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Sample records for acute optic neuritis

  1. Optic neuritis

    Science.gov (United States)

    Retro-bulbar neuritis; Multiple sclerosis - optic neuritis; Optic nerve - optic neuritis ... The exact cause of optic neuritis is unknown. The optic nerve carries visual information from your eye to the brain. The nerve can swell when ...

  2. 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......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 idiopathic ON, 66 with ON + CDMS), ethnically matched with 192 healthy volunteers. MAIN OUTCOME MEASURES: Relation between the HLA-DR15, -DR17, -DQA-1B, and -DQB-1B polymorphisms as defined by restriction fragment length polymorphism analysis, and presence of plaques on T2-weighted brain MRI. RESULTS......: The frequency of HLA-DR15 was significantly increased in patients with ON + CDMS (52%) and ON (47%) compared with control subjects (31%). The frequency of HLA-DR17 was almost equal in the ON + CDMS (18%), ON (23%), and control (23%) groups. The frequencies of HLA-DQA-1B (55% in ON + CDMS, 58% in ON) and HLA...

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

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

    2017-01-01

    BACKGROUND: The human monoclonal antibody opicinumab (BIIB033, anti-LINGO-1) has shown remyelinating activity in preclinical studies. We therefore assessed the safety and tolerability, and efficacy of opicinumab given soon after a first acute optic neuritis episode. METHODS: This randomised, doub...

  4. 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...

  5. 25-Hydroxyvitamin D levels in acute monosymptomatic optic neuritis

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    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...... in AON. 25HVITDL was significantly associated with CSF leukocyte count, but not ON severity. The study indicates a possible role of vitamin D in the early stages of MS, but does not support the use of 25HVITDL as a predictor of MS development in acute ON....

  6. Cortical neuroplasticity in patients recovering from acute optic neuritis

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    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...

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

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    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 stu...

  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...

  9. Magnetic resonance imaging findings at the first episode of acute optic neuritis

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    Soelberg, K; Skejoe, H P B; Grauslund, J

    2018-01-01

    BACKGROUND: Optic neuritis (ON) is a focal demyelinating event, which may evolve into multiple sclerosis (MS). OBJECTIVE: To study MRI characteristics in the acute phase of the first ON episode. METHODS: A prospective population-based study was performed on 31 patients with a first episode of acute...... ON episode facilitated an MS diagnosis. The extension of optic nerve lesions following ON suggests a long-term progressive degeneration as an important element of ON pathology....

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

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    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

  11. Management of optic neuritis

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    Menon Vimla

    2011-01-01

    Full Text Available Optic neuritis is an inflammatory condition of the optic nerve characterized by a sudden onset of unilateral visual loss, usually affecting young females. Demyelination associated with multiple sclerosis (MS is the most common cause in regions where MS is prevalent; while in other places, there are a substantial proportion of cases where infective or autoimmune causes are seen. Optic Neuritis Treatment Trial (ONTT was the first major study that provided information on the natural history, role of steroids in treatment and risk of development of MS. Subsequently, numerous clinical trials have evaluated different modalities of management of optic neuritis and MS. The Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study (CHAMPS; the Prevention of Relapses and Disability by Interferon β-1a Subcutaneously in Multiple Sclerosis (PRISMS Trial; and, most recently, the Betaferon in Newly Emerging Multiple Sclerosis for Initial Treatment (BENEFIT Study have provided large amount of information on the natural history of optic neuritis and management options available. However, due to the low prevalence of MS reported in Asian studies, high cost of therapy and indefinite time period of treatment, it may not be cost effective to start interferon therapy in most cases.

  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

    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 lesion (p = 0.0002), but not to the location of the optic nerve lesions (p = 0.72). CONCLUSIONS: In this study of the acute phase of optic...... neuritis, the degree of optic nerve head edema depended upon the extent of the optic nerve lesion, but not on its location. This suggests that factors other than inflammation, such as compromised venous drainage, vascular leakage, impaired axonal transport, and other mechanisms, are involved...

  13. Differential intrathecal inflammatory markers in acute optic neuritis and later conversion to multiple sclerosis

    DEFF Research Database (Denmark)

    Olesen, Mads Nikolaj; Soelberg, Kerstin; Nilsson, Anna Christine

    Background: Optic neuritis (ON) is often an early inflammatory, demyelinating event of multiple sclerosis (MS). We proffer that cytokine and chemokine profiles may (a) differ between patients with MS-related ON and those with non-MS-related ON and (b) predict conversion to MS in patients presenting...... ON (pcytokines IL-1β, IL-6 and IL-17 were measurable in CSF and serum, levels did not differ between groups. Conclusions: Levels of CSF TNF-α and IL-10 and CXCL13 differed between acute isolated ON patients who had converted to MS at follow...

  14. Acute Disseminated Encephalomyelitis (ADEM) Presenting with Bilateral Optic Neuritis

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    Sapuan, Sapiah; Basri, Hamidon

    2007-01-01

    A 43-year old lady presented with progressive loss of vision in both eyes followed by rapid deterioration of consciousness within the next few days. This was preceded by a viral infection one week before her presentation. At presentation she had evidence of meningism and signs of bilateral upper motor neuron lesions and was managed initially as acute meningoencephalitis with antibiotics. The brain CT was within normal limits but subsequent MRI of the brain revealed multiple foci of hyperintense lesions on T2-weighted and FLAIR images. The cerebrospinal fluid examination revealed lymphocytosis, and normal protein and glucose levels. Cultures of the CSF were negative. She was managed as acute disseminated encephalomyelitis (ADEM) with high-dose of intravenous methlyprednisolone one gram/day for three consecutive days followed by oral prednisolone 60 mg/day. Despite the management she lapsed into coma and succumbed to her illness nine days after admission. PMID:22593657

  15. Ophthalmic diagnoses in the ED: optic neuritis.

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    Germann, Carl A; Baumann, Michael R; Hamzavi, Sirus

    2007-09-01

    Optic neuritis is the most common cause of decreased vision due to optic nerve dysfunction in patients who are 20 to 40 years of age. Optic neuritis, or inflammation of the optic nerve, is primarily due to idiopathic demyelination. Demyelinative lesions seen in optic neuritis are not unlike those seen in plaque associated with multiple sclerosis. In fact, acute inflammatory demyelination of the optic nerve commonly occurs as an initial manifestation of multiple sclerosis. Key features of optic neuritis include a vision loss occurring over 1 to 10 days, color vision impairment, eye pain with motility, and an afferent pupillary defect. This significant diagnosis can be challenging to an emergency physician as it is relatively infrequently observed.

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

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    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.

  17. 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.

  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

    -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......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....... In addition, there was no significant difference in the secondary outcome measures, improvement in the visual function measures and MRI, at any time during follow-up. At baseline, a significantly higher number of patients in the IVIG group had one or more enhancing lesions on MRI and IVIG-treated patients had...

  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......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...

