreased color vision. His vision dramatically worsened after a course of oral steroids. Examination was remarkable for severe right optic disk edema with a macular cherry-red spot and mild posterior uveitis. Magnetic resonance imaging of the orbits with contrast revealed enhancement and enlargement of the distal right optic nerve. Fluorescein angiography demonstrated delayed filling of the right central retinal artery, suggestive of impending central retinal artery occlusion. Syphilis serologies were positive from the serum, and cerebrospinal fluid Venereal Disease Research Laboratory test was reactive, consistent with neurosyphilis. Oral steroids were discontinued and vision improved with 2 weeks of intravenous penicillin. This unusual case highlights one of the possible initial presentations of syphilis: unilateral optic neuritis and central retinal artery vasculitis with mild posterior uveitis. The worsening of vision after administration of oral steroids also highlights a potential complication of oral steroid use in the absence of a known etiology of vision loss. A thorough history and examination may be helpful in identifying risk factors for infectious causes, including syphilis, and should prompt additional evaluation.

  17. Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

    Directory of Open Access Journals (Sweden)

    Merle H

    2013-06-01

    Full Text Available Harold Merle,1 Stéphane Olindo,2 Séverine Jeannin,2 Rabih Hage,1 Angélique Donnio,1 Raymond Richer,1 Philippe Cabre2 1Service d'Ophtalmologie, 2Service de Neurologie, Centre Hospitalier Universitaire de Fort de France, Fort-de-France, Martinique, France Purpose: Optic neuritis (ON observed during neuromyelitis optica (NMO is in most cases very severe and with poor prognosis. This study's objective was to analyze visual field (VF abnormalities observed in the absence of ON and post-ON episode. Methods: Twenty-seven cases of both NMO and multiple sclerosis (MS were selected. Thorough ophthalmologic exam was performed at least 6 months post-ON attack. The VF was collected using the Humphrey 750 perimeter. We used the central threshold tests 24-2 with FASTPAC strategy. The abnormalities were categorized based on the Optic Neuritis Treatment Trial classification. Results: After one ON, 40% of the NMO group's eyes showed total VF loss (P = 0.01, 21% showed abnormalities of neurologic aspect, and 27% showed fascicular abnormalities of which 12% were altitudinal. Given the total VF loss, the positive predictive value in favor of an NMO was 92.8% and the negative predictive value was 47.3%. Conclusion: Alterations of the VF during the NMO differ from those observed in the course of the MS. One ON, blinding from the first attack, must call to mind an NMO. The altitudinal deficits point to a vascular mechanism. Keywords: optic neuritis, visual field, neuromyelitis optica, multiple sclerosis

  18. Retinal ganglion cell analysis in multiple sclerosis and optic neuritis

    DEFF Research Database (Denmark)

    Britze, Josefine; Pihl-Jensen, Gorm; Frederiksen, Jette Lautrup

    2017-01-01

    of Science and Scopus. Studies were included if they measured GCL thickness using OCT in patients with either ON, MS or clinically isolated syndrome. For the meta-analysis, we compared GCL thickness in MS patients with and without prior ON, to healthy controls. 42/252 studies were reviewed. In acute ON...

  19. The socioeconomic consequences of optic neuritis with and without multiple sclerosis

    DEFF Research Database (Denmark)

    Jennum, P; Frederiksen, J L; Wanscher, B;

    2012-01-01

    OBJECTIVES: Optic neuritis (ON) often precedes multiple sclerosis (MS). MS is associated with a significant socioeconomic burden. However, the burden of ON with and without MS before and after its diagnosis has never been calculated. METHODS: Using complete national records from the Danish National...... with primary and secondary sectors, and the use and costs of drugs. Productivity losses included labour supply and income. All social transfer payments were also calculated. RESULTS: Patients with ON had higher rates of contact with healthcare services, medication use and income from employment, all of which...

  20. 视神经炎与细胞因子%Optic neuritis and cytokine

    Institute of Scientific and Technical Information of China (English)

    秦朝晖; 余华峰

    2003-01-01

    视神经炎(optic neuritis,ON)是一组由病毒感染引起的,以视神经纤维脱髓鞘为特征的自身免疫性疾病.视神经炎与多发硬化关系密切.本文就影响视神经炎发展成为多发硬化的因素及细胞因子在多发硬化中所起的作用,综述如下.

  1. Recurrent optic neuritis and neuromyelitis optica-IgG following first and second human papillomavirus vaccinations.

    Science.gov (United States)

    Chang, Hyeyeon; Lee, Hye Lim; Yeo, Minju; Kim, Ji Seon; Shin, Dong-Ick; Lee, Sang-Soo; Lee, Sung-Hyun

    2016-05-01

    Human papillomavirus (HPV) vaccine is widely used to prevent cervical cancer caused by certain types of HPV in girls and young women. Demyelinating disorders within months following HPV innoculation have been reported, but the causal link between HPV vaccination and the onset of demyelinating disorders have not been certain. We report a case of neuromyelitis optica spectrum disorder (NMOSD) that was noteworthy because optic neuritis (ON) occurred in a very close temporal association with both the first and second HPV vaccinations, which might suggest an association between HPV vaccination and the development of NMO-IgG and recurrent ON. This emphasizes the necessity for continuing surveillance for adverse events after HPV vaccination.

  2. Successful treatment of bilateral visual loss caused by HIV-associated optic neuritis

    Directory of Open Access Journals (Sweden)

    Claire Cullen

    2011-12-01

    Full Text Available Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become involved within days. Bilateral swollen discs were apparent on fundoscopy. Investigations were performed for meningitis (including bacterial, cryptococcal, tuberculous and syphilitic types, auto-immune diseases, toxoplasma, rubella, cytomegalovirus, viral hepatitis, HTLV-1/2, HIV-1/2 and syphilis. The only positive result was a reactive HIV enzyme-linked immunosorbent assay. The CD4 count was 85 cells/µl. A post-contrast magnetic resonance imaging scan of the brain illustrated enhancement of the optic nerves. Treatment was 3 days of intravenous methylprednisolone 1 g daily, followed by 11 days of oral prednisone 60 mg daily. Highly active antiretroviral therapy was initiated after 2 weeks. Vision improved from day 6 after commencement of steroid therapy, with ongoing recovery at 5 months.

  3. Visual outcome following optic neuritis: A 5-year review

    African Journals Online (AJOL)

    2011-10-10

    Oct 10, 2011 ... density filter in front of one eye). The initial attack of optic ... 30%; and mean age of onset is in the third decade of life[8] with an annual ... clinical grounds, in atypical cases, magnetic resonance imaging. (MRI) is used to further ...

  4. Correlation of optic neuritis and retinal nerve fibre thickness using optical coherence tomography in a cohort of multiple sclerosis patients

    Directory of Open Access Journals (Sweden)

    Izanne Roos

    2016-03-01

    Full Text Available Background: Optical coherence tomography (OCT is a fast, non-invasive imaging technology that produces 3D, high-resolution images of the retina. Direct visualisation of the retina allows a unique opportunity to study the effects of multiple sclerosis (MS-associated neurodegeneration on retinal ganglion cells as well as effects of retrobulbar demyelination on axonal and retinal architecture through measurement of retinal nerve fibre layer (RNFL thickness and total macular volume (TMV. These findings are clinically important as axonal loss is irreversible and correlates with disability.Aim: To determine the role and usefulness of OCT in a local cohort of MS patients.Setting: Neurology Clinic, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa.Methods: Nineteen patients with MS currently being treated with interferon β-1b underwent OCT examination of both eyes. RNFL thickness and macular volume were measured and correlated with clinical disease characteristics, history of optic neuritis and level of disability.Results: Mean RNFL thickness was 77.3 μm with no significant difference in mean RNFL in eyes with a history of optic neuritis (ON and those without (p = 0.4. Eyes with a history of ON did, however, have significantly thinner RNFL compared with the contralateral eye (p = 0.04. Despite a strong correlation between TMV and RNFL (p = 0.001, a subset of patients with normal RNFL had TMV that was less than 1% of what was expected. There was no correlation between RNFL and disability scores.Conclusion: OCT enables a direct axonal ‘optical biopsy’, for monitoring disease progression and treatment response in MS. RNFL thinning occurs independently of a history of optic neuritis and may represent a chronic optic neuropathy in patients with MS.Keywords: Multiple sclerosis; optical coherence tomography

  5. CSF abnormalities can be predicted by VEP and MRI pathology in the examination of optic neuritis.

    Science.gov (United States)

    Horwitz, Henrik; Degn, Matilda; Modvig, Signe; Larsson, Henrik B W; Wanscher, Benedikte; Frederiksen, Jette L

    2012-12-01

    Optic neuritis (ON) is linked to multiple sclerosis (MS). The presence of white matter lesions on cerebral magnetic resonance imaging (MRI) predicts the risk of MS after ON with considerable accuracy. Oligoclonal bands (OCB) are present in 95 % of MS patients, and a lumbar puncture can also be valuable in the evaluation of patients with ON. We analyzed CSF findings in patients referred with ON in the context of MRI and visual evoked potential (VEP) pathology. We assessed the possible contributory role of a lumbar puncture and weigh this against disadvantages of the procedure. Between February 2003 and November 2011, 505 patients were referred by ophthalmologists to the Clinic of Optic Neuritis, Glostrup Hospital, University of Copenhagen. None had MS prior to referral. A total of 437 were included in the study, and all underwent MRI, a lumbar puncture and VEP. Patients with other organic causes of their symptoms and patients with >3 months between onset and tests were excluded. All files were reviewed retrospectively. CSF leukocytes and the IgG index were elevated in 33 and 41 %, respectively, and OCBs were detected in 61 % of patients. CSF abnormalities correlated strongly with VEP and MRI (p VEP and MRI had a 96 % probability of a normal lumbar puncture. The contributory role of a lumbar puncture in the evaluation of ON seems negligible when patients have a normal VEP and MRI. We suggest that all patients should be evaluated with VEP and MRI before deciding on a lumbar puncture.

  6. Magnetic resonance imaging (MRI) in the diagnosis of optic neuritis and neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Kakisu, Yonetsugu; Adachi-Usami, Emiko; Kojima, Shigeyuki; Hirayama, Keizo

    1989-02-01

    Magnetic resonance imaging (MRI) was performed in thirty patients who had been suffering from optic neuritis (ON). Twenty-one cases were caused by multiple sclerosis (MS) and in 9 cases the causes been defined. In MRI, abnormalities were found in 17 out of 21 MS cases in several places such as near the ventricles, mid-brain, spinal cord etc. Increased signals from the optic chiasm to optic radiation were found in 5 cases. However, abnormal MRI findings did not always correspond to Goldmann visual field defects. In 3 out of 9 cases of ON with unknown causes, high signals in the white matter of the brain were found, and it was suggested that those may develop to MS. MRI was, thus, proved to be very useful for the diagnois of MS.

  7. Retinal nerve fibre layer thinning in patients with clinically isolated optic neuritis and early treatment with interferon-beta.

    Directory of Open Access Journals (Sweden)

    Kurt-Wolfram Sühs

    Full Text Available BACKGROUND: Optic neuritis is associated with neurodegeneration leading to chronic impairment of visual functions. OBJECTIVE: This study investigated whether early treatment with interferon beta (IFN-β slows retinal nerve fibre layer (RNFL thinning in clinically isolated optic neuritis. METHODS: Twenty patients with optic neuritis and visual acuity decreased to ≤0.5 (decimal system were included into this prospective, open-label, parallel group 4-month observation. After methylprednisolone pulse therapy, 10 patients received IFN-β from week 2 onwards. This group was compared to 10 patients free of any disease modifying treatment (DMT. The parameter of interest was change in RNFL thickness assessed at baseline and at weeks 4, 8, and 16. Changes in visual acuity, visual field, and visual evoked potentials (VEPs served as additional outcome parameters. RESULTS: RNFL thinning did not differ between the groups with a mean reduction of 9.80±2.80 µm in IFN-β-treated patients (±SD vs. 12.44±5.79 µm in patients who did not receive DMT (baseline non-affected eye minus affected eye at week 16; p = 0.67, t-test, 95% confidence interval: -15.77 to 10.48. Parameters of visual function did not show any differences between the groups either. CONCLUSIONS: In isolated optic neuritis, early IFN-β treatment did not influence RNFL thinning nor had it any effect on recovery of visual functions.

  8. Increased immunopotency of monocyte derived dendritic cells from patients with optic neuritis is inhibited in vitro by simvastatin

    DEFF Research Database (Denmark)

    Tsakiri, Anna; Tsiantoulas, Dimitris; Frederiksen, Jette;

    2010-01-01

    properties of simvastatin influence the function of both T cells and APCs and could thus be a potential therapy for MS. The phenotype of myeloid DC in untreated patients with monosymptomatic optic neuritis (ON) was determined by flow cytometry and the impact of simvastatin on the function of myeloid DC...

  9. Effects of minocycline on apoptosis and neuronal changes in retinal ganglion cells from experimental optic neuritis rats

    Institute of Scientific and Technical Information of China (English)

    Jing Zhang

    2008-01-01

    BACKGROUND: Minocycline, a tetracycline derivative, is neuroprotective in models of various neurological diseases.OBJECTIVE: To investigate the effects of minocycline on retinal ganglion cells (RGCs) in rats with optic neuritis, and to compare with the effects of methylprednisolone.DESIGN, TIME AND SETTING: This neuropathology controlled study was performed at the First Affiliated Hospital, Chongqing Medical University, China in May 2007.MATERIALS: A total of 22 female Wistar rats were randomly assigned into a normal control group (n = 5) and an experimental group (n = 17). The experimental group was composed of a model subgroup (n = 7), a minocycline subgroup (n = 5), and a methylprednisolone subgroup (n = 5). Minocycline was supplied by Sigma, USA.METHODS: Antigen homogenate made from guinea pig spinal cord and complete Freund adjuvant was used to induce autoimmune encephalomyelitis, which could induce demyelinated optic neuritis models. Rats in the minocycline subgroup were intraperitoneally injected with minocycline (45 mg/kg) daily from day 8 following autoimmunity. Rats in the methylprednisolone subgroup were intraperitoneally injected with methylprednisolone (20 mg/kg) daily from day 8 following autoimmunity.MAIN OUTCOME MEASURES: On day 18 after autoimmunity induction, pathological changes in the optic nerve were observed by hematoxylin-eosin staining. The percentage area of axons in the transverse section of the optic nerve was measured by Bielschowsky staining. Apoptosis of RGCs was detected by TUNEL.RESULTS: Under an optical microscope, the optic nerve in rats with demyelinated optic neuritis showed a vacuole-like structure of fibers, irregular swelling of the axons, and infiltration of a large quantity of inflammatory cells. With an electron microscope, the optic nerve presented with vacuole-like structures in the axons, a small percentage area of axons in the transverse section, loose myelin sheaths, and microtubules and microfilaments disappeared. The

  10. Neuritis vestibularis

    DEFF Research Database (Denmark)

    Hansen, S.; Caye-Thomasen, P.; Boesen, J.

    2008-01-01

    Vestibular neuritis is the second most common cause of peripheral vestibular vertigo. Its assumed cause is a reactivation of herpes simplex virus type 1 infection. Methylprednisolone significantly improves the recovery of peripheral vestibular function in patients with vestibular neuritis. Clinical...

  11. Diffusion tensor imaging correlates of visual impairment in multiple sclerosis and chronic optic neuritis.

    Science.gov (United States)

    Kolbe, Scott C; Marriott, Mark; Walt, Anneke van der; Fielding, Joanne; Klistorner, Alexander; Mitchell, Peter J; Butzkueven, Helmut; Kilpatrick, Trevor J; Egan, Gary F

    2012-02-21

    To compare white matter (WM) injuries associated with vision loss in multiple sclerosis (MS) and optic neuritis (ON). Twenty-three patients with clinically definite relapsing-remitting MS and chronic unilateral ON and 14 neurologically healthy volunteers were monocularly tested with Sloan 100%, 2.5%, and 1.25% contrast visual acuity charts. Primary visual pathway and whole-brain WM injury were assessed with optical coherence tomography (OCT) and diffusion tensor imaging (DTI). OCT and DTI correlates of high- and low-contrast visual impairment were identified using correlation analyses. The MS patients displayed significantly reduced retinal nerve fiber layer (RNFL) thickness and altered optic nerve and radiation DTI measures compared with the controls. In the patients, 2.5% and 1.25% contrast letter acuity in the unaffected eye correlated significantly and independently with optic nerve and optic radiation DTI measures. Visual acuity in affected eyes did not correlate with optic nerve or optic radiation DTI measures, but did correlate with DTI measures in prefrontal and temporal brain regions that were shown to connect structurally to visual cortices. In unaffected eyes, visual impairment was associated with WM injury in the visual pathway. In contrast, irrecoverable visual impairment after ON was associated with injury to frontal WM, which potentially impairs the capacity for remapping visual processing.

  12. Human Rabies with Initial Manifestations that Mimic Acute Brachial Neuritis and Guillain-Barré Syndrome.

    Science.gov (United States)

    Mader, Edward C; Maury, Joaquin S; Santana-Gould, Lenay; Craver, Randall D; El-Abassi, Rima; Segura-Palacios, Enrique; Sumner, Austin J

    2012-01-01

    Human rabies can be overlooked in places where this disease is now rare. Its diagnosis is further confused by a negative history of exposure (cryptogenic rabies), by a Guillain-Barré syndrome (GBS) type of presentation, or by symptoms indicating another diagnosis, eg, acute brachial neuritis (ABN). A 19-year-old Mexican, with no past health problems, presented with a two-day history of left shoulder, arm, and chest pain. He arrived in Louisiana from Mexico five days prior to admission. Of particular importance is the absence of a history of rabies exposure and immunization. On admission, the patient had quadriparesis, areflexia, and elevated protein in the cerebrospinal fluid, prompting a diagnosis of GBS. However, emerging neurological deficits pointed towards acute encephalitis. Rabies was suspected on hospital day 11 after common causes of encephalitis (eg, arboviruses) have been excluded. The patient tested positive for rabies IgM and IgG. He died 17 days after admission. Negri bodies were detected in the patient's brain and rabies virus antigen typing identified the vampire bat as the source of infection. Rabies should be suspected in every patient with a rapidly evolving GBS-like illness-even if there is no history of exposure and no evidence of encephalitis on presentation. The patient's ABN-like symptoms may be equivalent to the pain experienced by rabies victims near the inoculation site.

  13. Optic neuritis

    Science.gov (United States)

    ... disease Cryptococcosis , a fungal infection Bacterial infections, including tuberculosis, syphilis, Lyme disease , and meningitis Viral infections, including viral encephalitis , measles , rubella , chickenpox , ...

  14. Lesion discrimination in optic neuritis using high-resolution fat-suppressed fast spin-echo MRI

    Energy Technology Data Exchange (ETDEWEB)

    Gass, A. [NMR Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom); Moseley, I.F. [Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom)]|[Moorfields Eye Hospital, City Road, London EC 1V 2PD (United Kingdom); Barker, G.J. [NMR Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom); Jones, S. [NMR Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom); MacManus, D. [NMR Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom); McDonald, W.I. [NMR Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom)]|[Moorfields Eye Hospital, City Road, London EC 1V 2PD (United Kingdom); Miller, D.H. [NMR Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC 1N 3BG (United Kingdom)

    1996-05-01

    Fast spin-echo (FSE) is a new sequence with acquisition times currently down to one-sixteenth of those obtained with conventional spin-echo sequences, which allows high-resolution (512 x 512 matrix) images to be acquired in an acceptable time. We compared the higher resolution of FSE with the medium resolution of a short inversion-time inversion-recovery (STIR) sequence in depicting the optic nerves of healthy controls and patients with optic neuritis. Optic nerve MRI examinations were performed in 18 patients with optic neuritis and 10 normal controls. Two sequences were obtained coronally: fat-suppressed FSE (FSE TR 3250 ms/TEef 68 ms, echo-train length 16, 4 excitations, 24 cm rectangular field of view, 3 mm interleaved contiguous slices, in-plane resolution 0.5 x 0.5 mm) and STIR (TR 2000 ms/TE 50 ms/TI 175 ms, in-plane resolution 0.8 x 0.8 mm, slice thickness 5 mm). FSE demonstrated much more anatomical detail than STIR, e. g. distinction of optic nerve and sheath. Lesions were seen in 20 of 21 symptomatic nerves using FSE and in 18 of 21 using STIR. Nerve swelling or partial cross-sectional lesions of the optic nerve were each seen only on FSE in 3 cases. Fat-suppressed FSE imaging of the optic nerve improves anatomical definition and increases lesion detection in optic neuritis. (orig.). With 5 figs.

  15. Neuromyelitis optica-IgG (aquaporin-4) autoantibodies in immune mediated optic neuritis.

    Science.gov (United States)

    Petzold, A; Pittock, S; Lennon, V; Maggiore, C; Weinshenker, B G; Plant, G T

    2010-01-01

    The clinical course of immune mediated optic neuritis (ON) will depend on the specific underlying inflammatory disease. These disorders have traditionally been classified according to clinical and MRI findings. Aquaporin-4 (AQP4) autoantibodies (neuromyelitis optica-IgG (NMO-IgG)) may have diagnostic and prognostic value in patients who present with isolated ON. In this prospective study, NMO-IgG was evaluated in 114 patients with ON in the following contexts: neuromyelitis optica (NMO), multiple sclerosis (MSON), chronic relapsing inflammatory ON (CRION), relapsing isolated ON (RION) and single isolated ON (SION). The proportion seropositive was 56% for NMO (n = 9), 0% for MSON (n = 28) and 5% for the remaining diagnostic categories (CRION (n = 19), RION (n = 17) and SION (n = 41)). Testing for NMO-IgG in patients with recurrent or severe ON who lack convincing evidence of MS may identify patients who would benefit from immunosuppression rather than MS directed immunomodulatory therapies.

  16. Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis

    Directory of Open Access Journals (Sweden)

    Koziolek Michael J

    2012-04-01

    Full Text Available Abstract Background In multiple sclerosis relapses refractory to intravenous corticosteroid therapy, plasma exchange is recommended. Immunoadsorption (IA is regarded as an alternative therapy, but its efficacy and putative mechanism of action still needs to be established. Methods We prospectively treated 11 patients with multiple sclerosis who had optical neuritis and fulfilled the indications for apheresis therapy (Trial registration DE/CA25/00007080-00. In total, five IA treatments were performed using tryptophan-IA. Clinical activity (visual acuity, Expanded Disability Status Scale, Incapacity Status Scale, laboratory values and visual evoked potentials were measured before, during and after IA, with a follow-up of six months. Moreover, proteomic analyses were performed to analyze column-bound proteins as well as corresponding changes in patients’ sera. Results After the third IA, we detected an improvement of vision in eight of eleven patients, whom we termed responders. Amongst these, the mean visual acuity improved from 0.15 ± 0.12 at baseline to 0.47 ± 0.32 after the third IA (P = 0.0252 up to 0.89 ± 0.15 (P P = 0.03, whereas in non-responders it did not. Proteomic analyses of proteins adsorbed to IA columns revealed that several significant immunological proteins as well as central nervous system protein fragments, including myelin basic protein, had been removed by IA. Conclusions IA was effective in the treatment of corticosteroid-refractory optic neuritis. IA influenced the humoral immune response. Strikingly, however, we found strong evidence that demyelination products and immunological mediators were also cleared from plasma by IA.

  17. Optic nerve atrophy and retinal nerve fibre layer thinning following optic neuritis: evidence that axonal loss is a substrate of MRI-detected atrophy.

    Science.gov (United States)

    Trip, S Anand; Schlottmann, Patricio G; Jones, Stephen J; Li, Wai-Yung; Garway-Heath, David F; Thompson, Alan J; Plant, Gordon T; Miller, David H

    2006-05-15

    Magnetic resonance imaging (MRI) measures of brain atrophy are often considered to be a marker of axonal loss in multiple sclerosis (MS) but evidence is limited. Optic neuritis is a common manifestation of MS and results in optic nerve atrophy. Retinal nerve fibre layer (RNFL) imaging is a non-invasive way of detecting axonal loss following optic neuritis. We hypothesise that if the optic nerve atrophy that develops following optic neuritis is contributed to by axonal loss, it will correlate with thinning of the RNFL. Twenty-five patients were studied at least 1 year after a single unilateral attack of optic neuritis without recurrence, with a selection bias towards incomplete recovery. They had MR quantification of optic nerve cross-sectional area and optic nerve lesion length, as well as optical coherence tomography (OCT) measurement of mean RNFL thickness and macular volume, quantitative visual testing, and visual evoked potentials (VEPs). Fifteen controls were also studied. Significant optic nerve atrophy (mean decrease 30% versus controls), RNFL thinning (mean decrease 33% versus controls), and macular volume loss occurred in patients' affected eyes when compared with patients' unaffected eyes and healthy controls. The optic nerve atrophy was correlated with the RNFL thinning, macular volume loss, visual acuity, visual field mean deviation, and whole field VEP amplitude but not latency. These findings suggest that axonal loss contributes to optic nerve atrophy following a single attack of optic neuritis. By inference, axonal loss due to other post-inflammatory brain lesions is likely to contribute to the global MRI measure of brain atrophy in multiple sclerosis.

  18. Impaired mental rotation in benign paroxysmal positional vertigo and acute vestibular neuritis.

    Directory of Open Access Journals (Sweden)

    Matteo eCandidi

    2013-11-01

    Full Text Available Vestibular processing is fundamental to our sense of orientation in space which is a core aspect of the representation of the self. Vestibular information is processed in a large subcortical-cortical neural network. Tasks requiring mental rotations of human bodies in space are known to activate neural regions within this network suggesting that vestibular processing is involved in the control of mental rotation. We studied whether mental rotation is impaired in patients suffering from two different forms of unilateral vestibular disorders (Vestibular Neuritis – VN- and Benign Paroxysmal positional Vertigo – BPPV with respect to healthy matched controls (C. We used two mental rotation tasks in which participants were required to: i mentally rotate their own body in space (egocentric rotation thus using vestibular processing to a large extent and ii mentally rotate human figures (allocentric rotation thus using own body representations to a smaller degree. Reaction times and accuracy of responses showed that VN and BPPV patients were impaired in both tasks with respect to C. Significantly, the pattern of results was similar in the three groups suggesting that patients were actually performing the mental rotation without using a different strategy from the control individuals. These results show that dysfunctional vestibular inflow impairs mental rotation of both own body and human figures suggesting that unilateral acute disorders of the peripheral vestibular input massively affect the cerebral processes underlying mental rotations.

  19. First-ever optic neuritis: distinguishing subsequent neuromyelitis optica from multiple sclerosis.

    Science.gov (United States)

    Lim, Young-Min; Pyun, So Young; Lim, Hyun Taek; Jeong, In Hye; Kim, Kwang-Kuk

    2014-05-01

    To identify factors distinguishing subsequent neuromyelitis optica (NMO) from multiple sclerosis (MS) after first-ever optic neuritis (ON), we compared ophthalmic findings and MRI features of 24 NMO and 55 MS patients who initially presented with ON. The female-to-male ratio was higher, and bilateral ON was more common in NMO patients than in MS patients (p = 0.044 and p = 0.020, respectively). The visual acuity (VA) score was higher in NMO patients (p = 0.034), and a greater proportion of NMO patients had a VA score ≥ 5 (p = 0.003). The frequency of patients without pattern-reversal and flash visual evoked potentials was higher in the NMO group (p = 0.015). Brain MRI abnormalities were more common in the MS group (p = 0.001). The optic chiasm was affected in 25 % of NMO patients and was unaffected in MS patients, although it did not reach statistical significance (p = 0.096). There were no differences with respect to the severity of swelling and enhancement of the optic nerve. In conclusion, severe optic nerve damage at the first ON attack was associated with subsequent development of NMO, whereas presence of brain MRI abnormalities was associated with developing MS.

  20. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

    Institute of Scientific and Technical Information of China (English)

    Juanarita Jaafar; Wan Hazabbah Wan Hitam; Raja Azmi Mohd Noor

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.

  1. Changes of CXCL12, CXCL14 and PDGF levels in the brain of patients with idiopathic demyelinating optic neuritis and neuromyelitis optica.

    Science.gov (United States)

    Tingjun, Chen; Zhaohui, Li; Zhaocai, Jiang; Zihao, Liu; Quangang, Xu; Dehui, Huang; Qing, Lin; Shihui, Wei

    2015-02-15

    The CXC chemokines (CXC-motif ligand 12 and CXC-motif ligand 14) and platelet-derived growth factor are suggested to modulate remyelination in the course of many demyelinating diseases. The present study compared the difference in the brain levels of these chemokines between patients with idiopathic demyelinating optic neuritis (IDON) and neuromyelitis optica (NMO) by measuring their concentrations in the cerebrospinal fluid using an enzyme linked immunosorbent assay. Our data indicate that the prognosis of neuritis depends on the remyelinating process that is impaired due to decreased chemokines. The much lower levels of chemokines would specifically indicate the severe neuritis, such as NMO.

  2. Neuromyelitis optica-IgG+ optic neuritis associated with celiac disease and dysgammaglobulinemia: a role for tacrolimus?

    Science.gov (United States)

    Meyts, Isabelle; Jansen, Katrien; Renard, Marleen; Bossuyt, Xavier; Roelens, Filip; Régal, Luc; Lagae, Lieven; Buyse, Gunnar

    2011-05-01

    We present a pediatric case of recurrent optic neuritis, celiac disease, partial IgA and IgG3 deficiency in the context of anti-aquaporin-4 auto-immunity and familial IgA deficiency with celiac disease. Treatment with tacrolimus was successful in preventing disease relapses. This case stresses the relevance of central nervous system anti-aquaporin-4 auto-immunity in a broader context of immune dysregulation and neuro-immunology.

  3. Class a prednisolone joint compound anisodine observation and nursing for the treatment of optic neuritis%甲强龙联合复方樟柳碱治疗ON的观察及护理

    Institute of Scientific and Technical Information of China (English)

    宋欣媛

    2015-01-01

    目的:观察糖皮质激素甲基强的松龙联合复方樟柳碱治疗视神经炎的疗效,并评估甲基强的松龙联合复方樟柳碱治疗的有效性和优越性。方法:视神经炎患者共51例(69只眼)随机分为治疗组和对照组,治疗组在常规治疗基础上联合应用复方樟柳碱,常规治疗为对照组。结果:两组疗效比较显示,治疗组总有效率(88.4%)明显优于对照组(56%),差异具有统计学意义(P<0.05)。结论:甲基强的松龙联合复方樟柳碱治疗视神经炎有显著疗效。%Objective:Observation of glucocorticoid methylprednisolone combined with compoundanisodine in the treatment of optic neuritis (optic neuritis) effect, and to evaluate the validity and superiority of methylprednisolone combined with compound anisodine methylprednisolone therapy. Methods:acute optic neuritis patients with a total of 51 cases (69 eyes) were randomly divided into treatment group and control group, The treatment group in the conven-tional treatment combined with compound anisodine, conventional treatment as control group. Results:the comparison between the two groups of curative effect, the total effective rate of treatment group (88.4%) was significantly better than the control group (56%), the difference was significant ( P<0.05). Conclusion:methylprednisolone combined with compound anisodine methylprednisolonein treatment of acute optic neuritis prove significant in efficacy.

  4. Research progress of optic neuritis epidemiology%视神经炎流行病学的研究进展

    Institute of Scientific and Technical Information of China (English)

    尚姗姗; 韦企平; 周剑

    2014-01-01

    Optic neuritis is one of the most important neuro-ophthalmologic diseases which cause vision loss in young adults. There are obvious differences in the prevalence of optic neuritis in different countries and regions. Through the review of the related literature at home and abroad in recent years, this article summarizes the etiology and epidemiological characteristics of optic neuritis. lt is expected to provide reference and comparison for the epidemiological investigation of cross regional, multi-center cooperation.%视神经炎是青壮年视力丧失的重要神经眼科疾病之一。不同国家及地区的视神经炎流行情况存在着明显差异。本文复习近年来国内外相关文献,从视神经炎的病因和流行病学特点等方面进行综述,为我国跨地区、多中心合作的视神经炎流行病学调查提供参考和比较。

  5. [A case of optic neuritis associated with lymphocytic hypophysitis revealed by pattern-reversal VEP].

    Science.gov (United States)

    Saito, Satoshi; Mori, Chiaki; Toma, Keiichiro; Kubori, Tamotsu; Nishinaka, Kazuto; Udaka, Fukashi

    2011-01-01

    Lymphocytic hypophysitis (LYH) is a rare neuroendocrine disorder characterized by autoimmune inflammation of the pituitary gland. Visual disturbance is one of the most common and serious symptoms of LYH. Most of the visual symptoms in LYH are secondary to compression of the optic chiasm and some reports have described direct inflammatory involvement of the optic pathways. We describe a 30-year-old man with a 9-day history of bilateral blurred vision. Ophthalmic examination demonstrated severely impaired vision without temporal hemianopsia. Hypothyroidism, hypocortisolism, and hypogonadism were detected in laboratory tests. Central diabetes insipidus was diagnosed by a hypertonic saline infusion test. MRI revealed thickening of the pituitary stalk and enlargement of the hypophysis, which was enhanced with gadolinium. High intensity of the posterior lobe was not recognized on T1-weighted images. These findings established a clinical diagnosis of lymphocytic panhypophysitis. Methylprednisolone pulse therapy was introduced and his visual acuity gradually recovered. The anterior pituitary function improved, but desmopressin was still required. Pattern-reversal visual evoked potentials (VEP) have been widely used to detect optic nerve lesions caused by multiple sclerosis and brain tumors. However, there have been no previous reports of their usefulness for LYH. The P100 latency in our case was slightly prolonged and the amplitude was markedly reduced. These findings are similar to ischemic optic neuropathy and other conditions in which axonal damage is prominent. The prolonged latency and low amplitude on VEP examination in this case showed rapid improvement in parallel with the recovery of visual acuity. Taken together, our case implies the usefulness of pattern-reversal VEP for the diagnosis of optic neuritis in LYH, especially for the evaluation of its pathogenic mechanisms.

  6. The expression and relativity of proinflammatory cytokines in sera of patients with acute optic neuritis who would like to develop into Multiple Sclerosis%急性视神经炎患者血清促炎细胞因子的表达及其与多发性硬化风险的相关性分析

    Institute of Scientific and Technical Information of China (English)

    于旭辉; 王宇虹; 宋晗; 遇颖

    2007-01-01

    目的 检测急性视神经炎(acute optic neuritis,AON)患者血清促炎细胞因子的表达水平,探讨这些细胞因子是否在AON演进为多发性硬化(multiple sclerosis,MS)中具有临床预测价值.方法 60例确诊的AON患者,应用ELISA方法检测血清促炎细胞因子IL12、IFNγ以及TNFα的表达.分别于发病后6个月和12个月对患者进行两次随访和综合评估,探讨IL12、IFNγ以及TNFα在AON向MS演进的预测价值.结果 AON血清IL12、IFNγ以及TNFα的表达显著增高(P<0.05);其中头部MRI异常组和脑脊液异常组的血清促炎细胞因子表达水平,均高于头部MRI正常组(P<0.05)和脑脊液正常组(P<0.05).随访6个月和12个月时,分别有6例和11例AON患者演进为确定的/可能的MS.演进组患者AON急性期血清IL12、IFNγ以及TNFα表达水平,显著高于非演进组(P<0.05).结论 检测AON患者血清促炎细胞因子IL12、IFNγ以及TNFα,可能对AON是否演进为MS具有一定的临床预测价值.

  7. Bilateral optic neuritis in a child diagnosed with Gd-enhanced MR imaging using fat-suppression technique

    Energy Technology Data Exchange (ETDEWEB)

    Okamoto, K.; Ogawa, R.; Furusawa, T.; Sakai, K. [Dept. of Radiology, Niigata Univ. School of Medicine, Niigata (Japan); Ito, J.; Tokiguchi, S. [Dept. of Radiology, Niigata University School of Dentistry (Japan); Takagi, M. [Dept. of Ophthalmology, Niigata Univ. School of Medicine (Japan)

    1999-05-01

    A 4-year-old boy developed bilateral optic neuritis. Although precise neuro-ophthalmological evaluation was difficult, the diagnosis was made with gadolinium-enhanced MR imaging using fat-suppression technique in the initial stage of the disease. Enhancement and enlargement of the intraorbital and intracanalicular optic nerve were demonstrated bilaterally as well as protrusion of the optic nerve head. The disease responded dramatically to intravenous steroid therapy. The etiologies in children usually differ from those in adolescent and adult patients. (orig.) With 1 fig., 13 refs.

  8. To improve understanding of etiology of optic neuritis in China%如何认识我国视神经炎的发病原因

    Institute of Scientific and Technical Information of China (English)

    韦企平; 张晓君

    2009-01-01

    Domestic ophthalmologists have different understandings on the causes of optic neuritis.Some of them consider infection is the main cause,some believe that so-called idiopathic optic neuritis caused bycentral nervous systemprimary demyelinating disease,such as multiple sclerosis is the most common type of optic neuritis,while others suggest that optic neuritis is attributed to autoimmune disease.Based on the review of literatures,we describe the development of definition and etiology of optic neuritis in Western countries and in China,and then provide some suggestion to a better understanding of etiology of optic neuritis in China.We also expect to have a population-based,multiple-center study to provide more extensive and accurate data on the etiology of optic neuritis in China.%国内眼科医师对视神经炎的病因尚有不同认识,例如有把感染作为视神经炎的主要病因;有认为无其他病因的特发性视神经炎大多数和以多发性硬化为主的中枢神经系统脱髓鞘疾病密切相关;也有从自身免疫系统疾病探讨视神经炎病因的.笔者回顾了国内外对该病病因的认识过程,从视神经炎定义的理解,分析认识视神经炎病因的片面性等几方面提出讨论,同时期待多中心研究能够对取得我国视神经炎的病因共识提供依据.

  9. Clinical Features and Visual Outcomes of Optic Neuritis in Chinese Children

    Science.gov (United States)

    Zhou, Huanfen; Xu, Quangang; Tan, Shaoying; Zhao, Shuo; Yang, Mo; Peng, Chunxia

    2016-01-01

    Purpose. Although optic neuritis (ON) in children is relatively common, visual outcomes and factors associated with the condition have not been well documented. The aim of this study was to evaluate the clinical features and visual outcomes of ON in Chinese children. Methods. Patients with a first episode of ON at a tertiary neuroophthalmic centre in China were assessed and followed up for at least three months. Visual outcomes and clinical, laboratory, and neuroimaging findings were reviewed. In patients with bilateral ON, only the eyes with worse visual acuity (VA) at presentation were used for statistical analysis. Results. Seventy-six children (76 eyes) with a first episode of ON were included. The mean age was 11.8 years, 60.5% were females, and 48.7% had bilateral involvement. The children were followed up for an average of 18.5 months (age range, 3–48 months). Vision loss at presentation was severe, with VA Chinese children. ON in children was associated with severe vision loss and relatively good visual recovery. The age at onset could predict the final visual function.

  10. Normal-appearing white matter in optic neuritis and multiple sclerosis: a comparative proton spectroscopy study

    Energy Technology Data Exchange (ETDEWEB)

    Tourbah, A. [Service de Neuroradiologie, Centre Hospitalier National d' Ophtalmologie, Paris (France); Faculte de Medecine Pitie-Salpetriere, Paris (France); Federation de Neurologie, Hopital de la Salpetriere, Paris (France); Pathologie de la Myeline, Hopital de la Salpetriere, Paris (France); Stievenart, J.L.; Abanou, A.; Iba-Zizen, M.T.; Cabanis, E.A. [Service de Neuroradiologie, Centre Hospitalier National d' Ophtalmologie, Paris (France); Faculte de Medecine Pitie-Salpetriere, Paris (France); Hamard, H. [Service d' Ophtalmologie II, Centre Hospitalier National d' Ophtalmologie, Paris (France); Lyon-Caen, O. [Faculte de Medecine Pitie-Salpetriere, Paris (France); Federation de Neurologie, Hopital de la Salpetriere, Paris (France); Stievenart, L. [Service de Biophysique et Medecine Nucleaire, Hopital Beaujon, Clichy (France)

    1999-10-01

    We investigated neurochemical abnormalities in the normal-appearing white matter (NAWM) on MRI of patients with optic neuritis (ON) and compared them to those of patients with multiple sclerosis (MS). Patients with ON (42) were classified into three groups according to abnormalities on brain MRI. Patients with MS (55) were devided in two groups: relapsing remitting MS (RRMS) and secondary progressive MS (SPMS). All patients underwent MRI of the brain and localised proton magnetic resonance spectroscopy (MRS) of NAWM. The results were compared to those of 15 controls. Patients with MS had significant abnormalities compared with controls and with patients with ON. Patients with RRMS and those with ON had comparable MRS parameters, while patients with SPMS had significant spectroscopic abnormalities in comparison with controls, but also with patients with RRMS. These changes consisted of a decrease in N -acetylaspartate, a neuronal marker, which may reflect axonal dysfunction and/or loss. MRS abnormalities were detected in 14 patients with ON (27 %). The main abnormalities consisted of a decrease in N -acetylaspartate, an increase in choline-containing compounds at long echo times, and the presence of free lipid peaks at short echo times. MRS of the NAWM on MRI may prove useful for detecting neurochemical brain abnormalities in ON not visible on MRI. (orig.)

  11. Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis

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    Sugasawa Jun

    2010-06-01

    Full Text Available Abstract Background Neuromyelitis optica (NMO is an inflammatory demyelinating disease that predominantly affects the optic nerves and the spinal cord, and is possibly mediated by an immune mechanism distinct from that of multiple sclerosis (MS. Central scotoma is recognized as a characteristic visual field defect pattern of optic neuritis (ON, however, the differing pathogenic mechanisms of NMO and MS may result in different patterns of visual field defects for ON. Methods Medical records of 15 patients with NMO and 20 patients with MS having ON were retrospectively analyzed. A thorough systemic and neurological examination was performed for evaluating ON. The total number of relapses of ON and visual fields was investigated. Visual fields were obtained by Goldmann perimeter with each ON relapse. Results All MS patients experienced central scotoma, with 90% of them showing central scotoma with every ON relapse. However, 53% of NMO patients showed central scotoma with every ON relapse (p = 0.022, and the remaining 47% of patients experienced non-central scotoma (altitudinal, quadrant, three quadrant, hemianopia, and bitemporal hemianopia. Thirteen percent of NMO patients did not experience central scotoma during their disease course. Altitudinal hemianopia was the most frequent non-central scotoma pattern in NMO. Conclusions NMO patients showed higher incidence of non-central scotoma than MS, and altitudinal hemianopia may be characteristic of ON occurring in NMO. As altitudinal hemianopia is highly characteristic of ischemic optic neuropathy, we suggest that an ischemic mechanism mediated by anti-aquaporin-4 antibody may play a role in ON in NMO patients.

  12. Multifocal and pattern-reversal visual evoked potentials vs. automated perimetry frequency-doubling technology matrix in optic neuritis

    Directory of Open Access Journals (Sweden)

    Marcella Nebbioso

    2013-01-01

    Full Text Available Background: To compare the usefulness of the traditional pattern-reversal Visual Evoked Potentials (VEP with multifocal VEP (mfVEP and Frequency-Doubling Technology (FDT perimetry in the evaluation of the ocular abnormalities induced by acute or subacute optic neuritis (ON. Materials and Methods: The test results of 24 ON patients were compared with those obtained in 40 normal control subjects. MfVEP recordings were obtained by using an Optoelectronic Stimulator that extracts topographic VEP using a pseudorandom m-sequence stimulus. Receiver operator characteristic (ROC curves were calculated to determine the sensitivity and specificity of abnormal values. Results: The frequency of the abnormal ocular findings differed in the ON patients according to the used technique. Reduced visual sensitivity was demonstrated in 12 eyes (54.5% using FDT perimetry; 17 eyes (77.2% showed decreased amplitude and/or an increase in the implicit time of the P1 wave in mfVEP and 20 eyes (90.9% showed an abnormal decrease in the amplitude and/or an increase in the latency of the P100 peak at VEP examination. The areas under the ROC curves ranged from 0.743 to 0.935, with VEP having the largest areas. The VEP and mfVEP amplitudes and latencies yielded the greatest sensitivity and specificity. Conclusions: The mfVEP and the FDT perimetry can be used for the evaluation and monitoring of visual impairment in patients with ON. The most sensitive and practical diagnostic tool in patients with ON is, however, the traditional VEP. The mfVEP can be utilized in those cases with doubtful or negative VEP results.