  20. Early retinal atrophy predicts long-term visual impairment after acute optic neuritis.

    Science.gov (United States)

    Sanchez-Dalmau, Bernardo; Martinez-Lapiscina, Elena H; Torres-Torres, Ruben; Ortiz-Perez, Santiago; Zubizarreta, Irati; Pulido-Valdeolivas, Irene V; Alba-Arbalat, Salut; Guerrero-Zamora, Ana; Calbet, David; Villoslada, Pablo

    2017-06-01

    Visual recovery after optic neuritis (ON) used to be defined as good, although patients frequently complain of poor vision. We carried out a prospective study on 38 consecutive patients with acute ON followed monthly for 6 months and evaluated high- and low-contrast visual acuity (HCVA and LCVA, respectively), quality of vision (National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25)), visual fields, and retinal thickness by spectral domain optical coherence tomography (OCT). We found significant impaired LCVA and color vision in ON eyes 6 months after acute ON, which impact on quality of life. LCVA and color vision were correlated with the thicknesses of the ganglion cell and inner plexiform layer (GCIPL; 2.5% LCVA r = 0.65 and p = 0.0001; color vision r = 0.75 and p color vision r = 0.62 and p color vision acuity. When adjusting for the value of visual acuity at baseline, predictors of the change in vision from baseline to month 6 achieved similar performance for all three types of vision (HCVA, LCVA, and color vision). Monitoring retinal atrophy by OCT within the first month after ON onset allows individuals at a high risk of residual visual impairment to be identified.

  1. Acute optic neuritis: Unmet clinical needs and model for new therapies.

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    Galetta, Steven L; Villoslada, Pablo; Levin, Netta; Shindler, Kenneth; Ishikawa, Hiroshi; Parr, Edward; Cadavid, Diego; Balcer, Laura J

    2015-08-01

    Idiopathic demyelinating optic neuritis (ON) most commonly presents as acute unilateral vision loss and eye pain and is frequently associated with multiple sclerosis. Although emphasis is often placed on the good recovery of high-contrast visual acuity, persistent deficits are frequently observed in other aspects of vision, including contrast sensitivity, visual field testing, color vision, motion perception, and vision-related quality of life. Persistent and profound structural and functional changes are often revealed by imaging and electrophysiologic techniques, including optical coherence tomography, visual-evoked potentials, and nonconventional MRI. These abnormalities can impair patients' abilities to perform daily activities (e.g., driving, working) so they have important implications for patients' quality of life. In this article, we review the sequelae from ON, including clinical, structural, and functional changes and their interrelationships. The unmet needs in each of these areas are considered and the progress made toward meeting those needs is examined. Finally, we provide an overview of past and present investigational approaches for disease modification in ON.

  2. Corticosteroids for treating optic neuritis

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    Vedula, Satyanarayana S; Folse, Suzanne Brodney; Gal, Robin L; Beck, Roy

    2014-01-01

    Background Optic neuritis is an inflammatory disease of the optic nerve. It occurs more commonly in women than in men. Usually presenting with an abrupt loss of vision, recovery of vision is almost never complete. Closely linked in pathogenesis to multiple sclerosis, it may be the initial manifestation for this condition. In certain patients, no underlying cause can be found. Objectives To assess the effects of corticosteroids on visual recovery of patients with acute optic neuritis. Search strategy We searched the Cochrane Controlled Trials Register (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (issue 4, 2005), MEDLINE (1966 to December 2005), EMBASE (1980 to January 2006), NNR (issue 4, 2006), LILACS and reference lists of identified trial reports. Selection criteria We included randomized trials that evaluated corticosteroids, in any form, dose or route of administration, in people with acute optic neuritis. Data collection and analysis Two authors independently extracted the data on methodological quality and outcomes for analysis. Main results We included five randomized trials which included a total of 729 participants. Two trials evaluated low dose oral corticosteroids and two trials evaluated a higher dose of intravenous corticosteroids. One three-arm trial evaluated low-dose oral corticosteroids and high-dose intravenous corticosteroids against placebo. Trials evaluating oral corticosteroids compared varying doses of corticosteroids with placebo. Hence, we did not conduct a meta-analysis of such trials. In a meta-analysis of trials evaluating corticosteroids with total dose greater than 3000 mg administered intravenously, the relative risk of normal visual acuity with intravenous corticosteroids compared with placebo was 1.06 (95% CI 0.89 to 1.27) at six months and 1.06 (95% CI 0.92 to 1.22) at one year. The risk ratio of normal contrast sensitivity for the same comparison was 1.10 (95% CI 0.92 to 1.32) at six months follow

  3. Sex-specific differences in retinal nerve fiber layer thinning after acute optic neuritis.

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    Costello, Fiona; Hodge, William; Pan, Y Irene; Burton, Jodie M; Freedman, Mark S; Stys, Peter K; Trufyn, Jessie; Kardon, Randy

    2012-10-30

    The primary objective of this study was to explore the potential influence of gender on recovery from optic neuritis (ON) by determining whether differences in retinal nerve fiber layer (RNFL) thickness can be detected between men and women 6 months after an ON event. In this prospective cohort study, 39 men and 105 women with acute ON underwent repeat visual and optical coherence tomography (OCT) testing. The main outcome measures were change in RNFL measurements for male and female patients 6 months after ON. Men were older (mean age = 39 years) than women (35 years) (p = 0.05) in this study, and more men (62%) than women (41%) had a diagnosis of relapsing-remitting multiple sclerosis (MS) (p = 0.02). Because age and MS subtype were 2 significant covariates, both variables were controlled for in multiple regression analyses. Other covariates controlled for in the multivariate regression included disease duration (years), use of disease-modifying therapy (yes/no), and use of high-dose corticosteroids for acute ON (yes/no). After 6 months, mean RNFL values were lower in men (74 μm) than women (91 μm) (p Men showed more apparent change in RNFL thickness in their ON eyes from baseline to 6 months after ON than women (p = 0.003). There may be differences in recovery between men and women after ON, which can be difficult to detect with conventional visual testing. Our findings raise interesting questions about the potential influence of gender in MS, which may be explored in future studies.

  4. Diffusion-weighted imaging helps differentiate multiple sclerosis and neuromyelitis optica-related acute optic neuritis.

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    Wan, Hailin; He, Huijin; Zhang, Fang; Sha, Yan; Tian, Guohong

    2017-06-01

    To evaluate the apparent diffusion coefficient (ADC) values between multiple sclerosis (MS) and neuromyelitis optica (NMO)-related acute optic neuritis (ON) patients and predict their optic nerve atrophy of optic coherence tomography (OCT) parameters. Nineteen MS and 15 NMO-related acute ON patients who underwent a diffusion-weighted imaging sequence in 3.0 Tesla MR scanner and a follow-up OCT examination after 6 months were included. The ADC values, thickness of the retinal nerve fiber layer (RNFL) and the macular ganglion cell complex (GCC) between MS and NMO related ON were assessed. The mean ADC value of the NMO-ON, (0.691 ± 0.195[SD]) × 10-3 mm2 /s, was significantly smaller (P = 0.0133) than that of MS-ON. The mean ADC value of MS-ON, (0.879 ± 0.144) × 10-3 mm2 /s, was significantly smaller (P < 0.0001) than that of control group, (1.025 ± 0.067) × 10-3 mm2 /s. Using an ADC value smaller than 0.830 × 10-3 mm2 /s as the threshold value for differentiating MS-ON from NMO-ON patients, the highest accuracy of 76.7%, with 75.0% sensitivity and 78.3% specificity, was obtained. The ADC value measured at the acute stage of ON was correlated with the thickness of the RNFL (r = 0.441; P = 0.006) and the GCC (r = 0.526; P < 0.0001) after 6 months. The ADC value might be helpful for differentiating MS-ON from NMO-ON patients. The decreased ADC value was correlated with optic nerve atrophy on OCT. 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1780-1785. © 2016 International Society for Magnetic Resonance in Medicine.

  5. 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.

  6. Current options for the treatment of optic neuritis

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

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    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...

  8. The dyschromatopsia of optic neuritis: a descriptive analysis of data from the optic neuritis treatment trial.

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    Katz, B

    1995-01-01

    We sought to characterize the dyschromatopsia of optic neuritis, to determine the type and severity of color defect present and its relation to central vision and spatial acuity, to examine changes in this dyschromatopsia over time, and to determine the applicability of Köllner's rule to patients with optic neuritis. We analyzed the raw data on color vision performance as assembled within the Optic Neuritis Treatment Trial (ONTT). The ONTT was designed to evaluate corticosteroids as a treatment for acute demyelinating optic neuritis and to allow long-term outcome and natural history analyses. Between July 1, 1988 and June 30, 1991, 488 patients were enrolled in this trial. All patients underwent extensive neurologic and ophthalmologic examinations including standardized testing of visual function that included testing of color vision. The ONTT population thus afforded a unique opportunity to characterize acquired dyschromatopsias in a large, homogenous, well-characterized cohort of patients with optic neuritis. We used quantitative analysis of FM-100 scores from this patient cohort to determine the severity of the dyschromatopsia, the selectivity of the dyschromatopsia (polarity of errors) and the type of dyschromatopsia (axis of confusion) by employing quadrant analysis of FM-100 scores. The results of high-and low-selectivity analyses of the FM-100 data showed that during the acute phase of optic neuritis, blue/yellow, red/ green, and non-selective color defects occurred; among patients with pure defects, blue/yellow defects were more frequent than red/green defects. At 6 months after the acute event, however, analyses showed that red/green defects were more common than blue/yellow defects. Among patients with selective color defects both acutely and at 6 months, the defect was as likely to change over time as remain the same. The likelihood of persistent dyschromatopsia at 6 months was related to the severity of initial central acuity loss, but the type of

  9. 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.

  10. Role of coronal high-resolution diffusion-weighted imaging in acute optic neuritis: a comparison with axial orientation

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Ping [Zhongshan Hospital, Fudan University, Shanghai Institution of Medical Imaging, Shanghai (China); Eye and ENT Hospital of Fudan University, Department of Radiology, Shanghai (China); Sha, Yan; Wan, Hailin; Wang, Feng [Eye and ENT Hospital of Fudan University, Department of Radiology, Shanghai (China); Tian, Guohong [Eye and ENT Hospital of Fudan University, Department of Ophthalmology, Shanghai (China)

    2017-08-15

    Through a comparison with the axial orientation, we aimed to evaluate the role of coronal high-resolution diffusion-weighted imaging (DWI) in acute optic neuritis based on diagnostic accuracy and the reproducibility of apparent diffusion coefficient (ADC) measurements. Orbital DWI, using readout-segmented, parallel imaging, and 2D navigator-based reacquisition (RESOLVE-DWI), was performed on 49 patients with acute vision loss. The coronal (thickness = 3 mm) and axial (thickness = 2 mm) diffusion images were evaluated by two neuroradiologists retrospectively. The sensitivity, specificity, and accuracy were calculated through diagnostic test; the inter- and intra-observer reliabilities were assessed with a weighted Cohen's kappa test. In addition, the agreement of ADC measurement among observers was evaluated by the intra-class correlation coefficient (ICC), coefficient of variation (CV), and Bland-Altman plots. Comparison of ADC values was also performed by unpaired t test. Among the 49 patients, 47 clinically positive optic nerves and 51 clinically negative optic nerves were found. The sensitivity, specificity, and accuracy were 85.1/87.2%, 90.2/94.12%, and 87.8/90.8%, respectively, for coronal RESOLVE-DWI and 83.0/85.1%, 66.7/76.5%, and 75.5/79.6%, respectively, for axial RESOLVE-DWI. The inter-observer kappa values were 0.710 and 0.806 for axial and coronal RESOLVE-DWI, respectively, and the intra-observer kappa values were 0.822 and 0.909, respectively (each P < 0.0001). Regarding the reproducibility of ADC measurements on axial and coronal RESOLVE-DWI, the ICCs among observers were 0.846 and 0.941, respectively, and the CV values were 7.046 and 4.810%, respectively. Bland-Altman plots revealed smaller inter-observer variability on coronal RESOLVE-DWI. ADC values were significantly lower in positive group (each P < 0.0001). Higher specificity and better reproducibility of ADC measurements were found for coronal RESOLVE-DWI, which demonstrated the

  11. The dyschromatopsia of optic neuritis: a descriptive analysis of data from the optic neuritis treatment trial.

    OpenAIRE

    Katz, B

    1995-01-01

    PURPOSE: We sought to characterize the dyschromatopsia of optic neuritis, to determine the type and severity of color defect present and its relation to central vision and spatial acuity, to examine changes in this dyschromatopsia over time, and to determine the applicability of Köllner's rule to patients with optic neuritis. METHODS: We analyzed the raw data on color vision performance as assembled within the Optic Neuritis Treatment Trial (ONTT). The ONTT was designed to evaluate corticoste...

  12. 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

  13. Interpretation of RNFLT values in multiple sclerosis-associated acute optic neuritis using high-resolution SD-OCT device.

    Science.gov (United States)

    Serbecic, Nermin; Beutelspacher, Sven C; Kircher, Karl; Reitner, Andreas; Schmidt-Erfurth, Ursula

    2012-09-01

    Optical coherence tomography (OCT) has emerged as the technique of choice in measuring the retinal nerve fibre layer (RNFL) quantitatively. It is suggested that RNFL reduction may correlate with lesion burden and diffuse axonal degeneration in the whole CNS of patients with multiple sclerosis (MS). However, RNFL changes because of optic neuritis (ON) must be taken into account. Twenty-three patients with acute ON (46 eyes) associated with clinical definite MS (23 ON eyes, 23 fellow eyes) and 23 sex- and age-matched healthy controls were studied. Retinal nerve fibre layer thickness (RNFLT) was measured at baseline, using a high-resolution spectral domain OCT (SD-OCT) applying circular, peripapillary OCT scans with a novel eye-tracking mechanism. The internal OCT software was able to identify RNFL atrophy in three out of five of the acute ON eyes and one out of four of the fellow eyes with previous ON episodes. Retinal nerve fibre layer thickness of two ON (8.7%) and five fellow eyes (21.7%) was overestimated, thus located within the 95% and 5% confidence interval of the company standard values (not marked pathologic). In contrast, our comparison with age- and sex-matched controls revealed RNFL atrophy suggestive of prior, clinically silent RNFL loss in ON and fellow eyes (30.4%). Retinal nerve fibre layer thickness measurements at a single time-point seem to have a limited role in detecting prior clinically silent optic nerve injury. Our data suggest that affected eyes should be compared with the fellow eyes and a sufficient number of age- and sex-matched controls to allow the detection of even subtle RNFL changes at baseline. The role of OCT for disease monitoring of MS must be evaluated in detail, as ON is often the initial symptom of MS. © 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.

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

    African Journals Online (AJOL)

    2011-10-10

    Oct 10, 2011 ... Optic neuritis (ON) is a demyelinating inflammatory disease of the optic nerve that typically affects young adults especially females.[1] Many cases of optic neuritis are associated with multiple sclerosis or neuromyelitis optica or can occur in isolation.[2] The association between optic neuritis and multiple ...

  15. 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....

  16. 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...

  17. Elevated serum anti-phosphatidylcholine IgG antibodies in patients with influenza vaccination-associated optic neuritis.