  13. Risk of multiple sclerosis after optic neuritis in patients with normal baseline brain MRI.

    Science.gov (United States)

    Marques, Inês Brás; Matias, Fernando; Silva, Eduardo Duarte; Cunha, Luis; Sousa, Lívia

    2014-04-01

    When assessing and managing a patient with optic neuritis (ON), the risk of future development of multiple sclerosis (MS) is an important issue, as this can be the first presentation of the disease. Although the presence of lesions on baseline brain MRI is the strongest predictor of MS conversion, some patients with normal imaging also develop MS. We aimed to estimate MS risk in patients with ON and a normal baseline MRI and identify individuals with higher risk of conversion. We performed a retrospective study including patients with idiopathic ON and normal baseline brain MRI who presented to our hospital over an 8 year period. Of a total of 42 patients, 10 converted to MS: five during the first follow-up year, seven during the first 2 years and all of the patients within the first 5 years, with a 5 year MS conversion rate of 23.8%. MS conversion rates were significantly higher in patients with history of previous symptoms suggestive of demyelination (p=0.002), cerebrospinal fluid oligoclonal bands unmatched in serum (p=0.004) and incomplete visual acuity recovery (≤6/12) after 1 year (p=0.002). Lower conversion rates were found in patients with optic disc edema (p=0.022). According to these results, a significant proportion of patients with idiopathic ON and a normal baseline brain MRI will develop MS, with a higher risk during the first 5 years. Therefore, in the presence of factors in favor of MS conversion, close follow-up, including semestral medical consultations and yearly brain MRI, can be recommended. Early immunomodulatory treatment may be individually considered as it can delay conversion and reduce new lesion development rate.

  14. Optic neuritis: a review on nosological classification%视神经炎的疾病分类学研究进展

    Institute of Scientific and Technical Information of China (English)

    陈翔; 魏世辉; 张卯年

    2014-01-01

    视神经炎指发生于视神经的一切炎性病变,是神经眼科最常见的视神经疾病之一,也是中青年人最易罹患的视神经疾病.目前,国内外对视神经炎的分类方法主要有两种,一种按发病部位分类,可分为球后视神经炎、视乳头炎、视神经周围炎和视神经视网膜炎;另一种根据病因学分类,可分为中枢神经系统炎性脱髓鞘性疾病相关视神经炎、感染性疾病相关性视神经炎及全身系统性自身免疫性疾病相关性视神经炎.目前,我国的视神经炎病因学特点尚有待进一步开展大样本的流行病学研究.%Optic neuritis refers to all inflammatory diseases in the optic nerve.It is one of the most common optic nerve diseases in neuro-ophthalmology,but also most likely to suffer in the middle-aged people.Currently,there are two main classifications of optic neuritis:according to anatomical site,optic neuritis was divided into retrobulbar neuritis,papillitis,optic perineuritis,and neuroretinitis; another based on the etiology,optic neuritis can be divided into the central nervous system inflammatory demyelinating disease of the optic nerve inflammation,infectious disease-related optic neuritis,and systemic autoimmune diseaserelated optic neuritis.At present,the etiology features of optic neuritis in China remains to be further characterized by large sample epidemiological studies.

  15. Simvastatin improves final visual outcome in acute optic neuritis

    DEFF Research Database (Denmark)

    Tsakiri, Anna; Kallenbach, Klaus; Fuglø, Dan;

    2012-01-01

    In recent years, small-scale clinical trials have indicated that statins or 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase inhibitors exert pleiotropic immunomodulatory effects, with potential therapeutic implications in multiple sclerosis (MS)....

  16. Combined brain and anterior visual pathways' MRIs assist in early identification of neuromyelitis optica spectrum disorder at onset of optic neuritis.

    Science.gov (United States)

    Buch, D; Savatovsky, J; Gout, O; Vignal, C; Deschamps, R

    2017-03-01

    Acute optic neuritis (ON) is the initial presentation in half of neuromyelitis optica spectrum disorder (NMO-SD) cases. Our objective was to evaluate accuracy of combined MRIs of the anterior visual pathways and of the brain to correctly identify NMO-SD among patients with acute ON. We performed a retrospective study on patients with acute ON in NMO-SD (16 episodes) and first-event non-NMO-SD (32 episodes). All MRIs included exams of the brain and anterior visual pathways using T2-weighted and post-gadolinium T1-weighted coronal thin slices. Images were reviewed by a neuroradiologist who was blinded to the final diagnosis. There were no multiple sclerosis (MS)-like lesions with dissemination in space (DIS) with NMO-SD (0 vs. 53%, p < 0.01). Non-NMO-SD ON usually spared the chiasma (3 vs. 44%, p < 0.01) and the optic tracts (0 vs. 19%, p < 0.01). Optic nerve lesions were longer [median (range) 26 mm (14-64) vs. 13 mm [8-36], p < 0.01] and the number of segments involved higher (3 [1-8] vs. 1 [1-4], p < 0.01) in NMO-SD. Bilateral optic nerve involvement, or involvement of ≥3 segments, or involvement of the chiasma, or optic tracts in the absence of MS-like lesions with DIS were suggestive of NMO-SD with a sensitivity of 69% (CI 95% 41-89) and a specificity of 97% (CI 95% 84-99) (p < 0.01). Combining brain and anterior visual pathways' MRIs seems efficient for detecting acute ON patients who are at high risk for NMO-SD.

  17. Correlation between full-field and multifocal VEPs in optic neuritis.

    Science.gov (United States)

    Klistorner, Alexander; Fraser, Clare; Garrick, Raymond; Graham, Stuart; Arvind, Hemamalini

    2008-01-01

    To compare performance of multi-focal and full-field Visual Evoked Potentials (VEP) in patients with optic neuritis (ON). 26 patients with unilateral ON were enrolled. Multi-focal VEP (MF VEP) was recorded using AccuMaptrade mark system. Four bipolar channels were analysed. Full-field VEP (FF VEP) was performed according to ISCEV standard using ESPION with frontal-occipital electrode placement. Pattern-reversal protocol was implemented with check size of 60' and field of view of 30 degrees . For both tests amplitude and latency of affected eye were statistically different from non-affected eye. The asymmetry of amplitude and latency between two eyes was also very similar for both tests. Averaged Relative Asymmetry Coefficient of amplitude (RAC) for the FF VEP was 0.10 +/- 0.15 and for the MF VEP was 0.12 +/- 0.12 (P = 0.21, paired t-test). Averaged latency difference between affected and non-affected eyes was 13.0 +/- 12 ms for FF and 14.1 +/- 11.1 ms for MF VEPs (P = 0.14, paired t-test). Coefficient of correlation (r) of p100 component of the FF VEP and averaged MF VEP was 0.60 (P < 0.0001) for amplitude and 0.79 (P < 0.0001) for latency. Correlation improved when amplitude and latency asymmetry between two eyes was analysed (r = 0.81 and r = 0.92 respectively). Overall 73% of affected eyes were identified as abnormal by amplitude and/or latency of the FF VEP and 89% was considered abnormal when MF VEP was used. Analysis of individual cases revealed superior performance of MF VEP in detecting small or peripheral defects.

  18. Early anisotropy changes in the corpus callosum of patients with optic neuritis

    Energy Technology Data Exchange (ETDEWEB)

    Bester, M.; Ding, X.Q.; Holst, B.; Fiehler, J. [University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Hamburg (Germany); Heesen, C.; Schippling, S.; Martin, R. [University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Hamburg (Germany); University Medical Center Hamburg-Eppendorf, Institute for Neuroimmunology and Clinical MS Research, Hamburg (Germany)

    2008-07-15

    Optic neuritis (ON) and any other early manifestation of multiple sclerosis (MS) are referred to as clinically isolated syndrome (CIS) as long as MS is suspected. In this prospective study we aimed to determine whether diffusion tensor imaging (DTI) could quantify structural changes in patients with early MS. A total of 24 patients and 15 control subjects were prospectively followed by clinical examinations and MRI. the main inclusion criterion was presentation with ON. Patients underwent serial MRI scans: MRI1 (baseline, n=24), MRI2 (mean 6.6 months, n=24), MRI3 (mean 13.0 months, n=14), MRI4 (mean 39.4 months, n=5). Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were derived from DTI. Four regions of interest (ROIs) were defined in normal-appearing white matter (NAWM). In the temporal course FA decreased in the genu of the callosal body (GCC) from MRI1 to MRI4 (P=0.005) and in the splenium of the callosal body (SCC) (P=0.006). Patients already had lower FA values in the SCC (P<0.01) on MRI1 compared with the controls. Patients had lower FA values in the GCC (P<0.01) starting from MRI2. Patients with definite MS on follow-up (n=9) showed a correlation between FA in the SCC and time (r=-0.40, P=0.004), whereas patients without progression did not. Our findings suggest that the corpus callosum is an early site for development of anisotropy changes in MS patients with ON. There seems to be a primary FA decrease in all patients with ON that only deteriorates in the group developing definite MS. (orig.)

  19. Dichoptic Metacontrast Masking Functions to Infer Transmission Delay in Optic Neuritis

    Science.gov (United States)

    Bruchmann, Maximilian; Korsukewitz, Catharina; Krämer, Julia; Wiendl, Heinz; Meuth, Sven G.

    2016-01-01

    Optic neuritis (ON) has detrimental effects on the transmission of neuronal signals generated at the earliest stages of visual information processing. The amount, as well as the speed of transmitted visual signals is impaired. Measurements of visual evoked potentials (VEP) are often implemented in clinical routine. However, the specificity of VEPs is limited because multiple cortical areas are involved in the generation of P1 potentials, including feedback signals from higher cortical areas. Here, we show that dichoptic metacontrast masking can be used to estimate the temporal delay caused by ON. A group of 15 patients with unilateral ON, nine of which had sufficient visual acuity and volunteered to participate, and a group of healthy control subjects (N = 8) were presented with flashes of gray disks to one eye and flashes of gray annuli to the corresponding retinal location of the other eye. By asking subjects to report the subjective visibility of the target (i.e. the disk) while varying the stimulus onset asynchrony (SOA) between disk and annulus, we obtained typical U-shaped masking functions. From these functions we inferred the critical SOAmax at which the mask (i.e. the annulus) optimally suppressed the visibility of the target. ON-associated transmission delay was estimated by comparing the SOAmax between conditions in which the disk had been presented to the affected and the mask to the other eye, and vice versa. SOAmax differed on average by 28 ms, suggesting a reduction in transmission speed in the affected eye. Compared to previously reported methods assessing perceptual consequences of altered neuronal transmission speed the presented method is more accurate as it is not limited by the observers’ ability to judge subtle variations in perceived synchrony. PMID:27711139

  20. Application of immunosuppressant facilitates the therapy of optic neuritis combined with Sj(o)gren's syndrome

    Institute of Scientific and Technical Information of China (English)

    Li Hongyang; Liu Zihao; Gong Yan; Jiang Zhaocai; Zhang Yixin; Dai Yanli; Zhang Yan

    2014-01-01

    Background Optic neuritis (ON) is often the first symptom of multiple sclerosis (MS) and neuromyelitis optica (NMO) while there has been very little research reported on ON combined with Sj(o)gren's syndrome (SS).The aim of this study is to provide different treatments and services for and NMO patients combined with SS.Methods Twenty-seven patients with ON combined SS were divided into two groups:corticosteroid group (C group,methylprednisolone sodium succinate,14 patients) and corticosteroid+ immunosuppressant group (C+I group,leflunomide,13 patients).ON relapse times in 1 year after treatment,number of patients who relapsed to NMO/MS in 1 years,visual acuity and retina nerve fiber layer (RNFL) thickness were measured.Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher's exact test was to compare proportions.Results ON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse,and the patients are often hormone dependent.The patients are more likely anti-aquaporin-4 IgG seropositive (70.4%).They are liable to form a centrocecal scotoma and tubular vision.The times of relapse decreased in patients who used immunosuppressant,and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month followup period (P <0.05); however,the RNFL thickness at the four quadrants was not significantly different.Conclusions The effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics.This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.

  1. Anti-Inflammatory Effects of FTY720 Do Not Prevent Neuronal Cell Loss in a Rat Model of Optic Neuritis

    Science.gov (United States)

    Rau, Christian R.; Hein, Katharina; Sättler, Muriel B.; Kretzschmar, Benedikt; Hillgruber, Carina; McRae, Bradford L.; Diem, Ricarda; Bähr, Mathias

    2012-01-01

    In multiple sclerosis, long-term disability is caused by axonal and neuronal damage. Established therapies target primarily the inflammatory component of the disease, but fail to prevent neurodegeneration. Fingolimod (codenamed FTY720) is an oral sphingosine 1-phosphate (S1P) receptor modulator with promising results in phase II trials in multiple sclerosis patients and is under further development as a novel treatment for multiple sclerosis. To evaluate whether FTY720 has neuroprotective properties, we tested this drug in a rat model of myelin oligodendrocyte glycoprotein-induced optic neuritis. FTY720 exerted significant anti-inflammatory effects during optic neuritis and reduced inflammation, demyelination, and axonal damage; however, FTY720 treatment did not prevent apoptosis of retinal ganglion cells (RGCs), the neurons that form the axons of the optic nerve. Consistent with this lack of effect on RGC survival, FTY720 treatment did not improve visual function, nor did it prevent apoptosis of RGCs in vitro. We observed a persistent activation of apoptotic signaling pathways in RGCs under FTY720 treatment, a possible underlying mechanism for the lack of neuroprotection in the presence of strong anti-inflammatory effects, Furthermore, FTY720 shifted the remaining inflammation in the optic nerve toward neurotoxicity by modest up-regulation of potential neurotoxic cytokines. We conclude that FTY720-induced anti-inflammation and axon protection did not of itself protect neurons from apoptotic cell death. PMID:21406175

  2. MMP-2 -1575G/A polymorphism modifies the onset of optic neuritis as a first presenting symptom in MS?

    Science.gov (United States)

    Gašparović, Iva; Čizmarević, Nada Starčević; Lovrečić, Luca; Perković, Olivio; Lavtar, Polona; Sepčić, Juraj; Jazbec, Saša Šega; Kapović, Miljenko; Peterlin, Borut; Ristić, Smiljana

    2015-09-15

    Previous studies show altered activities of matrix metalloproteinase (MMP)-2 and MMP-9 in serum and cerebrospinal fluid of multiple sclerosis (MS) and neuromyelitis optica (NMO) patients. Optic neuritis (ON) is a common symptom of both disorders. Here we investigated the impacts of MMP-2 -1575G/A and MMP-9 -1562 C/T gene polymorphisms on disease phenotype in 100 MS patients with ON as a first symptom and 376 MS patients with other initial symptomatology. The MMP-2 -1575G/A polymorphism led to a 5-year-earlier age of disease onset in MS patients with ON as a first symptom (p=0.009).

  3. Frequency of autoantibodies and connective tissue diseases in Chinese patients with optic neuritis.

    Directory of Open Access Journals (Sweden)

    Hongyang Li

    Full Text Available BACKGROUND: Optic neuritis (ON is often associated with other clinical or serological markers of connective tissue diseases (CTDs. To date, the effects of autoantibodies on ON are not clear. PURPOSE: To assess the prevalence, clinical patterns, and short outcomes of autoantibodies and Sjögren's syndrome (SS involvement in Chinese ON patients and evaluate the relationship between ON, including their subtypes, and autoantibodies. METHODS: A total of 190 ON patients were divided into recurrent ON (RON, bilateral ON (BON, and isolated monocular ON (ION. Demographic, clinical, and serum autoantibodies data were compared between them with and without SS involvement. Serum was drawn for antinuclear antibody (ANA, extractable nuclear antigen antibodies (SSA/SSB, rheumatoid factor (RF, anticardiolipin antibodies (ACA, and anti-double-stranded DNA antibody (A-ds DNA, anticardiolipin antibody (ACLs, anti-β2-glycoprotein I (β2-GPI and Aquaporin-4 antibodies (AQP4-Ab. Spectral-domain optical coherence tomography (SD-OCT was used to evaluate the atrophy of the optic nerve. RESULTS: 68 patients (35.79% had abnormal autoantibodies, 26(13.68% patients met diagnostic criteria for CTDs, including 15(7.89% patients meeting the criteria for SS. Antibodies including SSA/SSB 23 (30.26% (p1 and p 2<0.001 and AQP4-Ab10 (13.16% (p1 = 0.044, p2 = 0.01 were significantly different in patients in the RON group when compared with those in the BON (P1 = RON VS ION and ION (p2 = RON VS ION groups. SS was more common in RON patients (p1 = 0.04, p2 = 0.028. There was no significant difference between SSA/SSB positive and negative patients in disease characteristics or severity. Similar results were obtained when SS was diagnosed in SSA/SSB positive patients. CONCLUSION: RON and BON were more likely associated with abnormal autoantibodies; furthermore, AQP4 antibody, SSA/SSB and SS were more common in the RON patients. AQP4 antibody determination is

  4. Alveolar rhabdomyosarcoma of the sphenoid sinus mimicking optic neuritis presenting with intermittent visual loss in an adult

    Directory of Open Access Journals (Sweden)

    Liu W

    2016-10-01

    Full Text Available Wendong Liu,1 Libin Jiang,1 Yulan Jin,2 Bentao Yang,3 Timothy YY Lai4 1Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, 2Department of Pathology, 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 4Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, People’s Republic of China Abstract: A 23-year-old male with intermittent visual loss in his left eye for 4 months was originally treated as optic neuritis elsewhere. Upon presentation to our hospital (Beijing Tongren Hospital, his left eye visual acuity was reduced to hand motion at face. The left eye ocular motility was limited in upgaze, downgaze, adduction, and abduction. Computed tomography and magnetic resonance imaging revealed lesions in the sphenoid and ethmoid sinuses, orbital apex and carvernous sinus invading adjacent extraocular muscles. Endoscopic ethmo-sphenoidostomy and debulking surgery was performed and histopathology of the specimen demonstrated alveolar rhabdomyosarcoma. Despite having treatment with a combination of orbital radiation therapy and systemic chemotherapy, the patient developed generalized metastasis with cachexia and the left eye became no light perception due to optic atrophy. Keywords: alveolar rhabdomyosarcoma, sphenoid sinus, optic neuritis, misdiagnosis

  5. Retinitis Pigmentosa and Bilateral Idiopathic Demyelinating Optic Neuritis in a 6-Year-Old Boy with OFD1 Gene Mutation

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    Xun Wang

    2017-01-01

    Full Text Available To identify the cause of a sudden binocular vision decrease in patients with retinitis pigmentosa and bilateral idiopathic demyelinating optic neuritis is difficult, but early diagnosis and treatment significantly improve the prognosis. Here, we report a 6-year-old boy with a progressive binocular vision decrease in 38 days. The patient had a history of night blindness, a mottled retina without pigmentation, extinguished electroretinographic response, tritanopia, and an absent ellipsoid zone outside the macula fovea by optical coherence tomography in both eyes. His condition was diagnosed as retinitis pigmentosa (RP with idiopathic demyelinating optic neuritis (IDON. After corticosteroid therapy, visual acuity recovered to OD: 0.5 and OS: 0.4. Genetic analysis revealed a G985S variant in the oral-facial-digital syndrome 1 gene. Ophthalmologists should pay attention to the existence of other complications in patients with RP who suffer a sudden decrease in vision. A gene survey can help clarify this diagnosis. To our knowledge, this is the first report of a patient with RP and ON, as well as genetic testing results. Nevertheless, the pathogenicity of the variant needs further confirmation.

  6. Retinitis Pigmentosa and Bilateral Idiopathic Demyelinating Optic Neuritis in a 6-Year-Old Boy with OFD1 Gene Mutation

    Science.gov (United States)

    Wang, Xun; Zheng, Cong; Liu, Wen

    2017-01-01

    To identify the cause of a sudden binocular vision decrease in patients with retinitis pigmentosa and bilateral idiopathic demyelinating optic neuritis is difficult, but early diagnosis and treatment significantly improve the prognosis. Here, we report a 6-year-old boy with a progressive binocular vision decrease in 38 days. The patient had a history of night blindness, a mottled retina without pigmentation, extinguished electroretinographic response, tritanopia, and an absent ellipsoid zone outside the macula fovea by optical coherence tomography in both eyes. His condition was diagnosed as retinitis pigmentosa (RP) with idiopathic demyelinating optic neuritis (IDON). After corticosteroid therapy, visual acuity recovered to OD: 0.5 and OS: 0.4. Genetic analysis revealed a G985S variant in the oral-facial-digital syndrome 1 gene. Ophthalmologists should pay attention to the existence of other complications in patients with RP who suffer a sudden decrease in vision. A gene survey can help clarify this diagnosis. To our knowledge, this is the first report of a patient with RP and ON, as well as genetic testing results. Nevertheless, the pathogenicity of the variant needs further confirmation. PMID:28191358

  7. [Optic neuritis in childhood. A pediatric series, literature review and treatment approach].

    Science.gov (United States)

    Lopez-Martin, D; Martinez-Anton, J

    2016-08-01

    Introduccion. En la edad pediatrica, la forma mas frecuente de neuritis optica se presenta generalmente despues de un cuadro infeccioso, con edema de papila, que suele ser bilateral y tiene buen pronostico. La conversion a esclerosis multiple es infrecuente. Objetivo. Presentar las caracteristicas clinicas y de laboratorio de una serie pediatrica de neuritis optica. Pacientes y metodos. Se analiza una serie de 17 casos de neuritis optica en niños y jovenes de 4 a 14 años, referidos entre los años 2000 y 2015. Resultados. La edad mediana de la serie fue de 11 años. Predominaron los pacientes de sexo femenino y el antecedente infeccioso fue poco frecuente; en cinco pacientes, la afectacion fue bilateral, y cuatro casos se presentaron como neuritis optica retrobulbar. La resonancia magnetica mostro hiperintensidad en T2 en los nervios opticos afectados en cinco pacientes. El estudio del liquido cefalorraquideo y bandas oligoclonales fue normal en todos los casos. Los pacientes, tratados con metilprednisolona intravenosa, tuvieron buena recuperacion. Solo en tres casos se comprobo una evolucion posterior a esclerosis multiple. Conclusiones. En esta serie, los casos que evolucionaron a esclerosis multiple no mostraron diferencias clinicas, aunque si presentaron mayor cantidad de lesiones hiperintensas en la resonancia magnetica. Este hecho, descrito en trabajos previos, apoya nuestro esquema diagnostico y terapeutico en un intento por acercarnos al manejo optimo de esta patologia.

  8. Inner nuclear layer thickening is inversley proportional to retinal ganglion cell loss in optic neuritis.

    Directory of Open Access Journals (Sweden)

    Megha Kaushik

    Full Text Available AIM: To examine the relationship between retinal ganglion cell loss and changes in the inner nuclear layer (INL in optic neuritis (ON. METHODS: 36 multiple sclerosis (MS patients with a history of ON and 36 age and sex-matched controls underwent Optical Coherence Tomography. The paramacular retinal nerve fiber layer (RNFL, combined ganglion cell and inner plexiform layers (GCL/IPL and inner nuclear layer (INL thickness were measured at 36 points around the fovea. To remove inter-subject variability, the difference in thickness of each layer between the ON and fellow eye of each patient was calculated. A topographic analysis was conducted. RESULTS: The INL of the ON patients was thicker than the controls (42.9µm versus 39.6µm, p=0.002. ON patients also had a thinner RNFL (27.8µm versus 32.2µm, p<0.001 and GCL/IPL (69.3µm versus 98.1µm, p<0.001. Among the controls, there was no correlation between RNFL and GCL/IPL as well as RNFL and INL, but a positive correlation was seen between GCL/IPL and INL (r=0.65, p<0.001. In the ON group, there was a positive correlation between RNFL and GCL/IPL (r=0.80, p<0.001 but a negative correlation between RNFL and INL (r=-0.61, p<0.001 as well as GCL/IPL and INL (r=-0.44, p=0.007. The negative correlation between GCL/IPL and INL strengthened in the ON group when inter-subject variability was removed (r=-0.75, p<0.001. Microcysts within the INL were present in 5 ON patients, mainly in the superior and infero-nasal paramacular regions. While patients with microcysts lay at the far end of the correlation curve between GCL/IPL and INL (i.e. larger INL and smaller GCL/IPL compared to other patients, their exclusion did not affect the correlation (r= -0.76, p<0.001. CONCLUSIONS: INL enlargement in MS-related ON is associated with the severity of GCL loss. This is a continuous relationship and patients with INL microcysts may represent the extreme end of the scale.

  9. Clinical Features and Visual Outcomes of Optic Neuritis in Chinese Children

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    Huanfen Zhou

    2016-01-01

    Full Text Available Purpose. Although optic neuritis (ON in children is relatively common, visual outcomes and factors associated with the condition have not been well documented. The aim of this study was to evaluate the clinical features and visual outcomes of ON in Chinese children. Methods. Patients with a first episode of ON at a tertiary neuroophthalmic centre in China were assessed and followed up for at least three months. Visual outcomes and clinical, laboratory, and neuroimaging findings were reviewed. In patients with bilateral ON, only the eyes with worse visual acuity (VA at presentation were used for statistical analysis. Results. Seventy-six children (76 eyes with a first episode of ON were included. The mean age was 11.8 years, 60.5% were females, and 48.7% had bilateral involvement. The children were followed up for an average of 18.5 months (age range, 3–48 months. Vision loss at presentation was severe, with VA < 20/200 in 37 eyes (48.7%. At the final visit, 3 (3.9% eyes had VA of at least 20/20, and 41 (53.9% eyes had VA of at least 20/40. The final VA in 35 eyes (46.1% was worse than 20/40. Children aged ≤ 10 years had better predicted visual outcomes when compared to children over 10 years (odds ratio = 2.73, 95% confidential interval: 1.05–7.07, and P=0.039. The other features of this cohort, such as sex, experienced bilateral attack, VA at presentation, presence of optic disc edema, systemic diseases, magnetic resonance imaging (MRI findings, and aquaporin-4 (AQP-4 antibody status, were not significantly correlated with the final visual outcome. Conclusion. The data revealed the clinical characteristics and visual outcomes of ON in Chinese children. ON in children was associated with severe vision loss and relatively good visual recovery. The age at onset could predict the final visual function.

  10. Antibodies to myelin oligodendrocyte glycoprotein in bilateral and recurrent optic neuritis

    Science.gov (United States)

    Ramanathan, Sudarshini; Reddel, Stephen W.; Henderson, Andrew; Parratt, John D.E.; Barnett, Michael; Gatt, Prudence N.; Merheb, Vera; Kumaran, Raani-Yogeeta Anusuiya; Pathmanandavel, Karrnan; Sinmaz, Nese; Ghadiri, Mahtab; Yiannikas, Con; Vucic, Steve; Stewart, Graeme; Bleasel, Andrew F.; Booth, David; Fung, Victor S.C.; Dale, Russell C.

    2014-01-01

    Objective: We examined a cohort of adults with aquaporin-4 (AQP4) antibody–negative neuromyelitis optica/neuromyelitis optica spectrum disorder (NMO/NMOSD) for antibodies to myelin oligodendrocyte glycoprotein (MOG). Methods: We performed a flow cytometry cell-based assay using live human lentivirus–transduced cells expressing full-length surface MOG. Serum was tested in 23 AQP4 antibody–negative NMO/NMOSD patients with bilateral and/or recurrent optic neuritis (BON, n = 11), longitudinally extensive transverse myelitis (LETM, n = 10), and sequential BON and LETM (n = 2), as well as in patients with multiple sclerosis (MS, n = 76) and controls (n = 52). Results: MOG antibodies were detected in 9/23 AQP4 antibody–negative patients with NMO/NMOSD, compared to 1/76 patients with MS and 0/52 controls (p < 0.001). MOG antibodies were detected in 8/11 patients with BON, 0/10 patients with LETM, and 1/2 patients with sequential BON and LETM. Six of 9 MOG antibody–positive patients had a relapsing course. MOG antibody–positive patients had prominent optic disc swelling and were more likely to have a rapid response to steroid therapy and relapse on steroid cessation than MOG antibody–negative patients (p = 0.034 and p = 0.029, respectively). While 8/9 MOG antibody–positive patients had good follow-up visual acuity, one experienced sustained visual impairment, 3 had retinal nerve fiber layer thinning, and one had residual spinal disability. Conclusions: MOG antibodies have a strong association with BON and may be a useful clinical biomarker. MOG antibody–associated BON is a relapsing disorder that is frequently steroid responsive and often steroid dependent. Failure to recognize the disorder early and institute immunotherapy promptly may be associated with sustained impairment. Classification of evidence: This study provides Class II evidence that MOG antibodies are associated with AQP4 antibody–negative BON (sensitivity 69%, 95% confidence interval [CI

  11. Inner nuclear layer thickening is inversley proportional to retinal ganglion cell loss in optic neuritis.

    Science.gov (United States)

    Kaushik, Megha; Wang, Chen Yu; Barnett, Michael H; Garrick, Raymond; Parratt, John; Graham, Stuart L; Sriram, Prema; Yiannikas, Con; Klistorner, Alexandr

    2013-01-01

    To examine the relationship between retinal ganglion cell loss and changes in the inner nuclear layer (INL) in optic neuritis (ON). 36 multiple sclerosis (MS) patients with a history of ON and 36 age and sex-matched controls underwent Optical Coherence Tomography. The paramacular retinal nerve fiber layer (RNFL), combined ganglion cell and inner plexiform layers (GCL/IPL) and inner nuclear layer (INL) thickness were measured at 36 points around the fovea. To remove inter-subject variability, the difference in thickness of each layer between the ON and fellow eye of each patient was calculated. A topographic analysis was conducted. The INL of the ON patients was thicker than the controls (42.9µm versus 39.6µm, p=0.002). ON patients also had a thinner RNFL (27.8µm versus 32.2µm, p<0.001) and GCL/IPL (69.3µm versus 98.1µm, p<0.001). Among the controls, there was no correlation between RNFL and GCL/IPL as well as RNFL and INL, but a positive correlation was seen between GCL/IPL and INL (r=0.65, p<0.001). In the ON group, there was a positive correlation between RNFL and GCL/IPL (r=0.80, p<0.001) but a negative correlation between RNFL and INL (r=-0.61, p<0.001) as well as GCL/IPL and INL (r=-0.44, p=0.007). The negative correlation between GCL/IPL and INL strengthened in the ON group when inter-subject variability was removed (r=-0.75, p<0.001). Microcysts within the INL were present in 5 ON patients, mainly in the superior and infero-nasal paramacular regions. While patients with microcysts lay at the far end of the correlation curve between GCL/IPL and INL (i.e. larger INL and smaller GCL/IPL compared to other patients), their exclusion did not affect the correlation (r= -0.76, p<0.001). INL enlargement in MS-related ON is associated with the severity of GCL loss. This is a continuous relationship and patients with INL microcysts may represent the extreme end of the scale.

  12. The use of serum glial fibrillary acidic protein measurements in the diagnosis of neuromyelitis optica spectrum optic neuritis.

    Directory of Open Access Journals (Sweden)

    Mithu Storoni

    Full Text Available BACKGROUND: Glial fibrillary acidic protein (GFAP is a specific intermediate filament of the cytoskeleton of the astrocyte and may be used as a specific marker for astrocytic damage. It is detectable in the cerebrospinal fluid following a relapse caused by Multiple Sclerosis (MS and Neuromyelitis Optica (NMO spectrum disease. Higher levels are found following an NMO-related relapse. It is not known if GFAP is also detectable in the serum following such relapses. In particular, it is not known if lesions limited to the optic nerve release GFAP in sufficient quantities to be detectable within the serum. The aim of this study was to ascertain the extent to which serum GFAP levels can distinguish between an episode of optic neuritis (ON related to NMO spectrum disease and ON from other causes. METHODOLOGY/PRINCIPAL FINDINGS: Out of 150 patients consecutively presenting to our eye hospital over the period March 2009 until July 2010, we were able to collect a serum sample from 12 patients who had presented with MS-related ON and from 10 patients who had presented with NMO spectrum disease-related ON. We also identified 8 patients with recurrent isolated ON and 8 patients with a corticosteroid-dependent optic neuropathy in the absence of any identified aetiology. GFAP was detectable in the serum of all but three patients (two patients with MS-related ON and one with recurrent optic neuritis. The median serum GFAP level in the patient group with NMO spectrum disease was 4.63 pg/mL whereas in all other cases combined together, this was 2.14 pg/mL. The difference was statistically significant (P = 0.01. A similar statistically significant difference was found when cases with pathology limited to the optic nerve were compared (P = 0.03. CONCLUSIONS: Glial pathology in NMO related optic neuritis is reflected in elevated serum GFAP levels independently of whether or not there is extra-optic nerve disease.

  13. Isolated new onset 'atypical' optic neuritis in the NMO clinic: serum antibodies, prognoses and diagnoses at follow-up.

    Science.gov (United States)

    Piccolo, L; Woodhall, M; Tackley, G; Juryńczyk, M; Kong, Y; Domingos, J; Gore, R; Vincent, A; Waters, P; Leite, M I; Palace, J

    2016-02-01

    Severe, recurrent or bilateral optic neuritis (ON) often falls within the neuromyelitis optica spectrum disorders (NMOSD), but the diagnosis can be particularly challenging and has important treatment implications. We report the features, course and outcomes of patients presenting with atypical ON when isolated at onset. We retrospectively analyzed 69 sequential patients referred to a single UK NMO center with isolated ON at onset. Aquaporin-4 antibody (AQP4-Ab) assessment was performed in all patients and IgG1 myelin-oligodenrocyte glycoprotein (MOG-Ab) in AQP4-Ab(neg) patients. 37 AQP4-Ab positive (AQP4-Ab(pos)) and 32 AQP4-Ab negative (AQP4-Ab(neg)) patients (8 with MOG-Ab) were identified. The AQP4-Ab(neg) group included heterogeneous diagnoses: multiple sclerosis (MS), NMO, relapsing isolated ON (RION), monophasic isolated ON and relapsing acute disseminated encephalomyelitis (ADEM)-like syndromes. Compared to AQP4-Ab(neg) patients, AQP4-Ab(pos) patients had a worse residual visual outcome from first attack (median VFSS 4 vs. 0, p = 0.010) and at last assessment (median VFSS 5 versus 2, p = 0.005). However, AQP4-Ab(neg) patients with RION also had poor visual outcome. Up to 35% of AQP4-Ab(neg) patients developed a LETM and two developed low positivity for AQP4-Ab over time. Eight AQP4-Ab(neg) patients (25%) were MOG-Ab positive, covering a range of phenotypes excluding MS; the first ON attack was often bilateral and most had relapsing disease with a poor final visual outcome [VFSS 4, range (0-6)]. In conlcusion, AQP4-Ab positivity is confirmed as a predictor of poor visual outcome but AQP4-Ab(neg) RION also had a poor visual outcome. Of those without AQP4-Ab, 25% had MOG-Ab and another 25% developed MS; thus, MOG-Ab is associated with AQP4-Ab(neg) non-MS ON.

  14. Severe optic neuritis in a patient with combined neuromyelitis optica spectrum disease and primary Sjögren’s syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Tan Petrina

    2012-11-01

    Full Text Available Abstract Introduction Optic neuritis, although uncommon, can be the initial presentation of Sjögren’s syndrome. Coexisting Sjögren’s syndrome has also been reported with neuromyelitis optica spectrum disorder. This case report highlights the association between the two diseases and the importance of rheumatological and neurological evaluations in patients with such diagnoses. Distinction of neuromyelitis optica with coexisting connective tissue disease has both prognostic and therapeutic significance for the patient. Case presentation We report a case of a 56-year-old Chinese woman who presented with bilateral asymmetric visual loss secondary to optic neuritis. She was subsequently found to be seropositive for neuromyelitis optica immunoglobulin G (NMO-IgG (anti-aquaporin-4 antibody and was diagnosed with neuromyelitis optica spectrum disorder. She also fulfilled the international criteria for Sjögren’s syndrome. Despite initial high dose immunosuppressive therapy, she failed to regain vision in one eye. Conclusion Patients presenting with optic neuritis and severe visual loss should be screened for neuromyelitis optica and treated appropriately. Neuromyelitis optica has been associated with systemic autoimmune diseases, in particular Sjögren’s syndrome, and current evidence indicates that they are two distinct entities. We recommend that both diagnoses be considered in cases of optic neuritis with severe visual loss.

  15. Alveolar rhabdomyosarcoma of the sphenoid sinus mimicking optic neuritis presenting with intermittent visual loss in an adult

    Science.gov (United States)

    Liu, Wendong; Jiang, Libin; Jin, Yulan; Yang, Bentao; Lai, Timothy YY

    2016-01-01

    A 23-year-old male with intermittent visual loss in his left eye for 4 months was originally treated as optic neuritis elsewhere. Upon presentation to our hospital (Beijing Tongren Hospital), his left eye visual acuity was reduced to hand motion at face. The left eye ocular motility was limited in upgaze, downgaze, adduction, and abduction. Computed tomography and magnetic resonance imaging revealed lesions in the sphenoid and ethmoid sinuses, orbital apex and carvernous sinus invading adjacent extraocular muscles. Endoscopic ethmo-sphenoidostomy and debulking surgery was performed and histopathology of the specimen demonstrated alveolar rhabdomyosarcoma. Despite having treatment with a combination of orbital radiation therapy and systemic chemotherapy, the patient developed generalized metastasis with cachexia and the left eye became no light perception due to optic atrophy. PMID:27932889

  16. Analysis of macular and nerve fiber layer thickness in multiple sclerosis patients according to severity level and optic neuritis episodes.

    Science.gov (United States)

    Soler García, A; Padilla Parrado, F; Figueroa-Ortiz, L C; González Gómez, A; García-Ben, A; García-Ben, E; García-Campos, J M

    2016-01-01

    Quantitative assessment of macular and nerve fibre layer thickness in multiple sclerosis patients with regard to expanded disability status scale (EDSS) and presence or absence of previous optic neuritis episodes. We recruited 62 patients with multiple sclerosis (53 relapsing-remitting and 9 secondary progressive) and 12 disease-free controls. All patients underwent an ophthalmological examination, including quantitative analysis of the nerve fibre layer and macular thickness using optical coherence tomography. Patients were classified according to EDSS as A (lower than 1.5), B (between 1.5 and 3.5), and C (above 3.5). Mean nerve fibre layer thickness in control, A, B, and C groups was 103.35±12.62, 99.04±14.35, 93.59±15.41, and 87.36±18.75μm respectively, with statistically significant differences (P<.05). In patients with no history of optic neuritis, history of episodes in the last 3 to 6 months, or history longer than 6 months, mean nerve fibre layer thickness was 99.25±13.71, 93.92±13.30 and 80.07±15.91μm respectively; differences were significant (P<.05). Mean macular thickness in control, A, B, and C groups was 220.01±12.07, 217.78±20.02, 217.68±20.77, and 219.04±24.26μm respectively. Differences were not statistically significant. The mean retinal nerve fibre layer thickness in multiple sclerosis patients is related to the EDSS level. Patients with previous optic neuritis episodes have a thinner retinal nerve fibre layer than patients with no history of these episodes. Mean macular thickness is not correlated to EDSS level. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Experimental mouse model of optic neuritis with inflammatory demyelination produced by passive transfer of neuromyelitis optica-immunoglobulin G

    Science.gov (United States)

    2014-01-01

    Background Although optic neuritis (ON) is a defining feature of neuromyelitis optica (NMO), appropriate animal models of NMO ON are lacking. Most NMO patients are seropositive for immunoglobulin G autoantibodies (NMO-IgG) against the astrocyte water channel aquaporin-4 (AQP4). Methods Several approaches were tested to develop a robust, passive-transfer mouse model of NMO ON, including NMO-IgG and complement delivery by: (i) retrobulbar infusion; (ii) intravitreal injection; (iii) a single intracranial injection near the optic chiasm; and (iv) 3-days continuous intracranial infusion near the optic chiasm. Results Little ON or retinal pathology was seen using approaches (i) to (iii). Using approach (iv), however, optic nerves showed characteristic NMO pathology, with loss of AQP4 and glial fibrillary acidic protein immunoreactivity, granulocyte and macrophage infiltration, deposition of activated complement, demyelination and axonal injury. Even more extensive pathology was created in mice lacking complement inhibitor protein CD59, or using a genetically modified NMO-IgG with enhanced complement effector function, including significant loss of retinal ganglion cells. In control studies, optic nerve pathology was absent in treated AQP4-deficient mice, or in wild-type mice receiving control (non-NMO) IgG and complement. Conclusion Passive transfer of NMO-IgG and complement by continuous infusion near the optic chiasm in mice is sufficient to produce ON with characteristic NMO pathology. The mouse model of NMO ON should be useful in further studies of NMO pathogenesis mechanisms and therapeutics. PMID:24468108

  18. Elevation of AQP4 and selective cytokines in experimental autoimmune encephalitis mice provides some potential biomarkers in optic neuritis and demyelinating diseases.

    Science.gov (United States)

    Sun, Li; Weng, Huan; Li, Zhenxin

    2015-01-01

    Idiopathic optic neuritis (ION) is an inflammation of the optic nerve that may result in a complete or partial loss of vision. ION is usually due to the immune attack of the myelin sheath covering the optic nerve. ION acts frequently as the first symptoms of multiple sclerosis (MS) and neuromyelitis optica (NMO), or other inflammatory demyelinating disorders. The pathogenic progression of ION remains unclear. Experimental autoimmune encephalitis (EAE) is a commonly used model of idiopathic inflammatory demyelinating disorders (IIDDs); the optic nerve is affected in EAE as well. The specific mediators of demyelination in optic neuritis are unknown. Recent studies have indicated what T-cell activation in peripheral blood is associated with optic neuritis pathogenesis. The object of the present study was to determine whether certain cytokines (IL-6, IL-17A, and IL-23) and AQP4 contribute to the demyelinating process using EAE model. We have found that IL-6R, AQP4 and IL-23R are significantly increased in mRNA and protein levels in optic nerves in EAE mice compared to control mice; serum AQP4, IL-6, IL-17A, IL-23 are increased whereas transforming growth factor beta (TGF-β) is decreased in EAE mice. These results suggest that AQP4 and selective cytokines in serum are associated with ION pathogenesis in the animal model, and these results shine light for future clinical diagnosis as potential biomarkers in ION patients.

  19. Latency of multifocal visual evoked potentials in nonoptic neuritis eyes of multiple sclerosis patients associated with optic radiation lesions.

    Science.gov (United States)

    Alshowaeir, Daniah; Yiannikas, Con; Garrick, Raymond; Parratt, John; Barnett, Michael H; Graham, Stuart L; Klistorner, Alexander

    2014-05-15

    The aim of the study was to test the hypothesis that latency delay of multifocal visual evoked potentials (mfVEP) in nonoptic neuritis (NON) eyes of multiple sclerosis (MS) patients is related to retrochiasmal demyelinating lesions. A total of 57 MS patients with no history of optic neuritis at least in one eye, and 25 age- and sex-matched healthy controls was enrolled. Probabilistic tractography was used to reconstruct optic radiation (OR) fibers. The MS lesion volume within and outside of OR was calculated. Diffusion tensor imaging (DTI) indices were measured along OR fibers. The relationship of the mfVEP latency with OR lesions and DTI indices was examined. Average mfVEP latency in the MS cohort was significantly delayed compared to controls (P < 0.0001). Of the patients, 77% demonstrated OR lesions. Axial, radial, and mean diffusivity were significantly abnormal in MS patients (P < 0.001). Partial correlation demonstrated significant association between mfVEP latency delay and OR lesion load. There was also significant correlation between MfVEP latency and OR DTI. Subgroup analysis revealed significantly higher correlations in patients without a history of ON in either eye compared to the fellow eye of patients with previous ON. The findings of this study support our hypothesis that latency delay of the mfVEP in eyes of MS patients without previous ON is related to retrogenicular demyelinating lesions. Additionally, this study demonstrated that a previous episode of ON in the fellow eye may be a significant confounding factor, masking the relationship between the latency and OR lesions. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  20. Axonal loss in non-optic neuritis eyes of patients with multiple sclerosis linked to delayed visual evoked potential.