    Science.gov (United States)

    Korematsu, Seigo; Miyahara, Hiroaki; Kakita, Akiyoshi; Izumi, Tatsuro

    2014-11-12

    Because the optic nerve is mainly comprised from phospholipids such as phosphatidylcholine, the association between optic neuritis, anti-phospholipids antibodies and vaccination was examined. Two female pediatric patients suddenly presented bilateral optic neuritis after administration of trivalent inactivated influenza vaccine. These two patients and another 11 patients with central nervous system demyelinating diseases were examined these anti-phospholipids antibodies. And immune histopathology was examined using serum derived from a patient with optic neuritis. High serum titer of anti-phosphatidylcholine antibody levels were detected during acute phase in patients with optic neuritis. The patient's serum IgG antibodies were found to have stained the capillary endotheliums in the preserved autopsied optic nerve. Patients with optic neuritis had significantly elevated serum levels of anti-phosphatidylcholine antibody in comparison to the other patients without optic neuritis. Anti-phosphatidylcholine antibodies may be one of the causes of optic neuritis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Ipsilateral uveitis and optic neuritis in multiple sclerosis.

    Science.gov (United States)

    Thouvenot, Eric; Mura, Frédéric; De Verdal, Marie; Carlander, Bertrand; Charif, Mahmoud; Schneider, Christelle; Navarre, Sophie; Camu, William

    2012-01-01

    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.

  19. 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.

  20. 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......: The prospective incidence of ON was estimated. MRI enabled a diagnosis of MS in a subgroup of patients. Antibody-mediated ON with specificity for MOG was detected in 4% of cases....

  1. Optic neuritis as an early sign of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Kale N

    2016-10-01

    Full Text Available Nilufer Kale Department of Neurology, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital, Istanbul, Turkey Abstract: Optic neuritis (ON is an acute inflammatory demyelinating disorder of the optic nerve. The general characteristics of isolated ON include unilateral, subacute, and painful visual loss without systemic or other neurological symptoms. The etiology for ON varies including demyelinating disorders or infections, inflammation, toxic reasons, and genetic disorders. In most cases the responsible etiology may not be known for ON and in this case, it is termed idiopathic ON. When a patient presents with an initial episode of ON, patients should undergo further tests. Assessing the patient with routine blood work, magnetic resonance imaging, cerebrospinal fluid tests, and visual evoked potentials provide further insight. In this review, we aimed to provide a review of ON as an initial symptom of multiple sclerosis and present clinical characteristics, therapy options, and recent literature. Keywords: optic neuritis, multiple sclerosis, demyelination, corticosteroids, disease modifying treatments

  2. Early factors associated with axonal loss after optic neuritis.

    Science.gov (United States)

    Henderson, Andrew P D; Altmann, Daniel R; Trip, S Anand; Miszkiel, Katherine A; Schlottmann, Patricio G; Jones, Steve J; Garway-Heath, David F; Plant, Gordon T; Miller, David H

    2011-12-01

    Acute optic neuritis due to an inflammatory demyelinating lesion of the optic nerve is often seen in association with multiple sclerosis. Although functional recovery usually follows the acute episode of visual loss, persistent visual deficits are common and are probably due to axonal loss. The mechanisms of axonal loss and early features that predict it are not well defined. We investigated clinical, electrophysiological, and imaging measures at presentation and after 3 months as potential markers of axonal loss following optic neuritis. We followed 21 patients after their first attack of acute unilateral optic neuritis for up to 18 months. Axonal loss was inferred from optical coherence tomography measures of retinal nerve fiber layer (RNFL) thickness at least 6 months following the episode. Visual function, visual evoked potential, and optic nerve magnetic resonance imaging measures obtained during the acute episode and 3 months later were investigated for their association with later axonal loss. After multivariate analysis, prolonged visual evoked potential latency and impaired color vision, at baseline and after 3 months, were significantly and independently associated with RNFL thinning. Low-contrast acuity measures exhibited significant univariate associations with RNFL thinning. The association of RNFL loss with a prolonged visual evoked potential (VEP) latency suggests that acute and persistent demyelination is associated with increased vulnerability of axons. VEP latency and visual function tests that capture optic nerve function, such as color and contrast, may help identify subjects with a higher risk for axonal loss who are thus more suitable for experimental neuroprotection trials. Copyright © 2011 American Neurological Association.

  3. Parainfectious optic neuritis: manifestations in children vs adults.

    Science.gov (United States)

    Rappoport, Daniel; Goldenberg-Cohen, Nitza; Luckman, Judith; Leiba, Hana

    2014-06-01

    Parainfectious optic neuritis may appear at any age. The aim of our report was to compare the clinical manifestations and outcomes of this form of optic neuritis between children and adults. The study sample consisted of all patients diagnosed with parainfectious optic neuritis evaluated by 2 neuro-ophthalmology services between 2005 and 2012. Data were collected retrospectively from the medical files. Findings were compared between patients aged 0-18 years and 19 years or older. Ten children (50% female) and 8 adults (50% female) met the study criteria. Mean duration of follow-up was 29.4 months (range, 2-72 months) in the pediatric group and 14.2 months (range, 5-80 months) in the adult group. Respective rates of bilateral disease were 50% and 38%, and all patients had optic disc swelling. The associated pathogen was identified in 60% of the pediatric group, mainly Mycoplasma pneumoniae, and 75% of the adult group, in which no microorganism predominated. The interval from the febrile illness to symptom onset was 6 days (range, 1-14 days) in the pediatric group and 19.5 days (range, 14-30 days) in the adult group. Acute disseminated encephalomyelitis (ADEM) was diagnosed in 40% (4/10) of the children and none of the adults. Final visual outcome was 20/30 or better in all patients. There was a higher frequency of bilateral disease in prepubescent vs postpubescent children. Parainfectious optic neuritis is associated with a favorable visual prognosis regardless of age. Children tend to manifest visual symptoms sooner after the antecedent infectious illness and more often bilaterally and in conjunction with ADEM. The causative agent is isolated less frequently in children compared with adults.

  4. Optic neuritis, its differential diagnosis and management.

    Science.gov (United States)

    Hoorbakht, Hedieh; Bagherkashi, Farid

    2012-01-01

    The aim of this review is to summarize the latest information about optic neuritis, its differential diagnosis and management. Optic Neuritis (ON) is defined as inflammation of the optic nerve, which is mostly idiopathic. However it can be associated with variable causes (demyelinating lesions, autoimmune disorders, infectious and inflammatory conditions). Out of these, multiple sclerosis (MS) is the most common cause of demyelinating ON. ON occurs due to inflammatory processes which lead to activation of T-cells that can cross the blood brain barrier and cause hypersensitivity reaction to neuronal structures. For unknown reasons, ON mostly occurs in adult women and people who live in high latitude. The clinical diagnosis of ON consists of the classic triad of visual loss, periocular pain and dyschromatopsia which requires careful ophthalmic, neurologic and systemic examinations to distinguish between typical and atypical ON. ON in neuromyelitis optica (NMO) is initially misdiagnosed as ON in MS or other conditions such as Anterior Ischemic Optic Neuropathy (AION) and Leber's disease. Therefore, differential diagnosis is necessary to make a proper treatment plan. According to Optic Neuritis Treatment Trial (ONTT) the first line of treatment is intravenous methylprednisolone with faster recovery and less chance of recurrence of ON and conversion to MS. However oral prednisolone alone is contraindicated due to increased risk of a second episode. Controlled High-Risk Subjects Avonex(®) Multiple Sclerosis Prevention Study "CHAMPS", Betaferon in Newly Emerging Multiple Sclerosis for Initial Treatment "BENEFIT" and Early Treatment of MS study "ETOMS" have reported that treatment with interferon β-1a,b results in reduced risk of MS and MRI characteristics of ON. Contrast sensitivity, color vision and visual field are the parameters which remain impaired mostly even after good recovery of visual acuity.