    Science.gov (United States)

    Klistorner, Alexandr; Garrick, Raymond; Barnett, Michael H; Graham, Stuart L; Arvind, Hemamalini; Sriram, Prema; Yiannikas, Con

    2013-01-15

    Recent studies demonstrate significant thinning of the retinal nerve fiber layer (RNFL) in multiple sclerosis (MS) non-optic neuritis (MS-NON) eyes. However, the pathologic basis of this reduction is not clear. The aim of the current study was to investigate the relationship of the RNFL thickness in MS-NON eyes with latency delay of the multifocal visual evoked potential (mfVEP), a surrogate marker of the visual pathway demyelination. Total and temporal RNFL thickness and latency of the mfVEP in 45 MS-NON eyes of 45 patients with relapsing-remitting MS and 25 eyes of age- and gender-matched controls were measured and analyzed. There was significant reduction of total and temporal RNFL thickness (p = 0.015 and p = 0.006, respectively) and significant latency delay (p < 0.0001) in MS-NON eyes. Both total and temporal RNFL thickness were associated with latency of the mfVEP (r2 = 0.43, p < 0.0001 and r2 = 0.36, p = 0.001, respectively). MS-NON eyes with normal latency (n = 26) showed no significant reduction of RNFL thickness compared with controls (p = 0.44 and p = 0.1 for total and temporal RNFL, respectively), whereas eyes with delayed latency (n = 19) demonstrated significantly thinner RNFL (p = 0.001 and p = 0.0005). MS-NON eyes with delayed latency also had significantly thinner RNFL compared with those with normal latencies (p = 0.013 and p = 0.02). In patients with no previous optic neuritis in either eye, delayed latency and reduced RNFL were bilateral whenever present. The study demonstrated significant association between RNFL loss and a latency delay of the mfVEP in MS-NON eyes.

  1. Optic Neuritis and the Visual Pathway: Evaluation of Neuromyelitis Optica Spectrum by Resting-State fMRI and Diffusion Tensor MRI.

    Science.gov (United States)

    Lopes, Fernanda Cristina Rueda; Alves-Leon, Soniza Vieira; Godoy, Jose Mauricio; de Souza Batista Scherpenhuijzen, Simone; Fezer, Leticia; Gasparetto, Emerson Leandro

    2015-01-01

    Optic neuritis (ON) is an acute episode of inflammation in the visual pathway (VP). It may occur as part of a demyelinating disease, which can affect white matter (WM) throughout the VP. Compensatory cortical adaptations may occur following WM damage to maintain visual integrity. Our aim was to investigate whether resting-state functional MRI (rsfMRI) can detect cortical adaptations following ON attacks and to correlate rsfMRI with diffusion tensor imaging (DTI) of WM within the VP. Neuromyelitis optica spectrum patients were compared to healthy controls at least 6 months after ON onset. DTI and rsfMRI were performed and post-processed using FSL tools (TBSS for DTI and MELODIC for fMRI). Ptients had higher synchronization values than controls in the visual network (3.48 vs. 2.12, P < .05). A weak trend of correlation was revealed between fMRI and structural analysis by DTI using fractional anisotropy (right side: R = -.36, P < .08; left side: R = .075, P < .73). The rsfMRI detected cortical reorganization following ON attack, but WM was considerably preserved in the posterior VP. Copyright © 2015 by the American Society of Neuroimaging.

  2. Analysis on the clinical characters of optic neuritis caused by antituberculosis drugs%抗结核药物性视神经炎的临床分析

    Institute of Scientific and Technical Information of China (English)

    简奕娈; 古卓云; 魏琳; 张言斌

    2014-01-01

    目的:总结抗结核药物所致的视神经炎临床特点,探讨防治对策。  方法:回顾性分析广州市胸科医院2003-01/2013-01门诊和病房患者在抗结核治疗过程中出现药物性视神经炎的临床特点。  结果:抗结核药物治疗引起的药物性视神经炎不多见(17/60000),以球后视神经炎多见,引起视神经炎的抗结核药物主要是乙胺丁醇,其次是异烟肼、链霉素。明确诊断后及时停用与视神经炎相关的结核药,并根据病情给予补充维生素,扩张血管,激素等治疗,患者的视力都有不同程度的提高。  结论:在使用抗结核药期间要注意患者视力变化情况出现突发视力下降应作眼科检查,并及时给予干预,防止失明的严重后果。%To summarize the clinical characters of optic neuritis caused by antituberculosis drugs, and to discuss the prevention countermeasures. ● METHODS: The clinical characters of optic neuritis caused by antituberculosis drugs among those outpatients and ward patients from January 2003 to January 2013 were reviewed and analyzed. ● RESULTS: Optic neuritis caused by antituberculosis drugs was rare ( 17 / 60000 ), while retrobulbar neuritis was common. The drugs inducing optical neuritis were mainly ethambutol, followed by isoniazid and streptomycin. The vision of patients would have different degrees of improvement via the following treatment after specific diagnosis, i. e. , timely stopping the tuberculosis medicine associated with optic neuritis, and taking vitamin supplements, dilating blood vessels and applying hormone therapy according to the illness. ●CONCLUSlON: We should pay attention to the change of the vision of patients during the usage of antituberculosis drugs. ln the case of sudden eyesight deterioration, ophthalmology examination and timely treatment are advised preventing blindness.

  3. Eleven episodes of recurrent optic neuritis of the same eye for 22 years eventually diagnosed as neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Yew, Yih Chian; Hor, Jyh Yung; Lim, Thien Thien; Kanesalingam, Ruban; Ching, Yee Ming; Arip, Masita; Easaw, P E Samuel; Eow, Gaik Bee

    2016-11-01

    It is difficult to predict whether a particular attack of neuromyelitis optica spectrum disorder (NMOSD) will affect the optic nerve [optic neuritis (ON): unilateral or bilateral], spinal cord (myelitis), brain or brainstem, or a combination of the above. We report an interesting case of recurrent ON of the same eye for a total of 11 episodes in a Chinese woman. Over a period of 22 years, the attacks only involved the left eye, and never the right eye and also no myelitis. For a prolonged duration, she was diagnosed as recurrent idiopathic ON. Only until she was tested positive for aquaporin 4 antibody that her diagnosis was revised to NMOSD. Optical coherence tomography revealed thinning of the retinal nerve fibre layer (RNFL) for the affected left eye, while the RNFL thickness was within normal range for the unaffected right eye. The disability accrual in NMOSD is generally considered to be attack-related - without a clinical attack of ON, there shall be no visual impairment, and no significant subclinical thinning of RNFL. Our case is in agreement with this notion. This is in contrast to multiple sclerosis where subclinical RNFL thinning does occur. This case highlights the importance of revisiting and questioning a diagnosis of recurrent idiopathic ON particularly when new diagnostic tools are available.

  4. Imidazol-1-ylethylindazole Voltage-Gated Sodium Channel Ligands Are Neuroprotective during Optic Neuritis in a Mouse Model of Multiple Sclerosis

    Science.gov (United States)

    2014-01-01

    A series of imidazol-1-ylethylindazole sodium channel ligands were developed and optimized for sodium channel inhibition and in vitro neuroprotective activity. The molecules exhibited displacement of a radiolabeled sodium channel ligand and selectivity for blockade of the inactivated state of cloned neuronal Nav channels. Metabolically stable analogue 6 was able to protect retinal ganglion cells during optic neuritis in a mouse model of multiple sclerosis. PMID:24601592

  5. Severe optic neuritis in a patient with combined neuromyelitis optica spectrum disease and primary Sjögren’s syndrome: a case report

    OpenAIRE

    Tan Petrina; Yu Wai; Umapathi Thirugnanam; Lim Su-Ann

    2012-01-01

    Abstract Introduction Optic neuritis, although uncommon, can be the initial presentation of Sjögren’s syndrome. Coexisting Sjögren’s syndrome has also been reported with neuromyelitis optica spectrum disorder. This case report highlights the association between the two diseases and the importance of rheumatological and neurological evaluations in patients with such diagnoses. Distinction of neuromyelitis optica with coexisting connective tissue disease has both prognostic and therapeutic sign...

  6. Optic neuritis is associated with inner nuclear layer thickening and microcystic macular edema independently of multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Falko Kaufhold

    Full Text Available BACKGROUND: Microcystic macular edema (MME and inner nuclear layer thickening (INL were described in multiple sclerosis (MS and neuromyelitis optica (NMO patients using optical coherence tomography (OCT. The cause of these findings is currently unknown and a relation to inflammatory or degenerative processes in the optic nerve is discussed. OBJECTIVE: The aim of our study was to investigate whether INL thickening and MME are related to optic neuritis (ON in various neuro-inflammatory disorders causingON: MS, NMO and chronic inflammatory optic neuropathy. METHODS: We retrospectively analyzed data from 216 MS patients, 39 patients with a clinically isolated syndrome, 20 NMO spectrum disorder patients, 9 patients with chronic inflammatory optic neuropathy and 121 healthy subjects. Intra-retinal layer segmentation was performed for the eyes of patients with unilateral ON. Scanning laser ophthalmoscopy (SLO images were reviewed for characteristic ocular fundus changes. RESULTS: Intra-retinal layer segmentation showed that eyes with a history of ON displayed MME independent INL thickening compared to contralateral eyes without previous ON. MME was detected in 22 eyes from 15 patients (5.3% of all screened patients, including 7 patients with bilateral edema. Of these, 21 had a prior history of ON (95%. The SLO images of all 22 MME-affected eyes showed crescent-shaped texture changes which were visible in the perifoveal region. A second grader who was blinded to the results of the OCT classified all SLO images for the presence of these characteristic fundus changes. All MME eyes were correctly classified (sensitivity = 100% with high specificity (95.2%. CONCLUSION: This study shows that both MME and INL thickening occur in various neuro-inflammatory disorders associated with ON. We also demonstrate that detection and analysis of MME by OCT is not limited to B-scans, but also possible using SLO images.

  7. Altered intrinsic regional spontaneous brain activity in patients with optic neuritis: a resting-state functional magnetic resonance imaging study

    Directory of Open Access Journals (Sweden)

    Shao Y

    2015-12-01

    Full Text Available Yi Shao,1,* Feng-Qin Cai,2,* Yu-Lin Zhong,1 Xin Huang,1,3 Ying Zhang,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Fu-Qing Zhou,2 Xian-Jun Zeng2 1Department of Ophthalmology, 2Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, 3Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, People’s Republic of China *These authors contributed equally to this work Objective: To investigate the underlying regional homogeneity (ReHo in brain-activity deficit in patients with optic neuritis (ON and its relationship with behavioral performance.Materials and methods: In total, twelve patients with ON (four males and eight females and twelve (four males and eight females age-, sex-, and education-matched healthy controls underwent resting-state functional magnetic resonance imaging scans. The ReHo method was used to assess the local features of spontaneous brain activity. Correlation analysis was used to explore the relationship between the observed mean ReHo values of the different brain areas and the visual evoked potential (VEP in patients with ON.Results: Compared with the healthy controls, patients with ON showed lower ReHo in the left cerebellum, posterior lobe, left middle temporal gyrus, right insula, right superior temporal gyrus, left middle frontal gyrus, bilateral anterior cingulate cortex, left superior frontal gyrus, right superior frontal gyrus, and right precentral gyrus, and higher ReHo in the cluster of the left fusiform gyrus and right inferior parietal lobule. Meanwhile, we found that the VEP amplitude of the right eye in patients with ON showed a positive correlation with the ReHo signal value of the left cerebellum posterior lobe (r=0.701, P=0.011, the right superior frontal gyrus (r=0.731, P=0.007, and the left fusiform gyrus (r=0.644, P=0.024. We also found that the VEP latency of the right eye in ON showed a positive correlation with the ReHo signal value of the right insula (r=0.595, P=0

  8. Ocular vestibular evoked myogenic potential to air conducted sound stimulation and video head impulse test in acute vestibular neuritis.

    Science.gov (United States)

    Walther, Leif Erik; Blödow, Alexander

    2013-08-01

    Air-conducted (ACS) cervical VEMP (cVEMP) reflect both saccular and inferior vestibular nerve function. Ocular VEMP (oVEMP) to air and bone-conducted vibration (BCV) are critically discussed, whether they reflect predominantly utricular and superior vestibular nerve function. The video head impulse test (vHIT) accurately detects changes in the high frequency range (5-7 Hz) of the vestibular ocular reflex (VOR) in all 3 planes and can be used to assess semicircular canals (SCC) impairment. To evaluate oVEMP and cVEMP in response to 500 Hz ACS stimulation and to compare these with vHIT results in acute unilateral vestibular neuritis (VN) to classify the probable involvement of SCC and otolith organs. Patients with VN were studied. ACS oVEMP and ACS cVEMP (100 dB nHL 500 Hz tone burst stimulation) were recorded. The vHIT for the 3 SCC were performed simultaneously. ACS oVEMP and ACS cVEMP in combination with vHIT allows the differentiation of 4 types of VN: entire VN (EVN), superior VN (SVN), inferior VN (IVN), and ampullary VN (AVN). Lesions of EVN, SVN, and IVN may be either complete or partial. ACS oVEMP and ACS cVEMP to 500 Hz stimulation together with the vHIT allows a better differentiation of receptor involvement in VN. Results suggest a different origin of AC oVEMP and AC cVEMP to 500 Hz in complete SVN and IVN. Partial SVN and IVN may indicate a role of saccular fibers in oVEMP.

  9. Progress in evidence-based medicine for the treatment of optic neuritis%视神经炎治疗的循证医学研究进展

    Institute of Scientific and Technical Information of China (English)

    陈国海

    2012-01-01

    视神经炎是常见的视神经病变,典型表现为视力突然丧失.视力改变的严重程度可以不同,数月后有自愈倾向.通过检索Cochrane CENTRAL、Medline和Embase等数据库资料,收集了近十几年来有关视神经炎治疗方面最有说服力的8个Ⅰ级、Ⅱ级循证医学(EBM)证据.目前研究结果认为:就视力、视野、对比敏感度而言,还没有令人信服的证据证实静脉滴注糖皮质激素或口服糖皮质激素较对照组有明显的疗效.视神经炎首先应不给予治疗,或者先静脉滴注糖皮质激素治疗后再改为口服.鉴于中国和西方国家因地理环境、种族和遗传背景不同造成视神经炎的病因和临床特点方面的差异,其治疗可能有所区别.因此,应尽快组织实施中国治疗视神经炎多中心大样本的随机临床对照试验(RCT),为视神经炎患者提供较好的治疗.%Optic neuritis is a common optic neuropathy,which typically presents with sudden loss of vision.Visual deficit of optic neuritis varies in severity and generally can be improved spontaneously over several-month duration.The most convincing eight evidences from level Ⅰ and Ⅱ evidence of evidence-based medicine( EBM ) about the treatment of all the optic neuritis were collected by searching the Cochrane Controlled Trials Register (CENTRAL),MEDLINE,EMBASE and reference lists of identified trial reports since the last decade.At present,the latest findings showed that there is no conclusive evidence of benefit in terms of recovery to normal visual acuity,visual field or contrast sensitivity with either intravenous or oral corticosteroids at the doses evaluated in trials included in this review.Either no treatment or intravenous corticosteroid therapy followed by oral corticosteroids is appropriate,and intravenous corticosteroid may benefit the patient in terms of faster recovery to normal vision.There may be of different treatment of optic neuritis in China compared to

  10. Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis

    Directory of Open Access Journals (Sweden)

    Silvia Lanfranconi

    2013-01-01

    Full Text Available Introduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplastic meningitis and a review of ocular involvement in neoplastic meningitis. Ocular symptoms were the presenting clinical feature in 34 patients (83% out of 41 included in our review, the unique manifestation of meningeal carcinomatosis in 3 patients (7%. Visual loss was the presenting clinical manifestation in 17 patients (50% and was the most common ocular symptom (70%. Other ocular signs were diplopia, ptosis, papilledema, anisocoria, exophthalmos, orbital pain, scotomas, hemianopsia, and nystagmus. Associated clinical symptoms were headache, altered consciousness, meningism, limb weakness, ataxia, dizziness, seizures, and other cranial nerves involvement. All patients except five underwent CSF examination which was normal in 1 patient, pleocytosis was found in 11 patients, increased protein levels were observed in 16 patients, and decreased glucose levels were found in 8 patients. Cytology was positive in 29 patients (76%. Conclusion. Meningeal carcinomatosis should be considered in patients with ocular symptoms even in the absence of other suggestive clinical symptoms.

  11. 视神经炎的遗传学研究进展%Recent progress on genetics of optic neuritis

    Institute of Scientific and Technical Information of China (English)

    赵燕燕; 魏世辉

    2011-01-01

    视神经炎是一种神经眼科的常见疾病,严重威胁视力.目前其病因不明,但研究发现视神经炎伴有一定程度的家族性和遗传倾向.近年来,随着分子生物学技术和统计学方法的迅速发展,视神经炎的候选基因的关联研究取得了相当的进展,本文就目前与视神经炎相关的遗传学研究工作的最新进展加以阐述.%Optic neuritis (ON) is a common disorder of the neuro-ophthalmology,which harms patients vision seriously.However,there are a lot of controversy and confusion about its etiology.While ON has familial characteristic and the tendency of heredity to some extent. Recently,association studies have made considerable progress with the rapid development of molecular biology techniques and statistical methods.In this article,the latest progresses in genetics of ON are reviewed.

  12. Latency delay of visual evoked potential is a real measurement of demyelination in a rat model of optic neuritis.

    Science.gov (United States)

    You, Yuyi; Klistorner, Alexander; Thie, Johnson; Graham, Stuart L

    2011-08-29

    To investigate the relationship between size of demyelinated lesion, extent of axonal loss, and degree of latency delay of visual evoked potentials (VEPs) in a rat model of experimental demyelination. Lysolecithin 1% (0.4 or 0.8 μL) was microinjected into an optic nerve of each of 14 rats 2 mm posterior to the globe. Standard flash VEPs were recorded with skull-implanted electrodes before and 2, 4, and 6 days after the microinjection. The optic nerves were stained with Luxol-fast blue and Bielschowsky's silver to assess demyelination and axonal pathology, respectively. Demyelinated areas were measured on serial sections, and lesion volumes were deduced by three-dimensional reconstruction. Focal lesions of demyelination and variable axonal loss were observed. The mean volume of the lesion was 3.2 ± 1.1 × 10⁻² mm³. The injected eye showed a significant latency delay and amplitude decrease. Regression analysis demonstrated a strong correlation between N1 latency delay and lesion volume (r = 0.863, P < 0.0001), which remained significant after adjustment for axonal loss (r = 0.829, P < 0.001). N1 latency delay also showed a correlation with axonal loss (r = 0.552, P = 0.041), but the correlation became nonsignificant when controlling for demyelination (r = 0.387, P = 0.191). A linear association between N1-P2 amplitude decrease and axonal loss (r = 0.681, P = 0.007) was also observed. The latency of the VEP accurately reflected the amount of demyelination in the visual pathway, whereas the amplitude correlated with axonal damage. This study supports the concept that the VEP provides a highly sensitive tool with which to measure demyelination in optic neuritis.

  13. 视神经炎临床误诊54例分析%CIinicaI anaIysis of 54 cases misdiagnosed as optic neuritis

    Institute of Scientific and Technical Information of China (English)

    赵芳; 李双

    2015-01-01

    目的:对54例其他疾病误诊为视神经炎的临床资料进行分析,探讨减少误诊的措施。  方法:对2000-09/2013-06被误诊为视神经炎的54例患者的临床资料进行分析,总结其误诊特点。  结果:不少疾病极易被误诊为视神经炎,易误诊疾病包括缺血性视神经病变、颅内肿瘤、视乳头血管炎、有髓神经纤维等。  结论:详细询问病史,完善辅助检查,加强眼底疾病及神经眼科知识的学习,有助于减少眼底表现近似视神经炎的疾病的误诊。%· AlM: To analyze the clinical data of 54 cases misdiagnosed as optic neuritis and to explore measures to reduce misdiagnosis · METHODS: This retrospective study comprised 54 patients that had been misdiagnosed as optic neuritis from September 2000 to June 2013. The misdiagnosis features were summarized. · RESULTS:Many diseases can easily be misdiagnosed as optic neuritis, including ischemic optic neuropathy, intracranial tumors, optic nerve vasculitis, myelinated nerve fibers, and so on. · CONCLUSlON: The measures to reduce misdiagnosis consisted of detailed history collection, perfect physical examination and comprehensive expertise of fundus disease.

  14. Roles of Treg/Th17 Cell Imbalance and Neuronal Damage in the Visual Dysfunction Observed in Experimental Autoimmune Optic Neuritis Chronologically.

    Science.gov (United States)

    Liu, Yuanyuan; You, Caiyun; Zhang, Zhuhong; Zhang, Jingkai; Yan, Hua

    2015-12-01

    Optic neuritis associated with multiple sclerosis and its animal model, experimental autoimmune optic neuritis (EAON), is characterized by inflammation, T cell activation, demyelination, and neuronal damage, which might induce permanent vision loss. Elucidating the chronological relationship among the features is critical for treatment of demyelinating optic neuritis. EAON was induced in C57BL/6 mice immunized with myelin oligodendrocyte glycoprotein subcutaneously, and visual function was assessed by flash-visual evoked potential (F-VEP) at days 7, 11, 14, 19, 23, 28 post-immunization. Retinal ganglion cell (RGC) apoptosis was measured by terminal-deoxynucleotidyl transferase-mediated nick-end labeling. Demyelination and axonal damage were verified with myelin basic protein (MBP) and β-amyloid precursor protein staining, respectively. Real-time polymerase chain reaction quantified IL-17, IL-1β, TGF-β, FoxP3, IL-6, and IL-10 mRNA expression in the optic nerve, as well as FoxP3 and IL-17 staining. Systemic changes of Th17 and Treg cells were tested by flow cytometry in spleen. F-VEP latency was prolonged at 11 days and peaked at 23 days commensurate with demyelination. However, F-VEP amplitude was reduced at 11 days, preceding axon damage, and was exacerbated at 23 days when a peak in RGC apoptosis was detected. Th17 cells up-regulated as early as 7 days and peaked at 11 days, while Treg cells down-regulated inversely compared to Th17 cells change as verified by IL-17 and FoxP3 expression; spleen cell samples were slightly different, demonstrating marked changed at 14 days. Treg/Th17 cell imbalance in the optic nerve precedes and may initiate neuronal damage of axons and RGCs. These changes are commensurate with the appearances of visual dysfunction reflected in F-VEP and hence may offer a novel therapeutic avenue for vision preservation.

  15. Evaluation of changes in retinal nerve fiber layer thickness and visual functions in cases of optic neuritis and multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Rohit Saxena

    2013-01-01

    Full Text Available Context: Retinal nerve fiber layer (RNFL thinning has been demonstrated in cases of optic neuritis (ON and multiple sclerosis (MS in Caucasian eyes, but no definite RNFL loss pattern or association with visual functions is known in Indian eyes. Aim : To evaluate RNFL thickness in cases of ON and MS, and to correlate it with visual function changes in Indian patients. Settings and Design: Cross-sectional case-control study at a tertiary level institution . Materials and Methods: Cases consisted of patients of (i typical ON without a recent episode (n = 30:39 ON eyes and 21 fellow eyes, (ii MS without ON (n = 15;30 eyes while the controls were age-matched (n = 15; 30 eyes. RNFL thickness was measured using the Stratus 3 °CT. The visual functions tested included the best-corrected visual acuity (BCVA, contrast sensitivity, stereopsis, visual evoked responses, and visual fields. Statistical analysis used: Intergroup analysis was done using ANOVA and Pearson′s correlation coefficient used for associations. Results: RNFL thickness was reduced significantly in the ON and MS patients compared to the controls (P-0.001. Maximum loss is in the temporal quadrant. Lower visual function scores are associated with reduced average overall RNFL thickness. In ON group, RNFL thinning is associated with severe visual field defects while contrast sensitivity has strongest correlation with RNFL in the MS group. Conclusions:RNFL thickness is reduced in ON and MS cases in a pattern similar to Caucasians and is associated with the magnitude of impairment of other visual parameters. Contrast sensitivity and stereoacuity are useful tests to identify subclinical optic nerve involvement in multiple sclerosis.

  16. Impact of the anti-aquaporin-4 autoantibody on inner retinal structure, function and structure-function associations in Japanese patients with optic neuritis

    Science.gov (United States)

    Matsumoto, Yoshiko; Mori, Sotaro; Ueda, Kaori; Kurimoto, Takuji; Kanamori, Akiyasu; Yamada, Yuko; Nakashima, Ichiro

    2017-01-01

    Purpose An autoantibody against aquaporin-4 (AQP4 Ab) is highly specific for neuromyelitis optica spectrum disorder and plays a pathogenic role in this disease. The purpose of this study was to investigate the impact of AQP4 Ab on inner retinal structure, function, and the structure−function relationships in eyes with optic neuritis. Methods Thirty five eyes from 25 cases who had received visual function tests and RTVue optical coherence tomography (OCT) measurement at least six months after the latest episode of optic neuritis were enrolled. Patients with multiple sclerosis were excluded. AQP4 Ab was measured using a cell-based assay. Visual acuity, mean deviation (MD) of the Humphrey visual field SITA standard 30–2 tests, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thicknesses, and other clinical variables were compared between the AQP4 Ab-positive and -negative groups. Parameters associated with visual functions were evaluated by generalized estimating equation (GEE) models. Results The AQP4 Ab-positive group (20 eyes from 12 cases) had a higher proportion of bilateral involvement and longer duration of follow-up than the AQP4 Ab-negative group (15 eyes from 13 cases). Linear mixed effect models revealed worse MD and visual acuity in AQP4 Ab-positive eyes than those in AQP4 Ab-negative eyes after adjusting for within-patient inter-eye dependence, whereas there were no differences in RNFL and GCC thickness between the two groups. In seropositive eyes, GEE regression analyses revealed that depending on age and the number of recurrences of ON episodes, OCT parameters correlated strongly with MD and more weakly with visual acuity. Conclusions Reductions in RNFL and GCC thickness were proportional to the visual field defect in eyes with AQP4 Ab but not in eyes without AQP4 Ab. The presence of AQP4 Ab probably plays a critical role in retinal ganglion cell loss in optic neuritis. PMID:28199381

  17. Anti-aquaporin-4 IgG in patients presenting with unilateral optic neuritis: A cohort study

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    Masoud Etemadifar

    2012-01-01

    Full Text Available Background: Optic neuritis (ON can be the first presentation of multiple sclerosis (MS or neuromyelitis optica (NMO. Anti-aquaporin-4 IgG (AQP4 IgG is a highly specific and moderately sensitive biomarker for NMO. This study was designed to assess the rate of seropositivity for AQP4 IgG, and the short-term outcome of patients presenting with single isolated ON (SION. Methods: A cohort of 41 consecutive patients experiencing severe (< 20 / 200 SION (not fulfilling the diagnostic criteria for MS or NMO, was prospectively recruited. Blood sampling was carried out immediately after the diagnosis of ON, and AQP4 IgG was tested qualitatively, using an indirect immunofluorescence kit. After clinical and paraclinical investigations, all the patients were followed up for a short-term period of at least 18 months. Results: The seroprevalence among the initial ON patients was 9.7% (4 / 41. The short-term conversion rate to MS and NMO was estimated to be about 7.3 and 4.9%, respectively. The conversion rate to NMO in initially seropositive patients was greater than that for the whole cohort [2 / 4 (50% vs. 2 / 41 (4.9%; P = 0.035; Odds ratio: 19.5, 95% confidence interval: 1.73 to 219.50]. Conclusion: AQP4 IgG seropositive SION patients were more likely to develop NMO in comparison to the total SION population. Further studies, with a longer follow-up period and larger sample sizes are warranted to assess the clinical and prognostic value of assessing AQP4 IgG in SION.

  18. 儿童视神经炎诊治的现状与进展%Current status and progress in diagnosis and treatments of pediatric optic neuritis

    Institute of Scientific and Technical Information of China (English)

    陈兰兰; 姜利斌

    2014-01-01

    Pediatric optic neuritis (ON) is different from its adult counterpart in terms of epidemiology,etiology,clinical manifestations,and prognosis.Although adult optic neuritis was well described in treatments by the Optic Neuritis Treatment Trial (ONTT),there is no universal agreement on the treatments in a pediatric population.Since there is an inadequate knowledge about pediatric ON in our nation,we compared the clinical manifestations of pediatric ON with its adult population,reviewed the existing understanding of the relationship between pediatric ON and various diseases of CNS,and summarized the current treatments,expecting to provide useful reference in clinic.(Chin J Ophthalmol,2014,50:941-945)%儿童视神经炎(ON)流行病学、病因、临床表现及预后转归等方面与成人ON有较大的不同.成人典型性ON的治疗通过视神经炎治疗试验研究已相对成熟,但针对儿童ON治疗至今仍无统一标准.鉴于目前国内对儿童ON认识上的不足,本文比较了儿童与成人ON的临床特征,概述儿童ON与多种中枢神经系统疾病的关系,并归纳其相关的治疗,以期为国内儿童ON诊治提供参考.

  19. Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis

    DEFF Research Database (Denmark)

    Jarius, Sven; Frederiksen, Jette Lautrup Battistini; Waters, Patrick;

    2010-01-01

    Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord....

  20. Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis

    DEFF Research Database (Denmark)

    Jarius, Sven; Frederiksen, Jette Lautrup Battistini; Waters, Patrick;

    2010-01-01

    Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord.......Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord....

  1. Cerebrospinal fluid levels of chitinase 3-like 1 and neurofilament light chain predict multiple sclerosis development and disability after optic neuritis

    DEFF Research Database (Denmark)

    Modvig, S; Degn, M; Roed, H

    2015-01-01

    BACKGROUND: Cerebrospinal fluid (CSF) biomarkers have been suggested to predict multiple sclerosis (MS) after clinically isolated syndromes, but studies investigating long-term prognosis are needed. OBJECTIVE: To assess the predictive ability of CSF biomarkers with regard to MS development and long......-term disability after optic neuritis (ON). METHODS: Eighty-six patients with ON as a first demyelinating event were included retrospectively. Magnetic resonance imaging (MRI), CSF leukocytes, immunoglobulin G index and oligoclonal bands were registered. CSF levels of chitinase-3-like-1, osteopontin, neurofilament...

  2. New progress in the medication treatment of optic neuritis%视神经炎药物治疗新进展

    Institute of Scientific and Technical Information of China (English)

    李迎春; 樊映川

    2010-01-01

    视神经炎(optic neuritis,ON)指能够阻碍视神经传导功能,引起视功能一系列改变的视神经病变.其治疗以药物治疗为主,且大多采用以糖皮质激素为主的综合治疗方案,我们对目前已经应用于眼科临床的药物,包括糖皮质激素、抗病毒药物及其它药物的治疗现状作一综述.

  3. The latest advance of correlation between autophagy and optic neuritis%自噬与视神经炎相关性研究进展

    Institute of Scientific and Technical Information of China (English)

    施祥; 吴云成; 朱潇颖; 孙晓东

    2013-01-01

    视神经炎是一组引起急性、亚急性视力减退的视神经炎症性疾病,其确切发病机制尚未十分清楚.自噬是真核细胞内一条重要的代谢途径,它在降解受损的细胞器、蛋白质等以维持细胞内环境稳态方面有重要作用,它与多种疾病的发生发展有着密切的关系.本文就自噬参与视神经炎的发病及其调控关系做一综述.%Optic neuritis is an inflammatory disease of the optic nerve with an abrupt loss of vision.The mechanism of the disease is not completely clear.Autophagy is an important metabolic pathway of eukaryotic cells involved degrading and recycling damaged organelles and proteins to maintain intracellular homeostasis.It is involved in the pathogenesis of various diseases.In this article,the probable effects of autophagy in the mechanism of optic neuritis is reviewed.

  4. Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients.

    Directory of Open Access Journals (Sweden)

    Prema Sriram

    Full Text Available PURPOSE: Loss of retinal ganglion cells in in non-optic neuritis eyes of Multiple Sclerosis patients (MS-NON has recently been demonstrated. However, the pathological basis of this loss at present is not clear. Therefore, the aim of the current study was to investigate associations of clinical (high and low contrast visual acuity and electrophysiological (electroretinogram and multifocal Visual Evoked Potentials measures of the visual pathway with neuronal and axonal loss of RGC in order to better understand the nature of this loss. METHODS: Sixty-two patients with relapsing remitting multiple sclerosis with no previous history of optic neuritis in at least one eye were enrolled. All patients underwent a detailed ophthalmological examination in addition to low contrast visual acuity, Optical Coherence Tomography, full field electroretinogram (ERG and multifocal visual evoked potentials (mfVEP. RESULTS: There was significant reduction of ganglion cell layer thickness, and total and temporal retinal nerve fibre layer (RNFL thickness (p<0.0001, 0.002 and 0.0002 respectively. Multifocal VEP also demonstrated significant amplitude reduction and latency delay (p<0.0001 for both. Ganglion cell layer thickness, total and temporal RNFL thickness inversely correlated with mfVEP latency (r = -0.48, p<0.0001 respectively; r = -0.53, p<0.0001 and r = -0.59, p<0.0001 respectively. Ganglion cell layer thickness, total and temporal RNFL thickness also inversely correlated with the photopic b-wave latency (r = -0.35, p = 0.01; r = -0.33, p = 0.025; r = -0.36, p = 0.008 respectively. Multivariate linear regression model demonstrated that while both factors were significantly associated with RGC axonal and neuronal loss, the estimated predictive power of the posterior visual pathway damage was considerably larger compare to retinal dysfunction. CONCLUSION: The results of our study demonstrated significant association of RGC

  5. Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients.

    Science.gov (United States)

    Sriram, Prema; Wang, Chenyu; Yiannikas, Con; Garrick, Raymond; Barnett, Michael; Parratt, John; Graham, Stuart L; Arvind, Hemamalini; Klistorner, Alexander

    2014-01-01

    Loss of retinal ganglion cells in in non-optic neuritis eyes of Multiple Sclerosis patients (MS-NON) has recently been demonstrated. However, the pathological basis of this loss at present is not clear. Therefore, the aim of the current study was to investigate associations of clinical (high and low contrast visual acuity) and electrophysiological (electroretinogram and multifocal Visual Evoked Potentials) measures of the visual pathway with neuronal and axonal loss of RGC in order to better understand the nature of this loss. Sixty-two patients with relapsing remitting multiple sclerosis with no previous history of optic neuritis in at least one eye were enrolled. All patients underwent a detailed ophthalmological examination in addition to low contrast visual acuity, Optical Coherence Tomography, full field electroretinogram (ERG) and multifocal visual evoked potentials (mfVEP). There was significant reduction of ganglion cell layer thickness, and total and temporal retinal nerve fibre layer (RNFL) thickness (p<0.0001, 0.002 and 0.0002 respectively). Multifocal VEP also demonstrated significant amplitude reduction and latency delay (p<0.0001 for both). Ganglion cell layer thickness, total and temporal RNFL thickness inversely correlated with mfVEP latency (r = -0.48, p<0.0001 respectively; r = -0.53, p<0.0001 and r = -0.59, p<0.0001 respectively). Ganglion cell layer thickness, total and temporal RNFL thickness also inversely correlated with the photopic b-wave latency (r = -0.35, p = 0.01; r = -0.33, p = 0.025; r = -0.36, p = 0.008 respectively). Multivariate linear regression model demonstrated that while both factors were significantly associated with RGC axonal and neuronal loss, the estimated predictive power of the posterior visual pathway damage was considerably larger compare to retinal dysfunction. The results of our study demonstrated significant association of RGC axonal and neuronal loss in NON-eyes of MS patients

  6. Neuroprotective and anti-inflammatory mechanisms are activated early in optic neuritis

    DEFF Research Database (Denmark)

    Tsakiri, A; Ravanidis, S; Lagoudaki, R;

    2015-01-01

    -matched voluntary HC (n = 32). The mRNA expression of distinct cytokines and neurotrophic factors was assessed by semi/quantitative real-time PCR (RT-PCR). RESULTS: Brain- and glial cell-derived neurotrophic factor (BDNF and GDNF) and interleukin 10 (IL-10) expression was significantly increased in the CSF compared...... to the blood in both ON and HC (P BDNF and GDNF of the ON group were positively correlated with the presence of oligoclonal bands (OB). Additionally, patients with gadolinium (gd+) lesions on brain MRI showed increased levels of IL-5 in blood (P = 0.03). CONCLUSION: Our...... data indicate that both immuno-regulatory and neuroprotective mechanisms may potentially take place relatively early in the course of the ON. The presence of neurotrophic factors in healthy CSF and their overexpression already during the acute phase of ON supports the alertness of CNS defence...

  7. Experiences on treatment of optic neuritis from liver%视神经炎从肝论治经验琐谈

    Institute of Scientific and Technical Information of China (English)

    张晓; 张晰

    2015-01-01

    Professor Chen Xianmin has engaged in Chinese Ophthalmology for more than 40 years, having ac-cumulated rich experiences in diagnosis and treatment of optic neuritis. He had the original opinion on the etiology, pathogenesis and syndrome differentiation and treatment. He believed that optic neuritis could be differentiated from four aspects, the liver-qi, the liver-fire, the liver-blood, and the liver-yin. According to the state of the disease, it could be treated by dispersing the liver-qi, quenchig the liver-fire, tonifying the liver-blood, and nourishing the liv-er-yin.%陈宪民教授从事中医眼科40余年,对视神经炎的诊治积累了丰富的经验,对本病的病因病机、辨证论治等有独到的见解,认为视神经炎可从肝气、肝火、肝血、肝阴四个方面辨证,并根据病情可采用舒肝气、泻肝火、补肝血、益肝阴等法。

  8. Long-term structural retinal changes in patients with optic neuritis related to multiple sclerosis

    DEFF Research Database (Denmark)

    Andersen, Maria Rene; Roar, Malte; Sejbaek, Tobias

    2017-01-01

    .7-72.6 years) and 13 years (range 9-15 years), respectively. ON was not associated with impairment of visual acuity or color vision. Twenty-three patients had a history of ON in at least one eye. Compared to non-affected patients, these had a lower inferior (109 vs 113 μm, P=0.04) and temporal retinal nerve...... in Denmark. Patients gave a self-reported history of ON, and functional (visual acuity and color vision) and structural (spectra domain optical coherence tomography) markers of vision were tested. RESULTS: Median age and MS duration at the time of the clinical examination were 49.9 years (range 30...... thickness, respectively). Twenty patients had a history of ON in one eye. Compared to the non-affected eye, this eye had a lower RNFL (109 vs 115 μm, P=0.04) and a higher central retinal thickness/mean RNFL ratio (2.7 vs 2.4, P=0.04). CONCLUSION: Although patients with long-term MS and a previous history...

  9. MRI texture heterogeneity in the optic nerve predicts visual recovery after acute optic neuritis

    Directory of Open Access Journals (Sweden)

    Yunyan Zhang

    2014-01-01

    Conclusions: Tissue heterogeneity may be a potential measure of functional outcome in ON patients and advanced analysis of the texture in standard MRI could provide insights into mechanisms of injury and recovery in patients with similar disorders.

  10. Structural Alterations of Segmented Macular Inner Layers in Aquaporin4-Antibody-Positive Optic Neuritis Patients in a Chinese Population.

    Directory of Open Access Journals (Sweden)

    Chunxia Peng

    Full Text Available This study aimed to analyse the structural injury of the peripapillary retinal nerve fibre layer (pRNFL and segmented macular layers in optic neuritis (ON in aquaporin4-antibody (AQP4-Ab seropositivity(AQP4-Ab-positiveON patients and in AQP4-Ab seronegativity (AQP4-Ab-negative ON patients in order to evaluate their correlations with the best-corrected visual acuity (BCVA and the value of the early diagnosis of neuromyelitis optica (NMO.This is a retrospective, cross-sectional and control observational study.In total, 213 ON patients (291 eyes and 50 healthy controls (HC (100 eyes were recruited in this study. According to a serum AQP4-Ab assay, 98 ON patients (132 eyes were grouped as AQP4-Ab-positive ON and 115 ON patients (159 eyes were grouped as AQP4-Ab-negative ON cohorts. All subjects underwent scanning with spectralis optical coherence tomography (OCT and BCVA tests. pRNFL and segmented macular layer measurements were analysed.The pRNFL thickness in AQP4-Ab-positive ON eyes showed a more serious loss during 0-2 months (-27.61μm versus -14.47 μm and ≥6 months (-57.91μm versus -47.19μm when compared with AQP4-Ab-negative ON eyes. AQP4-Ab-positive ON preferentially damaged the nasal lateral pRNFL. The alterations in the macular ganglion cell layer plus the inner plexiform layer (GCIP in AQP4-Ab-positive ON eyes were similar to those in AQP4-Ab-negative ON eyes. AQP4-Ab-positive ON eyes had entirely different injury patterns in the inner nuclear layer (INL compared with AQP4-Ab-negative ON eyes during the first 6 months after the initial ON attack. These differences were as follows: the INL volume of AQP4-Ab-positive ON eyes had a gradual growing trend compared with AQP4-Ab-negative ON eyes, and it increased rapidly during 0-2 months, reached its peak during 2-4 months, and then decreased gradually. The pRNFL and GCIP in AQP4-Ab-positive ON eyes had positive correlations with BCVA. When the pRNFL thickness decreased to 95%CI (50.77

  11. Structural Alterations of Segmented Macular Inner Layers in Aquaporin4-Antibody-Positive Optic Neuritis Patients in a Chinese Population

    Science.gov (United States)

    Peng, Chunxia; Wang, Wei; Xu, Quangang; Zhao, Shuo; Li, Hongyang; Yang, Mo; Cao, Shanshan; Zhou, Huanfen; Wei, Shihui

    2016-01-01

    Objectives This study aimed to analyse the structural injury of the peripapillary retinal nerve fibre layer (pRNFL) and segmented macular layers in optic neuritis (ON) in aquaporin4-antibody (AQP4-Ab) seropositivity(AQP4-Ab-positiveON) patients and in AQP4-Ab seronegativity (AQP4-Ab-negative ON) patients in order to evaluate their correlations with the best-corrected visual acuity (BCVA) and the value of the early diagnosis of neuromyelitis optica (NMO). Design This is a retrospective, cross-sectional and control observational study. Methods In total, 213 ON patients (291 eyes) and 50 healthy controls (HC) (100 eyes) were recruited in this study. According to a serum AQP4-Ab assay, 98 ON patients (132 eyes) were grouped as AQP4-Ab-positive ON and 115 ON patients (159 eyes) were grouped as AQP4-Ab-negative ON cohorts. All subjects underwent scanning with spectralis optical coherence tomography (OCT) and BCVA tests. pRNFL and segmented macular layer measurements were analysed. Results The pRNFL thickness in AQP4-Ab-positive ON eyes showed a more serious loss during 0–2 months (-27.61μm versus -14.47 μm) and ≥6 months (-57.91μm versus -47.19μm) when compared with AQP4-Ab-negative ON eyes. AQP4-Ab-positive ON preferentially damaged the nasal lateral pRNFL. The alterations in the macular ganglion cell layer plus the inner plexiform layer (GCIP) in AQP4-Ab-positive ON eyes were similar to those in AQP4-Ab-negative ON eyes. AQP4-Ab-positive ON eyes had entirely different injury patterns in the inner nuclear layer (INL) compared with AQP4-Ab-negative ON eyes during the first 6 months after the initial ON attack. These differences were as follows: the INL volume of AQP4-Ab-positive ON eyes had a gradual growing trend compared with AQP4-Ab-negative ON eyes, and it increased rapidly during 0–2 months, reached its peak during 2–4 months, and then decreased gradually. The pRNFL and GCIP in AQP4-Ab-positive ON eyes had positive correlations with BCVA. When the p

  12. Adding Papillomacular Bundle Measurements to Standard Optical Coherence Tomography Does Not Increase Sensitivity to Detect Prior Optic Neuritis in Patients with Multiple Sclerosis.

    Directory of Open Access Journals (Sweden)

    Mona Laible

    Full Text Available To improve the detection of retinal nerve fiber layer (RNFL thinning in multiple sclerosis (MS, a special peripapillary ring scanning algorithm (N-site RNFL, N-RNFL was developed for spectral domain optical coherence tomography (SD-OCT. In contrast to the standard protocol (ST-RNFL scanning starts nasally, not temporally, and provides an additional sector of analysis, the papillomacular bundle (PMB. We aimed to ascertain whether the temporal RNFL differs between the two techniques, whether N-RNFL is more sensitive than ST-RNFL to detect previous optic neuritis (ON, and whether analyzing the PMB adds additional sensitivity. Furthermore, we investigated whether RNFL is associated with disease severity and/or disease duration.We conducted a cross-sectional case-control study of 38 patients with MS, of whom 24 had a history of ON, and 40 healthy controls (HC. Subjects with ON within the previous 6 months were excluded. Records included clinical characteristics, visual evoked potentials (VEP, and SD-OCT in both techniques.In a total of 73 evaluable MS eyes, temporal N-RNFL was abnormal in 17.8%, temporal ST-RNFL in 19.2%, and the PMB-RNFL in 21.9%. In ON eyes, the sensitivity of temporal N-RNFL and ST-RNFL did not differ significantly (37.0%/33.3%, p = 0.556. The sensitivity of VEP was 85.2%. RNFL thickness was associated with disease severity in all eyes, with and without a history of ON, and with disease duration.The two OCT techniques detected previous ON with similar sensitivity, but the sensitivity of VEPs was superior to that of both N-RNFL and ST-RNFL. Our results indicate that the widely used ST-RNFL technique is appropriate for peripapillary RNFL measurements in MS patients.