  5. Optic Neuritis, its Differential Diagnosis and Management

    Science.gov (United States)

    Hoorbakht, Hedieh; Bagherkashi, Farid

    2012-01-01

    The aim of this review is to summarize the latest information about optic neuritis, its differential diagnosis and management. Optic Neuritis (ON) is defined as inflammation of the optic nerve, which is mostly idiopathic. However it can be associated with variable causes (demyelinating lesions, autoimmune disorders, infectious and inflammatory conditions). Out of these, multiple sclerosis (MS) is the most common cause of demyelinating ON. ON occurs due to inflammatory processes which lead to activation of T-cells that can cross the blood brain barrier and cause hypersensitivity reaction to neuronal structures. For unknown reasons, ON mostly occurs in adult women and people who live in high latitude. The clinical diagnosis of ON consists of the classic triad of visual loss, periocular pain and dyschromatopsia which requires careful ophthalmic, neurologic and systemic examinations to distinguish between typical and atypical ON. ON in neuromyelitis optica (NMO) is initially misdiagnosed as ON in MS or other conditions such as Anterior Ischemic Optic Neuropathy (AION) and Leber’s disease. Therefore, differential diagnosis is necessary to make a proper treatment plan. According to Optic Neuritis Treatment Trial (ONTT) the first line of treatment is intravenous methylprednisolone with faster recovery and less chance of recurrence of ON and conversion to MS. However oral prednisolone alone is contraindicated due to increased risk of a second episode. Controlled High-Risk Subjects Avonex® Multiple Sclerosis Prevention Study “CHAMPS”, Betaferon in Newly Emerging Multiple Sclerosis for Initial Treatment “BENEFIT” and Early Treatment of MS study “ETOMS” have reported that treatment with interferon β-1a,b results in reduced risk of MS and MRI characteristics of ON. Contrast sensitivity, color vision and visual field are the parameters which remain impaired mostly even after good recovery of visual acuity. PMID:22888383

  6. 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

    The aim of this study was to summarise existing findings regarding optical coherence tomography (OCT) measurements of ganglion cell layer (GCL) alterations in optic neuritis (ON) and multiple sclerosis (MS). Peer-reviewed studies published prior to April 2016 were searched using PubMed, EMBASE, Web...... in MS patients both with and without previous ON compared to healthy controls. GCL thinning was associated with visual function in most studies (n = 10) and expanded disability status scale (EDSS) scores (n = 6). In acute ON, thinning of the GCL is measurable prior to RNFL thinning, and GCL thickness...

  7. 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.

  8. 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.

  9. 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. PMID:25000867

  10. [Acute monocytic leukemia simulating clinical manifestations of retrobulbar neuritis].

    Science.gov (United States)

    Furdová, A; Oláh, Z

    1995-02-01

    Lesion of optic disc may appear also with coherence to myeloid leukaemia. Authors introduce a case report of a patient, who found out help of an ophthalmologist with very indefinite difficulties (visual acuity deterioration of her left eye in connection with long-lasting sinusitis). Due to changes in orbit and the optic disc the status was evaluated as retrobulbar neuritis. During the indicated therapy by corticosteroids (Prednison) a steroid gastric ulcer was unfolded. During the additional therapy and after the sternal punction the acute monocytic leukaemia (AML) was diagnosed. On that base the aimed therapy at the Clinic of Haematology was realised. The patient died 27 months since the diagnose of AML was determined.

  11. Optic neuritis in a patient with Miller-Fisher syndrome.

    Science.gov (United States)

    Lolekha, Praween; Phanthumchinda, Kammant

    2008-12-01

    Miller-Fisher syndrome (MFS) is considered a variant of Guillain-Barrd syndrome (GBS). The syndrome is characterized by acute onset of gait ataxia, ophthalmoplegia, and areflexia. Conventionally, MFS has been considered exclusively a disease of the peripheral nervous system. However there are occasional reports of central nervous system involvement. Here, a 62 year-old woman who presented with classical features of MFS and progressive bilateral dyschromatopsia and reported visual impairment. Normal MRI of the brain and CSF albumino-cytologic dissociation were observed. CSF oligoclonal IgG pattern indicated a passive transfer of oligoclonal IgG from a systemic inflammatory response. Nerve conduction studies showed slow motor conduction velocity in her extremities. The optic fundi were normal. Visual evoked potentials (VEPs) revealed bilateral optic neuropathy. Marked spontaneous improvement of her syndrome was documented within six weeks. Optic neuritis may be a central nervous system feature that should be recognized as part of the MFS.

  12. Optic Neuritis Following Hepatitis B Vaccination in a 9-year-old Girl

    Directory of Open Access Journals (Sweden)

    Muferet Erguven

    2009-11-01

    Full Text Available Hepatitis B vaccination can prevent hepatitis B virus infection and its serious consequences, including liver cancer and cirrhosis. Serious side effects reported after receiving hepatitis B vaccination are very uncommon. A majority of the ophthalmological complications seen following hepatitis B vaccination consist of vision loss, optic neuritis, papillary edema, uveitis, acute placoid pigment epitheliopathy and central vein occlusion. We present a 9-year-old girl who was referred to our hospital with decrease in vision and pain in the left eye a week after hepatitis B vaccination. A diagnosis of vaccine- induced optic neuritis was made. The clinical picture improved after systemic corticosteroid treatment. Acute optic neuritis might be a rare complication of hepatitis B vaccination. Parents should be aware of the potential serious side effects of the vaccine.

  13. Current options for the treatment of optic neuritis

    OpenAIRE

    Pula, John H; MacDonald, Christopher J

    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...

  14. Optic neuritis as an early sign of multiple sclerosis

    Science.gov (United States)

    Kale, Nilufer

    2016-01-01

    Optic neuritis (ON) is an acute inflammatory demyelinating disorder of the optic nerve. The general characteristics of isolated ON include unilateral, subacute, and painful visual loss without systemic or other neurological symptoms. The etiology for ON varies including demyelinating disorders or infections, inflammation, toxic reasons, and genetic disorders. In most cases the responsible etiology may not be known for ON and in this case, it is termed idiopathic ON. When a patient presents with an initial episode of ON, patients should undergo further tests. Assessing the patient with routine blood work, magnetic resonance imaging, cerebrospinal fluid tests, and visual evoked potentials provide further insight. In this review, we aimed to provide a review of ON as an initial symptom of multiple sclerosis and present clinical characteristics, therapy options, and recent literature. PMID:28539814

  15. Clinical features and outcome of childhood optic neuritis at Queen Sirikit National Institute of Child Health.

    Science.gov (United States)

    Sri-udomkajorn, Somjit; Pongwatcharaporn, Kea

    2011-08-01

    To study the clinical features, treatment, outcome and factors affecting the outcome of optic neuritis in children. Children under 16 years of age diagnosed with optic neuritis (ON) at Queen Sirikit National Institute of Child Health over an 11-year period were reviewed. Demographic data, clinical characteristics, treatment and the outcome were analyzed. Thirty-one patients fulfilled the inclusion criteria. Mean age of onset was 9.2 years. Female to male ratio was 1.8:1. All cases had vision loss, bilateral 74.2% and monocular 25.8%, including decreased color vision 35% disc edema 54.8% and ocular pain 38.7%. The mean duration of follow-up was 20.38 months. The final diagnosis of these patients were 2 multiple sclerosis (MS), 2 neuromyelitis optica (NMO), 3 acute disseminated encephalomyelitis (ADEM) and 24 or isolated optic neuritis (ION). There was no statistically significant difference in gender, age of onset, number of ocular involvement, severity of visual acuity impairment, presented preceding infection, associated symptoms, CSF pleocytosis, high protein in CSF, abnormal brain or eye MRI. 93.3% of patients had clinical improvement, including 70% complete recovery visual acuity of both eyes. The statistically significance was that complete remission in females was more than in males. Childhood optic neuritis had bilateral vision loss and complete recovery. Females with optic neuritis had statistical significance with complete recovery, more than males.

  16. Risk factors for idiopathic optic neuritis recurrence.

    Directory of Open Access Journals (Sweden)

    Yi Du

    Full Text Available Approximately 30-50% of idiopathic optic neuritis (ION patients experience one or multiple episodes of recurrence. The aim of this study was to search for risk factors for ION recurrence.Clinical data on hospitalized patients diagnosed with ION between January 2003 and January 2011 at the First Affiliated Hospital of Guangxi Medical University were retrospectively collected. Univariate and multivariate analyses were performed on factors that might cause ION recurrence. In total, 115 ION cases (32 recurrent and 83 non-recurrent cases with complete data were analyzed. The length of the follow-up period ranged from 12 to 108 months (median: 42 months.The univariate analysis showed that the recurrence rate for unilateral ION was higher than that for bilateral ION (40% vs. 12%, p=0.001. Underlying diseases had a significant impact on recurrence (p<0.001: the recurrence rates due to neuromyelitis optica (NMO, multiple sclerosis (MS, demyelinating lesions alone of the central nervous system, and unknown causes were 89%, 70%, 41%, and 8.7%, respectively. The multivariate analysis showed that the factors causing relatively high recurrence rates included NMO (odds ratio [OR], 73.5; 95% confidence interval [CI], 7.3 to 740.9, MS (OR, 33.9; 95% CI, 5.2 to 222.2, and demyelinating lesions alone (OR, 8.9; 95% CI, 2.3 to 34.4, unilateral involvement (OR, 5.7; 95% CI, 1.5 to 21.3, relatively low initial glucocorticoid dosage (equivalent to ≤ 100 mg prednisone/day (OR, 4.3; 95% CI, 1.0 to 17.9.Underlying diseases, laterality (unilateral or bilateral, and initial glucocorticoid dosage are important risk factors of ION recurrence. Clinical physicians are advised to treat ION patients with a sufficient dose of glucocorticoid in the initial treatment stage to reduce the recurrence risk.

  17. Early Onset Optic Neuritis Following Measles-Rubella Vaccination

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    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. Targeting Oxidative Stress for Treatment of Glaucoma and Optic Neuritis

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    Atsuko Kimura

    2017-01-01

    Full Text Available Glaucoma is a neurodegenerative disease of the eye and it is one of the leading causes of blindness. Glaucoma is characterized by progressive degeneration of retinal ganglion cells (RGCs and their axons, namely, the optic nerve, usually associated with elevated intraocular pressure (IOP. Current glaucoma therapies target reduction of IOP, but since RGC death is the cause of irreversible vision loss, neuroprotection may be an effective strategy for glaucoma treatment. One of the risk factors for glaucoma is increased oxidative stress, and drugs with antioxidative properties including valproic acid and spermidine, as well as inhibition of apoptosis signal-regulating kinase 1, an enzyme that is involved in oxidative stress, have been reported to prevent glaucomatous retinal degeneration in mouse models of glaucoma. Optic neuritis is a demyelinating inflammation of the optic nerve that presents with visual impairment and it is commonly associated with multiple sclerosis, a chronic demyelinating disease of the central nervous system. Although steroids are commonly used for treatment of optic neuritis, reduction of oxidative stress by approaches such as gene therapy is effective in ameliorating optic nerve demyelination in preclinical studies. In this review, we discuss oxidative stress as a therapeutic target for glaucoma and optic neuritis.

  2. 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.

  3. 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.

  4. Disseminated lesions at presentation in patients with optic neuritis.

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    Ormerod, I E; McDonald, W I; du Boulay, G H; Kendall, B E; Moseley, I F; Halliday, A M; Kakigi, R; Kriss, A; Peringer, E

    1986-01-01

    Thirty five adults and two children with clinically isolated optic neuritis were examined by magnetic resonance imaging (MRI) to determine the presence of disseminated lesions within the brain at presentation and to compare these findings with the results of evoked potential studies. Of the adult patients, 61% showed lesions on the scans whereas the evoked potentials suggested the presence of lesions outside the visual system in 30%. MRI is a sensitive method for the demonstration of clinical...

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

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    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.

  6. Comparative evaluation of megadose methylprednisolone with dexamethasone for treatment of primary typical optic neuritis

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    Menon Vimala

    2007-01-01

    Full Text Available Aim: To compare the efficacy of intravenous methylprednisolone and intravenous dexamethasone on visual recovery and evaluate their side-effects for the treatment of optic neuritis. Materials and Methods: Prospective, randomized case-controlled study including 21 patients of acute optic neuritis presenting within eight days of onset and with visual acuity less then 20/60 in the affected eye who were randomly divided into two groups. Group I received intravenous dexamethasone 200 mg once daily for three days and Group II received intravenous methylprednisolone 250 mg/six-hourly for three days followed by oral prednisolone for 11 days. Parameters tested were pupillary reactions, visual acuity, fundus findings, color vision, contrast sensitivity, Goldmann visual fields and biochemical investigations for all patients at presentation and follow-up. Results: Both groups were age and sex-matched. LOGMAR visual acuity at presentation was 1.10 ± 0.52 in Group I and 1.52 ± 0.43 in Group II. On day 90 of steroid therapy, visual acuity improved to 0.28 ± 0.33 in Group I and 0.36 ± 0.41 in Group II ( P =0.59. At three months there was no statistically significant difference in the color vision, contrast sensitivity, stereoacuity, Goldman fields and the amplitude and latency of visually evoked response between the two groups. The concentration of vitamin C, glucose, sodium, potassium, urea and creatinine were within the reported normal limits. Conclusion: Intravenous dexamethasone is an effective treatment for optic neuritis. However, larger studies are required to establish it as a safe, inexpensive and effective modality for the treatment of optic neuritis.

  7. Optic neuritis heralding varicella zoster virus retinitis in a patient with acquired immunodeficiency syndrome

    NARCIS (Netherlands)

    Meenken, C.; van den Horn, G. J.; de Smet, M. D.; van der Meer, J. T.