  13. 62例儿童特发性视神经炎的临床分析%Clinical analysis of 62 cases of children with idiopathic optic neuritis

    Institute of Scientific and Technical Information of China (English)

    施维; 吴倩; 曹文红; 樊云葳; 崔燕辉; 梁天蔚; 李莉

    2016-01-01

    Objective To investigate the clinical features of children with idiopathic optic neuritis (ION), and assess the therapeutic efficacy of mouse nerve growth factor (NGF) combined methylprednisolone on idiopathic optic neuritis. Methods A total of 62 idiopathic optic neuritis children who were admitted to our hospital from January, 2014 to April, 2015 were retrospectively analyzed. Results The visual acuity of children with ION was decreased fastly, the visual field and VEP were varying damaged .After treatmeat,either NGF combined with methylprednisolone pulse ther-apy group (treatment group) or methylprednisolone pulse therapy alone group (control group) ,the visual acuity,visual field and P-VEP are all improved. After a week of treatment, the effective rate of treatment group was 93.55%, which was significantly better than the effective rate 0f 80.65% in the control group ( 0.05). The thick-ness of retinal nerve fiber layer became thinner after treatment in both groups, especially of nasal and temporal retina ( <0.05). Conclusion To the children with idiopathic optic neuritis, the early combination of mouse nerve growth fac-tor and methylprednisolone pulse therapy is an effective method , VEP and OCT maybe useful to the clinical research in these children.%目的:探讨儿童特发性视神经炎的临床特点,评估鼠神经生长因子(NGF)联合甲基强的松龙冲击治疗儿童特发性视神经炎的疗效。方法回顾性分析2014年1月~2015年4月我院门诊及病房确诊的62例(62只眼)儿童特发性视神经炎患儿的临床资料及随访资料。结果儿童视神经炎发病急,视力下降快,视野、VEP均有不同程度损害。NGF联合甲基强的松龙冲击治疗(治疗组)及单纯甲基强的松龙冲击治疗(对照组)后患眼的视力、视野、P-VEP均有不同程度改善。治疗一周后治疗组总有效率为93.55%,对照组为80.65%,治疗组疗效优于对照组(<0.05);治疗3个月后,两

  14. 特发性视神经炎的治疗及护理%Treatment and nursing of idiopathic optic neuritis

    Institute of Scientific and Technical Information of China (English)

    钱海燕; 王敏; 林方丽; 管叶; 刘钰风; 陈秀云

    2010-01-01

    Objective To observe the results of treating 67 idiopathic optic neuritis patients with large dose glucocorticoid and effective nursing intervention.Methods Sixty-seven cases of idiopathic optic neuritis patients were treated with combined modality therapy,practiced purposeful and planned mental nursing.More nursing experience was summarized from them.Results By our elaborative treatment,nursing and observation,most patients got vision improved.Conclusions Early medication was the basic treatment to rescue visual function.During the treatment,we should note the side effects of glucocorticoid,practiced planned mental nursing and health education,and enhance the consciousness of self health care as well.%目的 观察对67例特发性视神经炎患者进行大剂量激素冲击治疗,并实施有效护理措施的效果.方法 对67例特发性视神经炎患者进行药物综合治疗,实施有目的 、有计划地心理护理,从中总结更多的护理工作经验.结果 通过我们精心的治疗、观察和护理,大部分患者视力均有所提高.结论 早期药物治疗是挽救视功能的根本措施,治疗过程中要注意观察病情及激素药物的副作用,有计划地进行心理护理和健康教育指导,提高病人的自我保健意识.

  15. Comparison of 3D double inversion recovery and 2D STIR FLAIR MR sequences for the imaging of optic neuritis: pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Hodel, Jerome; Bocher, Anne-Laure; Pruvo, Jean-Pierre; Leclerc, Xavier [Hopital Roger Salengro, Department of Neuroradiology, Lille (France); Outteryck, Olivier; Zephir, Helene; Vermersch, Patrick [Hopital Roger Salengro, Department of Neurology, Lille (France); Lambert, Oriane [Fondation Ophtalmologique Rothschild, Department of Neuroradiology, Paris (France); Benadjaoud, Mohamed Amine [Radiation Epidemiology Team, Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Villejuif (France); Chechin, David [Philips Medical Systems, Suresnes (France)

    2014-12-15

    We compared the three-dimensional (3D) double inversion recovery (DIR) magnetic resonance imaging (MRI) sequence with the coronal two-dimensional (2D) short tau inversion recovery (STIR) fluid-attenuated inversion recovery (FLAIR) for the detection of optic nerve signal abnormality in patients with optic neuritis (ON). The study group consisted of 31 patients with ON (44 pathological nerves) confirmed by visual-evoked potentials used as the reference. MRI examinations included 2D coronal STIR FLAIR and 3D DIR with 3-mm coronal reformats to match with STIR FLAIR. Image artefacts were graded for each portion of the optic nerves. Each set of MR images (2D STIR FLAIR, DIR reformats and multiplanar 3D DIR) was examined independently and separately for the detection of signal abnormality. Cisternal portion of optic nerves was better delineated with DIR (p < 0.001), while artefacts impaired analysis in four patients with STIR FLAIR. Inter-observer agreement was significantly improved (p < 0.001) on 3D DIR (κ = 0.96) compared with STIR FLAIR images (κ = 0.60). Multiplanar DIR images reached the best performance for the diagnosis of ON (95 % sensitive and 94 % specific). Our study showed a high sensitivity and specificity of 3D DIR compared with STIR FLAIR for the detection of ON. These findings suggest that the 3D DIR sequence may be more useful in patients suspected of ON. (orig.)

  16. 视觉诱发电位在视神经炎诊断中的应用价值%Application of visual evoked potential in diagnosis of optic neuritis

    Institute of Scientific and Technical Information of China (English)

    董泽英; 尤广智; 张芹; 刘天刚; 朱洁茹; 李新

    2015-01-01

    Objective To investigate the visual evoked potential( VEP) variation in patients with optic neuritis and explore application value of VEP in diagnosis of optic neuritis.Methods 36 (40 eyes) patients with optic neuritis and 32(44 eyes) health volunteers were recruited to detect their VEP.Receiver operating characteristic curve ( ROC) was designed to evaluate the VEP power in distinguishing the optic neuritis patients from healthy people.Results The average VEP latency in optic neuritis patients was significantly delayed compared to the controls(P<0.001).In addition, diminished VEP amplitude was found in patients with optic neuritis compared with the healthy controls(P<0.001).According to ROC curve,a certain degree accuracy was demonstrated when VEP latency was applied to diagnose the optic neuritis patients [ Area ( area under ROC curve)=0.800,P<0.001],so was VEP amplitude(Area=0.722,P<0.001).Conclusion Compared to healthy controls, delayed VEP latency and diminished VEP amplitude were observed in optic neuritis patients.VEP, an auxiliary examination which was considered to be rapid,convenient and non-invasive,possesses certain degree of accuracy in diagnosing optic neuri-tis.More studies were desired to investigate the application of VEP in diagnosis,stage,treatment and prognosis of optic neuri-tis.%目的:观察视神经炎患者的视觉诱发电位( VEP)变化情况,探索VEP对视神经炎的诊断价值。方法对36例(40眼)视神经炎患者和32例(44眼)健康自愿者行VEP检测,比较2组间的VEP差异;绘制VEP鉴别视神经炎患者和健康人群的受试者特征曲线( ROC),分析其鉴别视神经炎的准确性。结果与健康对照组相比,视神经炎患者VEP潜伏期明显延长,振幅显著降低,差异具有统计学意义( P <0.001);由ROC曲线可知,采用VEP潜伏期和振幅鉴别视神经炎患者均有一定的准确性,ROC曲线下的面积( Area)分别为0.800和0.722

  17. Effects of vitamin D on retinal nerve fiber layer in vitamin D deficient patients with optic neuritis: Preliminary findings of a randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Mehri Salari

    2015-01-01

    Full Text Available Background: There is accumulating evidence for a possible protective role of vitamin D in the development and disease course of multiple sclerosis. Whether vitamin D is also effective in treating patients with optic neuritis (ON is not known. The aim of this study was to evaluate the effect of oral vitamin D on the thickness of retinal nerve fiber layer (RNFL in vitamin D deficient patients with ON by optical coherence tomography. Materials and Methods: A Phase II placebo-controlled randomized clinical trial conducted between July 2011 and November 2012 included 52 patients with confirmed unilateral ON aged 15-38 years and low serum 25-hydroxyvitamin D levels. The main outcome measures were changes in thickness of RNFL and macula 6 months after treatment. Patients were randomly allocated to receive 6 months of treatment with adding either 50,000 IU/week vitamin D or placebo. Results: In the 27 patients treated with vitamin D, the mean (standard deviation [SD] thickness of RNFL decreased from 111.3 (18.9 μm at baseline to 91.4 (13.3 at the end of study period (P 0.05. Average thickness of RNFL at the end of trial did not differ between groups. Conclusion: Adding vitamin D to routine disease therapy had no significant effect on the thickness of RNFL or macula in patients with ON. This trial is registered on www.clinicaltrials.gov (ID NCT01465893.

  18. 视神经炎流行病学特征的研究现状%Research status on the epidemiological characteristics of optic neuritis

    Institute of Scientific and Technical Information of China (English)

    杨超; 方凯; 胡永华

    2015-01-01

    Optic neuritis(ON) is one of common neuro-ophthalmologic diseases which cause vision loss in young and middle-aged population.There are obvious differences in the incidence and the epidemiological characteristics among different countries and regions.A number of studies on ON have been carried out at home and abroad.In China, it is still lack of muhi-center, prospective, large sample epidemiological studies so far.This paper reviews the epidemiological characteristics of ON through the related domestic and overseas literatures.%视神经炎是神经眼科的常见疾病,也是中青年人群的主要致盲性疾病之一.不同国家和地区视神经炎的发病水平和流行病学特征存在明显差异.目前国内外已开展多项关于视神经炎的研究,我国尚缺乏多中心、前瞻性、大样本的流行病学研究.本文结合国内外相关文献,对视神经炎流行病学特征的国内外研究现状进行综述.

  19. Clinical study of optic neuritis combined with viral hepatitis%视神经炎伴发病毒性肝炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    朱丽平; 卢海; 颜榕; 彭静婷; 陆长峰; 孙林; 张晓君

    2012-01-01

    目的 了解伴发病毒性肝炎的视神经炎的临床表现、治疗及预后.方法 回顾性系列病例研究.收集2003年9月至2010年6月北京同仁医院神经眼科20例伴发病毒性肝炎的视神经炎患者的临床资料,总结该组患者的临床特点、视野变化,并对治疗前后的视力采用Wingerchuk视力分级进行比较.结果 本组20例视神经炎患者,18例为慢性乙型肝炎,2例为慢性丙型肝炎.13例为单眼起病(65%),16例为单相病程(80%).视神经损害27只眼,视乳头水肿常见,共14只眼(52%);视力损害最严重时最佳矫正视力≤0.1者共19只眼(70%);视野损害以水平下半视野缺损最为常见,共10只眼(50%).经糖皮质激素治疗后3个月对所有患者进行随访,视力完全恢复3只眼(11%)、明显改善4只眼(15%)、好转12只眼(44%)、8只眼(30%)无变化.结论 本组伴发病毒性肝炎的视神经炎患者视力损害较重,糖皮质激素治疗后部分患者视力完全恢复,但多数患者视力恢复较差.应注意同期肝炎的抗病毒治疗.%Objective To investigate the clinical manifestation,management and prognosis of optic neuritis combined with viral hepatitis.Methods Retrospective study case series.Clinical data from twenty patients with optic neuritis combined with hepatitis who were hospitalized in Beijing Tongren Hospital neural eye wart from September 2003 to June 2010 were collected,the clinical characteristics and visual field changes in the group of patients were summarized,and comparison between the vision before and after treatment was made by the Wingerchuk vision classification.Results Among the twenty patients,eighteen patients had chronic hepatitis B and two patients had chronic hepatitis C.Thirteen (65%) patient were monocular,sixteen( 80% ) patients were single-phase course.Twenty-seven eyes were affected.Disc edema was very common which was found in 14 eyes(52% ),severe vision impairment ( Best corrected

  20. Normal levels of cerebrospinal fluid hypocretin-1 and daytime sleepiness during attacks of relapsing-remitting multiple sclerosis and monosymptomatic optic neuritis

    DEFF Research Database (Denmark)

    Knudsen, S; Jennum, P J; Korsholm, K

    2008-01-01

    There is emerging evidence that multiple sclerosis (MS), the hypothalamic sleep-wake regulating neuropeptide hypocretin-1 (hcrt-1) and the sleep disorder narcolepsy may be connected. Thus, the major pathophysiological component of narcolepsy is lack of hcrt-1. Dysfunction of the hypocretin system...... has been reported in MS case reports with attacks of hypothalamic lesions, undetectable cerebrospinal fluid (CSF) hcrt-1 and hypersomnia, but not found during remission in small samples. Finally, daytime sleepiness, the major symptom of narcolepsy, is reported in several MS populations......, and there are case reports of co-existent narcolepsy and MS. However, it is unknown whether hcrt-1 and daytime sleepiness generally change during MS attacks. We therefore analyzed whether daytime sleepiness (using the Epworth Sleepiness Scale (ESS)) and CSF hcrt-1 levels differed between MS attack and remission......, in 48 consecutively referred patients with relapsing-remitting MS (RRMS) or monosymptomatic optic neuritis (MON). Twenty-seven patients were in attack and 21 in remission. ESS was normal both during attacks (5.4 +/- 3.0) and remission (5.8 +/- 2.6), and mean CSF hcrt-1 was normal (456 +/- 41 pg...

  1. A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis

    DEFF Research Database (Denmark)

    Roed, H.G; Langkilde, Annika Reynberg; Sellebjerg, F;

    2005-01-01

    -four patients were randomized to IVIG 0.4 g/kg body wt, and 34 patients were randomized to placebo. Infusions were given at days 0, 1, 2, 30, and 60. Contrast sensitivity, visual acuity, and color vision were measured at baseline and after 1 week, 1 month, and 6 months. Pattern reversal visual evoked potential...

  2. Relationship between cerebrospinal fluid biomarkers for inflammation, demyelination and neurodegeneration in acute optic neuritis

    DEFF Research Database (Denmark)

    Modvig, Signe; Degn, Matilda; Horwitz, Henrik

    2013-01-01

    Various inflammatory biomarkers show prognostic potential for multiple sclerosis (MS)-risk after clinically isolated syndromes. However, biomarkers are often examined singly and their interrelation and precise aspects of their associated pathological processes remain unclear. Clarification of the...

  3. 亚洲女童视网膜炎合并多发性硬化1例%Optic neuritis with multiple sclerosis in a 10-year-old Asian girl

    Institute of Scientific and Technical Information of China (English)

    A R Rohana; I Shatriah; S Bakiah; W H Wan Hazabbah

    2007-01-01

    ·AIM: To report a case of unilateral optic neuritis with multiple sclerosis in an Asian child·METHODS: A case report·RESULTS: A 10-year-old Chinese girl presented with history of sudden loss of vision of the right eye for 3 days, duration.It was associated with pain in eye movement. She gave history of fever associated with ataxic gait a year ago. She had been diagnosed to have acute disseminated encephalomyelitis (ADEM). Visual acuity in the right eye was 'counting finger' with positive afferent pupillary defect. The optic disc was swollen and hyperemic. The colour vision was severely impaired. Visual field showed central scotoma and enlarged blind spot. Magnetic resonance imaging (MRI) of the brain revealed multiple intense lesions in the left occipital lobe, basal ganglia and periventricular regions suggesting multiple sclerosis. She was treated with intravenous methylprednisolone for 3 days, followed by oral prednisolone for 11 days. She had excellent recovery and her visual acuity improved to 6/9. She remained asymptomatic for 3 years.·CONCLUSION: The simultaneous occurrence of optic neuritis and multiple sclerosis is less common in children and seldom reported. We presented this case to highlight the possibility of this disease occurring in Asian population in a younger age group.%目的:报道亚洲儿童单侧视神经炎合并多发性硬化1例方法:病例报道结果:中国女孩10岁,右眼视力突然持续下降3d,伴有眼球运动痛.患者1a前曾有高热并伴有步态共济失调病史.当时被诊断为急性弥散性脑脊髓炎,右眼视力数指,伴有瞳孔传入阻滞,视盘充血水肿,色觉功能受损严重.视野检查显示中心暗点及盲点扩大.脑部磁共振MRI结果显示大脑左侧枕叶有较高密度影损害,神经中枢基部和脑室周围的区域提示多发性硬化.给予患者甲基强的松龙静脉滴注3d,以后改为口服强的松龙11d.患者出现明显好转,视力提高到6/9,并且维持3a没有

  4. 甲钴胺联合糖皮质激素治疗视神经炎患者的临床效果分析%The Clinical Effect Analysis of Mecobalamin Corticosteroid Therapy in Patients With Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    宋艳琳

    2015-01-01

    目的:分析甲钴胺与糖皮质激素联合治疗视神经炎患者的临床效果。方法回顾性分析2014年7月~2015年7月本院收治的98例视神经炎患者(176只眼)的临床资料,按治疗所用不同方法分为两组,对照组44例患者行糖皮质激素类药物治疗,观察组54例患者在其基础上联合甲钴胺治疗,比较两组疗效及患眼敏感度、视神经颜色改善情况。结果观察组治疗总有效率比对照组高(P<0.05)。结论甲钴胺与糖皮质激素联合治疗视神经炎的效果显著。%Objective Analysis mecobalamin and glucocorticoid therapy in patients with optic neuritis clinical results.Methods A retrospective analysis of July 2014 to July 2015 in our hospital 98 cases of optic neuritis patients (176 eyes) clinical data, according to the different treatment methods are divided into two groups, 44 cases of patients with glucocorticoid drug treatment, observation group of 54 patients with joint mecobalamin on its basis, compare the two groups and the risk of eye sensitivity, optic color to improve the situation.Results Total effective observation group than the control group (P<0.05).Conclusion Mecobalamin with glucocorticoid treatment of optic neuritis effect is remarkable.

  5. 非典型视神经炎的诊断及治疗研究进展%Research advance on diagnosis and treatment for atypical optic neuritis

    Institute of Scientific and Technical Information of China (English)

    曾国燕; 张远平; 李静华

    2016-01-01

    Optic neuritis ( ON) is one of the most common causes of vision loss by neural eye diseases in youth and middle-aged. In the past, the diagnosis simply according to the risk position, which did not distinguish from the pathogenesis and clinical characteristics, can not meet the current clinical diagnosis and treatment needs. Combining with the etiology, clinical characteristics and prognosis, the latest classification of the current international diagnosis of ON are typical and atypical ON. Typical ON relates to multiple sclerosis ( MS ) or demyelinating disease of the central nervous system, it has a relatively good therapeutic effect and prognosis. Rather than, atypical ON has complex etiology, clinical manifestation, and the treatment and prognosis are also different. At present there are many international ON treatment guidelines with level I evidence-based medical evidence, but with different genetic background, geographical environment and ethnic groups, they are not been determined. China lacks of such a multicenter large sample, a wide range of research evidence. In this paper, we will summarize the progress of the diagnosis and treatment about ON, especially about the atypical ON, in order to provide some suggestions to further improve the standardization and individualization for clinical diagnosis and treatment on ON.%视神经炎( optic neuritis,ON)是导致青、中年人群视力丧失的最常见神经眼科疾病之一。以往简单地按照发病部位分类诊断,未从发病机制及临床特征区分,已不能满足目前临床诊疗需求。结合病因学、临床特征及预后,目前国际最新的分类诊断为典型ON及非典型ON。典型ON特指与多发性硬化( multiple sclerosis,MS)或中枢神经系统脱髓鞘疾病相关,治疗效果及预后相对良好。而非典型ON 病因复杂,临床表现、治疗方法、预后亦不尽相同。目前国际上有多个ON治疗方面的Ⅰ级循证医学证据,但鉴于遗传背景

  6. Longitudinal study of visual function in patients with relapsing-remitting multiple sclerosis with and without a history of optic neuritis.

    Science.gov (United States)

    González Gómez, A; García-Ben, A; Soler García, A; García-Basterra, I; Padilla Parrado, F; García-Campos, J M

    2017-03-15

    The contrast sensitivity test determines the quality of visual function in patients with multiple sclerosis (MS). The purpose of this study is to analyse changes in visual function in patients with relapsing-remitting MS with and without a history of optic neuritis (ON). We conducted a longitudinal study including 61 patients classified into 3 groups as follows: a) disease-free patients (control group); b) patients with MS and no history of ON; and c) patients with MS and a history of unilateral ON. All patients underwent baseline and 6-year follow-up ophthalmologic examinations, which included visual acuity and monocular and binocular Pelli-Robson contrast sensitivity tests. Monocular contrast sensitivity was significantly lower in MS patients with and without a history of ON than in controls both at baseline (P=.00 and P=.01, respectively) and at 6 years (P=.01 and P=.02). Patients with MS and no history of ON remained stable throughout follow-up whereas those with a history of ON displayed a significant loss of contrast sensitivity (P=.01). Visual acuity and binocular contrast sensitivity at baseline and at 6 years was significantly lower in the group of patients with a history of ON than in the control group (P=.003 and P=.002 vs P=.006 and P=.005) and the group with no history of ON (P=.04 and P=.038 vs P=.008 and P=.01). However, no significant differences were found in follow-up results (P=.1 and P=.5). Monocular Pelli-Robson contrast sensitivity test may be used to detect changes in visual function in patients with ON. Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Brain Tissue Volumes and Perfusion Change with the Number of Optic Neuritis Attacks in Relapsing Neuromyelitis Optica: A Voxel-Based Correlation Study.

    Directory of Open Access Journals (Sweden)

    Carlos A Sánchez-Catasús

    Full Text Available Recent neuroimaging studies show that brain abnormalities in neuromyelitis optica (NMO are more frequent than earlier described. Yet, more research considering multiple aspects of NMO is necessary to better understand these abnormalities. A clinical feature of relapsing NMO (RNMO is that the incremental disability is attack-related. Therefore, association between the attack-related process and neuroimaging might be expected. On the other hand, the immunopathological analysis of NMO lesions has suggested that CNS microvasculature could be an early disease target, which could alter brain perfusion. Brain tissue volume changes accompanying perfusion alteration could also be expected throughout the attack-related process. The aim of this study was to investigate in RNMO patients, by voxel-based correlation analysis, the assumed associations between regional brain white (WMV and grey matter volumes (GMV and/or perfusion on one side, and the number of optic neuritis (ON attacks, myelitis attacks and/or total attacks on the other side. For this purpose, high resolution T1-weighted MRI and perfusion SPECT imaging were obtained in 15 RNMO patients. The results showed negative regional correlations of WMV, GMV and perfusion with the number of ON attacks, involving important components of the visual system, which could be relevant for the comprehension of incremental visual disability in RNMO. We also found positive regional correlation of perfusion with the number of ON attacks, mostly overlapping the brain area where the WMV showed negative correlation. This provides evidence that brain microvasculature is an early disease target and suggests that perfusion alteration could be important in the development of brain structural abnormalities in RNMO.

  8. Progressive Loss of Retinal Ganglion Cells and Axons in Nonoptic Neuritis Eyes in Multiple Sclerosis: A Longitudinal Optical Coherence Tomography Study.

    Science.gov (United States)

    Graham, Elizabeth C; You, Yuyi; Yiannikas, Con; Garrick, Raymond; Parratt, John; Barnett, Michael H; Klistorner, Alexander

    2016-04-01

    To examine the rate of retinal ganglion cell (RGC) layer and retinal nerve fiber layer (RNFL) changes in nonoptic neuritis (NON) eyes of relapsing remitting multiple sclerosis (RRMS) patients, and to find a specific imaging parameter useful for identifying disease progression. Forty-five consecutive RRMS patients and 20 age- and sex-matched healthy subjects were enrolled. All patients were followed up for 3 years with annual optical coherence tomography (OCT) scans, which included a peripapillary ring scan protocol for RNFL analysis and a macular radial star-like scan to obtain RGC/inner plexiform layer (IPL) thickness measures. Healthy controls were scanned twice, 3 years apart. Retinal ganglion cell/inner plexiform layer and temporal RNFL (tRNFL) demonstrated highly significant thinning (P < 0.01), but all nasal segments and global RNFL (gRNFL) were not significantly different from normal controls. While receiver operating characteristics (ROC) analysis showed no advantage of RGC/IPL over tRNFL in cross-sectional detection of thinning, cut-off point based of fifth percentile in healthy controls demonstrated higher rate of abnormality for RGC/IPL. There was a significant progressive loss of RGC/IPL and tRNFL during the follow-up period. The largest thickness reduction was observed in tRNFL. ROC analysis demonstrated that tRNFL provided better sensitivity/specificity for detecting change over time than RGC/IPL (area under the curve [AUC] 0.78 vs. 0.52), which was confirmed by higher detection rate when 95th percentile of progression in healthy controls was used as a cut-off. This study confirmed significant thinning of RGC/IPL and tRNFL in NON eyes of RRMS patients. Progressive losses were more apparent on tRNFL, while RGC/IPL showed less change over the follow-up period.

  9. Brain Tissue Volumes and Perfusion Change with the Number of Optic Neuritis Attacks in Relapsing Neuromyelitis Optica: A Voxel-Based Correlation Study.

    Science.gov (United States)

    Sánchez-Catasús, Carlos A; Cabrera-Gomez, José; Almaguer Melián, William; Giroud Benítez, José Luis; Rodríguez Rojas, Rafael; Bayard, Jorge Bosch; Galán, Lídice; Sánchez, Reinaldo Galvizu; Fuentes, Nancy Pavón; Valdes-Sosa, Pedro

    2013-01-01

    Recent neuroimaging studies show that brain abnormalities in neuromyelitis optica (NMO) are more frequent than earlier described. Yet, more research considering multiple aspects of NMO is necessary to better understand these abnormalities. A clinical feature of relapsing NMO (RNMO) is that the incremental disability is attack-related. Therefore, association between the attack-related process and neuroimaging might be expected. On the other hand, the immunopathological analysis of NMO lesions has suggested that CNS microvasculature could be an early disease target, which could alter brain perfusion. Brain tissue volume changes accompanying perfusion alteration could also be expected throughout the attack-related process. The aim of this study was to investigate in RNMO patients, by voxel-based correlation analysis, the assumed associations between regional brain white (WMV) and grey matter volumes (GMV) and/or perfusion on one side, and the number of optic neuritis (ON) attacks, myelitis attacks and/or total attacks on the other side. For this purpose, high resolution T1-weighted MRI and perfusion SPECT imaging were obtained in 15 RNMO patients. The results showed negative regional correlations of WMV, GMV and perfusion with the number of ON attacks, involving important components of the visual system, which could be relevant for the comprehension of incremental visual disability in RNMO. We also found positive regional correlation of perfusion with the number of ON attacks, mostly overlapping the brain area where the WMV showed negative correlation. This provides evidence that brain microvasculature is an early disease target and suggests that perfusion alteration could be important in the development of brain structural abnormalities in RNMO.

  10. Application of magnetic resonance imaging in idiopathic demyelinating optic neuritis%磁共振成像在特发性脱髓鞘性视神经炎研究中的应用

    Institute of Scientific and Technical Information of China (English)

    秦军

    2013-01-01

    特发性脱髓鞘性视神经炎(IDON)是最常见的视神经炎类型,与多发性硬化(MS)关系密切,二者有共同的病理过程,IDON通常是MS的首发症状.在IDON视神经损害的评估技术中,视神经磁共振成像正逐渐成为一种有价值的技术.本文主要从特发性脱髓鞘性视神经炎的临床特点及病理特征、常规视神经磁共振成像及功能磁共振成像在特发性脱髓鞘性视神经炎视神经损害评估中的应用等方面做一综述.%Idiopathic demyelinating optic neuritis(IDON) is the most common type of optic neuritis, and closely related to multiple sclerosis. They have common pathological foundation, and IDON is usually the first clinical feature of MS. In the optic nerve damage assessment techniques of IDON, magnetic resonance imaging has become a valuable technique. This review summarises the main results obtained from clinical expressions, pathological features, and conventional and functional magnetic resonance imaging techniques for the evaluation of optic nerve damage in IDON.

  11. Efficacy of Glucocorticoid Combined With Mecobalamin Treatment in the Treatment of Optic Neuritis%糖皮质激素与甲钴胺联合治疗视神经炎的效果研究

    Institute of Scientific and Technical Information of China (English)

    程笑冬

    2016-01-01

    Objective Glucocorticoid combined with mecobalamin treatment effect in treatment of optic neuritis is to be studied. Methods Chose 55 patients of optic neuritis who were treated in hospital from January 2015 to October 2015 and separated them into two groups according to digits,27 patients in control group were given glucocorticoid treatment only,while 28 patients in study group were given glucocorticoid combined with mecobalamin treatment, and then observed and compared treatment effects between two groups. Results Patients’treatment sensitivity,symptom improvement incidence and treatment efficacy in study group were much higher than counterparts in control group,there was a differential between two groups and such a differential had statistic value(P < 0.05). Conclusion Glucocorticoid combined with mecobalamin treatment is effective in treatment of optic neuritis.%目的:研究糖皮质激素与甲钴胺联合治疗视神经炎的效果。方法研究年度2015年1月~2015年10月纳入视神经炎患者55例,按数字法分两组。糖皮质激素治疗者27例,设对照组;糖皮质激素与甲钴胺联合治疗者28例,设实验组。比较效果。结果两组中实验组敏感度更高,改善率更高,治疗有效率更高,差异具有统计学意义(P <0.05)。结论糖皮质激素与甲钴胺联合治疗视神经炎效果佳。

  12. Expression of serum AQP4-Ab and the significance in patients with optic neuritis%血清AQP4-Ab在视神经炎患者中的表达

    Institute of Scientific and Technical Information of China (English)

    赵峰; 陈伟; 孙青山; 付金营

    2016-01-01

    目的:探讨血清水通道蛋白4抗体( AQP4-Ab )在视神经炎患者中的阳性表达率及其意义。  方法:选取2012-01/2015-12本院眼科中心确诊的98例128眼视神经炎患者进行研究,检测患者的血清AQP4-Ab、抗核抗体( ANAs )的阳性率,根据AQP4-Ab表达进行分组,对比两组间最佳矫正视力、盘周视网膜神经纤维层厚度( pRNFL )、黄斑容积、黄斑部RNFL ( mRNFL )、黄斑部内核层容积( mINL)测定值。  结果:确诊的视神经炎患者98例128眼,经过检查发现AQP4-Ab 阳性患者22例(22%),阴性患者76例(78%);ANAs 阳性患者21例(21%),阴性患者77例(79%);视神经炎患者的血清AQP4-Ab阳性率与ANAs阳性率具有显著的相关关系(r=0.707,P0.05);经过检查发现AQP4-Ab阳性患者的pRNFL、黄斑容积测定值均显著地小于阴性患者,差异均具有统计学意义( P0.05)。  结论:AQP4-Ab在视神经炎患者中的阳性表达与ANAs存在显著的相关性, AQP4-Ab 阳性视神经炎患者的pRNFL变薄、黄斑容积下降明显。%AIM:To investigate the serum antibody of aquaporin 4 ( AQP4 - Ab ) in positive expression rate and the significance in patients with neuritis. ●METHODS: A total of 98 cases ( 128 eyes ) of patients with optic neuritis were studied to detect the patient′s serum AQP4-Ab positive rate of antinuclear antibodies ( ANAs) from Jan. 2012 to Dec. 2015 in ophthalmology center of our hospital. According to the expression of AQP4 - Ab group, the best corrected visual acuity between the two groups, peripapillary nerve fiber layer thickness (pRNFL), the volume of the macula, macular RNFL ( mRNFL ) , macular core layer volume ( mlNL ) measurement were compared. ●RESULTS:Ninety-eight patients (128 eyes) with optic neuritis cases diagnosed through examination revealed AQP4-Ab positive in 22 patients ( 22%) , negative in 76 patients ( 78%) , ANAs positive in 21 patients ( 21%) , negative 77 patients ( 79%) . Optic

  13. Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

    Directory of Open Access Journals (Sweden)

    Osman Okan Olcaysu

    2015-01-01

    Full Text Available Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE. The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

  14. Neurodegeneration in Autoimmune Optic Neuritis Is Associated with Altered APP Cleavage in Neurons and Up-Regulation of p53.

    Directory of Open Access Journals (Sweden)

    Sabine Herold

    Full Text Available Multiple Sclerosis (MS is a chronic autoimmune inflammatory disease of the central nervous system (CNS. Histopathological and radiological analysis revealed that neurodegeneration occurs early in the disease course. However, the pathological mechanisms involved in neurodegeneration are poorly understood. Myelin oligodendrocyte glycoprotein (MOG-induced experimental autoimmune encephalomyelitis (EAE in Brown Norway rats (BN-rats is a well-established animal model, especially of the neurodegenerative aspects of MS. Previous studies in this animal model indicated that loss of retinal ganglion cells (RGCs, the neurons that form the axons of the optic nerve, occurs in the preclinical phase of the disease and is in part independent of overt histopathological changes of the optic nerve. Therefore, the aim of this study was to identify genes which are involved in neuronal cell loss at different disease stages of EAE. Furthermore, genes that are highly specific for autoimmune-driven neurodegeneration were compared to those regulated in RGCs after optic nerve axotomy at corresponding time points. Using laser capture micro dissection we isolated RNA from unfixed RGCs and performed global transcriptome analysis of retinal neurons. In total, we detected 582 genes sequentially expressed in the preclinical phase and 1150 genes in the clinical manifest EAE (P 1.5. Furthermore, using ingenuity pathway analysis (IPA, we identified amyloid precursor protein (APP as a potential upstream regulator of changes in gene expression in the preclinical EAE but neither in clinical EAE, nor at any time point after optic nerve transection. Therefore, the gene pathway analysis lead to the hypothesis that altered cleavage of APP in neurons in the preclinical phase of EAE leads to the enhanced production of APP intracellular domain (AICD, which in turn acts as a transcriptional regulator and thereby initiates an apoptotic signaling cascade via up-regulation of the target gene p

  15. [Acute optic neuropathy: differential diagnoses].

    Science.gov (United States)

    Buompadre, María Celeste

    2013-09-06

    Introduccion. La alteracion funcional del nervio optico se caracteriza por un deficit en la agudeza visual, en la vision cromatica y en el campo visual, defecto pupilar aferente y, en algunos casos, edema del nervio o atrofia y palidez. Objetivo. Describir el espectro de neuropatias opticas agudas, su clinica, diagnostico y tratamiento, con mayor interes en aquellas de presentacion en la edad pediatrica. Desarrollo. La neuritis optica puede ser monofasica, recurrente o el componente de un cuadro desmielinizante polisintomatico. El objetivo del tratamiento es reducir el numero y la gravedad de los ataques y prevenir discapacidad. La infecciosa es secundaria a diferentes microorganismos (bacterias, virus, hongos y protozoos). El tratamiento depende de la etiologia. La isquemica anterior no arteritica o idiopatica es la forma mas frecuente y es secundaria a enfermedad de pequeños vasos (ciliares posteriores). La neuropatia optica hereditaria o de Leber representa una causa importante de afectacion visual cronica y se caracteriza por la afectacion selectiva de las celulas ganglionares de la retina. Hasta el momento, la terapia solo es de apoyo. En el papiledema asociado a hipertension endocraneal, la agudeza visual generalmente se conserva pero existe aumento de la mancha ciega. El tratamiento se basa en disminuir la hipertension y el factor etiologico si existe. Conclusiones. Las neuropatias opticas agudas constituyen un amplio grupo de entidades, de etiologia diversa y con un pronostico visual variable. La presencia de signos del examen neurologico, fondo de ojo y neuroimagenes pueden orientar hacia el diagnostico y tratamiento oportuno.

  16. 多发性硬化患者视神经炎发作早期的相干光断层扫描表现%Analysis of optical coherence tomography in early stage of optic neuritis in multiple sclerosis patients

    Institute of Scientific and Technical Information of China (English)

    程钢炜; 赵家良; 梁珍; 钟勇; 张华; 马建民; 睢瑞芳; 毛进

    2011-01-01

    目的 探讨多发性硬化(MS)患者在视神经炎发作早期的视网膜神经纤维层(RNFL)、黄斑区节细胞复合体层(GCC)及视神经乳头的改变.方法 前瞻性系列病例研究.2007年2月至2010年11月中国医学科学院北京协和医学院北京协和医院眼科疑似视神经炎急性发作的MS患者22例,在其急性视神经炎发作1周内,应用相干光断层扫描技术(OCT)对其进行检查,测量RNFL平均厚度、GCC平均厚度,对RNFL地形图和视神经乳头三维重建进行分析.结果 MS患者视神经炎发作1周内,首次发作的视神经炎早期眼的RNFL平均厚度为(141.55±53.73)μm,其中有75%( 12/16)的受检眼RNFL平均厚度增加,GCC平均厚度范围为91.54~118.45μm,其中64%(7/11)的受检眼G CC平均厚度增加;复发的视神经炎早期眼的RNFL平均厚度为(59.71±8.98)μm,其中有91.7%(11/12)的RNFL平均厚度变薄,GCC平均厚度范围为58.92 ~91.76 μm,其中62.5%(5/8)的受检眼GCC平均厚度较正常薄;视神经炎发作早期眼的对侧眼的RNFL平均厚度为(125.45±26.16) μm,其中60%( 6/10)的受检眼RNFL平均厚度增加,GCC平均厚度范围为90.35~117.37μm,43% (3/7)的受检眼GCC平均厚度增加;OCT较直接眼底镜检查可以更多发现视神经乳头水肿和RNFL增厚.结论 MS患者在视神经炎首次发作早期、复发早期具有不同程度的RNFL、GCC及视神经乳头改变.应用OCT可以检测到相关的变化.%Objective To detect the changes in the retinal nerve fiber layer (RNFL) and ganglion cell complex ( GCC ) in the eyes of multiple sclerosis patients during the early stage of optic neuritis.Methods A prospective case series study.Suspected acute optic neuritis of multiple sclerosis (MS) patients who attended the department of ophthalmology in Peking Union Medical College hospital from Feb.2007 to Nov.2010 were collected.Twenty two MS patients were evaluated within the first week of the attack of acute

  17. Features of anti-aquaporin 4 antibody-seropositive Chinese patients with neuromyelitis optica spectrum optic neuritis.

    Science.gov (United States)

    Li, Hongyang; Wang, Yanling; Xu, Quangang; Zhang, Aidi; Zhou, Huanfen; Zhao, Shuo; Kang, Hao; Peng, Chunxia; Cao, Shanshan; Wei, Shihui

    2015-10-01

    The detection of anti-aquaporin-4 autoantibody (AQP-4 Ab) is crucial to detect patients who will develop neuromyelitis optica (NMO); however, there are few studies on the AQP-4 Ab serostatus of patients with neuromyelitis optica spectrum ON. We analyzed the clinical and paraclinical features of neuromyelitis optica spectrum ON patients in China according to the patients' AQP4-Ab serostatus. 125 patients with recurrent and bilateral ON with simultaneous attacks were divided into AQP-4 Ab-seropositive and -seronegative groups. Demographic, clinical, serum autoantibody data, connective tissue disorders (CTDs), visual performance were compared. A Visual Acuity (VA) of less than 0.1 during acute ON attacks occurred more frequently in the seropositive group (p = 0.023); however, there was not a significant difference between groups on VA recovery after the first attack. The seropositive group experienced the worst outcome during the last attack (p = 0.017). Other co-existing autoimmunity antibodies (p optica spectrum ON.

  18. Retinal Nerve Fiber Layer May Be Better Preserved in MOG-IgG versus AQP4-IgG Optic Neuritis: A Cohort Study

    Science.gov (United States)

    Chodick, Gabriel; Bialer, Omer; Marignier, Romain; Bach, Michael; Hellmann, Mark Andrew

    2017-01-01

    Background Optic neuritis (ON) in patients with anti-myelin oligodendrocyte glycoprotein (MOG)-IgG antibodies has been associated with a better clinical outcome than anti-aquaporin 4 (AQP4)- IgG ON. Average retinal nerve fiber layer thickness (RNFL) correlates with visual outcome after ON. Objectives The aim of this study was to examine whether anti-MOG-IgG ON is associated with better average RNFL compared to anti-AQP4-IgG ON, and whether this corresponds with a better visual outcome. Methods A retrospective study was done in a consecutive cohort of patients following anti-AQP4-IgG and anti-MOG-IgG ON. A generalized estimating equation (GEE) models analysis was used to compare average RNFL outcomes in ON eyes of patients with MOG-IgG to AQP4-IgG-positive patients, after adjusting for the number of ON events. The final mean visual field defect and visual acuity were compared between ON eyes of MOG-IgG and AQP4-IgG-positive patients. A correlation between average RNFL and visual function was performed in all study eyes. Results Sixteen patients were analyzed; ten AQP4-IgG-positive and six MOG-IgG-positive. The six patients with MOG-IgG had ten ON events with disc edema, five of which were bilateral. In the AQP4-IgG-positive ON events, 1/10 patients had disc edema. Final average RNFL was significantly better in eyes following MOG-IgG-ON (75.33μm), compared to 63.63μm in AQP4-IgG-ON, after adjusting for the number of ON attacks (GEE, p = 0.023). Mean visual field defects were significantly smaller (GEE, p = 0.046) among MOG-IgG positive ON eyes compared to AQP-IgG positive ON eyes, but last visual acuity did not differ between the groups (GEE, p = 0.153). Among all eyes, average RNFL positively correlated with mean visual field defect (GEE, p = 0.00015) and negatively correlated with final visual acuity (GEE, p = 0.00005). Conclusions Following ON, RNFL is better preserved in eyes of patients with MOG-IgG antibodies compared to those with AQP4-IgG antibodies

  19. The clinical observation and etiologies of binocular recurrent optic neuritis%双眼复发性视神经炎的病因研究

    Institute of Scientific and Technical Information of China (English)

    韦企平; 周剑; 孙艳红; 宫晓红; 路明

    2010-01-01

    目的 明确双眼复发性视神经炎的病因及和多发性硬化等脱髓鞘疾病的相关性.方法 对1992~2006年间38例双眼复发性视神经炎进行回顾性分析,并随访调查最终病因.结果 该38例随访时间9~96个月,平均(45.8±20.83)个月.19例(50%)诊断为中枢神经系统脱髓鞘疾病,其中多发性硬化14例(36.8%),视神经脊髓炎5例(13.2%).另有19例(50%)病因不明.结论 双眼复发性视神经炎的重要病因是以多发性硬化为主的中枢神经系统脱髓鞘疾病,这类视神经炎在病因不明时应建立长期随访制度.%Objective To define the clinical characters and etiologies of binocular recurrent optic neuritis (ON), and to estimate the relations of ON to multiple sclerosis (MS) or neuromyelitis optica (NMO).Methods Retrospective medical record review of both clinical and laboratory evidence supporting the diagnosis of 38 patients with binocular recurrent ON between 1992 and 2006, and all cases had been followed-up for 9-96 months (45.8± 20.83M). Results The conversion rate to NMO was 13.2% and to MS, 36.8%. Nineteen patients (50%) of 38 cases were diagnosed eventually to an inflammatory demyelinating disease of the central nervous system. Conclusions The inflammatory demyelinating diseases of the central nervous system are the important etiologies of binocular recurrent ON.

  20. Visual dependency and dizziness after vestibular neuritis.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Symptomatic recovery after acute vestibular neuritis (VN is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI. The third of patients showing the worst clinical outcomes (mean DHI score 36-80 had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03. Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.

  1. MOG抗体在不同类型免疫介导性视神经炎血清中的表达%Anti-MOG antibody in different types of immune-mediated optic neuritis

    Institute of Scientific and Technical Information of China (English)

    孔秀云; 彭静婷; 刘丽娟; 颜榕; 张晓君

    2012-01-01

    目的 初步探索抗髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)在不同临床类型免疫介导性视神经炎(IM-ON)患者血清中的表达.方法 采用临床病例横断面研究.2010年5月至2011年2月至北京同仁医院神经内科就诊的免疫介导性视神经炎患者(IM-ON) 129例,根据其临床特点分为以下5组:多发性硬化相关视神经炎(MS-ON) 20例,视神经脊髓炎相关视神经炎(NMO-ON) 13例,自身免疫病相关视神经炎(AON) 33例,复发性孤立性视神经炎(RION) 43例及单发性孤立性视神经炎(SION)20例.用ELISA方法对其血清中MOG-Ab进行检测,应用SPSS17.0软件,采用x2检验及方差分析、t检验方法对数据进行统计学分析,比较其阳性率与抗体滴度在不同组间的区别.结果 所有129例IM-ON患者中12例(9.3%)患者的血清MOG-Ab阳性.其中MS-ON组血清MOG-Ab阳性者5例(5/20),NMO-ON组0例(0/13),AON组4例(4/33),RION组2例(2/43),SION组1例(1/20).5组间阳性率差异无统计学意义(Fisher确切概率法,x2=7.051,P=0.088).将除MS-ON组之外的其余4组合并为“视神经脊髓炎(NMO)谱系视神经炎”后与MS-ON组比较发现,MS-ON组的MOG-Ab阳性率和抗体滴度均明显高于“NMO谱系视神经炎”组.结论 MOG抗体见于除NMO-ON之外的各种类型的IM-ON,在MS-ON患者血清中的表达明显高于“NMO谱系视神经炎”.%Objective To investigate the expression of anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in different types of immune-mediated optic neuritis (IM-ON).Methods Case-control and cross section study.The serum of 129 consecutive cases of immune-mediated optic neuritis (IM-ON group) seen in Neuro-ophthalmology clinic in Department of Neurology,Beijing Tongren Hospital during May 2010 and February 2011 were collected.All IM-ON cases were further classified into five different types as:20 cases of multiple sclerosis related ON (MS-ON),13 cases of neuromyelitis optica related ON (NMO-ON),33 cases of

  2. 视神经炎伴多发性硬化的彩色多普勒成像特点%Color Doppler imaging characteristics in optic neuritis with multiple sclerosis

    Institute of Scientific and Technical Information of China (English)

    周必业; 张宇虹

    2014-01-01

    Objective To evaluate retrobulbar hemodynamics in patients with optic neuritis associated with multiple sclerosis,and compare with the contralateral eye and the eyes of the healthy control group.Methods From the list of neurology side neuritis recruit 34 patients with multiple sclerosis and 32 healthy subjects.By ultrasound Doppler imaging optic neuritis side of the eye suffering from eye artery,posterior ciliary artery and central retinal artery peak systolic and diastolic blood flow velocity and resistance index (resistivity index).Then these values in healthy subjects with normal contralateral eye and the eye were as comparison.Statistical methods were used paired t test and unpaired t test.Results The optic neuritis eyes,not involving the contralateral eye,as well as healthy control eyes,mean blood flow velocity after the ball,the average resistance index was no significant difference (P >0.05).And compared with control eyes,optic neuritis eye mean central retinal artery diastolic flow velocity was low (P =0.04),central retinal artery (P =0.02) and post-ciliary artery (P =0.009),the average resistance index higher.In patients with multiple sclerosis patients,and not involving the contralateral eye compared ciliary artery (P =0.02),and central retinal artery (P =0.04) with optic neuritis with higher resistance to lateral eye index.Retrobulbar blood flow velocity and vascular resistance index all without involving the contralateral eye and normal control eyes was no significant difference (P >0.05).Conclusions This study suggests that multiple sclerosis and optic neuritis is related with retrobulbar hemodynamics related damage,especially in the ciliary artery and central retinal arteries.However,a causal relationship between the two remains to be demonstrated.%目的 评价视神经炎伴多发性硬化患者的眼球后血流动力学改变,并与健侧眼及健康对照组眼对比.方法 回顾性分析34例单侧视神经炎伴

  3. 中西医结合治疗视神经炎74例临床观察%Clinical observation on 74 optical neuritis of combined treatment of western and Chinese medicine

    Institute of Scientific and Technical Information of China (English)

    刘红

    2012-01-01

    OBJECTIVE To observe the clinical effects of modified Danzhi Xiaoyao Powder combined with conventional western medicine in treating optical neuritis. METHODS Seventy-four optical neuritis patients (83 eyes) were randomly divided into two groups. Thirty-seven cases (42 eyes) in control group underwent steroids or other conventional western medicine treatment, and 37 cases (41 eyes) in treatment group took modified Danzhi Xiaoyao Powder orally combined with conventional western medicine. RESULTS In control group, 8 eyes were cured, 10 eyes showed obvious effects, 17 eyes were improved and 7 eyes showed no improvement. The total effective rate was 83.3%. In treatment group, 12 eyes were cured, 12 eyes showed obvious effects, 16 eyes were improved and 1 eye showed no improvement. The total effective rate was 97.6%. The difference between the two groups was statistically significant (P<0.05). CONCLUSION Modified Danzhi Xiaoyao Powder combined with conventional western medicine treatment could improve the treatment effects of optical neuritis.%目的 观察丹栀逍遥散加减联合常规西药治疗视神经炎的临床疗效.方法 视神经炎患者74例(83只眼),随机分为2组.对照组37例(42只眼)采用激素等常规西药治疗,治疗组37例(41只眼)在常规西药治疗的基础上给予口服丹栀逍遥散加减方,观察治疗效果.结果 对照组治愈8只眼,显效10只眼,好转17只眼,无效7只眼,总有效率83.3%;治疗组治愈12只眼,显效12只眼,好转16只眼,无效1只眼,总有效率为97.6%,2组差异有统计学意义(P<0.05).结论 丹栀逍遥散加减联合常规西药治疗可以提高治疗视神经炎的疗效.

  4. 视神经炎的MRI表现及与视觉诱发电位的相关性研究%MRI findings and correlative study of MRI and visual evoked potentials in optic neuritis

    Institute of Scientific and Technical Information of China (English)

    燕飞; 李静; 王振常; 刘守斌; 张晓君

    2008-01-01

    Objective To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential(VEP)in diagnosing optic neuritis.Methods One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis,papillitis,multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using x2 test,wilcoxon test and Kappa test.Results Out of the 154 sick eyes.56 eyes presented thickened optic nerves.76 eyes had normal diameter of the optic nerve,and 22 eyes had thin optic nerves.A total of 132 optic nerves showed abnormally high signal in STIR sequences.including involvement of intraocular segment in 7,intraorbitsl segment in 135,intracanalicular segment in 109,intracranial segment in 97,optic chiasm in 56,and optic tract in 23.A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement.Among the 196 eyes of 98 patients,132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve.and 26 eyes had both normal vision and normal MR signal of optic nerve.The consistency of MRI findings and vision status was 80.61%(Kappa=0.453,P<0.01).Among the 175 eyes with VEP results.129 eyes had visual loss with simultaneous VEP abnormalities,and 30 eyes had both normal vision and normal VEP results.The consistency of VEP and vision status was 90.86%(Kappa=0.731,P<0.01).Among the 175 eyes with VEP results,117 eyes had abnormal MR signal of the optic nerve and simultaneous abnormal VEP,and 24 eyes had both normal MR signal of the optic nerve and normal VEP.The consistency of MRI findings and VEP was 80.57%(Kappa=0.460,P<0.01).Conclusion STIR sequence and gadolinium-enhanced T1-weighted MR sequence combined with fatsuppression are helpful in diagnosis of optic neuritis.VEP is helpful in diagnosing optic neuritis and in finding subclinical visual

  5. Idiopathic brachial neuritis in a child: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Shikha Jain

    2014-01-01

    Full Text Available Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies.

  6. Serum uric acid levels in patients with optic neuritis%视神经炎患者血清尿酸浓度检测

    Institute of Scientific and Technical Information of China (English)

    邓娟; 梁雪梅; 杨婷婷; 李敏; 彭福华

    2013-01-01

    目的 观察视神经炎((ON)患者的血清尿酸浓度.方法 临床确诊的39例ON患者(ON组)及年龄、性别与之匹配的69例多发性硬化(MS)患者(MS组)、51例视神经脊髓炎(NMO)患者(NMO组)和53名健康对照者(对照组)纳入研究.ON组患者中,视盘炎25例,球后ON 14例;初发者28例,复发者11例;病程<1年者28例,病程≥1年者11例.所有受检者均于入院后第2天抽取空腹静脉血,采用尿酸酶-过氧化物酶偶联法检测血清尿酸浓度.对比分析各组受检者之间血清尿酸浓度差异;各组间不同性别者血清尿酸浓度差异;ON组不同病变性质、不同复发情况、不同病程患者间血清尿酸浓度差异.结果 ON组患者血清尿酸浓度较对照组受检者明显降低,差异有统计学意义(t=3.16,P<0.05).ON组与MS组、ON组与NMO组、MS组与NMO组患者间血清尿酸浓度比较,差异均无统计学意义(t=0.26、0.94、1.36,P>0.05).ON组、MS组、NMO组女性患者及对照组女性受检者血清尿酸浓度均较男性明显降低,差异均有统计学意义(F=6.27、16.20、21.09、11.96,P<0.05).ON组男女性患者血清尿酸浓度较对照组男女性受检者明显降低,差异有统计学意义(t=2.13、3.04,P<0.05).ON组与MS组(t=0.25、0.59)、ON组与NMO组(t=0.33、0.63)、MS组与NMO组(t=0.63、1.41)男女性患者间血清尿酸浓度比较,差异均无统计学意义(P>0.05).ON组复发者血清尿酸浓度较初发者低(F=2.73),病程≥1年者血清尿酸浓度较病程<1年者低(F=0.23),球后ON患者血清尿酸浓度较视盘炎患者低(F=0.76),但差异均无统计学意义(P>0.05).结论 ON患者血清尿酸浓度较正常健康者降低.不同发病情况、不同病程及不同病变部位的ON患者血清尿酸浓度间无明显差异.%Objective To observe serum uric acid (UA) level of patients with optic neuritis (ON).Methods Thirty-nine patients with ON (ON group),53 healthy control subjects (control

  7. A connection between neurovascular conflicts within the cerebellopontine angle and vestibular neuritis, a case controlled cohort study

    OpenAIRE

    Loader, B.; Linauer, I.; Korkesch, S.; Krammer-Effenberger, I.; Zielinski, V.; Schibany, N.; Kaider, A.; Vyskocil, E.; Tscholakoff, D.; Franz, P.

    2016-01-01

    SUMMARY This retrospective, observer blinded case-control study aims to compare the prevalence of neurovascular conflicts (NVCs) of the vestibulocochlear nerve and the anterior inferior cerebellar artery (AICA) in patients presenting with clinical signs of acute vestibular neuritis with and without subsequent objective vestibular function loss (VFL). 58 acute cases of clinically suspected acute vestibular neuritis were investigated with same day cranial MRI at a tertiary referral centre and c...

  8. Chikungunya fever presenting with acute optic neuropathy.

    Science.gov (United States)

    Mohite, Abhijit Anand; Agius-Fernandez, Adriana

    2015-07-28

    Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling. Serology confirmed recent CHIKV infection. Treatment with intravenous methylprednisolone was delayed while awaiting MRI scans and serology results. At 5-month follow-up, there was a persistent right RAPD and marked optic atrophy with a corresponding inferior scotoma in the visual field. 2015 BMJ Publishing Group Ltd.

  9. MRI in acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Caldemeyer, K.S. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States)); Smith, R.R. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States)); Harris, T.M. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States)); Edwards, M.K. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States))

    1994-04-01

    A retrospective analysis of CT and MRI studies in 12 patients with a clinical diagnosis of acute disseminated encephalomyelitis (ADEM) was performed. MRI was the definitive modality for the assessment of the lesions of ADEM: all patients had abnormalities consistent with the clinical diagnosis. Ten had abnormalities in the brain, three spinal cord lesions, and three showed evidence of optic neuritis. CT was normal in 6 of the 7 patients in which it was performed. (orig.)

  10. Bilateral optic neuropathy in acute cryptococcal meningitis

    Institute of Scientific and Technical Information of China (English)

    Qi Zhe Ngoo; Li Min Evelyn Tai; Wan Hazabbah Wan Hitam; John Tharakan

    2016-01-01

    We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had som-nolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous flu-conazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

  11. Clinical observation on 94 cases of optic neuritis treated with combination of Chinese traditional and Western medicine%中西医结合治疗视神经炎94例临床观察

    Institute of Scientific and Technical Information of China (English)

    杨琴

    2014-01-01

    Objective:To investigate the clinical effect of Danzhixiaoyao powder combined with conventional western medicine in the treatment of optic neuritis.Methods:94 patients with optic neuritis(102 eyes) were selected from March 2010 to October 2012. They were randomly divided into the observation group and the control group with 47 cases in each.The control group(50 eyes) were treated with conventional western medicine treatment primary in glucocorticoid.The observation group(52 eyes) added with oral administration of Danzhixiaoyaosan decoction on the basis of glucocorticoid,1 dose per day,decocted in water for oral dose, lasted for 1 months.Then we compared the clinical efficacy between the two groups.Results:In the control group,11 eyes were cured;13 eyes markedly effective;19 eyes effective;7 eyes invalid;the total effective rate was 86%.In the observation group,16 eyes were cured;17 eyes markedly effective;17 eyes effective;2 eyes invalid;the total effective rate was 96.2%.The difference of total effectiveness comparisons of two group was statistically significante(P<0.05).Conclusion:Danzhixiaoyao powder combined with conventional western medicine in the treatment of optic neuritis have an satisfactory effect,so it is worthy of clinical application.%目的:探讨丹栀逍遥散联合常规西医疗法在视神经炎治疗中的临床疗效。方法:2010年3月-2012年10月收治视神经炎患者94例(102眼),将其随机分成观察组及对照组,各47例。对照组(50眼)给予糖皮质激素为主的常规西医药物治疗,观察组(52眼)在对照组的基础上,给予口服丹栀逍遥散加减方,1剂/d,水煎服,连服1个月。比较两组的临床疗效。结果:对照组中,11眼治愈,13眼显效,19眼有效,7眼无效,总有效率86.0%;观察组中,16眼治愈,17眼显效,17眼有效,2眼无效,总有效率96.2%,两组总有效率比较差异有统计学意义(P<0.05)。结论:丹栀逍遥散联合

  12. Clinical Effects of Ganciclovir Combined with Methylprednisolone in Treating Viral Optic Neuritis%更昔洛韦联合甲泼尼龙治疗病毒性视神经炎

    Institute of Scientific and Technical Information of China (English)

    李迎春; 樊映川; 胡建斌; 陈豫川; 刘娅莉; 李宇

    2012-01-01

    目的 比较更昔洛韦联合甲泼尼龙综合疗法和甲泼尼龙综合疗法治疗病毒性视神经炎的疗效.方法 将2008年10月-2010年3月入院41例(60只眼)病毒抗体检测阳性的病毒性视神经炎患者随机分为治疗组,21例30只眼)和对照组(20例30只眼).于治疗前和治疗第3、7、14、30、90、180天观察两组患者的视力、视野.结果 两组患者的视力、平均视野缺损治疗组采用更昔洛韦联合甲泼尼龙综合疗法,对照组采用甲泼尼龙综合疗法.均随时间得到改善(P<0.001).两组患者视力在治疗的第3天开始恢复,30d治疗组视力明显优于对照组(P<0.05),治疗180 d时两组视力改善无差异(P>0.05);治疗组与对照组分别在第7天和第14天平均视野缺损开始恢复(P<0.001).结论 更昔洛韦联合甲泼尼龙综合疗法较单纯甲泼尼龙综合疗法治疗病毒性视神经炎能更快提高患者视力、恢复视野、改善患者视觉质量.%Objective To compare the clinical effects of ganciclovir combined with methyiprednisolone and a comprehensive therapy with methyiprednisolone in treating viral optic neuritis. Methods Forty-one patients (60 eyes) with viral optic neuritis admitted into hospital during October 2008 and March 2010 were randomly divided into a control group with 20 patients (30 eyes) and a treatment group with 21 patients (30 eyes). Visual acuity and visual field were observed before and 3rd, 7th, 14th, 30th, 90th, 180th days after the treatment. Results Visual acuity and visual field mean deviation (MD) in two groups were both improved over time (P 0.05). MD began to improve on the 7th day in the treatment group and on the 14th day in the control group (P < 0.001). Conclusion Visual acuity and visual field can be quickly improved by the comprehensive therapy of ganciclovir combined with methyiprednisolone for viral optic neuritis, campared with the comprehensive therapy of methyiprednisolone.

  13. Analysis of incidence and influence factor on clinical idiopathic optic neuritis in Guangxi ophthalmic outpatient%广西眼科门诊特发性视神经炎发病情况及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    陈尽好; 郝小波; 陈洁秀; 赖小玲; 赵建英; 徐辉; 梁俊

    2011-01-01

    OBJECTIVE To understand the incidence of Idiopathic Optic Neuritis of Guangxi ophthalmic outpatient clinic, and to describe the distribution characteristics and provide the relevant factors to further development and analysis epidemiological studies.METHODS The third week of every month in 2008.8~2009.7, 7602 patients of The First Affiliated Hospital of Guangxi Traditional Chinese Medical University and Guangxi People's Hospital were investigated through effective questionnaires by randomly stratified cluster sampling method, then epidemiology investigation in the 18 confirmed cases was done.RESULTS The Age distribution of Idiopathic Optic Neuritis: 5 male, average age was 42.00± 11.113; 13 female, average age was 42.62± 12.901 (P<0.05); Relevant factors :gender(x2=4.697 2,P=0.0302),age(x2=11.390 0,P=0.003 0),educational level(x2=9.195 5 ,P=0.026 8),vocational distribution (x2=23.208 2,P=0.000 1 ).CONCLUSIONA The incidence of Idiopathic Optic Neuritis of Guangxi ophthalmic outpatient clinic was 2.367%.And this disease was relevant to gender, age, educational level and vocational distribution.Higher incidence was among female, young, middle school educational level and farmers.It had no relevance to the nation, the residential area, the past medical history and the systemic diseases.%目的 了解广西眼科门诊就诊患者特发性视神经炎的发病率,描述其分布特点,为进一步开展分析流行病学研究提供相关因素的线索.方法 采用分层随机整群抽样方法,将2008年8月至2009年7月每月第3周,广西壮族自治区中医院、区人民医院的眼科门诊就诊的初诊病人进行问卷调查,对确诊特发性视神经炎的病例进行流行病学调查分析.结果 有效调查7 602人,其中男4 047人,女3 555人.特发性视神经炎确诊病例18人,男5人,女13人.相关因素有:性别(χ2=4.697 2,P=0.030 2),年龄(χ2=11.390 0,P=0.003 0),文化程度(χ2=9.195 5,P=0.026 8)和职业分布(χ2=23.208 2,P=0

  14. Initial Stody on Multifocal Visualevoked Potential (Multifocal Vep) of Optic Neuritis%视神经炎多焦视觉诱发电位的初步研究

    Institute of Scientific and Technical Information of China (English)

    隋源; 李雪丽; 勾晓梅; 周丽霞

    2016-01-01

    Objective To investigate the wavelet character in the same ring according to the dieffrent eccentricity dis-tribution in the multifocal visual evoked potential of optic neuritis:Tracking the local damage to the optic nerve after out-break of optic neuritis and the recovery after treatment,so offer the objective way of the early diagnosis,the effects of treatments and the monitor of Prognosis.Methods Carry on the multifocal VEP examination to30 eyes with thirty cases of optic neuritis,and adopt to contrast the sick eyes and the normal eyes in the same patients and the 30 eyes of fifteen normal individuals,mainly analysis the multifocal VEP Second-order kernel response,according to the diffent ring in the same heart, analysing each reaction total wave, carrying on the comparison to each ring.Results Before treatment the sick eyes contrast to the normal eyes in the same Patients, the latencies of P-wavelet were lengthened,and the ampli-tudes of P -wavelet were lowered ( P 0.05),the latencies of p-wavelet still have the obvious difference (P<0.05).Conclusion The multifo-cal VEP can apply the early diagnosis of optic neuritis, and the effects of treatments,and have the obvious advantage in estimating the local damage to the optic Nerve and traeking the recovery of damage of the optic nerve contrasting to visual field or the traditional VEP.%目的:研究视神经炎在多焦视觉诱发电位( mfVEP)检查中按照不同离心度分布的各同心环的波形特征;追踪视神经炎发病后局部视神经损害情况及经治疗后的恢复情况,从而为视神经炎的诊断、疗效判定及预后监测提供客观依据。方法对30例(30只眼)单眼患轴性球后视神经炎患者进行多焦视觉诱发电位(mfVEP)和视野检测,采用同一个体的患眼治疗前后与健侧眼及15例(30只眼)正常对照组的比较方法,主要分析多焦视觉诱发电位( mfVEP)的特征,按不同离心度的同心环进行分析,

  15. 鼠神经生长因子联合甲基强的松龙治疗急性球后视神经炎的临床研究%The investigation the therapeutic effects of combined mouse nerve growth factor and methylprednisolone on acute retrobulbar neuritis

    Institute of Scientific and Technical Information of China (English)

    陆君华; 马吴波; 赵茂竹

    2013-01-01

    目的 探讨鼠神经生长因子(NGF)联合甲基强的松龙治疗急性球后视神经炎(ARN)临床疗效.方法 对44例(64只眼)ARN患者治疗后的资料进行总结分析.结果 鼠NGF联合甲基强的松龙治疗后患者的视力、视野、P-VEP均有不同程度改善.治疗组有效率为93.5%,对照组有效率为69.6%.治疗组疗效优于对照组(P<0.05).结论 鼠NGF联合甲基强的松龙为ARN的治疗提供了有效方法.%Objective To Investigate the therapeutic efficacy of mouse nerve growth factor combined with methylprednisolone on acute retrobulbar neuritis (ARN).Methods To summarize and analyze the data of 44 cases (64 eyes) of acute retrobulbar neuritis that were treated with mouse nerve growth factor combined with methylprednisolone.Results After treatment,the VA,VF and P-VEP are all improved.The rate of improvement was 93.5 %,which was significantly better than the improvement rate of 69.6% in the control group (P <0.05).Conclusion Combination ofnerve growth factor and methylprednisolone is a superior treatment for acute retrobulbar neuritis than steroids alone.

  16. 钾离子通道在特发性视神经炎发病中的作用研究进展%Research advance in the effect of potassium channel on pathogenesis of idiopathic optic neuritis

    Institute of Scientific and Technical Information of China (English)

    刘珏; 李平华

    2009-01-01

    特发性视神经炎(ION)是一种神经眼科的常见疾病,严重威胁视力.因其病因及发病机制不明,治疗方法众多,疗效不一.目前研究发现钾离子通道如Stichodactyla helianthus peptide(ShK)和TRAM-34参与了ION的免疫发病过程.控制炎性细胞上钾离子通道为ION的治疗提供了新的途径.就ION自身免疫性炎性细胞上钾离子通道的研究进展进行综述,以期进一步明确其病因,寻求更有效的治疗方法.%Idiopathic optic neuritis (ION) is a common disorder in neuro-ophthalmology. It harms vision function seriously. However, there are a lots of controversy and confusion about its etiology, etiopathogenesis and outcome of treatments. Recently, potassium channel, such as stichodactyla helianthus peptide (ShK) and TRAM-34, was found to be involved in the immunopathogenesis of ION, and regulation of potassium channel provide a novel immunomodulatory therapy for ION. This paper reviewed the research advance of potassium channel in ION. It is expected to further clarify the pathogenesis and search for effective treatment.

  17. 中西医结合治疗多发性硬化相关视神经炎疗效观察%Clinical Observation on Treating Multiple Sclerosis Optic Neuritis by Integrative Medicine

    Institute of Scientific and Technical Information of China (English)

    苏莉; 刘永民; 刘永红; 王亦山

    2016-01-01

    目的:观察在激素常规治疗的基础上加用针刺治疗多发性硬化相关视神经炎(multiple sclero-sis optic neuritis,MS-ON)的临床疗效.方法:所有病例均给予激素及针刺治疗,针刺治疗每天1次,10天为1个疗程,连用3个疗程.结果:10例(12眼)治疗效果满意,视力恢复至0.8以上7眼,0.25 ~ 0.6者5眼,视野较发病初改善;1眼治疗不满意,视力提高小于1行.11例患者随访8~ 34个月,未见复发.结论:在激素常规治疗的基础上加用针刺治疗MS-ON疗效显著.

  18. Screening for mt-DNA mutations in optic neuritis of unknown reason%原因不明的视神经炎线粒体DNA突变检测

    Institute of Scientific and Technical Information of China (English)

    郭莉; 贾小云; 肖学珊; 郭向明; 于强; 李梅; 黎仕强; 张清炯

    2000-01-01

    目的 了解原因不明的视神经炎(optic neuritis of unknown reason,ONUR)患者线粒体DNA(mt-DNA)突变情况,探讨mt-DNA突变检测在ONUR诊断和鉴别诊断中的应用价值.方法 运用单链构像多态分析、突变特异性引物多聚酶链反应以及序列分析法等检测30例ONUR患者mt-DNA突变情况.结果 30例患者中mt-DNA 11778突变者12例,占40%.mt-DNA 3460和15257在所有受试者中均为阴性.结论 相当一部分ONUR是mt-DNA突变所致;mt-DNA突变检测对ONUR的诊断和鉴别诊断有重要意义.

  19. 视神经炎为首诊的多发性硬化21例%Analysis in 21 cases of multiple sclerosis with first-diagnosis of optic neuritis

    Institute of Scientific and Technical Information of China (English)

    李金颖; 王俊荣; 金春花

    2010-01-01

    目的:分析以视神经炎(optic neuritis, ON)为首诊的多发性硬化(multiple sclerosis,MS)21例,提高对ON与MS的认识,评价大剂量甲强龙冲击治疗效果.方法:回顾性分析我院2004-04/2008-04收治的以ON为首诊的MS 21例的临床表现、诊断及治疗.结果:患者4例符合Poser诊断标准,17例行MRI后确诊;通过给以大剂量甲强龙冲击治疗,15例(71%)患者视力改善.结论:对于首发视力障碍就诊于眼科、诊断为视神经炎的患者,应常规行MRI检查以除外MS,大剂量甲强龙冲击治疗是MS首选方式.

  20. Hypodermic injection of compound anisodine around superficial temporal artery in 37 patients with optic neuritis%复方樟柳碱颞浅动脉旁注射治疗视神经炎37例

    Institute of Scientific and Technical Information of China (English)

    韩有兰; 李雪萍

    2009-01-01

    目的 观察复方樟柳碱治疗早期视神经炎的疗效.方法 将81例(93眼)视神经炙患者随机分为2组,治疗组37例41眼,对照组44例52眼;治疗组在与对照组同样的全身用药的同时,于患眼颞浅动脉旁注射复方樟柳碱注射液,每天1次,每次2 mL,1个月后观察2组患者治疗前后视力、视野、视觉诱发电位及眼底荧光血管造影的变化.结果 治疗组治愈37眼,有效率100.0%,对照组治愈33眼,有效率86.5%,二者比较差异有统计学意义(χ2=4.17>3.84,P 3.84 ,P < 0.05). There were statistically significant differences in the variations of visual acuity, visual field,visual evoked potential, and fluorescence fundus angiography between the two groups(All P< 0.05). Conclusions The hypodermic injection of compound anisodine in treating the optic neuritis at its early stage has proved effectively in improving the vigor of the optic nerves as well as blood circulation,increasing blood flow and supply, enhancing the restoration of tissue blood deficiency and oxygen deficiency within a short span of time,and finally heightening the visual power of patients.

  1. Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ju Young; Lee, In Ho; Song, Chang June [Chungnam National University Hospital, Daejeon (Korea, Republic of); Hwang, Hee Youn [Eulji University Hospital, Daejeon(Korea, Republic of)

    2012-03-15

    A 57-year-old woman experienced bilateral acute ischemic optic neuropathy after spine surgery. Routine MR imaging sequence, T2-weighted image, showed subtle high signal intensity on bilateral optic nerves. A contrast-enhanced T1 weighted image showed enhancement along the bilateral optic nerve sheath. Moreover, diffusion-weighted image (DWI) and an apparent diffusion coefficient map showed markedly restricted diffusion on bilateral optic nerves. Although MR findings of T2-weighted and contrast enhanced T1-weighted images may be nonspecific, the DWI finding of cytotoxic edema of bilateral optic nerves will be helpful for the diagnosis of acute ischemic optic neuropathy after spine surgery.

  2. Serial quantitative MR assessment of optic neuritis in a case of neuromyelitis optica, using gadolinium-'enhanced' STIR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Barkhof, F.; Scheltens, P.; Valk, J. (Vrije Univ., Amsterdam (Netherlands). Dept. of Diagnostic Radiology); Waalewijn, C.; Uitdehaag, B.M.J.; Polman, C.H. (Vrije Univ., Amsterdam (Netherlands). Dept. of Neurology)

    1991-02-01

    A patient is presented with neuromyelitis optica. MR imaging, using a short inversion time inversion recovery (STIR) technique, clearly depicted the lesion in the left optic nerve. Subsequent serial STIR imaging, with and without Gadolinium-DTPA, allowed quantitative assessment of changes parallel to improved optic nerve function. STIR imaging is a sensitive technique to demonstrate optic nerve lesions, and enables quantitative assessment to be made of the effect of (steroid) medication. (orig.).

  3. Distribution of autoimmune antibodies and clinical features in 54 cases with recurrent optic neuritis%复发性视神经炎54例临床特点及自身免疫抗体的分布

    Institute of Scientific and Technical Information of China (English)

    王颖云; 魏世辉; 范珂; 闫洪欣; 张译心; 戴艳丽

    2013-01-01

    目的 观察复发性视神经炎的临床特点以及自身免疫抗体(水通道蛋白4抗体和血清抗核抗体)的分布.方法 收集2010年10月至2012年4月间在解放军总医院神经眼科住院诊治的复发性视神经炎患者54例的临床资料,回顾分析其一般临床特点,统计其水通道蛋白4抗体(AQP4-Ab)(36例)和血清抗核抗体(ANAs)的阳性率,并与相关文献数据分析比较.结果 男女比例1∶2.6,发病年龄平均30.3岁;病程50d~20年,发病次数2~8次.病程中最差视力(矫正后)在0.1以下者44例,占81.5%.ANAs阳性率22.2% (12/54),AQP4-Ab阳性率27.8% (10/36);颅脑和/或脊髓核磁异常者占48.0% (24/50);脑脊液异常70.0% (16/23).结论 复发性视神经炎多发于青壮年,视力损害较重,自身免疫抗体(AQP4-Ab和ANAs)阳性率较视神经脊髓炎及复发性长节段横贯性脊髓炎略低,中枢神经系统影像检查对其诊治有重要价值.%ObJective To investigate the clinical features and seroprevalence of autoimmune antibodies (aquaporin-4 antibodies,AQP4-Ab and antinuclear antibodies,ANAs) in patients with recurrent optic neuritis (RON).Methods Fifty-four RON patients who were in-hospital in Ophthalmology Department of PLA from October 2010 to April 2012 were enrolled in the study.The general clinical features and statistic the positive rate of AQP4-Ab and ANAs were analyzed retrospectively,and the relative data in other studies were compared.Results The ratio of male to female was 1:2.6 and the average age of onset was 30.3 years old.The recurrent attacks of optic neuritis were 2 to 8 times during 50 days to 20 years.There were 44 patients (81.5%) who had ever appeared the lowest visual acuity (corrected) of <0.1 in the course of disease.The rate of seropositive ANAs was 22.2% (12/54) while 27.8% (10/36) for AQP4-Ab.The 48.0% (24/50) cases were abnormal in Brain and/or spinal cord MRI and 70.0% (16/23) in CSF.Conclusions RON is more appeared in

  4. 31例儿童视神经炎的临床特点和转归分析%Clinical Characteristics and Outcome Analysis of 31 Cases of Children Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    余姗姗; 吴茜; 陈博; 卜碧涛

    2014-01-01

    目的:总结儿童视神经炎(ON)的临床特点和预后。方法:回顾性分析2007年1月至2013年1月我院确诊为 ON 的患儿共31例(52眼)的临床资料及随访结果,比较不同临床特征对 ON 转化为多发性硬化(MS)或视神经脊髓炎(NMO)的影响。结果:10例(32.3%)病前1~3周有上呼吸道感染史,21例(67.7%)双眼起病,初诊视力下降至≤0.1共29眼(55.8%),13例(41.9%)出现视乳头炎;治疗后视力恢复至逸1.0者共21眼(40.4%)。平均随访时间为43.6月(12~84月),9例(29.0%)在随访期间转化为 MS 或 NMO,其中6例诊断为 MS,3例诊断为 NMO。2组复发比例差异有统计学意义(=0.015)。结论:儿童 ON 双眼起病多见,视力下降严重,治疗后恢复良好。%Objective To outline the clinical characteristics and prognosis of children optic neuritis (ON). Methods: Thirty-one children (52 eyes) who were diagnosed as ON at Tongji Hospital from January 2007 to January 2013 were retrospectively analyzed. The different clinical characteristics which could affect transformation of ON into multiple sclerosis (MS) or neuromyelitis optica (NMO) were compared. Results: An upper respiration tract infection 1~3 weeks prior to onset of ON was reported in 10 patients (32.3%). Bilateral involvement was presented in 21 patients (67.7%). 29 eyes (55.8%) had visual acuity of 0.1 or less at onset and papillitis was evident in 13 patients (41.9%). Visual acuity better than 1.0 after treatment was reported up to 21 eyes (40.4%). Average follow-up time was 43.6 months (12~84 months) and nine patients (29.0%) had converted into MS (6 cases) or NMO (3 cases) in this observation. There was significant difference of the recurrence rate in 2 groups ( =0.015). Conclusion: Optic neuritis in childhood is more likely to be bilateral with severe vision loss, but the visual prognosis is relatively good after treatment.

  5. 肝郁气滞证视神经炎大鼠模型的建立%The establishment of the rat model with liver qi stagnation syndrom of optic neuritis

    Institute of Scientific and Technical Information of China (English)

    高芳; 柴金苗

    2015-01-01

    目的:建立肝郁气滞证视神经炎大鼠模型。方法:利用EAE动物模型和肝郁证大鼠模型的组合方法,对40只Wistar大鼠进行造模,观察大鼠的行为学变化、糖水偏好值、血浆促肾上腺皮质激素(ACTH)水平、肝脏及视网膜的病理改变。结果:与正常组比较,模型组的EAE神经功能评分、ACTH水平增加,1%蔗糖水摄入量降低(P<0.05,P<0.01)。结论:利用EAE动物模型结合肝郁证大鼠模型的方法,通过各指标显示,肝郁气滞证视神经炎组动物模型具备了视神经炎病肝郁气滞证的特点,与正常组相比模型制备成功。%Objective:To built the rat models with liver qi stagnation syndrom of optic neuritis. Method:Models were built through injection of immune antigen,chronic stimulation and solitary feeding. Then the behavioral changes,1%sucrose in-take,pathology changes of liver as well as retinal tissue were observed,and adrenocorticotropic hormone (ACTH)level in plasma was detected. Results:Compared with the normal group,the EAE score and ACTH concentration of rats in model group were increased,but the 1% sucrose intake was decreased (P<0.05,P<0.01). Conclusion:This modeling method is feasible.

  6. The clinical outcomes of idiopathic optic neuritis with no light perception in 21 eyes%特发性视神经炎无光感21只眼临床观察

    Institute of Scientific and Technical Information of China (English)

    李学晶; 童绎; 张守康

    2012-01-01

    目的 观察特发性视神经炎(IDON)无光感眼的治疗情况及预后.方法 回顾性系列病例研究.临床病例来自中国中医科学院眼科医院2003年8月至2011年4月住院患者.观察17例(21只眼)IDON无光感患者经糖皮质激素冲击并配合其他药物治疗后出现光感时间、最佳矫正视力、视觉诱发电位(VEP)等情况,至少随访3个月.结果 21只眼无光感时间1.0 ~90.0 d,除1只眼90.0 d外,余20只眼平均无光感时间(12.5±10.6)d.治疗后14只眼(66.7%)部分恢复视力,出现光感的时间为治疗后2.0 ~25.0 d,平均(9.9±7.9)d.出院时最佳矫正视力为1只眼手动,2只眼指数,1只眼0.01,3只眼0.02,2只眼0.025,1只眼0.04,1只眼0.06,1只眼0.15,1只眼0.6,1只眼1.0.治疗前未见VEP波形者10只眼,治疗后5只眼出现P100波,但仍潜时延迟、振幅低;3只眼复查无波形;2只眼未行VEP复查.治疗前可见VEP波形者11只眼,治疗后8只眼VEP波形改善,2只眼VEP波形消失;1只眼未行VEP检查.随访时除1只眼视力提高外,其余眼视力稳定.结论 对就诊时无光感的视神经炎患者,不应放弃治疗;不能通过无光感时间的长短、出现光感时间的早晚和是否有VEP波形来评估视力预后.%Objective To evaluate the treatment outcomes of idiopathic optic neuritis with no light perception in 21 eyes.Methods This is a retrospective study.The hospital data of 17 patients (21 eyes)with idiopathic optic neuritis whose visual acuity were no light perception from August 2003 to April 2011 were retrospectively analyzed.These patients were treated with steroid pulse and other drugs.The clinical features,the time of appearance light perception,the best corrected visual acuity and VEP were measured.The follow-up was at least three months.Results Before the treatment,the average time of occurring no light perception were 1.0 ~ 90.0 days,except 1 eye was 90.0 days while the other 20 eyes was (12.5 ±10.6)days.After the

  7. [Inferior vestibular neuritis: diagnosis using VEMP].

    Science.gov (United States)

    Walther, L E; Repik, I

    2012-02-01

    Vestibular evoked myogenic potentials (VEMP) are a new method to establish the functional status of the otolith organs. The sacculocollic reflex of the cervical VEMP to air conduction (AC) reflects predominantly saccular function due to saccular afferents to the inferior vestibular nerve. We describe a case of inferior vestibular neuritis as a rare differential diagnosis of vestibular neuritis. Clinical signs were a normal caloric response, unilaterally absent AC cVEMPs and bilaterally preserved ocular VEMPs (AC oVEMPs).

  8. Scanning laser polarimetry reveals status of RNFL integrity in eyes with optic nerve head swelling by OCT.

    Science.gov (United States)

    Kupersmith, Mark J; Kardon, Randy; Durbin, Mary; Horne, Melissa; Shulman, Julia

    2012-04-18

    Optical coherence tomography (OCT) shows retinal nerve fiber layer (RNFL) thickening in optic nerve head (ONH) swelling, but does not provide information on acute axonal disruption. It was hypothesized that scanning laser polarimetry (SLP) compared with OCT might reveal the status of axon integrity and visual prognosis in acute RNFL swelling. Threshold perimetry, OCT, and SLP were used to prospectively study eyes with papilledema (24), optic neuritis (14), nonarteritic anterior ischemic optic neuropathy (NAION) (21), and ONH swelling (average RNFL value by OCT was above the 95th percentile of controls at presentation). Regional RNFL was judged reduced if the quadrant measurement was below the fifth percentile of controls. At presentation, average RNFL by OCT was similar for eyes with papilledema and NAION (P = 0.97), and reduced for optic neuritis. Average RNFL by SLP was slightly increased for papilledema and optic neuritis, and reduced for NAION (P = 0.02) eyes. The RNFL by SLP was reduced in at least one quadrant in 1 eye with papilledema, 1 eye with optic neuritis, and in 13 eyes with NAION. In NAION eyes, quadrants with reduced SLP had corresponding visual field loss that did not recover. By one month, eyes with NAION showed RNFL thinning by OCT (7/17 eyes) and by SLP (14/16 eyes) in contrast to optic neuritis (by OCT, 0/12, P = 0.006; and by SLP, 1/12, P = 0.0004). OCT and SLP revealed different aspects of RNFL changes associated with ONH swelling. OCT revealed thickening due to edema. SLP revealed a decrease in retardance in eyes with axonal injury associated with visual field loss, which is unlikely to recover.

  9. Therapeutic evaluation of glucocorticoid on optic neuritis and analysis of effective factors%糖皮质激素治疗视神经炎疗效评价及影响疗效因素分析

    Institute of Scientific and Technical Information of China (English)

    张彩; 王大博; 白海青; 商卫卫; 房娇; 李延

    2008-01-01

    目的 评价糖皮质激素治疗视神经炎(optic neuritis,ON)的效果,并分析影响本病疗效的相关因素.方法 对1996 年 1 月至 2008 年 1 月在我院收治的 68 例(116 眼)ON患者的病案资料进行回顾性分析.结果 糖皮质激素治疗ON 的有效率为 72.41%,常规剂量地塞米松组与大剂量甲基强的松龙组的视力恢复速度及疗效比较,差异均无统计学意义(P>0.05);儿童患者的疗效最好,中青年次之,老年患者疗效最差(P<0.05);病程<15 d患者的疗效好于病程≥15d 的患者(P<0.05);不同入院视力视神经炎患者的疗效比较.差异无统计学意义(P>0.05);视盘炎患者的疗效好于视盘视网膜炎患者(P<0.05).结论 不同类型和剂量的糖皮质激素疗法不影响 ON 的视力恢复速度和治疗效果.随年龄及病程增长,本病疗效有变差趋势.不同临床类型可能对ON 的疗效有一定影响.入院视力可能不影响本病的治疗效果.

  10. Clinical profile, immunological indicators and prognosis of simultaneous bilateral optic neuritis%双眼同时发病的视神经炎患者的临床表现、免疫学指标及转归

    Institute of Scientific and Technical Information of China (English)

    刘子豪; 姜兆财; 李红阳; 魏世辉

    2014-01-01

    目的 研究双眼同时发病的视神经炎(optic neuritis,ON)患者的基线临床特征、血清免疫学指标及发病后12个月的预后和转归.方法 回顾性分析解放军总医院以双眼同时发病为首发的ON患者,从中选择接受相同的激素冲击治疗方案的患者47例94眼.分析患者人口学特征、基线临床表现、免疫学指标、12个月内恢复程度及不良事件发生情况.结果 47例患者中男12例,女35例;32例(68.1%)患者发病前半个月有明确诱因,30例(63.8%)患者合并眼球转动痛,73眼(77.7%)发病时视力小于0.1.17例(36.2%)患者血清抗AQP4抗体阳性,21例(44.7%)患者血清风湿免疫指标异常.19例患者12个月内发生不良事件,13例患者进展为中枢神经系统脱髓鞘疾病,以视神经脊髓炎多见.28例单次病程患者12个月后视力恢复较好.结论 双眼同时发病的ON患者多存在免疫学指标异常,在发病后12个月内不良事件发生率较高,对于同时存在免疫学指标异常的患者不良事件的发生率更高.

  11. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Neuritis, cranial or peripheral. 4.123 Section 4.123 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss...

  12. MRI in Optic Neuritis: Structure, Function, Interactions

    DEFF Research Database (Denmark)

    Fuglø, Dan

    2011-01-01

    resonance imaging (MRI), and the visual evoked potential (VEP) continues to show a delayed P100 indicating persistent demyelination. The explanation for this apparent discrepancy between structure and function could be due to either a redundancy in the visual pathways so that some degree of signal loss...... are low. Functional MRI (fMRI) is a non-invasive technique that can measure brain activity with a high spatial resolution. Recently, technical and methodological advancements have made it feasible to record VEPs and fMRI simultaneously and the relationship between averaged VEPs and averaged fMRI signals...... have been described. Still, to take full advantage of simultaneously recorded VEP-fMRI one would ideally want to track single-trial changes in the VEP and use this information in the fMRI analysis. In order to do this we examined 10 healthy volunteers with simultaneous VEP-fMRI. Different measures...

  13. Anterior ischemic optic neuropathy precipitated by acute primary angle closure

    Directory of Open Access Journals (Sweden)

    Choudhari Nikhil

    2010-01-01

    Full Text Available A 59-year-old man with a history of longstanding systemic hypotension developed asymmetric non-arteritic anterior ischemic optic neuropathy (NAION apparently precipitated by bilateral sequential acute primary angle closure. NAION is very rarely reported in association with raised intraocular pressure. In contrast to optical coherence tomography, the failure of scanning laser polarimetry to detect axonal swelling was another interesting finding. Possible reasoning for these observations is discussed.

  14. [The prevalence of acute vascular optic neuropathies in Donetsk Province].

    Science.gov (United States)

    Antonova, A I

    1989-01-01

    The analysis of the wide-spread nature of acute vascular pathology of the optic nerve in Donetsk Province, according to applications for the period of 10 years--from 1978 to 1987, has shown a continuing growth of this pathology in the general structure of optic nerve diseases, being considerably greater in a young (30-44 years) and a middle-aged (45-59 years) age groups. The highest level of the wide-spread nature of the disease has been and remains in persons above 60 years of age. At the present time, the most critical age for development of acute vascular optic neuropathies is a middle-aged group. Among the patient of this age group women prevail and among men with this pathology prevail unskilled workers and employers.