    1998-01-01

    We report on a 29-year-old severely compromised acquired immunodeficiency syndrome patient who developed retrobulbar optic neuritis 5 weeks after an episode of cutaneous herpes zoster infection. During the optic neuritis, varicella zoster virus could be demonstrated in the cerebrospinal fluid. The

  8. Systemic lupus erythematosus-associated optic neuritis: clinical experience and literature review.

    Science.gov (United States)

    Lin, Yen-Ching; Wang, An-Guor; Yen, May-Yung

    2009-03-01

    This study aimed to evaluate the visual outcome of optic neuritis in patients with systemic lupus erythematosus (SLE). A retrospective, case-observational study was conducted by reviewing eight patients with SLE-associated optic neuritis from January 1986 to October 2004. The demographic data, clinical manifestations, laboratory data, medical management and disease courses of these eight patients were retrospectively analysed. Main outcome measurements included final visual acuity (VA) and relapse of optic neuritis. Statistical analyses were made using the chi-square test and a linear regression model. The English-language literature on SLE-associated optic neuritis was reviewed. Initial visual loss was severe in SLE-associated optic neuritis. Seven patients (87%) had VA oral steroid tapering. Final visual outcome was highly variable, ranging from the complete recovery of VA in four patients, to partial recovery in one and poor recovery in three. Better visual recovery occurred in patients who received earlier treatment (within 10 days). However, longer duration of steroid administration was found to have no significant benefit on visual outcome. Systemic lupus erythematosus-associated optic neuritis is not common. However, it is important that ophthalmologists differentiate SLE-associated optic neuritis from idiopathic optic neuritis because of the severe visual impairment and steroid dependence associated with the former. Early diagnosis and prompt treatment are important for restoring visual function in these patients.

  9. 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

  10. [Unilateral optic neuritis and Miller Fisher syndrome].

    Science.gov (United States)

    Tabary, A; Lousteau, B; Signolles, C

    2013-06-01

    Miller Fisher syndrome is an autoimmune neuropathy characterized by the clinical triad of ataxia, areflexia and external ophthalmoplegia. Ophthalmologic involvement in this syndrome is most often represented by motility disorders. The diagnosis is confirmed by the presence of anti-GQ1b antibodies. We report the case of a 65-year-old patient referred by his treating physician to the emergency department for ataxia, dizziness and decreased visual acuity in the left eye. In addition, the patient presented with clinical signs of subacute appendicitis for 2 weeks. After treatment with intravenous immunoglobulin, the patient complained of further decreased visual acuity and oculomotor disorders. On ophthalmological follow-up, he quickly recovered his initial visual acuity and more gradually his ocular motility. Unilateral optical neuropathy does not preclude the diagnosis of Miller Fisher syndrome. On the contrary, in the case of any rapidly progressive ophthalmologic involvement associated with peripheral neurological signs of ataxia, the diagnosis of Miller Fisher syndrome must be considered. Miller Fisher is a rare syndrome for which the diagnosis must be made quickly, so that the patient may benefit from urgent intravenous immunoglobulin therapy. In most cases, ophthalmologic recovery precedes peripheral neurologic recovery by 6 months to 1 year. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Optic nerve demyelination induced by human serum: patients with multiple sclerosis or optic neuritis and normal subjects.

    Science.gov (United States)

    Sergott, R C; Brown, M J; Polenta, R M; Lisak, R P; Silberberg, D H

    1985-10-01

    We injected guinea pig optic nerves with serum from patients with MS or acute optic neuritis (ON), or normal subjects. Serum from 12 of 17 MS patients, 3 of 3 patients with ON, and 5 of 11 normal age- and sex-matched controls produced myelin vesiculation and demyelination 24 hours after injection. Nerves injected with demyelinating serum contained oligodendrocytes with pyknotic nuclei and edematous, rarefied cytoplasm. Nerves injected with serum that did not cause demyelination did not have these oligodendrocyte changes. Serum from normal subjects or patients with MS may induce in vivo demyelination in mammalian CNS.

  12. Impaired math achievement in patients with acute vestibular neuritis.

    Science.gov (United States)

    Moser, Ivan; Vibert, Dominique; Caversaccio, Marco D; Mast, Fred W

    2017-12-01

    Broad cognitive difficulties have been reported in patients with peripheral vestibular deficit, especially in the domain of spatial cognition. Processing and manipulating numbers relies on the ability to use the inherent spatial features of numbers. It is thus conceivable that patients with acute peripheral vestibular deficit show impaired numerical cognition. Using the number Stroop task and a short math achievement test, we tested 20 patients with acute vestibular neuritis and 20 healthy, age-matched controls. On the one hand, patients showed normal congruency and distance effects in the number Stroop task, which is indicative of normal number magnitude processing. On the other hand, patients scored lower than healthy controls in the math achievement test. We provide evidence that the lower performance cannot be explained by either differences in prior math knowledge (i.e., education) or slower processing speed. Our results suggest that peripheral vestibular deficit negatively affects numerical cognition in terms of the efficient manipulation of numbers. We discuss the role of executive functions in math performance and argue that previously reported executive deficits in patients with peripheral vestibular deficit provide a plausible explanation for the lower math achievement scores. In light of the handicapping effects of impaired numerical cognition in daily living, it is crucial to further investigate the mechanisms that cause mathematical deficits in acute PVD and eventually develop adequate means for cognitive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis

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    Ahmet Z. Burakgazi

    2016-01-01

    Full Text Available Optic neuritis (ON is one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme ON is an exceedingly rare ocular manifestation of Lyme disease (LD and only a few cases have been published in the literature. Lyme ON is very rare but should be included in the differential diagnosis in unexplained cases, particularly in Lyme endemic areas. Careful and detailed examination and investigation are warranted to make the diagnosis. We report this case to increase awareness of clinicians to include Lyme disease in differential diagnosis of ON for unexplained cases of ON. Herein we present a unique case with a unilateral ON caused by LD along with pre- and posttreatment findings and literature review.

  14. 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).

  15. 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.

  16. 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 of the activ......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...... 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...

  17. Research advance on diagnosis and treatment for atypical optic neuritis

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    Guo-Yan Zeng

    2016-06-01

    Full Text Available Optic neuritis(ONis 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(MSor 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.

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

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    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.

  19. 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

    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...... 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...

  20. Isolated palatal weakness without optic neuritis as the presenting manifestation of multiple sclerosis and its diagnostic dilemma with acute disseminated encephalomyelitis in a young boy.

    Science.gov (United States)

    Shah, Virti D; Mirgh, Sumeet Prakash; Surya, Nirmal

    2017-01-01

    We present a case of a young boy who at initial presentation was diagnosed as acute disseminated encephalomyelitis (ADEM) but subsequently on follow-up was diagnosed as multiple sclerosis (MS). Differentiating ADEM from MS in their first presentation can be tricky as the features may not be typical of anyone. The importance lies in the close follow-up of these patients.

  1. 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

    -L), myelin basic protein, osteopontin and chitinase-3-like-1) predict visual outcome after optic neuritis. METHODS: We included 47 patients with optic neuritis as a first demyelinating episode. Patients underwent visual tests, optical coherence tomography (OCT), magnetic resonance imaging (MRI) and lumbar......-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...

  2. Visual outcome following optic neuritis: A 5‑year review | Pedro ...

    African Journals Online (AJOL)

    Background: Optic neuritis is a demyelinating inflammatory disease of the optic nerve that typically affects young adults especially females, and is usually associated with multiple sclerosis especially in Caucasians. The prognosis for visual recovery is usually good but with poor quality. Objective: The objective was to ...

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

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    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.

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

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    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.