  15. Current status, hotspots and trends of optic neuritis research: Bibliometric analysis based on PubMed database%视神经炎研究现状、热点与趋势——基于PubMed数据库的文献计量分析

    Institute of Scientific and Technical Information of China (English)

    王伟; 张秀兰; 魏世辉

    2014-01-01

    背景 视神经炎研究领域近年来发展较快,分支较多且复杂,了解视神经炎相关研究现状、研究热点,预测未来发展趋势,对于相关的科研和临床工作均十分重要. 目的 了解视神经炎研究文献的分布规律、学科知识结构并预测未来发展趋势. 方法 利用PubMed数据库为数据源,对2000年1月至2012年7月收录的视神经炎相关文献进行统计分析,采用多元统计方法对高频主题词共现矩阵进行转换、降维和聚类分析,绘制战略坐标图,并根据社会网络分析方法绘制可视化网络图谱.结果 共检出视神经炎相关文献2 191篇,发文量逐年增加.美国、英国、德国、荷兰和日本5个国家总发文量为1 615篇,占发文总数的73.71%.相关高频主题词共52个,成功建立视神经炎学科知识可视化图谱,直观展示了视神经炎的知识分布,并形成重点研究聚类,结果显示当前的热点主要集中在9个领域,其中免疫学研究已经较为成熟但处于边缘的地位,视神经炎病因及诊断、病理学研究、病理生理学研究和视神经脊髓炎(NMO)专题研究是目前研究的核心领域,药物治疗、非中枢性脱髓鞘性视神经炎研究、流行病学研究和遗传学研究相对薄弱,有较大的提升空间.结论 近年国际上对视神经炎的关注和发文量逐年增加,欧美国家的发文量占主导地位.国际视神经炎的研究热点主要集中在9个领域,可能为今后研究的发展方向.%Background The research field of optic neuritis has developed rapidly and become more complex in recent years.It is very important for the reseachers and clinicians to known its status and the future trend.Objective This survey was to learn the distribution pattern,subject domain knowledge and worldwide research tendency of optic neuritis based on literatures in PubMed database.Methods Literatures on optic neuritis published in January 2000 to July 2012 were identified

  16. [Local involvement of the optic nerve by acute lymphoblastic leukemia].

    Science.gov (United States)

    Bernardczyk-Meller, Jadwiga; Stefańska, Katarzyna

    2005-01-01

    The leucemias quite commonly involve the eyes and adnexa. In some cases it causes visual complants. Both, the anterior chamber of the eye and the posterior portion of the globe may sites of acute or chronic leukemia and leucemic relapse. We report an unique case of a 14 years old leucemic patient who suffered visual loss and papilloedema, due to a unilateral local involvement within optic nerve, during second relapse of acute lymphocytic leuemia. In spite of typical treatment of main disease, the boy had died. The authors present typical ophthalmic features of the leucemia, too.

  17. Remyelination of optic nerve lesions: spatial and temporal factors.

    Science.gov (United States)

    Klistorner, Alexandr; Arvind, Hemamalini; Garrick, Raymond; Yiannikas, Con; Paine, Mark; Graham, Stuart L

    2010-07-01

    Optic neuritis provides an in vivo model to study demyelination. The effects of myelin loss and recovery can be measured by the latency of the multifocal visual evoked potentials. We investigated whether the extent of initial inflammatory demyelination in optic neuritis correlates with the remyelinating capacity of the optic nerve. Forty subjects with acute unilateral optic neuritis and good visual recovery underwent multifocal visual evoked potentials testing at 1, 3, 6 and 12 months. Average latency changes were analyzed. Extensive latency delay at baseline significantly improved over time with rate of recovery slowed down after 6 months. Magnitude of latency recovery was independent of initial latency delay. Latency recovery ranged from 7 to 17 ms across the whole patient cohort (average = 11.3 (3.1) ms) despite the fact that in a number of cases the baseline latency delay was more than 35-40 ms. Optic nerve lesions tend to remyelinate at a particular rate irrespective of the size of the initial demyelinated zone with smaller lesions accomplishing recovery more completely. The extent of the initial inflammatory demyelination is probably the single most important factor determining completeness of remyelination. The time period favorable to remyelination is likely to be within the first 6 months after the attack.

  18. Combined Striatum, Brain Stem, and Optic Nerve Involvement due to Mycoplasma pneumoniae in an Ambulatory Child

    Directory of Open Access Journals (Sweden)

    Jin-Won Bae

    2011-05-01

    Full Text Available In children, Mycoplasma pneumoniae encephalitis has been characterized by acute onset of an encephalopathy associated with extrapyramidal symptoms and symmetric basal ganglia with or without brain stem involvement on magnetic resonance imaging. Our case, showing unilateral optic neuritis, ophthalmoplegia, no extrapyramidal symptoms, and typical striatal involvement on magnetic resonance imaging, broadens the spectrum of varying clinical manifestations of childhood M. pneumoniae-associated encephalopathy.

  19. 特发性脱髓鞘性视神经炎的临床转归%Conversion of idiopathic demyelinating optic neuritis to multiple sclerosis: its rate and risks

    Institute of Scientific and Technical Information of China (English)

    张晓君; 彭静婷; 贾楠

    2009-01-01

    目的 了解特发性脱髓鞘性视神经炎(IDON)临床转归、转化为多发性硬化(MS)或视神经脊髓炎(NMO)的比例以及相关影响因素.方法 对确诊且临床资料完整的IDON患者进行病例回顾及随访,记录视功能和其他神经功能变化以及MS或NMO转化率,应用卡方检验分析不同临床特征对转化率的影响.结果 共入组资料完整且完成随访的IDON患者107例.多数患者视力恢复较好,12例(11.2%)在随访期间转化为MS或NMO.全部12例患者均符合2005年修订的McDonald诊断标准,其中4例符合1999年NMO诊断标准,其余8例中部分表现为"视神经脊髓型MS".复发性IDON较首次发病患者、伴头颅MRI异常较MRI正常者转化为MS或NMO的比例高,分别为23.1%和4.4%(χ2=6.899,P<0.01)以及18.2%和8.1%.是否伴有视乳头水肿以及不同视力损害程度组之间转化为MS或NMO的比例没有差异.结论 该组IDON患者转化为MS或NMO的比例为11.2%.复发性IDON和伴有头颅MRI异常的患者更易转化为MS或NMO.%Objective To investigate the clinical prognosis of idiopathic demyelinating optic neuritis (IDON), the rate of its conversion to multiple sclerosis (MS) or neuromyelitis optica (NMO) and its clinical features related to the conversion.Methods Patients satisfying our entry criteria for IDON hospitalized in Beijing Tongren Hospital during the period from 2002 to 2007 were re-evaluated with follow-ups for 6-months to 5-years.The McDonald diagnostic criteria for MS (revised, 2005) was used to diagnose MS in these subjects during follow-up and the diagnosis of NMO utilized 1999 Wingerchuk' s NMO criteria.The Chi-Squared χ2 test was applied to statistically analyze association of clinical features and development of MS or NMO.Results In 107 recruited IDON cases with complete clinical data and follow-up, 12 cases (11.2%) developed into MS or NMO during follow-up period.All 12 cases met the revised McDonald criteria, of which 4 cases met NMO

  20. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    OpenAIRE

    Greco, A.; Macri, G. F.; Gallo, A.; M. Fusconi; DE VIRGILIO, A.; G. Pagliuca; Marinelli, C.; M. De Vincentiis

    2014-01-01

    Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a su...

  1. Optic nerve infiltration by acute lymphoblastic leukemia: MRI contribution

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Maria de Fatima; Braga, Flavio Tulio [Federal University of Sao Paulo, Department of Diagnostic Imaging, Paulista School of Medicine, Sao Paulo (Brazil); Rocha, Antonio Jose da [Santa Casa de Misericordia de Sao Paulo, Servico de Diagnostico por Imagem, Sao Paulo (Brazil); Lederman, Henrique Manoel [Federal University of Sao Paulo, Division of Diagnostic Imaging in Pediatrics, Department of Diagnostic Imaging, Sao Paulo (Brazil)

    2005-08-01

    We describe the clinical presentation and imaging features of a patient with acute lymphoblastic leukemia (ALL) that was complicated by optic nerve infiltration. The clinical and diagnostic characteristics of this complication must be recognized so that optimal therapy can be started to prevent blindness. MR imaging is useful in early detection and should be performed in any leukemic patient with ocular complaints, even during remission. (orig.)

  2. Bilateral optic neuropathy in acute cr yptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Qi Zhe Ngoo

    2016-11-01

    Full Text Available We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had somnolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous fluconazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

  3. Distribution and relevance study of aquaporin-4 antibodies and antinuclear antibodies in patients with optic neuritis%水通道蛋白4抗体及抗核抗体在视神经炎中的分布及相关性分析

    Institute of Scientific and Technical Information of China (English)

    王颖云; 魏世辉

    2012-01-01

    Objective To observe the seroprevalence of autoimmune antibodies in patients with optic neuritis,mainly including aquaporin-4 antibodies(AQP4-Ab),antinuclear antibodies(ANAs),and analyze the relevance of distribution between AQP4-Ab and ANAs.Methods Ninety-six patients with optic neuritis in hospital from October 2010 to February 2012,all were screened for AQP4-Ab,ANAs and anticardiolipin antibodies,partial for rheumatoid antibodies(APF,AKA,CCP)and HLA-B27,and statistics the positive outcome.Results Among of all patients,the positive rate of AQP4-Ab,ANAs,anticardiolipin antibodies,APF,HLA-B27 were 19.8%(19/96),13.5%(13/96),2.1%(2/96),6.7%(3/45)and 7.1%(1/14),respectively.AQP4-Ab and/or ANAs were positive in 22 patients at a rate of 22.9%(22/96),of which 10 cases showed the two positive simultaneous at a rate of 10.4%(10/96),with a prevalence statistically in distribution of AQP4-Ab and ANAs(P<0.01).Conclusions Minority patients with optic neuritis show positive autoimmune antibodies,including AQP4-Ab,ANAs,anticardiolipin antibodies.The distribution of AQP4-Ab and ANAs exist correlation statistically.%目的 观察水通道蛋白4抗体(AQP4-Ab)及抗核抗体(ANAs)等多种自身免疫抗体在视神经炎中的分布及其相关性.方法 收集2010年10月至2012年2月间在解放军总医院神经眼科病房住院诊治的视神经炎患者96例,全部检测AQP4-Ab、ANAs及抗心磷脂抗体,部分检测类风湿三项(APF、AKA、CCP)及人白细胞抗原-B27(HLA-B27),统计其阳性率,分析AQP4-Ab及ANAs的相关性.结果 观察视神经炎患者中AQP4-Ab、ANAs、抗心磷脂抗体、类风湿三项及HLA-B27阳性率分别为19.8%(19/96)、13.5%(13/96)、2.1%(2/96)、6.7%(3/45)和7.1%(1/14);AQP4-Ab和(或)ANAs阳性者22例,占22.9%(22/96)两者均为阳性者10例,占10.4%(10/96),其分布在统计学差异有统计学意义(P<0.01).结论 少数视神经炎患者表现有AQP4-Ab和(或)ANAs、抗心磷脂抗体等

  4. Dimethyl Fumarate Ameliorates Lewis Rat Experimental Autoimmune Neuritis and Mediates Axonal Protection.

    Directory of Open Access Journals (Sweden)

    Kalliopi Pitarokoili

    Full Text Available Dimethyl fumarate is an immunomodulatory and neuroprotective drug, approved recently for the treatment of relapsing-remitting multiple sclerosis. In view of the limited therapeutic options for human acute and chronic polyneuritis, we used the animal model of experimental autoimmune neuritis in the Lewis rat to study the effects of dimethyl fumarate on autoimmune inflammation and neuroprotection in the peripheral nervous system.Experimental autoimmune neuritis was induced by immunization with the neuritogenic peptide (amino acids 53-78 of P2 myelin protein. Preventive treatment with dimethyl fumarate given at 45 mg/kg twice daily by oral gavage significantly ameliorated clinical neuritis by reducing demyelination and axonal degeneration in the nerve conduction studies. Histology revealed a significantly lower degree of inflammatory infiltrates in the sciatic nerves. In addition, we detected a reduction of early signs of axonal degeneration through a reduction of amyloid precursor protein expressed in axons of the peripheral nerves. This reduction correlated with an increase of nuclear factor (erythroid derived 2-related factor 2 positive axons, supporting the neuroprotective potential of dimethyl fumarate. Furthermore, nuclear factor (erythroid derived 2-related factor 2 expression in Schwann cells was only rarely detected and there was no increase of Schwann cells death during EAN.We conclude that immunomodulatory and neuroprotective dimethyl fumarate may represent an innovative therapeutic option in human autoimmune neuropathies.

  5. MRI of optic nerve and postchiasmal visual pathways and visual evoked potentials in secondary progressive multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Davies, M.B.; Hawkins, C.P. [School of Postgraduate Medicine, Keele Univ. (United Kingdom)]|[Department of Neurology and Neurophysiology, Royal Infirmary, Stoke-on-Trent (United Kingdom); Williams, R. [MRI Unit Cornwall House, Stoke-on-Trent (United Kingdom); Haq, N. [Department of Neurology, North Staffordshire Hospital, Stoke-on-Trent (United Kingdom); Pelosi, L. [Department of Neurology and Neurophysiology, Royal Infirmary, Stoke-on-Trent (United Kingdom)

    1998-12-01

    We studied the relationship between abnormalities shown by MRI and functional disturbances in the visual pathway as assessed by the visual evoked potential (VEP) in 25 patients with established multiple sclerosis (MS); only 4 of whom had a history of acute optic neuritis. Optic nerve MRI was abnormal in 19 (76 %) and is thus useful in detecting subclinical disease. Optic nerve total lesion length and area on the STIR sequence was found to correlate significantly with prolongation of the VEP latency. This may reflect a predominantly demyelinating rather than inflammatory origin for the signal change in the optic nerve. (orig.) With 5 figs., 1 tab., 25 refs.

  6. 加味丹栀逍遥散治疗急性视神经炎%Acute Optic Neuritis Treated by Modified Danzhi Xiaoyao Powder

    Institute of Scientific and Technical Information of China (English)

    王笑可; 阿琴

    2001-01-01

    @@ 急性视神经炎属眼科急症,临床治疗本病多以激素为主,但对部分患者疗效不佳.笔者自1988年~1998年采用中药丹栀逍遥散治疗急性视神经炎36例,取得了较满意的效果,现报告如下.

  7. Unilateral Acute Anterior Ischemic Optic Neuropathy in a Patient with an Already Established Diagnosis of Bilateral Optic Disc Drusen

    Science.gov (United States)

    Ayhan, Ziya; Yaman, Aylin; Söylev Bajin, Meltem; Saatci, A. Osman

    2015-01-01

    Optic disc drusen (ODD) are calcific deposits that form in the optic nerve head secondary to abnormalities in axonal metabolism and degeneration. Anterior ischemic optic neuropathy, central retinal artery, and vein occlusion are among the rare vascular complications of disc drusen. We reported the clinical course of a 51-year-old patient with a unilateral acute nonarteritic anterior ischemic optic neuropathy (NAION) who received the diagnosis of bilateral optic disc drusen five years earlier and thereby reiterated the association of ODD and acute NAION. PMID:26550507

  8. Unilateral Acute Anterior Ischemic Optic Neuropathy in a Patient with an Already Established Diagnosis of Bilateral Optic Disc Drusen

    Directory of Open Access Journals (Sweden)

    Ziya Ayhan

    2015-01-01

    Full Text Available Optic disc drusen (ODD are calcific deposits that form in the optic nerve head secondary to abnormalities in axonal metabolism and degeneration. Anterior ischemic optic neuropathy, central retinal artery, and vein occlusion are among the rare vascular complications of disc drusen. We reported the clinical course of a 51-year-old patient with a unilateral acute nonarteritic anterior ischemic optic neuropathy (NAION who received the diagnosis of bilateral optic disc drusen five years earlier and thereby reiterated the association of ODD and acute NAION.

  9. Case of acute optic nerve compression caused by tuberculum sellae meningioma with optic canal involvement

    Directory of Open Access Journals (Sweden)

    Chai Y

    2012-05-01

    Full Text Available Yuzhu Chai1, Hiroko Yamazaki1, Akihide Kondo2, Toshiyuki Oshitari3, Shuichi Yamamoto31Department of Ophthalmology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, 2Department of Neurosurgery, Juntendo University, School of Medicine, Tokyo, 3Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, JapanAbstract: We present detailed ophthalmic findings in a case of tuberculum sellae meningioma with acute visual symptoms due to optic canal involvement. A 62-year-old Japanese woman reported a 1-week history of headaches and blurred vision in her left eye. Her visual acuity was 0.3 in the left eye with no ophthalmoscopic abnormalities. A relative afferent pupillary defect and inferior temporal field defect were found in the left eye. Pattern visual evoked potentials were undetectable in the left eye. Enhanced magnetic resonance imaging showed a 9 mm intracranial lesion around the left optic nerve anterior to the chiasm. She was diagnosed with granulomatous inflammation because of the increased cell counts and protein concentration in the cerebrospinal fluid. She was treated with steroid pulse therapy, and her visual acuity and visual field defect improved to normal in 3 weeks. However, 16 months after the onset, she suffered from headaches again and had a complete loss of vision in her left eye. There was no response to steroid pulse therapy. Enhanced magnetic resonance imaging revealed that the lesion had extended into the left optic canal, and emergency tumor removal surgery was carried out. The histopathological diagnosis was meningioma. One month after the surgery, her left visual acuity improved to 1.2, and her visual field was almost normal. Pattern visual evoked potentials were present but had a prolonged P100 latency of 170 ms. A thinning of the ganglion cell complex was detected by optical coherence tomography. Ophthalmologists should be aware that a small tuberculum

  10. Inferior vestibular neuritis in a fighter pilot: a case report.

    Science.gov (United States)

    Xie, Su Jiang; Jia, Hong Bo; Xu, Po; Zheng, Ying Juan

    2013-06-01

    Spatial disorientation in airplane pilots is a leading factor in many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. One condition that can lead to sudden pilot incapacitation in flight is vestibular neuritis. Vestibular neuritis is commonly diagnosed by a finding of unilateral vestibular failure, such as a loss of caloric response. However, because caloric response testing reflects the function of only the superior part of the vestibular nerve, it cannot detect cases of neuritis in only the inferior part of the nerve. We describe the case of a Chinese naval command fighter pilot who exhibited symptoms suggestive of vestibular neuritis but whose caloric response test results were normal. Further testing showed a unilateral loss of vestibular evoked myogenic potentials (VEMPs). We believe that this pilot had pure inferior nerve vestibular neuritis. VEMP testing plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. We also discuss this issue in terms of aeromedical concerns.

  11. Optical coherence tomography for retinal imaging in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Zimmermann H

    2014-12-01

    Full Text Available Hanna Zimmermann,1 Timm Oberwahrenbrock,1 Alexander U Brandt,1 Friedemann Paul,1–3 Jan Dörr1,2 1NeuroCure Clinical Research Center, 2Clinical and Experimental Multiple Sclerosis Research Center, 3Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany Abstract: Visual disturbances caused by inflammatory and demyelinating processes of the visual system, mainly in the optic nerve, are a common symptom in multiple sclerosis (MS. Optical coherence tomography (OCT is a tool that is increasingly used for quantifying retinal damage in MS and other neurologic diseases. Based on spectral interferometry, it uses low-coherent infrared light to generate high-resolution spatial images of the retina. The retinal nerve fiber layer (RNFL consists of unmyelinated axons that form the optic nerve, and thus represents a part of the central nervous system. OCT allows for noninvasive measurements of RNFL thickness in micrometer resolution. With the help of OCT, researchers have managed to demonstrate that eyes of MS patients show distinct RNFL thinning after an event of acute optic neuritis in MS, and even subclinical damage in eyes with no previous optic neuritis. OCT is also a useful tool in terms of providing a differential diagnosis of MS toward, for example, neuromyelitis optica, a disease that usually shows stronger retinal thinning, or Susac syndrome, which is characterized by distinct patchy thinning of the inner retinal layers. RNFL thinning is associated with magnetic resonance imaging-derived measurements of the brain, such as whole-brain atrophy, gray and white matter atrophy, and optic radiation damage. These features suggest that OCT-derived retinal measurements are a complement for measuring central nervous system neurodegeneration in the context of clinical trials – for example, with neuroprotective substances. Keywords: visual function, multiple sclerosis, optic neuritis, retinal nerve fiber layer, neuromyelitis optica

  12. Quantitative contrast-enhanced MR imaging of the optic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Simon, J.H. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States); Rubinstein, D. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States); Brown, M. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States); Yuh, W. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States); Birch-Iensen, M. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States); Szumowski, J. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States); Stears, J. [Depts. of Radiology, Univ. of Colorado Health Sciences Center, Denver, CO (United States)]|[Iowa Univ., Iowa City, IA (United States)

    1994-11-01

    During the acute stages of optic neuritis damage to the blood-optic nerve barrier can be detected using i.v. paramagnetic contrast-enhanced MR imaging. Quantification of the enhancement pattern of the optic nerve, intraorbital fat and muscle was determined in 15 normal subjects using 3 fat-suppression MR imaging methods: T1-weighted spin-echo and spoiled gradient-echo sequences preceded by a flat-frequency selective pulse (FATSAT+SE and FATSAT+SPGR, respectively) and a pulse sequence combining CHOPPER fat suppression with a fat-frequency selective preparation pulse (HYBRID). Pre- and postcontrast-enhanced studies were acquired for FATSAT+SE and FATSAT+SPGR. There was no significant enhancement of the optic nerve by either method (mean increase of 0.96% and 5.3%, respectively), while there was significant enhancement in muscle (mean 118.2% and 108.2%, respectively; p<0.005) and fat (mean increase of 13% and 37%, respectively; p<0.05). Postcontrast optic nerve/muscle signal intensity ratios (mean, SD) were 0.51 (0.07), 0.58 (0.05) and 0.75 (0.05) for FATSAT+SE, FATSAT+SPGR and HYBRID, respectively. These results suggest a practical methodology and range of values for normal signal intensity increases and ratios of tissue signal that can be used as objective measures of optic neuritis for natural history studies and treatment trials. (orig.).

  13. Early Swept-Source Optical Coherence Tomography Angiography Findings in Unilateral Acute Idiopathic Maculopathy.

    Science.gov (United States)

    Nicolo, Massimo; Rosa, Raffaella; Musetti, Donatella; Musolino, Maria; Traverso, Carlo Enrico

    2016-02-01

    Unilateral acute idiopathic maculopathy (UAIM) is a rare disorder presenting in young people with an acute onset of unilateral central visual loss often associated with a prodromal flu-like illness. The authors present the early anatomical findings of a 35-year-old man clinically diagnosed with UAIM using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography.

  14. Retrobulbar optic neuropathy secondary to isolated sphenoid sinus disease

    Directory of Open Access Journals (Sweden)

    Vishal Annaji Chafale

    2015-01-01

    Full Text Available Paranasal sinus disease can cause a condition that mimics optic neuritis. Simultaneous appearance of both diseases would create etiological dilemma .We report two cases of retrobulbar optic neuropathy secondary to isolated sphenoid sinus disease. In the case of a 65-year-old female who had presented with acute loss of vision in the left eye associated with left-sided frontal headache which subsequently turned out to be caused by optic nerve compression at the orbital apex due to collection in abnormally pneumatized left lesser wing of the sphenoid. In another case, a 65-year-old lady had presented with symptoms of bilateral retrobulbar optic neuropathy which was found to be due to direct compression of optic nerves at the orbital apex secondary to metastases from breast carcinoma.

  15. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis

    DEFF Research Database (Denmark)

    Martinez-Lapiscina, Elena H; Arnow, Sam; Wilson, James A

    2016-01-01

    BACKGROUND: Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of dis...

  16. 脑脊液CXCL12、PDGF及CXCL14水平和变化与视神经炎和视神经脊髓炎的关系%Relationship between the levels and variation of CXCL12, PDGF, CXCL14 in cerebrospinal fluid of optic neuritis and neuromyelitis optica

    Institute of Scientific and Technical Information of China (English)

    姜兆财; 魏世辉; 刘子豪; 李红阳; 陈霆隽

    2015-01-01

    差,预后和转归不良.%Objective To explore the predictive value of the prognosis and outcome for optic neuritis (ON) and neuromyelitis optica (NMO) by investigating the levels and variation of CXCL12, PDGF and CXCL14 in CSF of patients with ON and NMO.Methods Retrospective study.Thirty-five patients with ON, 10 patients with NMO and 10 patients with cerebral venous sinus thrombosis (CVST) were scheduled in the research unit from September 2012 to September 2013 in Neuro-Ophthalmology Department of PLA General Hospital.Clinical data and cerebrospinal fluid (CSF) parameters were collected.CXCL12, PDGF and CXCL14 concentrations were measured in CSF using enzyme linked immunosorbent assay (ELISA).The CXCL12, PDGF and CXCL14 levels in CSF were compared by using ANOVA in different diseases with different phases and recurrent cases found by MRI.Multiple comparisons were used by LSD method.The comparison of positive rate for MRI in ON different phases was used by exact probability.Meanwhile,correlation analysis was conducted between CXCL12, PDGF, CXCL14 and white blood cells (WBC), IgG and protein in CSF.Results Compared with NMO group(3.69±0.35,2.04±0.24, 7.05±0.94), the CXCL12,PDGF and CXCL14 levels in CSF were higher in ON (4.39±0.51, 2.51±0.39, 8.65±1.55) and CVST(4.84±-0.49, 2.79±0.47, 10.53±1.11) group (F=14.593, 10.060, 10.003, P<0.001, <0.001, <0.001), especially the CXCL12, PDGF and CXCL14 levels in CSF of CVST group patients were higher than that in ON group.Among them, the CXCL12 and PDGF levels in CSF were higher in acute phase of ON (4.63 ±0.50, 2.65 ±0.40) and CVST(4.84±0.49, 2.79±0.47) group than stationary phase of ON (4.13±0.39, 2.34±0.32) group (F=8.823, 4.906, P=0.001, 0.012).In addition, 28 of 35 ON patients were conducted the cerebral or orbital magnetic resonance imaging (MRI).The result showed that the CXCL12 and PDGF levels in CSF of patients with positive finding in MRI (3.96±0.30, 2.23±0.16) were higher than those patients with negative finding in MRI (4.64

  17. Ocular perfusion pressure and hemodynamics analysis in non-arteritic anterior ischemic optic neuropathy and idiopathic optic neuritis%非炎性前部缺血性视神经病变和特发性视神经炎眼灌注压与眼部血流动力学研究

    Institute of Scientific and Technical Information of China (English)

    王欣玲; 李雪姣; 阎启昌

    2014-01-01

    Objective To compare the Ocular perfusion pressure (OPP) and ocular hemodynamics of patients with non-arteritic anterior ischemic optic neuropathy (NAION) and idiopathic optic neuritis (ION),and analyze their relationship with fixation features.Methods It was a retrospective case study.Data were collected in patients with NAION and ION who were treated in Department of Ophthalmology,the Fourth Affiliated Hospital,China Medical University from March 2011 to May 2013.OPP and ocular hemodynamics were analyzed,as well as the ages,gender,and systemic diseases after these patients were divided as the central fixation group and the extra-central fixation one on the basis of ocular fixation features.The reason making the differences were thought over.Results There were 21 NAION cases (21 eyes,14 for central fixation and 7 for extra-central fixation) and 21 ION ones (21 eyes,8 for central fixation and 13 for extra-central fixation).The peak systolic velocity (PSV) of posterior ciliary artery (PCA) and central retinal artery (CRA) were significantly decreased in the NAION group comparing with the ION group in central fixation eyes (t =12.49,P =0.00; t =14.25,P =0.00).In the extra-central fixation eyes,the sitting mean artery pressure (MAP) of brachial artery and OPP were significantly increased in the NAION group,and the PSV of PCA and CRA were significantly decreased in the NAION group (t =6.41,P =0.02; t =5.66,P =0.03; t =8.47,P =0.01; t =11.32,P =0.00).However,the PSV of PCA and CRA were significantly decreased in the NAION group when the fixation features were excluded from the classification criteria and all kinds of vision was regarded totally as central fixation vision (t =5.81,P =0.02; t =9.20,P =0.00).Conclusions The fixation features of NAION and ION eyes can be classified as central fixation and extra-central fixation.The comparisons of OPP and ocular hemodynamics should be classified according to the fixation features.%目的 比较非炎性前部缺血性视神

  18. Distinguishing features of acute Vogt-Koyanagi-Harada disease and acute central serous chorioretinopathy on optical coherence tomography angiography and en face optical coherence tomography imaging.

    Science.gov (United States)

    Aggarwal, Kanika; Agarwal, Aniruddha; Deokar, Ankit; Mahajan, Sarakshi; Singh, Ramandeep; Bansal, Reema; Sharma, Aman; Dogra, Mangat R; Gupta, Vishali

    2017-12-01

    The aim of this study is to determine the differences in optical coherence tomography angiography (OCTA) features of acute Vogt-Koyanagi-Harada disease (VKH) and acute central serous chorioretinopathy (CSC). Clinical and imaging data of patients with acute CSC and VKH in a tertiary-care institute were analyzed. Multimodal imaging including fluorescein angiography, indocyanine green angiography (ICGA), and enhanced-depth imaging OCT were performed. OCTA images were analyzed for alterations in retinochoroidal microvasculature. Thirty-four eyes (24 patients; 10 with VKH and 14 with CSC) were included. OCTA en face images showed apparent areas of choriocapillaris flow void due to shadowing effect from overlying subretinal fluid and pigment epithelial detachment in CSC. However, eyes with VKH showed presence of true choriocapillaris flow void on OCTA that corresponded to choriocapillaris ischemia on ICGA. OCTA is a useful tool to assess choriocapillaris ischemia in VKH and is helpful to differentiate it from CSC in the acute stage.

  19. Immunoadsorption therapy for neuromyelitis optica spectrum disorders long after the acute phase.

    Science.gov (United States)

    Kobayashi, Masatake; Nanri, Kazunori; Taguchi, Takeshi; Ishiko, Tomoko; Yoshida, Masaharu; Yoshikawa, Noriko; Sugisaki, Kentaro; Tanaka, Nobuyuki

    2015-02-01

    Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease with exacerbations involving recurrent or bilateral optic neuritis and longitudinally extensive transverse myelitis. Pulse steroid therapy is recommended as the initial, acute-phase treatment for NMO. If ineffective, treatment with plasma exchange (PE) should commence. However, no evidence exists to support the effectiveness of PE long after the acute phase. Immunoadsorption therapy (IA) eliminates pathogenic antibodies while sparing other plasma proteins. With IA, side effects of PE resulting from protein substitution can be avoided. However, whether IA is effective for NMO remains unclear. We describe a patient with anti-aquaporin-4-positive myelitis who responded to IA using a tryptophan polyvinyl alcohol gel column that was begun 52 days after disease onset following the acute phase. Even long after the acute phase when symptoms appear to be stable, IA may be effective and should not be excluded as a treatment choice.

  20. Visual Evoked Potential Recording in a Rat Model of Experimental Optic Nerve Demyelination.

    Science.gov (United States)

    You, Yuyi; Gupta, Vivek K; Chitranshi, Nitin; Reedman, Brittany; Klistorner, Alexander; Graham, Stuart L

    2015-07-29

    The visual evoked potential (VEP) recording is widely used in clinical practice to assess the severity of optic neuritis in its acute phase, and to monitor the disease course in the follow-up period. Changes in the VEP parameters closely correlate with pathological damage in the optic nerve. This protocol provides a detailed description about the rodent model of optic nerve microinjection, in which a partial demyelination lesion is produced in the optic nerve. VEP recording techniques are also discussed. Using skull implanted electrodes, we are able to acquire reproducible intra-session and between-session VEP traces. VEPs can be recorded on individual animals over a period of time to assess the functional changes in the optic nerve longitudinally. The optic nerve demyelination model, in conjunction with the VEP recording protocol, provides a tool to investigate the disease processes associated with demyelination and remyelination, and can potentially be employed to evaluate the effects of new remyelinating drugs or neuroprotective therapies.

  1. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    Directory of Open Access Journals (Sweden)

    A. Greco

    2014-01-01

    Full Text Available Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes.

  2. Treatment for idiopathic and hereditary neuralgic amyotrophy (brachial neuritis) (Review)

    NARCIS (Netherlands)

    Alfen, N. van; Engelen, B.G.M. van; Hughes, R.A.

    2009-01-01

    BACKGROUND: Neuralgic amyotrophy (also know as Parsonage-Turner syndrome or brachial plexus neuritis) is a distinct peripheral nervous system disorder characterised by episodes (attacks) of extreme neuropathic pain and rapid multifocal weakness and atrophy in the upper limbs. Neuralgic amyotrophy ha

  3. Preliminary clinical research on the viral optic neuritis in a comprehensive therapy of anti-viral drug combined methylprednisolone%抗病毒药联合甲基强的松龙治疗病毒性视神经炎

    Institute of Scientific and Technical Information of China (English)

    李迎春; 樊映川; 胡建斌; 陈豫川; 刘娅莉; 江梅

    2012-01-01

    目的:比较更昔洛韦联合甲基强的松龙综合疗法和甲基强的松龙综合疗法治疗病毒性视神经炎(optic neuritis,ON)的疗效.方法:将41例60眼病毒抗体检测阳性的ON患者随机分为治疗组(更昔洛韦组,21例30眼)和对照组(20例30眼).于治疗前和治疗后3,7,14,30,90,180d观察两组患者的视力、视觉诱发电位(visual evoked potential,VEP).结果:两组患者的视力、LP100随时间得到改善(P<0.01).两组患者视力在治疗的第3d开始恢复,治疗30d时治疗组视力明显优于对照组(P=0.009),治疗180d时两组视力改善无差异(P>0.05);两组LP100在治疗初期(14d内),恢复速率均快,与治疗前差异具有统计学意义(P<0.01),但LP100的近期恢复效果治疗组优于对照组,远期差别减小.结论:更昔洛韦联合甲基强的松龙综合疗法较单纯甲基强的松龙综合疗法治疗ON能更快提高患者视力,增强视神经电活动,改善患者视觉质量.

  4. Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Kannan, Anusha; Srinivasan, Sivasubramanian [Khoo Teck Puat Hospital, Singapore (Singapore)

    2012-09-15

    We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

  5. Papilloedema and MRI enhancement of the prechiasmal optic nerve at the acute stage of Leber hereditary optic neuropathy.

    Science.gov (United States)

    Lamirel, Cédric; Cassereau, Julien; Cochereau, Isabelle; Vignal-Clermont, Catherine; Pajot, Olivier; Tanguy, Jean-Yves; Zanlonghi, Xavier; Reynier, Pascal; Amati-Bonneau, Patrizia; Dubas, Frédéric; Bonneau, Dominique; Verny, Christophe

    2010-05-01

    The authors report a case of one patient from a family carrying the homoplasmic Leber hereditary optic neuropathy (LHON) G11778A mitochondrial DNA mutation with papilloedema 9 months prior to the acute stage of LHON and still present at the onset of visual loss. During the vision loss, the MRI demonstrated a T2 hyperintensity and an enhancement of the prechiasmal left optic nerve, suggesting the existence of an inflammatory mechanism. A retrospective review of the chart of two others members of the same family, with bilateral optic disc oedema at onset of the vision loss, suggests that the relationship of papilloedema and acute phase of LHON may not be just a coincidence, at least in this family. The visual loss related to LHON could have been triggered in the setting of the chronic papilloedema, associated with the intracranial hypertension.

  6. 健康教育和心理护理提高特发性脱髓鞘性视神经炎患者治疗效果%Effects of Health Education and Psychological Nursing Intervention on Patients with Idiopathic Demyelinating Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    任慧; 王敬荣

    2011-01-01

    目的 观察健康教育和心理护理干预对特发性脱髓鞘性视神经炎(idiopathicdemyelinating optic neuritis,IDON)患者治疗效果的影响,探讨提高IDON疗效的护理措施.方法 采用随机数字表法将2008年10月至2010年10月的238例IDON住院患者分为对照组和干预组各119例,对照组给予常规护理措施,干预组在常规护理措施的基础上加强健康教育和心理护理干预.比较两组患者入院1周后的焦虑、抑郁评分、治疗依从性,出院时的疾病知晓率、护理满意率,以及出院后3个月的疾病复发率.结果 治疗1周后,两组患者的焦虑和抑郁程度均有所下降,而干预组焦虑和抑郁评分均低于对照组,差异有统计学意义(P<0.05);干预组的治疗依从性(89.1%)高于对照组(79.8%),差异有统计学意义(χ2=3.872,P<0.05).干预组患者出院时的疾病知晓率(94.1%)和护理满意率(94.6%)均高于对照组(82.4%和81.5%),差异有统计学意义(P<0 05或P<0.01);出院后3个月,干预组的疾病复发率(0.8%)低于对照组(5.9%),差异有统计学意义(χ2=4.657,P<0 05).结论 在IDON治疗过程中,应重视加强患者的健康教育和心理护理干预,以提高IDON患者的治疗效果,降低疾病的复发率.%Objective To observe the clinical influence of health education and psychological nursing intervention on the therapeutic effects of patients with idiopathic demyelinating optic neuritis(IDON) and to explore the nursing methods for IDON patients. Methods From October 2008 to October 2010,238 IDON patients were equally randomized into control group to undergo the conventional nursing and intervention group to undergo health education and psychological nursing intervention based on the conventional nursing. Comparisons were conducted on the anxiety, depression score and treatment compliance, awareness of disease at discharge and nursing satisfaction one week after admission,as well as the recurrence rate in 3 months after

  7. A case of secondary syphilis presenting as optic neuritis.

    Science.gov (United States)

    Bandettini di Poggio, Monica; Primavera, Alberto; Capello, Elisabetta; Bandini, Fabio; Mazzarello, Giovanni; Viscoli, Claudio; Schenone, Angelo

    2010-06-01

    Neurosyphilis is still a significant medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed due to the lack of typical characteristics. We describe the case of a 59-year-old homosexual man with a 1-month history of decreased vision acuity in his left eye who was diagnosed with neurosyphilis and received treatment with intravenous penicillin G (16 million units in divided daily doses), with great improvement of visual acuity and CSF examination findings. The interest of this case is not only represented by the unusually early ocular involvement, but also by the rapid evolution of the disease into the secondary stage in a man who had had one at-risk homosexual relationship only 3 months before the onset symptoms. We also support the view that the presence of ocular involvement in syphilitic patients is suggestive of involvement of the CNS and should be considered synonymous with neurosyphilis.

  8. Scanning laser polarimetry, but not optical coherence tomography predicts permanent visual field loss in acute nonarteritic anterior ischemic optic neuropathy.

    Science.gov (United States)

    Kupersmith, Mark J; Anderson, Susan; Durbin, Mary; Kardon, Randy

    2013-08-15

    Scanning laser polarimetry (SLP) reveals abnormal retardance of birefringence in locations of the edematous peripapillary retinal nerve fiber layer (RNFL), which appear thickened by optical coherence tomography (OCT), in nonarteritic anterior ischemic optic neuropathy (NAION). We hypothesize initial sector SLP RNFL abnormalities will correlate with long-term regional visual field loss due to ischemic injury. We prospectively performed automated perimetry, SLP, and high definition OCT (HD-OCT) of the RNFL in 25 eyes with acute NAION. We grouped visual field threshold and RNFL values into Garway-Heath inferior/superior disc sectors and corresponding superior/inferior field regions. We compared sector SLP RNFL thickness with corresponding visual field values at presentation and at >3 months. At presentation, 12 eyes had superior sector SLP reduction, 11 of which had inferior field loss. Six eyes, all with superior field loss, had inferior sector SLP reduction. No eyes had reduced OCT-derived RNFL acutely. Eyes with abnormal field regions had corresponding SLP sectors thinner (P = 0.003) than for sectors with normal field regions. During the acute phase, the SLP-derived sector correlated with presentation (r = 0.59, P = 0.02) and with >3-month after presentation (r = 0.44, P = 0.02) corresponding superior and inferior field thresholds. Abnormal RNFL birefringence occurs in sectors corresponding to regional visual field loss during acute NAION when OCT-derived RNFL shows thickening. Since the visual field deficits show no significant recovery, SLP can be an early marker for axonal injury, which may be used to assess recovery potential at RNFL locations with respect to new treatments for acute NAION.

  9. Autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

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    Kamikura, Isao; Mizutani, Tomohiko; Sakamaki, Shuji; Takasu, Toshiaki; Kawamura, Toshiaki

    1988-01-01

    A 34-year-old woman presented with urination difficulty and consciousness disturbance, followed by persistent neurologic findings, such as semicomatose mental status and bilateral optic neuritis, and monophasic clinical course. Cranial CT showed multifocal low density areas in cerebral white matter. The patient was clinically diagnosed as having acute disseminated encephalomyelitis. She died of sepsis four months later. Autopsy revealed multifocal large demyelinating lesions confined to the cerebral white matter, shown as low density areas on CT scans, and demyelinating plaques scattered in the optic nerves and chiasm, and cerebral peduncle. The final diagnosis was acute multiple sclerosis. The CT appearance of multifocal low density areas was most likely due to demyelinating lesions causing edema and tissue necrosis. (Namekawa, K.).

  10. Predictors of development of chronic vestibular insufficiency after vestibular neuritis.

    Science.gov (United States)

    Adamec, Ivan; Krbot Skorić, Magdalena; Ozretić, David; Habek, Mario

    2014-12-15

    To evaluate the role of clinical parameters, MRI and ocular VEMP (oVEMP) and cervical VEMP (cVEMP) as predictors of development of chronic vestibular insufficiency after vestibular neuritis. Twenty-six patients with vestibular neuritis were included: 15 patients (58%) showed complete clinical recovery, and 11 patients (41%) were diagnosed with the syndrome of chronic vestibular insufficiency. Clinical parameters (vomiting, nystagmus, postural stability, and nausea) were assessed at diagnosis. MRI was performed within 3 months and VEMP within 6 days and at 1 year after the initial presentation. The amplitude asymmetry ratio (AR) was calculated using the following formula: AR=((healthy side-affected side)/(healthy side+affected side) × 100). Of all studied parameters, only chronic white matter supratentorial lesions present on brain MRI negatively correlated with clinical recovery (Phi coefficient=-0.637, p=0.001). The logistic regression analysis showed that positive brain MRI and older age reduced odds for clinical recovery. There was no correlation between clinical recovery and oVEMP AR recovery between groups (p=0.781). Seven patients showed improvement, and 19 showed worsening on oVEMP AR after a 1-year follow-up. Statistical regression model for predicting the outcome of clinical recovery using asymmetry score recovery, as an independent variable, was not statistically significant. Older age and chronic white matter lesions on brain MRI are positive predictors of development of chronic vestibular insufficiency after vestibular neuritis. VEMPs are not useful in predicting the development of chronic vestibular insufficiency. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. The use of optical microscope equipped with multispectral detector to distinguish different types of acute lymphoblastic leukemia

    Science.gov (United States)

    Pronichev, A. N.; Polyakov, E. V.; Tupitsyn, N. N.; Frenkel, M. A.; Mozhenkova, A. V.

    2017-01-01

    The article describes the use of a computer optical microscopy with multispectral camera to characterize the texture of blasts bone marrow of patients with different variants of acute lymphoblastic leukemia: B- and T- types. Specific characteristics of the chromatin of the nuclei of blasts for different types of acute lymphoblastic leukemia were obtained.

  12. Concurrent acute disseminated encephalomyelitis and Guillain-Barré syndrome in a child

    Directory of Open Access Journals (Sweden)

    Isha S Deshmukh

    2015-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM and Guillain-Barrι syndrome (GBS are distinct demyelinating disorders that share an autoimmune pathogenesis and prior history of viral infection or vaccination. Our patient is a 10 years with acute flaccid paralysis, quadriparesis (lower limbs affected more than upper limbs, generalized areflexia and urinary retention. He had difficulty in speech and drooling of saliva. He also presented with raised intracranial pressure with papilledema; then bilateral optic neuritis developed during the later course of illness. Based on the temporal association and exclusion of alternative etiologies, diagnosis of the association between ADEM and GBS was made. Electro-diagnosis (electromyography-nerve conduction velocity and magnetic resonance imaging study supported our diagnosis. He improved remarkably after treatment with intravenous immunoglobulin and intravenous methylprednisolone.

  13. Chronic symptoms after vestibular neuritis and the high velocity vestibulo-ocular reflex

    Science.gov (United States)

    Patel, Mitesh; Arshad, Qadeer; Roberts, R Edward; Ahmad, Hena; Bronstein, Adolfo M.

    2015-01-01

    Hypothesis As the anterior and posterior semicircular canals are vital to the regulation of gaze stability, particularly during locomotion or vehicular travel, we tested whether the high velocity vestibulo-ocular reflex (VOR) of the three ipsilesional semicircular canals elicited by the modified Head Impulse Test would correlate with subjective dizziness or vertigo scores after vestibular neuritis (VN). Background Recovery following acute VN varies with around half reporting persistent symptoms long after the acute episode. However, an unanswered question is whether chronic symptoms are associated with impairment of the high velocity VOR of the anterior or posterior canals. Methods Twenty patients who had experienced an acute episode of VN at least three months earlier were included in this study. Participants were assessed with the video head impulse test (vHIT) of all six canals, bithermal caloric irrigation, the Dizziness Handicap Inventory (DHI) and the Vertigo Symptoms Scale short-form (VSS). Results Of these 20 patients, 12 felt that they had recovered from the initial episode whereas 8 did not and reported elevated DHI and VSS scores. However, we found no correlation between DHI or VSS scores and the ipsilesional single or combined vHIT gain, vHIT gain asymmetry or caloric paresis. The high velocity VOR was not different between patients who felt they had recovered and patients who felt they had not. Conclusions Our findings suggest that chronic symptoms of dizziness following VN are not associated with the high velocity VOR of the single or combined ipsilesional horizontal, anterior or posterior semicircular canals. PMID:26719963

  14. [A case of subacute necrotizing lymphadenitis complicated with brachial plexus neuritis].

    Science.gov (United States)

    Sugiyama, A; Araki, E; Arakawa, K; Kikuchi, H; Iwaki, T; Yamada, T; Kira, J

    1998-01-01

    gadolinium-enhancement of the right brachial plexus. As a result, her right upper limb paresis was thus considered to have been caused by right brachial plexus neuritis, which was probably associated with histocytic necrotizing lymphadentis. Although acute cerebellar ataxia and meningitis have previously been reported to be complicated with histiocytic necrotizing lymphadenitis, this is the first report to describe the complication of peripheral neuritis with this condition.

  15. Central Retinal Vein Occlusion and Paracentral Acute Middle Maculopathy Diagnosed With En Face Optical Coherence Tomography.

    Science.gov (United States)

    Phasukkijwatana, Nopasak; Rahimi, Mansour; Iafe, Nicholas; Sarraf, David

    2016-09-01

    A 21-year-old healthy female presented with acute-onset vision loss in the left eye. Multimodal imaging, including fundus photography and fluorescein angiography, was unremarkable. En face optical coherence tomography (OCT) demonstrated paracentral acute middle maculopathy (PAMM) lesions in a perivenular fern-like pattern leading to the diagnosis of central retinal vein occlusion (CRVO). En face OCT can be an important modality to identify the distribution of abnormalities of the middle retina such as PAMM. The distribution of PAMM lesions in the posterior pole will be a critical element in the determination of the etiologic disorder. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:862-864.]. Copyright 2016, SLACK Incorporated.

  16. [Leber's hereditary optic neuropathy].

    Science.gov (United States)

    Leo-Kottler, B; Wissinger, B

    2011-12-01

    Leber's hereditary optic neuropathy (LHON) is a rare disease primarily affecting the retinal ganglion cells. In most cases patients with LHON develop permanent visual loss with a large central scotoma in the visual field of both eyes. The optic disc becomes partially or completely pale. At the onset of the disease many patients are considered to suffer from an optic neuritis and are treated under the diagnostic and therapeutic regimen of optic neuritis. LHON is mostly only considered when high dose cortisone therapy fails to be effective or the second eye is affected. Thereafter, molecular genetic analysis will prove LHON in these cases. Detailed anamnesis including pedigree analysis in combination with observance of the peripapillary microangiopathic alterations at the fundus will help to speed up the diagnosis of LHON, but even after exact clinical and molecular genetic diagnosis of LHON some aspects of the disease still remain a mystery today.

  17. Peripheral neuritis in psittacine birds with proventricular dilatation disease.

    Science.gov (United States)

    Berhane, Y; Smith, D A; Newman, S; Taylor, M; Nagy, E; Binnington, B; Hunter, B

    2001-10-01

    Necropsies were performed on 14 psittacine birds of various species suspected to have proventricular dilatation disease (PDD). Eight of the birds exhibited neurological signs (seizures, ataxia, tremors and uncoordinated movements) and digestive tract signs (crop stasis, regurgitation, inappetance and presence of undigested food in the faeces). At necropsy, the birds had pectoral muscle atrophy, proventricular and ventricular distention, thinning of the gizzard wall, and duodenal dilation. In addition, five birds had a transparent fluid (0.2 to 1.0 ml) in the subarachnoidal space of the brain, and one bird had dilatation of the right ventricle of the heart. The histological lesions differed from earlier reports of PDD in that peripheral (sciatic, brachial and vagal) neuritis was seen in addition to myenteric ganglioneuritis, myocarditis, adrenalitis, myelitis and encephalitis.

  18. Queratosis plantar sifilítica. Neuritis óptica

    Directory of Open Access Journals (Sweden)

    RICARDO FERNANDEZ RODRIGUEZ

    2012-03-01

    Full Text Available Paciente de 45 años que acude a Urgencias por pérdida aguda de visión en el ojo izquierdo. En la exploración se aprecia pupila aferente de Marcus Gunn en el ojo afecto y enla fundoscopia borramiento del borde temporal de la papila.Ingresa en Neurología con el diagnóstico de neuritis óptica. Se confirma una amplitud disminuida de los potencialesevocados visuales en el OI. La RMN cerebral fue normal. Seadministró 1 gr de metilprednisolona iv/d/ 3días, sin mejoríaen la visión.

  19. Treatment of 43 Cases of Lateral Femoral Cutaneous Neuritis with Pricking and Cupping Therapy

    Institute of Scientific and Technical Information of China (English)

    王秀珍; 朱冬霞; 洪珏

    2009-01-01

    @@ Lateral femoral cutaneous neuritis, also named as meralgia paresthetica or Roth syndrome, is marked by cutaneous pain or paresthesia such as formication or numbness in one or both thighs, which can be aggravated by prolonged standing or walking; it is also characterized by hypoesthesia or skin sensibility without muscular atrophy or dyskinesia. Forty-three cases of lateral femoral cutaneous neuritis have been treated by pricking and cupping therapy since 1996. Now it was reported as follows.

  20. Magnetic resonance imaging in acute intractional tuberculosis; Magnetresonanztomographie bei akuter intrakranieller Tuberkulose

    Energy Technology Data Exchange (ETDEWEB)

    Venz, S. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Sander, B. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Benndorf, G. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Terstegge, K. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Podrabsky, P. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Cordes, M. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1994-12-31

    We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. All patients had native and contrast enhanced CT and MRI scans. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis. (orig.) [Deutsch] Die Befunde von drei Patienten mit intrakranieller Tuberkulose (intrakranielle Miliartuberkulose, Meningitis tuberculosa, Neuritis und Tuberkulome) in der Magnetresonanztomographie (MRT) wurden mit der Computertomographie (CT) verglichen. Sowohl die MRT als auch die CT wurden nativ und nach Kontrastmittelgabe durchgefuehrt. Die MRT zeigte sich im Nachweis von Granulomen insbesondere im Bereich des Hirnstamms ueberlegen. Ebenso wurde ein hoeherer Bildkontrast bei der Darstellung der Meningitis beobachtet. Eine Neuritis der Hirnnerven war nur mit der MRT nachweisbar. Die kontrastmittelunterstuetzte MRT sollte in der bildgebenden Diagnostik einer intrakraniellen Turberkulose primaer zum Einsatz gelangen. (orig.)

  1. Diagnosis and classification of autoimmune optic neuropathy.

    Science.gov (United States)

    Petzold, Axel; Plant, Gordon T

    2014-01-01

    The spectrum of autoimmune optic neuropathies (ON) is extending. The phenotypic spectrum includes single isolated optic neuritis (SION), relapsing isolated optic neuritis (RION), chronic relapsing inflammatory optic neuropathy (CRION), the neuromyelitis optica (NMO) spectrum disorder, multiple sclerosis associated optic neuritis (MSON) and unclassified optic neuritis (UCON) forms. Epidemiological data suggests a slight female predominance. The ethnic heritage is relevant as Caucasian patients are more likely to suffer from MSON, whilst SION, RION, CRION and NMO are more frequent in non-Caucasian patients. Importantly, prognosis for recovery of visual function is good in MSON, but poorer in NMO and CRION which also have a high chance for recurrent episodes. Testing for serum anti-AQP4 autoantibodies is advised in all patients with severe, atypical or recurrent ON because of the high diagnostic specificity. The diagnostic specificity may be aided by testing for glial biomarkers in the CSF and prognostic accuracy by testing for biomarkers for neuroaxonal degeneration. Optical coherence tomography is a highly accurate tool to document the final outcome. The current clinical classification criteria rely on the phenotype, response to treatment and presence of anti-AQP4 autoantibodies.

  2. Acute myocardial infarction in a young athlete: Optical coherence tomographic features of the culprit lesion

    Directory of Open Access Journals (Sweden)

    Matjaz Klemenc

    2016-04-01

    Full Text Available Objectives: We report on a young male athlete who suffered from acute myocardial infarction immediately after a vigorous training. Methods: A comprehensive optical coherence tomographic investigation of the culprit coronary artery was performed after the combined mechanical and pharmacological thrombus removal. Results and Conclusion: The imaging discovered a tear at the junction of the non-obstructive, largely fibrotic plaque with the normal arterial wall. This exertion-related vessel damage resulted in a dynamic thrombosis that almost completely occluded the culprit artery. As the vessel obstruction was not considered flow-limiting, the stent implantation was not required and the patient was discharged on the double antiplatelet therapy and statin.

  3. Acute and chronic spectral domain optical coherence tomography features of branch retinal artery occlusion

    Science.gov (United States)

    Rodrigues, Ian Aureliano Stephen

    2013-01-01

    Branch retinal artery occlusion (BRAO) is a common vascular occlusive disorder. BRAO involving the posterior pole is usually symptomatic, but occasionally has very limited clinical features. We describe 2 cases where the underlying pathology was initially unclear and the diagnosis therefore not reached at presentation. Use of the latest retinal imaging, spectral domain optical coherence tomography (SD-OCT) enabled correct diagnosis of BRAO. The images demonstrate and contrast the fine changes that can be seen in the acute and chronic phases of this condition and illustrate how the pathogenesis of BRAO is confined to the outer retinal layers. We believe the subtle presentations of this common condition that we discuss highlight how diagnosis of BRAO can often be challenging, but may be facilitated by the use of SD-OCT retinal imaging. PMID:23661655

  4. High-resolution CT of lesions of the optic nerve

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    Peyster, R.G.; Hoover, E.D.; Hershey, B.L.; Haskin, M.E.

    1983-05-01

    The optic nerves are well demonstrated by high-resolution computed tomography. Involvement of the optic nerve by optic gliomas and optic nerve sheath meningiomas is well known. However, nonneoplastic processes such as increased intracranial pressure, optic neuritis, Grave ophthalmopathy, and orbital pseudotumor may also alter the appearance of the optic nerve/sheath on computed tomography. Certain clinical and computed tomographic features permit distinction of these nonneoplastic tumefactions from tumors.

  5. Clinical Study on the Wrist-Ankle Acupuncture Treatment for 30 Cases of Diabetic Peripheral Neuritis

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To study the mechanisms of wrist-ankle acupuncture for prevention and treatment of diabetic peripheral neuritis. Methods: Ninety cases of diabetic peripheral neuritis were randomly divided into 3groups, and treated respectively with wrist-ankle acupuncture, body-acupuncture, and the western routine medical treatment, with 30 cases in each of the groups; and therapeutic effects and laboratory results compared. Results: It is proved that the therapeutic effects of the wrist-ankle acupuncture group and body acupuncture group were significantly superior to those of the control group, with no significant differences between the former two groups. Conclusion: Wrist-ankle acupuncture has the actions of improving the metabolisms of blood sugar and blood-lipid, lowering down blood viscosity, and restoring the functions of peripheral nerve cells, thus giving definite therapeutic effects for diabetic peripheral neuritis.

  6. Optic nerve involvement in childhood onset systemic lupus erythematosus: Three cases and a review of the literature.

    Science.gov (United States)

    Suri, D; Abujam, B; Gupta, A; Rawat, A; Saikia, B; Walker Minz, R; Gupta, V; Bansal, R; Kaushik, S; Singh, S

    2016-01-01

    The ocular system can be affected in systemic lupus erythematosus (SLE) in one third of patients. However, optic nerve involvement is relatively uncommon, but is more so in pediatric SLE patients, where it can occur in 1% of cases. We report three children with SLE who presented with optic nerve involvement. Two children had optic neuritis, with optic neuritis being the first manifestation in one child. The third child had ischaemic optic neuropathy secondary to antiphospholipid syndrome. A careful work up for SLE should be performed in every child with optic nerve disease. Prompt diagnosis and early treatment results in a better prognosis.

  7. Surgical treatment of type I neuritis in a teenage boy with borderline tuberculoid leprosy

    Directory of Open Access Journals (Sweden)

    Christiane Salgado Sette

    2015-04-01

    Full Text Available Exacerbation of the immune response against Mycobacterium leprae can lead to neuritis, which is commonly treated via immunosuppression with corticosteroids. Early neurolysis may be performed concurrently, especially in young patients with a risk of functional sequelae. We report the case of a young patient experienced intense pain in the left elbow one year after the treatment of tuberculoid-tuberculoid leprosy. The pain was associated with paresthesias in the ulnar edge and left ulnar claw. After evaluation, the diagnosis was changed to borderline tuberculoid leprosy accompanied with neuritis of the left ulnar nerve. Early neurolysis resulted in rapid reduction of the pain and recovery of motor function.

  8. OPTICAL IMAGING OF LIPOPOLYSACCHARIDE-INDUCED OXIDATIVE STRESS IN ACUTE LUNG INJURY FROM HYPEROXIA AND SEPSIS

    Directory of Open Access Journals (Sweden)

    REYHANEH SEPEHR

    2013-07-01

    Full Text Available Reactive oxygen species (ROS have been implicated in the pathogenesis of many acute and chronic pulmonary disorders such as acute lung injury (ALI in adults and bronchopulmonary dysplasia (BPD in premature infants. Bacterial infection and oxygen toxicity, which result in pulmonary vascular endothelial injury, contribute to impaired vascular growth and alveolar simplification seen in the lungs of premature infants with BPD. Hyperoxia induces ALI, reduces cell proliferation, causes DNA damage and promotes cell death by causing mitochondrial dysfunction. The objective of this study was to use an optical imaging technique to evaluate the variations in fluorescence intensities of the auto-fluorescent mitochondrial metabolic coenzymes, NADH and FAD in four different groups of rats. The ratio of these fluorescence signals (NADH/FAD, referred to as NADH redox ratio (NADH RR has been used as an indicator of tissue metabolism in injuries. Here, we investigated whether the changes in metabolic state can be used as a marker of oxidative stress caused by hyperoxia and bacterial lipopolysaccharide (LPS exposure in neonatal rat lungs. We examined the tissue redox states of lungs from four groups of rat pups: normoxic (21% O2 pups, hyperoxic (90% O2 pups, pups treated with LPS (normoxic + LPS, and pups treated with LPS and hyperoxia (hyperoxic + LPS. Our results show that hyperoxia oxidized the respiratory chain as reflected by a ~ 31% decrease in lung tissue NADH RR as compared to that for normoxic lungs. LPS treatment alone or with hyperoxia had no significant effect on lung tissue NADH RR as compared to that for normoxic or hyperoxic lungs, respectively. Thus, NADH RR serves as a quantitative marker of oxidative stress level in lung injury caused by two clinically important conditions: hyperoxia and LPS exposure.

  9. OPTICAL IMAGING OF LIPOPOLYSACCHARIDE-INDUCED OXIDATIVE STRESS IN ACUTE LUNG INJURY FROM HYPEROXIA AND SEPSIS.

    Science.gov (United States)

    Sepehr, Reyhaneh; Audi, Said H; Maleki, Sepideh; Staniszewski, Kevin; Eis, Annie L; Konduri, Girija G; Ranji, Mahsa

    2013-07-01

    Reactive oxygen species (ROS) have been implicated in the pathogenesis of many acute and chronic pulmonary disorders such as acute lung injury (ALI) in adults and bronchopulmonary dysplasia (BPD) in premature infants. Bacterial infection and oxygen toxicity, which result in pulmonary vascular endothelial injury, contribute to impaired vascular growth and alveolar simplification seen in the lungs of premature infants with BPD. Hyperoxia induces ALI, reduces cell proliferation, causes DNA damage and promotes cell death by causing mitochondrial dysfunction. The objective of this study was to use an optical imaging technique to evaluate the variations in fluorescence intensities of the auto-fluorescent mitochondrial metabolic coenzymes, NADH and FAD in four different groups of rats. The ratio of these fluorescence signals (NADH/FAD), referred to as NADH redox ratio (NADH RR) has been used as an indicator of tissue metabolism in injuries. Here, we investigated whether the changes in metabolic state can be used as a marker of oxidative stress caused by hyperoxia and bacterial lipopolysaccharide (LPS) exposure in neonatal rat lungs. We examined the tissue redox states of lungs from four groups of rat pups: normoxic (21% O2) pups, hyperoxic (90% O2) pups, pups treated with LPS (normoxic + LPS), and pups treated with LPS and hyperoxia (hyperoxic + LPS). Our results show that hyperoxia oxidized the respiratory chain as reflected by a ~31% decrease in lung tissue NADH RR as compared to that for normoxic lungs. LPS treatment alone or with hyperoxia had no significant effect on lung tissue NADH RR as compared to that for normoxic or hyperoxic lungs, respectively. Thus, NADH RR serves as a quantitative marker of oxidative stress level in lung injury caused by two clinically important conditions: hyperoxia and LPS exposure.

  10. Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography.

    Science.gov (United States)

    Bennett, J L; de Seze, J; Lana-Peixoto, M; Palace, J; Waldman, A; Schippling, S; Tenembaum, S; Banwell, B; Greenberg, B; Levy, M; Fujihara, K; Chan, K H; Kim, H J; Asgari, N; Sato, D K; Saiz, A; Wuerfel, J; Zimmermann, H; Green, A; Villoslada, P; Paul, F

    2015-05-01

    Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel aquaporin-4 present in up to 80% of NMO patients enables distinction from MS. Optic neuritis may occur in either condition resulting in neuro-anatomical retinal changes. Optical coherence tomography (OCT) has become a useful tool for analyzing retinal damage both in MS and NMO. Numerous studies showed that optic neuritis in NMO typically results in more severe retinal nerve fiber layer (RNFL) and ganglion cell layer thinning and more frequent development of microcystic macular edema than in MS. Furthermore, while patients' RNFL thinning also occurs in the absence of optic neuritis in MS, subclinical damage seems to be rare in NMO. Thus, OCT might be useful in differentiating NMO from MS and serve as an outcome parameter in clinical studies.

  11. Optic radiation damage in multiple sclerosis is associated with visual dysfunction and retinal thinning - an ultrahigh-field MR pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Sinnecker, Tim [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Asklepios Fachklinikum Teupitz, Department of Neurology, Teupitz (Germany); Oberwahrenbrock, Timm; Zimmermann, Hanna; Ramien, Caren; Brandt, Alexander U. [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Metz, Imke; Brueck, Wolfgang [University Medicine Goettingen, Institute of Neuropathology, Goettingen (Germany); Pfueller, Caspar F.; Doerr, Jan [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Clinical and Experimental Multiple Sclerosis Research Center, Berlin (Germany); Harms, Lutz; Ruprecht, Klemens [Charite - Universitaetsmedizin Berlin, Clinical and Experimental Multiple Sclerosis Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Hahn, Katrin [Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Niendorf, Thoralf [Max Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility (B.U.F.F), Berlin (Germany); Charite - Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany); Paul, Friedemann [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Clinical and Experimental Multiple Sclerosis Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Charite - Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany); Wuerfel, Jens [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Max Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility (B.U.F.F), Berlin (Germany); University Medicine Goettingen, Institute of Neuroradiology, Goettingen (Germany)

    2015-01-15

    To investigate posterior visual pathway damage in multiple sclerosis using ultrahigh-field magnetic resonance imaging (MRI) at 7 Tesla (7 T), and to determine its correlation with visual disability and retinal fibre layer (RNFL) damage detectable by optic coherence tomography (OCT). We studied 7 T MRI, OCT, functional acuity contrast testing (FACT), and visually evoked potentials (VEP, n = 16) in 30 patients (including 26 relapsing-remitting MS and four clinically isolated syndrome patients) and 12 healthy controls to quantify RNFL thickness, optic radiation lesion volume, and optic radiation thickness. Optic radiation lesion volume was associated with thinning of the optic radiation (p < 0.001), delayed VEP (p = 0.031), and visual disability indicated by FACT (p = 0.020). Furthermore, we observed an inverse correlation between optic radiation lesion volume and RNFL thickness (p < 0.001), including patients without previous optic neuritis (p < 0.001). Anterior visual pathway damage, but also (subclinical) optic radiation integrity loss detectable by 7 T MRI are common findings in MS that are mutually affected. Given the association between optic radiation damage, visual impairment, and increased VEP latency in this exploratory study of a limited sample size, clinicians should be aware of acute lesions within the optic radiation in patients with (bilateral) visual disturbances. (orig.)

  12. [Neurological disorders caused by equine herpesvirus type 1 and cauda equina neuritis in horses].

    Science.gov (United States)

    Sloet van Oldruitenborgh-Oosterbaan, M M; Binkhorst, G J

    1984-12-15

    The differences in aetiology, symptomatology, pathomorphology, diagnosis and therapy between the nervous form (paralytic form) of Equine Herpes Virus, type 1, and Neuritis Caudae Equinae are reviewed. The conclusion is that in most cases it is possible to differentiate between these two clinical syndromes.

  13. Optical-fiber-coupled inferometric measurement of tympanic membrane temperature: a new diagnostic tool for acute otitis media

    Science.gov (United States)

    DeRowe, Ari; Ophir, Eyal; Sade, Sharon; Fishman, Gadi; Ophir, Dov; Grankin, Mila; Katzir, Abraham

    1998-07-01

    A novel infrared (IR) transparent optical fiber coupled to a hand held otoscope and a radiometer was constructed and used to measure the temperatures of the tympanic membrane (TM) and to distinguish between diseased and healthy middle ears. A greater temperature difference between TM readings was found when Acute Otitis Media (AOM) existed in one of the ears examined. This supports the hypothesis that acute inflammation of the middle ear will result in elevated local temperature when measured in such a way that the reading is taken only from the TM without interference of the external canal. The use of an optical fiber enabled temperature measurements of the TM with high spatial resolution eliminating the external ear canal interference. A small patient population was examined and the initial results were statistically significant. In the hands of the primary care physician, this tool would prevent misdiagnosis of AOM preventing indiscriminate use of antibiotics and avoiding complications by early diagnosis.

  14. Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

    Directory of Open Access Journals (Sweden)

    Tuğba Aydoğan

    2015-01-01

    Full Text Available A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF was slightly increased. Spectral domain optical coherence tomography (SD-OCT showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL. One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

  15. Acute Myeloid Leukemia Relapse Presenting as Complete Monocular Vision Loss due to Optic Nerve Involvement

    Directory of Open Access Journals (Sweden)

    Shyam A. Patel

    2016-01-01

    Full Text Available Acute myeloid leukemia (AML involvement of the central nervous system is relatively rare, and detection of leptomeningeal disease typically occurs only after a patient presents with neurological symptoms. The case herein describes a 48-year-old man with relapsed/refractory AML of the mixed lineage leukemia rearrangement subtype, who presents with monocular vision loss due to leukemic eye infiltration. MRI revealed right optic nerve sheath enhancement and restricted diffusion concerning for nerve ischemia and infarct from hypercellularity. Cerebrospinal fluid (CSF analysis showed a total WBC count of 81/mcl with 96% AML blasts. The onset and progression of visual loss were in concordance with rise in peripheral blood blast count. A low threshold for diagnosis of CSF involvement should be maintained in patients with hyperleukocytosis and high-risk cytogenetics so that prompt treatment with whole brain radiation and intrathecal chemotherapy can be delivered. This case suggests that the eye, as an immunoprivileged site, may serve as a sanctuary from which leukemic cells can resurge and contribute to relapsed disease in patients with high-risk cytogenetics.

  16. Characterization of rat model of acute anterior uveitis using optical coherence tomography angiography

    Science.gov (United States)

    Choi, Woo June; Pepple, Kathryn L.; Zhi, Zhongwei; Wang, Ruikang K.

    2015-03-01

    Uveitis, or ocular inflammation, is a cause of severe visual impairment. Rodent models of uveitis are powerful tools used to investigate the pathological mechanisms of ocular inflammation and to study the efficacy of new therapies prior to human testing. In this paper, we report the utility of spectral-domain optical coherence tomography (SD-OCT) angiography in characterizing the inflammatory changes induced in the anterior segment of a rat model of uveitis. Acute anterior uveitis (AAU) was induced in two rats by intravitreal injection of a killed mycobacterial extract. One of them received a concurrent periocular injection of steroids to model a treatment effect. OCT imaging was performed prior to inflammation induction on day 0 (baseline), and 2 days post-injection (peak inflammation). Baseline and inflamed images were compared. OCT angiography identified swelling of the cornea, inflammatory cells in the anterior and posterior chambers, a fibrinous papillary membrane, and dilation of iris vessels in the inflamed eyes when compared to baseline images. Steroid treatment was shown to prevent the changes associated with inflammation. This is a novel application of anterior OCT imaging in animal models of uveitis, and provides a high resolution, in vivo assay for detecting and quantifying ocular inflammation and the response to new therapies.

  17. An unusual cause of optic neuritis:rickettsiosis disease

    Institute of Scientific and Technical Information of China (English)

    Loukil Hanen; Snoussi Mouna; Frikha Faten; Ben Salah Raida; Jallouli Moez; ChérifYosra; ElAoud Sahar; Marzouk Sameh; Bahloul Zouhir

    2014-01-01

    Optic neuritis (ON) may be associated to a range of autoimmune or infectious diseases. We report herein a case of ON induced by Rickettsia conorii. A 53-year-old woman presented with a recent decrease in visual acuity and headache. ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials. Etiological investigation made in our department eliminated first autoimmune disorders (vasculitis and connective tissue diseases). Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests. An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.

  18. Acute and chronic pain syndromes in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Knudsen, L; Jensen, K

    1991-01-01

    included neuralgia, L'Hermitte's sign and pain associated with optic neuritis. Thirty-five per cent were pain-free. Of the remaining patients had 45% pain at the time of the examination, 32% indicated pain among the most severe symptoms of MS and 23% had pain at the onset of MS. The number of patients...

  19. Optic neuropathy in children with Lyme disease.

    Science.gov (United States)

    Rothermel, H; Hedges, T R; Steere, A C

    2001-08-01

    Involvement of the optic nerve, either because of inflammation or increased intracranial pressure, is a rare manifestation of Lyme disease. Of the 4 children reported here with optic nerve abnormalities, 2 had decreased vision months after disease onset attributable to optic neuritis, and 1 had headache and diplopia early in the infection because of increased intracranial pressure associated with Lyme meningitis. In these 3 children, optic nerve involvement responded well to intravenous ceftriaxone therapy. The fourth child had headache and visual loss attributable to increased intracranial pressure and perhaps also to optic neuritis. Despite treatment with ceftriaxone and steroids, he had persistent increased intracranial pressure leading to permanent bilateral blindness. Clinicians should be aware that neuro-ophthalmologic involvement of Lyme disease may have significant consequences. If increased intracranial pressure persists despite antibiotic therapy, measures must be taken quickly to reduce the pressure.

  20. Anatomic Predictive Factors of Acute Corneal Hydrops in Keratoconus: An Optical Coherence Tomography Study.

    Science.gov (United States)

    Fuentes, Esteban; Sandali, Otman; El Sanharawi, Mohamed; Basli, Elena; Hamiche, Taous; Goemaere, Isabelle; Borderie, Vincent; Bouheraoua, Nacim; Laroche, Laurent

    2015-08-01

    To define the optical coherence tomography (OCT) corneal changes predisposing to acute corneal hydrops among patients with advanced keratoconus. Retrospective cohort study. A total of 191 advanced keratoconic eyes from 191 patients with advanced keratoconus cases were studied. Data collected from patients with advanced keratoconus cases were studied during a minimum period of 24 months of follow-up. High-resolution Fourier-domain corneal OCT (5 μm of axial resolution) and corneal topography were performed every 4 months during the follow-up. Several anatomic features at the keratoconus cone were analyzed with OCT, including epithelial and stromal thicknesses, the aspect of Bowman's layer, the presence of Vogt's striae, and stromal opacities. A comparative analysis between anatomic corneal features in eyes that developed corneal hydrops and those that did not develop this complication during the follow-up was performed. Evaluation of anatomic corneal changes at risk of developing a corneal hydrops on the basis of OCT findings. Eleven cases of corneal hydrops (5.8%) occurred in our series during a mean follow-up of 30 months (24-36 months). All of these patients were male and younger (23.7±5.9 years) than patients with no acute keratoconus (32.7±11.3 years). Increased epithelial thickening with stromal thinning at the conus and the presence of anterior hyperreflectives at the Bowman's layer level were significantly associated with corneal hydrops, whereas the presence of corneal scarring was a preventive factor. At the healing stage, a pan-stromal scar occurs, with a significant stromal thickening and cornea flattening. Increased epithelial thickening, stromal thinning at the keratoconus cone, anterior hyperreflectives at the Bowman's layer level, and the absence of stromal scarring are associated with a high risk of developing corneal hydrops. These aspects should be taken into account by the clinician in the evaluation of keratoconus eyes and in the planning of

  1. Imaging of a Severe Case of Acute Hydrops in a Patient with Keratoconus Using Anterior Segment Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Hiroki Ueno

    2012-09-01

    Full Text Available Aim: To investigate the clinical and diagnostic findings of a patient with acute hydrops using anterior segment optical coherence tomography (AS-OCT. Methods: The AS-OCT findings of a 43-year-old patient with acute hydrops associated with keratoconus were examined. At the initial examination and during follow-up, evaluation of the anterior segment was performed. Results: The patient presented with decreased visual acuity, pain, and redness in the right eye. The symptoms, clinical presentation, and topographical findings of the right eye confirmed the diagnosis of acute corneal hydrops. Changes in the stroma and Descemet’s membrane during the healing process of acute hydrops could be demonstrated by high-resolution AS-OCT. The use of contact lenses was improved at the last follow-up visit after 8 months and increased visual acuity to 20/20 with correction. Conclusions: AS-OCT is a useful tool for studying the morphologic features of acute hydrops.

  2. Importance of spontaneous nystagmus detection in the differential diagnosis of acute vertigo.

    Science.gov (United States)

    Pavlin-Premrl, Davor; Waterston, John; McGuigan, Sean; Infeld, Bernard; Sultana, Ron; O'Sullivan, Richard; Gerraty, Richard P

    2015-03-01

    Vertigo is a common cause of emergency department attendance. Detection of spontaneous nystagmus may be a useful sign in distinguishing vestibular neuritis from other vestibular diagnoses. We aimed to assess the contribution of spontaneous nystagmus in the diagnosis of acute vertigo. We enrolled consecutive consenting patients arriving at a single emergency department with acute vertigo. There was no declared protocol for the emergency department staff. A standardized history and examination was conducted by the investigators. Observation for spontaneous nystagmus, its response to visual fixation, and testing the vestibulo-ocular reflex with the horizontal head impulse test were the chief examination components. MRI was obtained within 24 hours. Clinical criteria and MRI were used to reach the final diagnosis. The investigators' physical findings and final neurological diagnosis were compared with the initial emergency department examination findings and the referral diagnosis. There were 28 patients, 15 with vestibular neuritis, six with benign paroxysmal positional vertigo, one with stroke, suspected clinically, and three with migraine. In three the diagnosis remained uncertain. Spontaneous nystagmus was seen in all 15 patients with vestibular neuritis, fixation-suppressed in eight of 11 tested for this. The head impulse test was positive in 12 of 15 with vestibular neuritis. The emergency department referral diagnosis was correct in six of 23 patients. The ability to detect spontaneous nystagmus is useful in vestibular diagnosis, both in support of a diagnosis of vestibular neuritis and in avoiding false positive diagnoses of benign paroxysmal positional vertigo. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Fiber optic probe enabled by surface-enhanced Raman scattering for early diagnosis of potential acute rejection of kidney transplant

    Science.gov (United States)

    Chi, Jingmao; Chen, Hui; Tolias, Peter; Du, Henry

    2014-06-01

    We have explored the use of a fiber-optic probe with surface-enhanced Raman scattering (SERS) sensing modality for early, noninvasive and, rapid diagnosis of potential renal acute rejection (AR) and other renal graft dysfunction of kidney transplant patients. Multimode silica optical fiber immobilized with colloidal Ag nanoparticles at the distal end was used for SERS measurements of as-collected urine samples at 632.8 nm excitation wavelength. All patients with abnormal renal graft function (3 AR episodes and 2 graft failure episodes) who were clinically diagnosed independently show common unique SERS spectral features in the urines collected just one day after transplant. SERS-based fiber-optic probe has excellent potential to be a bedside tool for early diagnosis of kidney transplant patients for timely medical intervention of patients at high risk of transplant dysfunction.

  4. Anterior ischemic optic neuropathy following dengue fever.

    Science.gov (United States)

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  5. Characterization and Predictive Value of Near Infrared 2-Deoxyglucose Optical Imaging in Severe Acute Pancreatitis.

    Directory of Open Access Journals (Sweden)

    Cristiane de Oliveira

    Full Text Available Studying the uptake of 2-deoxy glucose (2-DG analogs such as 2-Deoxy-2-[18F] fluoroglucose (FDG is a common approach to identify and monitor malignancies and more recently chronic inflammation. While pancreatitis is a common cause for false positive results in human studies on pancreatic cancer using FDG, the relevance of these findings to acute pancreatitis (AP is unknown. FDG has a short half-life. Thus, with an aim to accurately characterize the metabolic demand of the pancreas during AP in real-time, we studied the uptake of the non-radioactive, near infrared fluorescence labelled 2-deoxyglucose analog, IRDye® 800CW 2-DG probe (NIR 2-DG; Li-Cor during mild and severe biliary AP.Wistar rats (300 g; 8-12/group were administered NIR 2-DG (10 nM; I.V.. Mild and severe biliary AP were respectively induced by biliopancreatic duct ligation (DL alone or along with infusing glyceryl trilinoleate (GTL; 50 μL/100 g within 10 minutes of giving NIR 2-DG. Controls (CON only received NIR 2-DG. Imaging was done every 5-10 minutes over 3 hrs. Average Radiant Efficiency [p/s/cm²/sr]/[μW/cm²] was measured over the pancreas using the IVIS 200 in-vivo imaging system (PerkinElmer using the Living Image® software and verified in ex vivo pancreata. Blood amylase, lipase and pancreatic edema, necrosis were measured over the course of AP.NIR 2-DG uptake over the first hour was not influenced by AP induction. However, while the signal declined in controls and rats with mild AP, there was significantly higher retention of NIR 2-DG in the pancreas after 1 hour in those with GTL pancreatitis. The increase was > 3 fold over controls in the GTL group and was verified to be in the pancreas ex vivo. In vitro, pancreatic acini exposed to GTL had a similar increase in NIR 2-DG uptake which was followed by progressively worse acinar necrosis. Greater retention of NIR 2-DG in vivo was associated with worse pancreatic necrosis, reduced ATP concentrations and mortality

  6. Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Browning DJ

    2016-12-01

    Full Text Available David J Browning, Omar S Punjabi, Chong Lee Department of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, P.A., Charlotte, NC, USA Purpose: To determine the relationship between different spectral domain optical coherence tomography (SD-OCT signs of retinal ischemia in acute central retinal vein occlusion (CRVO and whether they predict anterior segment neovascularization (ASNV.Design: Retrospective, observational study.Subjects: Thirty-nine consecutive patients with acute CRVO and 12 months of follow-up.Methods: We graded baseline SD-OCTs for increased reflectivity of the inner retina, loss of definition of inner retinal layers, presence of a prominent middle-limiting membrane (p-MLM sign, and presence of paracentral acute middle maculopathy (PAMM. Graders were masked with respect to all clinical information.Results: The intraclass correlation coefficients (ICCs of grading–regrading by graders 1 and 2 were 0.8104, 95% confidence interval (CI (0.6686, 0.8956, and 0.7986, 95% CI (0.6475, 0.8892, respectively. The intragrader coefficients of repeatability (COR for graders 1 and 2 were 0.94 and 0.92, respectively. The ICC of graders 1 compared with 2 was 0.8039, 95% CI (0.6544, 0.8916. The intergrader COR was 0.80. SD-OCT grades of baseline ischemia were not associated with baseline visual acuity (VA, central subfield mean thickness (CSMT, or relative afferent pupillary defect; 12-month VA, CSMT, change in VA, change in CSMT, number of antivascular endothelial growth factor injections or corticosteroid injections, or proportion of eyes developing ASNV. SD-OCT grades of ischemia did not correlate with the proportion of eyes having the p-MLM sign or PAMM. PAMM and p-MLM are milder signs of ischemia than increased reflectivity of the inner retinal layers. Eyes with PAMM can evolve, losing PAMM and gaining the p-MLM sign.Conclusion: Grading of ischemia from SD-OCT in acute CRVO was repeatable within graders and reproducible across

  7. Neuronal apoptosis and neurofilament protein expression in the lateral geniculate body of cats following acute optic nerve injuries

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: The visual pathway have 6 parts, involving optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation and cortical striatum area. Corresponding changes may be found in these 6 parts following optic nerve injury. At present, studies mainly focus on optic nerve and retina, but studies on lateral geniculate body are few.OBJECTIVE: To prepare models of acute optic nerve injury for observing the changes of neurons in lateral geniculate body, expression of neurofilament protein at different time after injury and cell apoptosis under the optical microscope, and for investigating the changes of neurons in lateral geniculate body following acute optic nerve injury.DESIGN: Completely randomized grouping design, controlled animal experiment.SETTING: Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA.MATERIALS: Twenty-eight adult healthy cats of either gender and common grade, weighing from 2.0 to 3.5 kg, were provided by the Animal Experimental Center of Fudan University. The involved cats were divided into 2 groups according to table of random digit: normal control group (n =3) and model group (n =25). Injury 6 hours, 1, 3, 7 and 14 days five time points were set in model group for later observation, 5 cats at each time point. TUNEL kit (Bohringer-Mannheim company)and NF200& Mr 68 000 mouse monoclonal antibody (NeoMarkers Company) were used in this experiment.METHODS: This experiment was carried out in the Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA between June 2004 and June 2005. ① The cats of model group were developed into cat models of acute intracranial optic nerve injury as follows: The anesthetized cats were placed in lateral position. By imitating operation to human, pterion approach was used. An incision was made at the joint line between outer canthus and tragus, and deepened along cranial base until white optic nerve via optic nerve pore

  8. Quantification of optic disc edema during exposure to high altitude shows no correlation to acute mountain sickness.

    Directory of Open Access Journals (Sweden)

    Gabriel Willmann

    Full Text Available BACKGROUND: The study aimed to quantify changes of the optic nerve head (ONH during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS. This work is related to the Tuebingen High Altitude Ophthalmology (THAO study. METHODOLOGY/PRINCIPAL FINDINGS: A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3® was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m. Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL and AMS-cerebral (AMS-c scores; oxygen saturation (SpO₂ and heart rate (HR were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation changed significantly at high altitude compared to baseline (p<0.05 and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO₂ or HR. CONCLUSIONS/SIGNIFICANCE: Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO₂ and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS.

  9. Quantification of Optic Disc Edema during Exposure to High Altitude Shows No Correlation to Acute Mountain Sickness

    Science.gov (United States)

    Willmann, Gabriel; Fischer, M. Dominik; Schatz, Andreas; Schommer, Kai; Messias, Andre; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian

    2011-01-01

    Background The study aimed to quantify changes of the optic nerve head (ONH) during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS). This work is related to the Tuebingen High Altitude Ophthalmology (THAO) study. Methodology/Principal Findings A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3®) was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m). Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL) and AMS-cerebral (AMS-c) scores; oxygen saturation (SpO2) and heart rate (HR) were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE) 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation) changed significantly at high altitude compared to baseline (p<0.05) and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO2 or HR. Conclusions/Significance Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO2 and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS. PMID:22069483

  10. Parsonage-Turner Syndrome rather than Zoster Neuritis

    Directory of Open Access Journals (Sweden)

    Karim Gariani

    2011-07-01

    Full Text Available We report the case of an 86-year-old man with acute left shoulder pain, followed by left limb monoparesis and a herpetic rash on the left upper limb and thoracic region. This situation presented a diagnostic challenge because of the simultaneity of symptoms attributable to Parsonage-Turner syndrome and herpes zoster neuropathy. A detailed clinical history, physical examination and electroneuromyography were essential to distinguish the neurological structures involved and to ascertain the diagnosis.

  11. Multiparametric, longitudinal optical coherence tomography imaging reveals acute injury and chronic recovery in experimental ischemic stroke

    National Research Council Canada - National Science Library

    Srinivasan, Vivek J; Mandeville, Emiri T; Can, Anil; Blasi, Francesco; Climov, Mihail; Daneshmand, Ali; Lee, Jeong Hyun; Yu, Esther; Radhakrishnan, Harsha; Lo, Eng H; Sakadžić, Sava; Eikermann-Haerter, Katharina; Ayata, Cenk

    2013-01-01

    .... A multi-parametric Optical Coherence Tomography (OCT) platform for longitudinal imaging of ischemic stroke in mice, through thinned-skull, reinforced cranial window surgical preparations, is described...

  12. Acute dizziness in rural practice: Proposal of a diagnostic procedure

    Directory of Open Access Journals (Sweden)

    Ehab Eid

    2015-01-01

    Full Text Available Acute dizziness is a frequent index symptom in the emergency department as well as in the rural practice office. Most acute dizziness, however, is not dangerous, but some types are highly dangerous. Clinical routine acute dizziness can be separated into frequent benign syndromes including benign paroxysmal positional vertigo (BPPV, vestibular neuritis, Meniθre′s disease or vestibular migraine, and what is here referred to as the "white shark" of dizziness, i.e. a stroke in the posterior circulation or more rarely a tumor in the posterior fossa. A practical concept is presented to clarify most frequent acute dizziness syndromes using clinical and low budget methods.

  13. Acute dizziness in rural practice: Proposal of a diagnostic procedure

    Science.gov (United States)

    Eid, Ehab; Dastan, Sajed; Heckmann, Josef G.

    2015-01-01

    Acute dizziness is a frequent index symptom in the emergency department as well as in the rural practice office. Most acute dizziness, however, is not dangerous, but some types are highly dangerous. Clinical routine acute dizziness can be separated into frequent benign syndromes including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniθre's disease or vestibular migraine, and what is here referred to as the “white shark” of dizziness, i.e. a stroke in the posterior circulation or more rarely a tumor in the posterior fossa. A practical concept is presented to clarify most frequent acute dizziness syndromes using clinical and low budget methods. PMID:25883501

  14. Delayed rupture of flexor tendons in zone V complicated by neuritis 18 years following Galeazzi fracture-dislocation.

    Science.gov (United States)

    Nagy, Mathias Thomas; Ghosh, Sabyasachi; Shah, Bhavik; Sankar, Thangasamy

    2014-04-16

    We report a rare case of an 84-year-old woman who presented with delayed, complete rupture of superficial (flexor digitorum superficialis) and deep flexor tendons (flexor digitorum profundus) of the third, fourth and fifth digits of the right hand in zone V of the flexor tendons. The patient, who was otherwise healthy, active and independent, incurred a closed fracture of her right wrist 18 years ago, which was treated conservatively. Current X-rays and operative findings confirmed a malunited Galeazzi fracture-dislocation with volar dislocation of the ulna from the distal radioulnar joint. She underwent surgical treatment to improve her hand function and agonising neuritis symptoms, as she was unable to use her middle, ring and little fingers and had developed severe neuritis of the ulnar nerve. Exploration and repair of the flexor tendons, nerve decompressions and Darrach procedure were performed. On follow-up, the patient showed improvement in hand function with the neuritis completely resolved.

  15. Language skills in a child with Leber hereditary optic neuropathy following intrathecal chemotherapy for acute lymphoblastic leukemia.

    Science.gov (United States)

    Lewis, Fiona M; Coman, David J; Murdoch, Bruce E

    2010-11-01

    The language skills of a male child with Leber hereditary optic neuropathy (LHON) and coincidentally treated for acute lymphoblastic leukemia (ALL) with intrathecal chemotherapy at the age of 3 years 8 months were comprehensively evaluated twice over a 6-month period approximately 5½ years after diagnosis of ALL. Despite marked chemotherapy-related leukoencephalopathic changes documented on magnetic resonance imaging, the child presented with stable language skills, which were generally average to above-average based on the normative data from a comprehensive language test battery. In light of the coincidental presentation in the child of a diagnosis of LHON, which may lead to serious vision impairment and increased vulnerability to drug neurotoxicity, coupled with a history of central nervous system (CNS)-directed treatment for ALL resulting in progressive white matter pathology, the study highlights the importance of ongoing monitoring of the child's language development throughout his adolescent years.

  16. Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke

    Science.gov (United States)

    Steinkellner, Oliver; Gruber, Clemens; Wabnitz, Heidrun; Jelzow, Alexander; Steinbrink, Jens; Fiebach, Jochen B.; MacDonald, Rainer; Obrig, Hellmuth

    2010-11-01

    We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

  17. Multiplex neuritis in a patient with autoimmune hepatitis: A case report

    Institute of Scientific and Technical Information of China (English)

    S Lüth; F Birklein; C Schramm; J Herkel; E Hennes; W Müller-Forell; PR Galle; AW Lohse

    2006-01-01

    A 37-year old woman presented with a 9-year history of hepatitis of unknown origin and aminotransferases within a 3-fold upper limit of normal. Autoimmune hepatitis (AIH) was diagnosed on the basis of elevated aminotransferases, soluble liver antigen/liver pancreas (SLA/LP) autoantibodies and characteristic histology.Immunosuppressive therapy led to rapid normalization of aminotransferases. Two years later, the patient developed left sided hemisensory deficits under maintenance therapy of prednisolone and azathioprine (AZT). Later she developed right foot drop and paraesthesia in the ulnar innervation territory on both sides. Magnetic resonance imaging (MRI) and cerebral panangiography suggested cerebral vasculitis. Neurological investigation and electromyography disclosed multiplex neuritis (MN) probably due to vasculitis. Consistent with this diagnosis, autoantibodies to extractable nuclear antigens were detectable in serum. Immunosuppression was changed to oral 150 mg cyclophosphamide (CPM0) per day. Prednisolone was increased to 40 mg/d and then gradually tapered to 5 mg. Oral CPM was administered up to a total dose of 40 g and then substituted by 6 times of an intervall infusion therapy of CPM (600 mg/m2).Almost complete motoric remission was achieved after 3 mo of CPM. Sensibility remained reduced in the right peroneal innervation territory. Follow-up of cranial MRI provided stable findings without any new or progressive lesions. This is the first report of multiplex neuritis in a patient with autoimmune hepatitis.

  18. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    DEFF Research Database (Denmark)

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

    2002-01-01

    to both the results of the contrast sensitivity test and to the Snellen visual acuity. Our results indicate that fMRI is a useful method for the study of ON, even in cases where the visual acuity is severely impaired. The reduction in activated volume could be explained as a reduced neuronal input...

  19. Optics

    CERN Document Server

    Fincham, W H A

    2013-01-01

    Optics: Ninth Edition Optics: Ninth Edition covers the work necessary for the specialization in such subjects as ophthalmic optics, optical instruments and lens design. The text includes topics such as the propagation and behavior of light; reflection and refraction - their laws and how different media affect them; lenses - thick and thin, cylindrical and subcylindrical; photometry; dispersion and color; interference; and polarization. Also included are topics such as diffraction and holography; the limitation of beams in optical systems and its effects; and lens systems. The book is recommen

  20. Syringomyelia presenting with unilateral optic neuropathy: a case report

    Directory of Open Access Journals (Sweden)

    Ngoo QZ

    2017-03-01

    Full Text Available Qi Zhe Ngoo, Evelyn Li Min Tai, Wan Hazabbah Wan Hitam Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Purpose: In this case report, we present two cases of syringomyelia with optic neuropathy.Findings: In Case 1, a 36-year-old Malay lady presented to our clinic with acute onset of blurring of vision in her left eye that she experienced since past 1 month. She was diagnosed with syringomyelia 12 years ago and was on conservative management. Her visual acuity was 6/6 in the right eye and counting fingers at 1 m in the left. There was a positive relative afferent pupillary defect in her left eye. Optic nerve functions of her left eye were reduced. Visual field showed a left inferior field defect. Her extraocular muscle movements were full. Magnetic resonance imaging of the brain and spine showed syringomyelia at the level of C2–C6 and T2–T9. Both of her optic nerves were normal. Her condition improved with intravenous and oral corticosteroids. In Case 2, a 44-year-old Malay lady presented to our clinic with a progressive central scotoma in her right eye that she experienced since past 1 month. She had previous history of recurrent episodes of weakness in both of her lower limbs from past 8 months. Visual acuity in her right and left eye was 6/9 and 6/6, respectively. The relative afferent pupillary defect in her right eye was positive. Optic nerve functions of her right eye were affected. Visual field showed a central scotoma in her right eye. Her extraocular muscle movements were full. Fundoscopy of her right eye showed a pale optic disc. Her left eye fundus was normal. Magnetic resonance imaging of the brain and spine showed syringomyelia at T3–T6. Both of her optic nerves were normal. A diagnosis of syringomyelia with right optic atrophy was performed. Her condition improved with intravenous and oral corticosteroids.Conclusion: Optic neuropathy is a rare neuro

  1. Unilateral optic disk edema with central retinal artery and vein occlusions as the presenting signs of relapse in acute lymphoblastic leukemia.

    Science.gov (United States)

    Salazar Méndez, R; Fonollá Gil, M

    2014-11-01

    A 39-year-old man with Philadelphia chromosome-positive acute lymphoblastic leukemia (LAL Ph+) developed progressive vision loss to no light perception in his right eye. He had optic disk edema and later developed central artery and vein occlusions. Pan-photocoagulation, as well as radiotherapy of the whole brain were performed in several fractions. Unfortunately the patient died of hematological relapse 4 months later. Optic nerve infiltration may appear as an isolated sign of a leukemia relapse, even before a hematological relapse occurs. Leukemic optic neuropathy is a critical sign, not only for vision, but also for life, and radiotherapy should be immediately performed before irreversible optic nerve damage occurs. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  2. The optical imaging of idiopathic paracentral acute middle maculopathy in a Chinese young man and review of the literature.

    Science.gov (United States)

    Chen, Yanyan; Hu, Yuedong

    2017-09-01

    We report a case of idiopathic paracentral acute middle maculopathy with typical optical imaging and clinical features. A 26-year-old Chinese policeman presented with a 20-day history of paracentral scotoma in the left eye after early wake-up and long-time working in front of computer the day before. He experienced sudden-onset strong flash in his left eye. Paracentral scotoma appeared in his left eye after 6hours of rest. The general history was negative. His best corrected visual acuity was 20/20 OU. Anterior segment, dilated fundus examination, papillary evaluation and intraocular pressure were normal. Fuorescein angiography and blue light fundus autofluorescence showed no significant abnormality. In multicolor photography, the lesion was visible on the monochromic infrared/blue reflectance images and not clear in green reflectance. The 10 degree visual field examination revealed superior paracentral relative scotoma. Multifocal electroretinogram revealed reduced response in central area in the left eye. Spectral-domain optical coherence tomography showed that hyperreflective plaque was present at the IPL/INL/OPL level with hyperreflective point at the GCL. The plaque became thinner 3 months later and diminished 6 months later with obviously atrophied INL. In the 3 months follow-up, transverse scan revealed that there was a well-demarcated hypo-refractive lesion in IPL and hyper-refractive lesion in INL. OCTA revealed the deceased flow signal intensity of focal deep capillaries. En face OCT imaging of the left eye revealed a relative well-defined, hypo-refractive lesion and non-flow area localized at the level of the deep capillary plexus. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Attenuation of experimental autoimmune neuritis with locally administered lovastatin-encapsulating poly(lactic-co-glycolic) acid nanoparticles.

    Science.gov (United States)

    Langert, Kelly A; Goshu, Bruktawit; Stubbs, Evan B

    2017-01-01

    Acute inflammatory demyelinating polyneuropathy (AIDP) is an aggressive antibody- and T-cell-mediated variant of Guillain-Barré Syndrome (GBS), a prominent and debilitating autoimmune disorder of the peripheral nervous system. Despite advancements in clinical management, treatment of patients with AIDP/GBS and its chronic variant CIDP remains palliative and relies on the use of non-specific immunemodulating therapies. Our laboratory has previously reported that therapeutic administration of statins safely attenuates the clinical severity of experimental autoimmune neuritis (EAN), a well-characterized animal model of AIDP/GBS, by restricting the migration of autoreactive leukocytes across peripheral nerve microvascular endoneurial endothelial cells that form the blood-nerve barrier. Despite these advancements, the clinical application of systemically administered statins for the management of inflammatory disorders remains controversial as a result of disappointingly inconclusive phase trials. Here, poly(lactic-co-glycolic) acid (PLGA) nanoparticles were evaluated as an alternative strategy by which to locally administer statins for the management of EAN. When tested in vitro, lovastatin-encapsulating PLGA nanoparticles elicited a marked increase in RhoB mRNA content in peripheral nerve microvascular endoneurial endothelial cells, similar to cells treated with activated unencapsulated lovastatin. Unilateral peri-neural administration of lovastatin-encapsulating PLGA nanoparticles, but not empty nanoparticles, to naïve Lewis rats similarly enhanced RhoB mRNA content in adjacent nerve and muscle tissue. When administered in this manner, serum levels of lovastatin were below the level of detection. Bilateral peri-neural administration of lovastatin-encapsulating PLGA nanoparticles to EAN-induced Lewis rats significantly attenuated EAN clinical severity while protecting against EAN-induced peripheral nerve morphological and functional deficits. This study provides

  4. Optics

    CERN Document Server

    Fincham, W H A

    2013-01-01

    Optics: Eighth Edition covers the work necessary for the specialization in such subjects as ophthalmic optics, optical instruments and lens design. The text includes topics such as the propagation and behavior of light; reflection and refraction - their laws and how different media affect them; lenses - thick and thin, cylindrical and subcylindrical; photometry; dispersion and color; interference; and polarization. Also included are topics such as diffraction and holography; the limitation of beams in optical systems and its effects; and lens systems. The book is recommended for engineering st

  5. Electro-acupuncture Combined with Plum-blossom Needle Tapping for Treatment of Supraorbital Neuritis- A Clinical Observation of 59 Cases

    Institute of Scientific and Technical Information of China (English)

    曾红文; 刘悦

    2003-01-01

    @@ Supraorbital neuritis is an inflammatory infection of the supraorbital nerve due to invasion of viruses. The authors have treated 59 such cases by means of electroacupuncture combined with plum-blossom needle tapping, with satisfactory therapeutic results reported as follows.

  6. An Evaluation Of Acupuncture As A Modality Of Treatment Of Leprous Neuritis

    Directory of Open Access Journals (Sweden)

    Chattopadhyay S P

    1995-01-01

    Full Text Available Eighty patients of leprosy who developed peripheral neuritis as a presenting feature or during the course of antileprotic trearment were selected for the study. Groups 1,2,3(N= 20 each were given acupuncture therapy and considered as acupuncture group . Twenty patients were used as control (Group 4. Patients in acupuncture group showed improvement in subsidence of neural plain and tenderness after ten sittings of acupuncture. The response was best when acupuncture was given as adjunct to antireaction drugs. Relapse rates in Gr. 1, 2, 3 and 4 were 20, 30, 10 and 40 percents respectively. However the effect of acupuncture was temporary and on statistical analysis it was not considered significant when taken as a whole (acupuncture group. Hence acupunture is only recommended where corti- costeroids/NSAIDS are contraindicated. In view of AIDS and Hepatitis B infection, all cases are advised to be screened before acupuncture therapy and the acupuncture needles are autoclaved.

  7. Brachial neuritis or Parsonage-Turner syndrome: A problem of liability. A presentation of 3 cases.

    Science.gov (United States)

    Rodríguez-Hornillo, M; de la Riva, M C; Ojeda, R

    2016-01-01

    Neuralgic amyotrophy, brachial neuritis or Parsonage-Turner syndrome is a rare neuromuscular involvement of unknown aetiology. When it onsets in connection with a health care act, such as childbirth or surgery, a malpractice argument is often used as a cause of adverse outcome, usually due to an incorrect position of the patient on the operating table, a circumstance which directly involves the anesthesia area. Three cases are presented of Parsonage-Turner syndrome following very different surgery, with different results as regards prognosis. A review and discussion of bibliography is presented on the possibility that such circumstances are the subject of malpractice claims. Special emphasis is placed on the most currently accepted aetiopathogenic theories, and the relationship of this syndrome with the surgical act as a determining medico-legal aspect. Valuation parameters are proposed.

  8. [Transcranial duplex scanning in estimation of cerebral hemodynamics in patients with secondary cochleovestibular neuritis].

    Science.gov (United States)

    Poliakova, T S; Kuntsevich, G I; Kadymova, M I; Ogorodnikov, D S; Ter-Khachaturova, I E; Burtseva, E A

    2002-01-01

    The authors present pilot experience with transcranial duplex scanning (TCDS) of the cerebral vessels in 17 patients with secondary cochleovestibular neuritis combined with chronic leptomeningitis (primarily of the posterior cranial fossa). This method has determined extra- and intracranial hemodynamics, characterized arterial and venous blood flow qualitatively and quantitatively, outlined possible genetically determined factors in development of dyscirculatory disorders. Finally, hemodynamic defects of two types were revealed in 12 patients. Type 1 (3 patients) was characterized by asymmetric circulation in the territory of the middle, anterior and posterior cerebral arteries, by the absence of venous congestion. Type 2 (9 patients) was characterized by impaired venous outflow manifesting as higher speed of the blood flow and its phase response along the intracranial veins and sinuses. In 7 patients these defects combined with asymmetric circulation along brain stem arteries. These patients were diagnosed to have perilymphatic labyrinthine hydrops.

  9. Acute skin lesions following psoralen plus ultraviolet A radiation investigated by optical coherence tomography

    Science.gov (United States)

    Liu, Z. M.; Zhong, H. Q.; Zhai, J.; Wang, C. X.; Xiong, H. L.; Guo, Z. Y.

    2013-08-01

    Psoralen plus ultraviolet A radiation (PUVA) therapy is a very important clinical treatment of skin diseases such as vitiligo and psoriasis, but associated with an increased risk of skin photodamage, especially photoaging. In this work, optical coherence tomography (OCT), a novel non-invasive imaging technology, was introduced to investigate in vivo the photodamage induced by PUVA qualitatively and quantitatively. Balb/c mouse dorsal skin was treated with 8-methoxypsoralen (8-MOP), and then exposed to UVA radiation. OCT images of the tissues were obtained by an OCT system with a 1310 nm central wavelength. Skin thickness and the attenuation coefficient were extracted from the OCT images to analyze the degree of injury to mouse skin. The results demonstrated that PUVA-treated skin showed an increase in skin thickness, and a reduction of attenuation coefficient in the OCT signal compared with the control groups. The data also showed good correlation with the results observed in histological sections using hematoxylin and eosin staining. In conclusion, OCT is a promising tool for photobiological studies aimed at assessing the effect of PUVA therapy in vivo.

  10. Brachial Neuritis With Phrenic Nerve Involvement in a Patient With a Possible Connective Tissue Disease

    Directory of Open Access Journals (Sweden)

    Meera Subash BS

    2014-05-01

    Full Text Available Background. Brachial neuritis (BN is a rare inflammatory condition of peripheral nerves, usually involving the cervicobrachial plexus. These patients present with sudden onset of shoulder and arm pain that evolves into muscle weakness and atrophy.. Case Report. A 33-year-old woman presented with a 1-month history of diffuse pain in her thorax. She had no trauma or inciting incident prior to the onset of this pain and was initially treated for muscle spasms. The patient was seen in the emergency room multiple times and was treated with several courses of antibiotics for pneumonia on the basis of clinical symptoms and abnormal x-rays. The pleuritic chest pain persisted for at least 4 months, and the patient was eventually admitted for worsening pain and dyspnea. On physical examination, crackles were heard at both lung bases, and chest inspection revealed increased expansion in the upper thorax but poor expansion of the lower thorax and mild paradoxical respiration. “Sniff” test revealed no motion of the left hemidiaphragm and reduced motion on the right hemidiaphragm. Her computed tomography scan revealed bilateral atelectasis, more severe at the left base. She reported no symptoms involving her joints or skin or abdomen. Her presentation and clinical course are best explained by BN with a bilateral diaphragmatic weakness. However, she had a positive ANA, RF, anti-RNP antibody, and anti SS-A. Conclusion. Patients with BN can present with diffuse thoracic pain, pleuritic chest pain, and diaphragmatic weakness. Our patient may represent a case of connective tissue disease presenting with brachial plexus neuritis.

  11. Peripapillary retinal vessel density in eyes with acute primary angle closure: an optical coherence tomography angiography study.

    Science.gov (United States)

    Wang, Xiaolei; Jiang, Chunhui; Kong, Xiangmei; Yu, Xiaobo; Sun, Xinghuai

    2017-05-01

    The purpose was to investigate peripapillary retinal vessel density in resolved acute primary angle closure (APAC) eyes. This was a prospective, cross-sectional observational study. Thirty-four eyes of 34 patients with unilateral APAC were included, together with the fellow eyes with primary angle closure suspect (PACS) as controls. Peripapillary retinal vessel density was measured using optical coherence tomography (OCT) angiography. Peripapillary retinal vessel density was compared in both eyes and the potential relationship with visual field (VF) test results was evaluated. After an acute attack, the peripapillary retinal vessel density was lower in the APAC than in the PACS eyes (79.3 ± 8.2 versus 85.6 ± 4.9, respectively; P = 0.001). The VF mean deviation (MD) (-7.7 ± 6.7 versus -3.3 ± 1.8 dB, P = 0.002), and the pattern standard deviation (PSD) (4.6 ± 3.3 versus 2.4 ± 0.9 dB, P = 0.001) were worse for the APAC than the PACS eyes, but both had similar thicknesses of the retinal nerve fiber layer (RNFL) (111.8 ± 9.6 versus 114.1 ± 29.1 μm, P = 0.880) and ganglion cell complex (GCC) (94.7 ± 7.5 versus 91.8 ± 9.3 μm, P = 0.328). The peripapillary retinal vessel density was significantly correlated with the VF MD (vessel density: r = 0.455, P = 0.008) and PSD (vessel density: r = -0.592, P density, which was correlated with the VF values. OCT angiography is a reliable method for detecting vascular changes in glaucomatous eyes that show no thinning of the RNFL and GCC.

  12. Spectral-Domain Optical Coherence Tomography Features of Acute Syphilitic Posterior Placoid Chorioretinitis: The Role of Autoimmune Response in Pathogenesis

    Directory of Open Access Journals (Sweden)

    Pedro Brito

    2011-01-01

    Full Text Available Purpose: Syphilis is an infectious disease that can cause a wide variety of ocular signs. One of the rarest manifestations of ocular syphilis is acute syphilitic posterior placoid chorioretinitis (ASPPC. We report on the spectral-domain optical coherence tomography (SD-OCT features of a case diagnosed with unilateral ASPPC. Methods: A 64-year-old man presented with a sudden loss of visual acuity (VA in the right eye. His only clinical sign was a large, geographic, yellow-white lesion centered on the right fovea. Our patient was studied with SD-OCT on presentation and during follow-up, as well as with fluorescein and indocyanine green angiography, electrophysiological study, and serologic and autoimmune screening. Results: Laboratory workup revealed positive serology for active syphilis and elevated anti-beta2 glycoprotein I antibodies. SD-OCT showed a marked distortion of both the choroidal and outer retinal architecture. After treatment, best-corrected VA improved to 20/25. Pattern electroretinography displayed a severe reduction of P50 amplitude, which improved in late follow-up. Six months after presentation, VA was 20/25 and anti-beta2 glycoprotein I antibodies returned to normal levels. Conclusions: Our findings are compatible with immunologically mediated temporary physiological impairment of the neuroretina, since the changes seen by SD-OCT could not have normalized if they were due to anatomical injury. The results of our study provide clues to understanding the pathogenesis of this disease and allow us to define a characteristic temporal sequence of events in ASPPC.

  13. In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

    Science.gov (United States)

    Jia, Haibo; Abtahian, Farhad; Aguirre, Aaron D; Lee, Stephen; Chia, Stanley; Lowe, Harry; Kato, Koji; Yonetsu, Taishi; Vergallo, Rocco; Hu, Sining; Tian, Jinwei; Lee, Hang; Park, Seung-Jung; Jang, Yang-Soo; Raffel, Owen C.; Mizuno, Kyoichi; Uemura, Shiro; Itoh, Tomonori; Kakuta, Tsunekazu; Choi, So-Yeon; Dauerman, Harold L.; Prasad, Abhiram; Toma, Catalin; McNulty, Iris; Zhang, Shaosong; Yu, Bo; Fuster, Valentine; Narula, Jagat; Virmani, Renu; Jang, Ik-Kyung

    2013-01-01

    Objectives To characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods One hundred and twenty-six patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or others using a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest compared with those with PR and OCT-CN (53.8±13.1 years vs. 60.6±11.5 years, 65.1±5.0 years, p=0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS (NSTE-ACS) was more common in patients with OCT-erosion (61.5% vs. 29.1%, p=0.008) and OCT-CN (100% vs. 29.1%, perosion had a lower frequency of lipid plaque (43.6% vs. 100%, perosion followed by OCT-CN and PR (55.4±14.7% vs. 66.1±13.5% vs. 68.8±12.9%, perosion and OCT-CN in vivo. OCT-erosion is a frequent finding in patients with ACS, especially in those with NSTE-ACS and younger patients. OCT-CN is the least common etiology for ACS and is more common in older patients. PMID:23810884

  14. A twenty-eight channel coil array for improved optic nerve imaging

    Science.gov (United States)

    Merrill, Robb Phillip

    The purpose of this work was to design and construct a radio-frequency coil optimized for imaging the Optic Nerve (ON) on a Siemens 3T magnetic resonance imaging (MRI) scanner. The specific goals were to optimize signal sensitivity from the orbit to the optic chiasm and improve SNR over designs currently in use. The constructed coil features two fiberglass formers that can slide over each other to accommodate any arbitrary head size, while maintaining close coupling near the eyes and around the head in general. This design eliminates the air void regions that occur between the coil elements and the forehead when smaller heads are imaged in one-piece, nonadjustable coil formers. The 28 coil elements were placed using a soccer-ball pattern layout to maximize head coverage. rSNR profiles from phantom imaging studies show that the ON coil provides approximately 55% greater rSNR at the region of the optic chiasm and approximately 400% near the orbits compared to the 12-channel commercial coil. The improved rSNR in the optic nerve region allows performance of high resolution DTI, which provides a qualitative measurement for evaluating optic neuritis. Images from volunteer and patient studies with the ON coil reveal plaques that correspond well with the patient disease history of chronic bilateral optic neuritis. Correspondence of image findings with patient disease histories demonstrates that optic neuritis can be visualized and detected in patients using 3T MRI with advanced imaging coils, providing improved patient care.

  15. Relationship between chronic demyelination of the optic nerve and short term axonal loss.

    Science.gov (United States)

    Klistorner, A; Garrick, R; Paine, M; Graham, S L; Arvind, H; Van Der Walt, A; Tsonis, S; Yiannikas, C

    2012-03-01

    Axonal loss is a major determinant of disability in multiple sclerosis (MS). While acute inflammatory demyelination is a principal cause of axonal transection and subsequent axonal degeneration in acute disease, the nature of chronic axonal loss is less well understood. In the current study, the relationship between degree of chronic demyelination and axonal degeneration was investigated using optic neuritis (ON) as a model. 25 patients with a first episode of unilateral ON, good recovery of visual function and concurrent brain or spinal cord MRI lesions were enrolled. Axonal loss was assessed using change in retinal nerve fibre layer (RNFL) thickness between 1 and 3 years after ON. Optic nerve conduction was evaluated using latency of multifocal visual evoked potentials (mfVEP). The level of mfVEP latency delay at 12 and 36 months was considered indicative of the degree of permanent demyelination. Data from 25 age and gender matched normal controls were used for comparison. RNFL thickness was significantly reduced in ON eyes at 12 months compared with controls but remained unchanged in fellow eyes. Average RNFL thickness demonstrated a small but significant reduction between 12 and 36 months for both ON and fellow eyes. Change in RNFL thickness between 12 and 36 months, however, did not correlate with the degree of mfVEP latency delay. The results, therefore, show no association between the degree of permanent optic nerve demyelination (as measured by latency delay) and progressive axonal degeneration, at least in the early stages of the disease. The fact that fellow eyes demonstrated a similar degree of progressive axonal loss supports this suggestion.

  16. Topiramate and visual loss in a patient carrying a Leber hereditary optic neuropathy mutation.

    Science.gov (United States)

    Rinalduzzi, Steno; Cipriani, Anna Maria; Accornero, Neri

    2012-04-01

    We describe a 43-year-old patient who experienced visual loss 4 years after beginning antiepileptic therapy with topiramate. Ophthalmological and neurological examinations led to a preliminary diagnosis of bilateral toxic optic neuritis. Mitochondrial genome sequence analysis detected a Leber hereditary optic neuropathy 11778G>A mutation. The possibility that topiramate might favor a conversion disease, alerts physicians to seek a history of blindness in patients undergoing chronic antiepileptic therapy.

  17. Traditional Chinese medicine Yisui Tongjing relieved neural severity in experimental autoimmune neuritis rat model

    Science.gov (United States)

    Zhang, Erli; Li, Mingquan; Zhao, Jianjun; Dong, Yuxiang; Yang, Xueqin; Huang, Jingbo

    2016-01-01

    Objective To study the effect of Yisui Tongjing (YSTJ) prescription on motor nerve conduction velocity (MNCV) and microstructure of the sciatic nerve in experimental autoimmune neuritis (EAN) rats, the Guillain–Barré syndrome classic animal models. Materials and methods In this study, we established an EAN model in Lewis rats by immunization. We evaluated the potential clinical application of a traditional Chinese medicine YSTJ by intragastric administration and compared its effect with immunoglobulin. The sciatic MNCV was measured by electrophysiology experiment. Hematoxylin–eosin staining and transmission electron microscope analysis were used to determine the pathologically morphological changes before and after YSTJ application. Results We found that application of YSTJ could significantly alleviate the clinical signs in EAN rats. The treatment also increased MNCV in the sciatic nerve compared to that in the untreated nerve. Demyelination in the sciatic nerve in EAN rats was significantly ameliorated, and newly generated myelinated nerve fibers were observed with treatment of high dose of YSTJ. Conclusion This study showed that the traditional Chinese medicine YSTJ was likely to serve as a therapeutic medicine in autoimmune neuropathies, providing an effective and economic means to the treatment of Guillain–Barré syndrome. PMID:27729792

  18. Erythropoietin-derived nonerythropoietic peptide ameliorates experimental autoimmune neuritis by inflammation suppression and tissue protection.

    Directory of Open Access Journals (Sweden)

    Yuqi Liu

    Full Text Available Experimental autoimmune neuritis (EAN is an autoantigen-specific T-cell-mediated disease model for human demyelinating inflammatory disease of the peripheral nervous system. Erythropoietin (EPO has been known to promote EAN recovery but its haematopoiesis stimulating effects may limit its clinic application. Here we investigated the effects and potential mechanisms of an EPO-derived nonerythropoietic peptide, ARA 290, in EAN. Exogenous ARA 290 intervention greatly improved EAN recovery, improved nerve regeneration and remyelination, and suppressed nerve inflammation. Furthermore, haematopoiesis was not induced by ARA 290 during EAN treatment. ARA 290 intervention suppressed lymphocyte proliferation and altered helper T cell differentiation by inducing increase of Foxp3+/CD4+ regulatory T cells and IL-4+/CD4+ Th2 cells and decrease of IFN-γ+/CD4+ Th1 cells in EAN. In addition, ARA 290 inhibited inflammatory macrophage activation and promoted its phagocytic activity. In vitro, ARA 290 was shown to promote Schwann cell proliferation and inhibit its inflammatory activation. In summary, our data demonstrated that ARA 290 could effectively suppress EAN by attenuating inflammation and exerting direct cell protection, indicating that ARA 290 could be a potent candidate for treatment of autoimmune neuropathies.

  19. Local phenol injection in the treatment of interdigital neuritis of the foot (Morton's neuroma).

    Science.gov (United States)

    Magnan, B; Marangon, A; Frigo, A; Bartolozzi, P

    2005-01-01

    The symptomatic treatment of Civinini-Morton syndrome (interdigital neuritis: IDN) may be performed directly on the nervous trunk involved using orthotic, local pharmacological or surgical methods. Alcoholization with phenol in the percutaneous treatment of IDN has the purpose of provoking a permanent chemical neurolysis, obtaining remission of the neuritic pain symptoms. A total of 71 cases were treated by a dorsal approach to the intermetatarsal space using a needle-electrode connected to the electro-stimulator. Once the nervous trunk with a reproduction of the paresthesia to the fingers was localized, 2.5 ml of phenol at 5% water solution was injected, immediately followed by local anesthetic with a postsurgical analgesic purpose. Mean follow-up was 36 +/- 8 months. The patients were evaluated by visual analogue scale for pain (VAS). Alcoholization of the common interdigital nerve proved to be effective in treating pain in 80.3% of cases (57/71). Treatment must be considered a percutaneous mini-invasive surgical procedure. The results are better than those reported in the literature with conservative and infiltrative treatment and they appear to be comparable today with those obtained when surgical treatment was used, with no complications occurring.

  20. Study of large dose methyl-prednisoxlone therapy for acute optic neuritis and retard the transformation to multiple sclerosis%大剂量甲泼尼龙冲击治疗急性视神经炎及延迟转化为多发性硬化的探讨(附106例报告)

    Institute of Scientific and Technical Information of China (English)

    李众; 王景群; 马志军; 丁宁; 余华峰

    2005-01-01

    目的评价大剂量甲泼尼龙治疗急性视神经炎(AON)的疗效,观察其延迟转化为多发性硬化(MS)的情况.方法应用大剂量甲泼尼龙冲击治疗急性视神经炎106例,并与对照组病例对照观察.结果治疗组与对照组比较有显著性差异(P<0.01),且延迟转化为多发性硬化具有显著性差异(P<0.05).结论大剂量甲泼尼龙冲击疗法是治疗急性视神经炎的有效方法,且2年内可延迟其向多发性硬化的转化.

  1. Optical Coherence Tomography to Assess Neurodegeneration in Multiple Sclerosis.

    Science.gov (United States)

    Petzold, Axel

    2016-01-01

    Retinal spectral domain optical coherence tomography (OCT) has emerged as a clinical and research tool in multiple sclerosis (MS) and optic neuritis (ON). This chapter summarizes a short OCT protocol as included in international consensus guidelines. The protocol was written for hands-on style such that both clinicians and OCT technicians can make use of it. The protocol is suitable for imaging of the optic nerve head and macular regions as a baseline for follow-up investigations, individual layer segmentation, and diagnostic assessment.

  2. Multiparametric, Longitudinal Optical Coherence Tomography Imaging Reveals Acute Injury and Chronic Recovery in Experimental Ischemic Stroke: e71478

    National Research Council Canada - National Science Library

    Vivek J Srinivasan; Emiri T Mandeville; Anil Can; Francesco Blasi; Mihail Climov; Ali Daneshmand; Jeong Hyun Lee; Esther Yu; Harsha Radhakrishnan; Eng H Lo; Sava Sakadzic; Katharina Eikermann-Haerter; Cenk Ayata

    2013-01-01

    .... A multi-parametric Optical Coherence Tomography (OCT) platform for longitudinal imaging of ischemic stroke in mice, through thinned-skull, reinforced cranial window surgical preparations, is described...

  3. Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography

    Science.gov (United States)

    Bennett, JL; de Seze, J; Lana-Peixoto, M; Palace, J; Waldman, A; Schippling, S; Tenembaum, S; Banwell, B; Greenberg, B; Levy, M; Fujihara, K; Chan, KH; Kim, HJ; Asgari, N; Sato, DK; Saiz, A; Wuerfel, J; Zimmermann, H; Green, A; Villoslada, P

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel aquaporin-4 present in up to 80% of NMO patients enables distinction from MS. Optic neuritis may occur in either condition resulting in neuro-anatomical retinal changes. Optical coherence tomography (OCT) has become a useful tool for analyzing retinal damage both in MS and NMO. Numerous studies showed that optic neuritis in NMO typically results in more severe retinal nerve fiber layer (RNFL) and ganglion cell layer thinning and more frequent development of microcystic macular edema than in MS. Furthermore, while patients’ RNFL thinning also occurs in the absence of optic neuritis in MS, subclinical damage seems to be rare in NMO. Thus, OCT might be useful in differentiating NMO from MS and serve as an outcome parameter in clinical studies. PMID:25662342

  4. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study.

    Science.gov (United States)

    Martinez-Lapiscina, Elena H; Arnow, Sam; Wilson, James A; Saidha, Shiv; Preiningerova, Jana Lizrova; Oberwahrenbrock, Timm; Brandt, Alexander U; Pablo, Luis E; Guerrieri, Simone; Gonzalez, Ines; Outteryck, Olivier; Mueller, Ann-Kristin; Albrecht, Phillip; Chan, Wesley; Lukas, Sebastian; Balk, Lisanne J; Fraser, Clare; Frederiksen, Jette L; Resto, Jennifer; Frohman, Teresa; Cordano, Christian; Zubizarreta, Irati; Andorra, Magi; Sanchez-Dalmau, Bernardo; Saiz, Albert; Bermel, Robert; Klistorner, Alexander; Petzold, Axel; Schippling, Sven; Costello, Fiona; Aktas, Orhan; Vermersch, Patrick; Oreja-Guevara, Celia; Comi, Giancarlo; Leocani, Letizia; Garcia-Martin, Elena; Paul, Friedemann; Havrdova, Eva; Frohman, Elliot; Balcer, Laura J; Green, Ari J; Calabresi, Peter A; Villoslada, Pablo

    2016-05-01

    Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis, and progressive multiple sclerosis. Patients were recruited from centres in Spain, Italy, France, Germany, Czech Republic, Netherlands, Canada, and the USA, with the first cohort starting in 2008 and the latest cohort starting in 2013. We assessed disability worsening using the Expanded Disability Status Scale (EDSS). The pRNFL thickness and macular volume were assessed once at study entry (baseline) by optical coherence tomography (OCT) and was calculated as the mean value of both eyes without optic neuritis for patients without a history of optic neuritis or the value of the non-optic neuritis eye for patients with previous unilateral optic neuritis. Researchers who did the OCT at baseline were masked to EDSS results and the researchers assessing disability with EDSS were masked to OCT results. We estimated the association of pRNFL thickness or macular volume at baseline in eyes without optic neuritis with the risk of subsequent disability worsening by use of proportional hazards models that included OCT metrics and age, disease duration, disability, presence of previous unilateral optic neuritis, and use of disease-modifying therapies as covariates. 879 patients with clinically isolated syndrome (n=74), relapsing-remitting multiple sclerosis (n=664), or progressive multiple sclerosis (n=141) were included in the primary analyses. Disability worsening occurred in 252 (29%) of 879 patients with

  5. Management and Outcome of Patients With Acute Coronary Syndrome Caused by Plaque Rupture Versus Plaque Erosion: An Intravascular Optical Coherence Tomography Study.

    Science.gov (United States)

    Hu, Sining; Zhu, Yinchun; Zhang, Yingying; Dai, Jiannan; Li, Lulu; Dauerman, Harold; Soeda, Tsunenari; Wang, Zhao; Lee, Hang; Wang, Chao; Zhe, Chunyang; Wang, Yan; Zheng, Gonghui; Zhang, Shaosong; Jia, Haibo; Yu, Bo; Jang, Ik-Kyung

    2017-02-24

    Plaque rupture and erosion are the 2 most common mechanisms for acute coronary syndromes. However, the outcome of these 2 distinct pathologies in patients with acute coronary syndromes has never been studied. We retrospectively studied 141 patients with acute coronary syndromes who underwent optical coherence tomography (OCT) imaging of the culprit lesion prior to stenting from the Massachusetts General Hospital OCT Registry. Management (stent versus no stent), poststent OCT findings, and outcomes were compared. Among the 141 culprit lesions, rupture was found in 79 (56%) patients and erosion in 62 (44%). Stent implantation was performed in 77 (97.5%) patients with rupture versus 49 (79.0%) in those with erosion (Perosion group. Plaque rupture was associated with a higher incidence of no reflow or slow flow and distal embolization. Although cardiac event rates were comparable between the two groups at the 1-year follow-up, none of the erosion patients who were treated conservatively without stenting had adverse cardiac events. Unfavorable poststent OCT findings were more frequent in rupture patients compared with erosion patients. A subset of erosion patients who were treated conservatively without stenting remained free of adverse cardiac events for up to 1 year. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  6. A comparison of economic aspects of hospitalization versus ambulatory care in the management of neuritis occurring in lepra reaction.

    Science.gov (United States)

    H N, Ravi; George, Renu; Eapen, Elizabeth P; Pulimood, Susanne A; Gnanamuthu, Chandran; Jacob, Mary; John, K R

    2004-12-01

    Neuritis is one of the important causes of deformities and disabilities in leprosy. Neuritis has been managed both in the field and in hospital. This study was done to compare the economic aspects of cost of ambulatory vs in-patient management of neuritis in leprosy. The quality of life of the affected patients and the clinical improvement in the 2 groups were also studied. Twenty six patients fulfilling the study criteria were randomized into the ambulatory and in-patient group (13 in each group). The primary outcome examined was cost, in various categories; the secondary outcomes included pre- and post-treatment comparison of Quality of Life (QOL) scores and tests of sensory and motor function. The direct and indirect medical costs incurred by patients in the hospitalized group were higher than those patients in the ambulatory group. The difference in the direct medical costs between the two groups was Rs. 9110.5, and the extra direct non medical costs incurred by patients in the hospitalized group was Rs. 888.50 because of more frequent visits of family members. A greater percentage of ambulatory than in-patients returned to work in

  7. Twenty-eight Cases of Neuritis of Lateral Cutaneous Nerve of Thigh Treated by Acupuncture and Point-Injection

    Institute of Scientific and Technical Information of China (English)

    廖明扬

    2001-01-01

    @@Neuritis of lateral cutaneous nerve of thigh, also called meralgia paresthetica, is a commonly encountered disease in clinical practice. The author has treated 28 cases of meralgia paresthetica since 1996 by acupuncture plus point-injection with satisfactory results. A report follows. Clinical Data Among the 28 cases, 13 were male and 15 female. Their age ranged from 24 to 72 years, most of the patients being 35 to 50 years; the duration of illness varied from one month to ten years and 6 cases were affected on left side, 8 cases on right side and 14 cases on both sides.

  8. Marked Mydriasis and Neuritis Nervi Optici Associated with Galactorrhea Following Citalopram Treatment: A Case Report and Discussion

    Science.gov (United States)

    Koch, Horst J.; Zellmer, Heike

    2011-01-01

    We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Moreover, abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophysiology. The ocular symptoms disappeared rapidly after the discontinuation of citalopram and pulse therapy with methyl-prednisolone. However, galactorrhea persisted for a few weeks necessitating treatment with bromocriptine. PMID:21869891

  9. Trealment of rats with experimental allergic neuritis using high dose immunoglobulin

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To investigate the therapeutic potential of high-dase immunoglobulin (HIG) in experimental allergic neuritis (FAN) to provide a theoretical basis of its clinical use in the treatment of human inflammatory emyelinating neuropathies. Methods Female Lewis rats were induced to EAN,and divided into experimental and control groups. The rats were treated with either 0.3 g/kg.day-1 of IgG oran equivalent volume of 0.15 rnoVL glycine. Clinicst,electrophysiologic,and histologic evaluations were carried out in a blind fashion. Results Clinically, rars treated with fgG had significantly less severe symptoms (P<0.001) and slower progression (P<0.001) than controls. Electrophysiologically, the mean conduction latency of the experimental group was significantly shorter than controls (P<0.05).Histologically,rats treated with lgG prepared from normal Lewis rats had a significantly lower percentage of damyelinated fibem (P=0.01)and total abnormal fibers (P<0.001) than ontrels,Statistically,clinicat, electrophysiologic and moqrphologic data were all significantly correlated. Concluslons The EAN animal model is reliable for observation of HIG effects, and useful to provide data for clinical work. HIG has a significant therapeutic effect in EAN when given soon after disease onset. Itcan reduce clincal disease severity and decrease the number of demyelinated fibers as well as the number of total abnormal fibers. For the current corntroversy over whether HIG is effective, the results of this research support the clinical use of HIG in human damyelinating neuropathy.

  10. [Applications of optical coherence tomography (OCT) in neuro-ophthalmology].

    Science.gov (United States)

    Kernstock, C; Friebe, K; Tonagel, F

    2013-11-01

    Optical coherence tomography (OCT) has revolutionised ophthalmology. Due to modern instruments with extremely high resolution there are more and more applications also in neuro-ophthalmological disorders. This review gives an overview on typical changes in OCT for the following diseases: autosomal dominant optic atrophy, Leber hereditary optic neuropathy, toxic, traumatic and compressive optic neuropathy, optic nerve drusen, anterior ischaemic optic neuropathy, optic disc pit, papilledema, optic neuritis (isolated or associated with multiple sclerosis or neuromyelitis optica), neurodegenerative diseases and hereditary retinal diseases. A diagnosis exclusively based on an OCT examination is not always possible, but in several diseases there are pathognomonic changes that directly lead to the correct diagnosis. Particularly with the often complex settings in neuro-ophtalmology the OCT should be seen as a supplementary modality and not as a replacement for other techniques.

  11. Usefulness of combined fat- and fluid-suppressed SPIR-FLAIR images in optic neurits : Comparison with fat-suppressed SPIR or STIR images

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Yeon; Son, Seok Hyun; Eun, Choong Ki; Han, Sang Suk [Inje Univ., College of Medicine, Pusan (Korea, Republic of)

    2001-12-01

    To compare the usefulness of combined fat- and fluid-suppressed selective partial inversion recovery-fluid attenuated inversion recovery(SPIR-FLAIR) images in the detection of high signal intensity of the optic nerve in optic neuritis with that of fat-suppressed selective partial inversion recovery(SPIR) or short inversion time inversion recovery(STIR) images. Two radiologists independently analyzed randomly mixed MR images of 16 lesions in 14 patients (M:F=7:7; mean age, 40 years) in whom optic neuritis had been clinically diagnosed. All subjects underwent both SPIR-FLAIR and fat-suppressed SPIR or STIR imaging, in a blind fashion. In order to evaluate the optic nerve, coronal images perpendicular to its long axis were obtained. The detection rate of high signal intensity of the optic nerve, the radiologists preferred imaging sequences, and intersubject consistency of detection were evaluated. 'High signal intensity' was defined as the subjective visual evaluation of increased signal intensity compared with that of the contralateral optic nerve or that of white matter. The mean detection rate of high signal intensity of the optic nerve was 90% for combined fat- and fluid-suppressed SPIR-FLAIR images, and 59% for fat-suppressed SPIR or STIR images. In all cases in which the signal intensity observed on SPIR-FLAIR images was normal, that on fat-suppressed SPIR or STIR images was also normal. The radiologists preferred the contrast properties of SPIR-FLAIR to those of fat-suppressed SPIR or STIR images. In the diagnosis of optic neuritis using MRI, combined fat- and fluid-suppressed SPIR-FLAIR images were more useful for the detection of high signal intensity of the optic nerve than fat-suppressed SPIR or STIR images. For the evaluation of optic neuritis, combined fat- and fluid-suppressed SPIR-FLAIR imaging is superior to fat-suppressed SPIR or STIR imaging.

  12. In Vivo Optical Imaging of Acute Myeloid Leukemia by Green Fluorescent Protein: Time-Domain Autofluorescence Decoupling, Fluorophore Quantification, and Localization

    Directory of Open Access Journals (Sweden)

    Emmet McCormack

    2007-05-01

    Full Text Available Human xenografts of acute myeloid leukemia (AML in nonobese diabetic/sever