  5. Scanning laser polarimetry quantification of retinal nerve fiber layer thinning following optic neuritis.

    Science.gov (United States)

    Trip, S Anand; Schlottmann, Patricio G; Jones, Stephen J; Kallis, Constantinos; Altmann, Daniel R; Garway-Heath, David F; Thompson, Alan J; Plant, Gordon T; Miller, David H

    2010-09-01

    Several studies with optical coherence tomography (OCT) have demonstrated thinning of the retinal nerve fiber layer (RNFL) in patients with optic neuritis and multiple sclerosis. Similar studies have not been performed with scanning laser polarimetry (SLP), which relies on different physical phenomena. This study was designed to use SLP to measure axonal loss following a single episode of optic neuritis and to determine if there is a relationship between the degree of axonal loss and the degree of residual visual dysfunction. Twenty-five patients with a single episode of optic neuritis and 15 control subjects were studied with SLP using the GDxVCC device to determine RNFL thickness in relation to visual acuity, visual fields, color vision, visual evoked potentials (VEPs), and previously published OCT data. SLP detected significant RNFL thinning in affected eyes compared to clinically unaffected fellow eyes in patients and in control eyes (P color vision. RNFL thinning correlated with reduced whole visual field and central visual field measures and VEP amplitudes. Superior and inferior quadrant RNFL thinning was related to corresponding regional visual field loss. There was a scaling factor between SLP and OCT RNFL measurements but only modest agreement. SLP detected functionally relevant axonal loss in eyes affected by optic neuritis. There was a scaling factor between RNFL measurements obtained with SLP and OCT but only modest agreement. Care should therefore be taken when comparing RNFL data from studies using these different devices.

  6. Bilateral Retrobulbar Optic Neuritis Caused by Varicella Zoster Virus in a Patient with AIDS.

    Science.gov (United States)

    Duda, Jose F; Castro, Jose G

    To report on a case of bilateral retrobulbar optic neuritis in a patient with acquired immune deficiency syndrome (AIDS) caused by varicella-zoster virus (VZV); and to review the literature focusing on: cases reported, epidemiology, pathophysiology, diagnosis and treatment. A 38-year-old woman with AIDS presented with a 10-day history of progressive bilateral visual loss and ocular pain. She had bilateral dilated pupils with no light perception; the fundoscopic examination was normal. Facial herpes zoster lesions appeared on the second day of hospitalization Magnetic resonance imaging (MRI) findings were compatible with a bilateral optic neuritis; the cerebrospinal fluid (CSF) showed pleocytosis, increased proteins and a positive VZV-DNA PCR. She was treated with intravenous acyclovir and corticosteroids and was able, when discharged 2 weeks after admission, to carry out activities of daily living. VZV retrobulbar optic neuritis has previously been reported in 12 patients with AIDS, more than half of the cases had concomitant herpes zoster and an associated retinopathy. A positive VZV-DNA in the CSF is indicative of VZV infection, initial use of intravenous acyclovir is recommended, and the concomitant use of corticosteroids would be a prudent choice; the duration of antiviral therapy remains undefined. VZV retrobulbar optic neuritis in AIDS patients can occur with or without herpes zoster. It is a sight-threatening infectious and inflammatory process requiring the advice of specialists in infectious diseases, ophthalmology, neurology and viral microbiology.

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

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    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.

  8. Inferior vestibular neuritis: 3 cases with clinical features of acute vestibular neuritis, normal calorics but indications of saccular failure

    Directory of Open Access Journals (Sweden)

    Økstad Siri

    2006-12-01

    Full Text Available Abstract Background Vestibular neuritis (VN is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. Case presentations We describe three patients with symptoms suggestive of VN, but normal calorics. All 3 had unilateral loss of vestibular evoked myogenic potential. A slight, asymptomatic position dependent nystagmus, with the pathological ear down, was observed. Conclusion We believe that these patients suffer from pure inferior nerve vestibular neuritis.

  9. Bilateral Multifocal Chorioretinitis and Optic Neuritis due to Epstein-Barr Virus: A Case Report

    Directory of Open Access Journals (Sweden)

    Vasileios G. Peponis

    2012-10-01

    Full Text Available Epstein-Barr virus (EBV is a DNA virus that mainly causes infectious mononucleosis. Ocular manifestations are rare and typically mild. Only a few cases of EBV involving the retina or the optic nerve have been reported. Herein, we report the case of a 67-year-old man with bilateral chorioretinitis and optic neuritis due to EBV. The patient had no previous ocular history and presented with decreased vision in both eyes. His past medical history included EBV encephalopathy, which was confirmed serologically, a few months before. Ophthalmological examination revealed bilateral chorioretinitis and optic neuritis, confirmed by fluorescein angiography as well as electrophysiological tests (visual evoked potentials and electroretinogram. It is very important to include EBV in the differential diagnosis of chorioretinal atrophic lesions. Clinicians should be aware of ocular manifestations of EBV, in order to suggest ophthalmological examination and start treatment promptly before irreversible damage to the optic nerve or retina occurs.

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

    OpenAIRE

    Andersen, Maria Rene; Roar, Malte; Sejbaek,Tobias; Illes, Zsolt; Grauslund, Jakob

    2017-01-01

    PURPOSE: To evaluate the long-term structural and functional outcome in patients with multiple sclerosis (MS) with and without a history of optic neuritis (ON).METHODS: This was a cross-sectional study of 82 patients diagnosed with MS between 2000 and 2006 from a tertiary hospital center 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: Med...

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

    OpenAIRE

    Andersen, Maria Rene; Roar, Malte; Sejbaek,Tobias; Illes, Zsolt; Grauslund, Jakob

    2017-01-01

    Purpose To evaluate the long-term structural and functional outcome in patients with multiple sclerosis (MS) with and without a history of optic neuritis (ON). Methods This was a cross-sectional study of 82 patients diagnosed with MS between 2000 and 2006 from a tertiary hospital center 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 Medi...

  12. Bilateral optic neuritis--the only ocular finding in a case of subacute sclerosing panencephalitis.

    Science.gov (United States)

    Ozer, Pinar Altiaylik; Ozkan, Mehpare; Sekeroglu, Hande Taylan; Kadayifcilar, Sibel; Yuksel, Deniz; Aksoy, Ayse

    2014-02-01

    Subacute sclerosing panencephalitis is a rare disease of central nervous system caused by defective measles virus. Chorioretinitis with macular involvement is the mostly observed ocular finding in the disease. Other reported ocular findings in the disease are cortical blindness, hemianopsia, nystagmus, extraocular muscle paresis and optic atrophy. We present a rare case of subacute sclerosing panencephalitis with isolated bilateral optic neuritis as the only ocular finding without macular involvement.

  13. Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis.

    Science.gov (United States)

    Trip, S Anand; Schlottmann, Patricio G; Jones, Stephen J; Altmann, Daniel R; Garway-Heath, David F; Thompson, Alan J; Plant, Gordon T; Miller, David H

    2005-09-01

    Axonal loss is thought to be a likely cause of persistent disability after a multiple sclerosis relapse; therefore, noninvasive in vivo markers specific for axonal loss are needed. We used optic neuritis as a model of multiple sclerosis relapse to quantify axonal loss of the retinal nerve fiber layer (RNFL) and secondary retinal ganglion cell loss in the macula with optical coherence tomography. We studied 25 patients who had a previous single episode of optic neuritis with a recruitment bias to those with incomplete recovery and 15 control subjects. Optical coherence tomography measurement of RNFL thickness and macular volume, quantitative visual testing, and electrophysiological examination were performed. There were highly significant reductions (p color vision, and visual-evoked potential amplitude. This study has demonstrated functionally relevant changes indicative of axonal loss and retinal ganglion cell loss in the RNFL and macula, respectively, after optic neuritis. This noninvasive RNFL imaging technique could be used in trials of experimental treatments that aim to protect optic nerves from axonal loss.

  14. 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

  15. 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

    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...... fluid as well as levels of CXCL10 and MMP9 in the cerebrospinal fluid. These findings suggest that blood-brain barrier permeability, as measured by magnetic resonance imaging, may provide novel pathological information as a marker of neuroinflammation related to multiple sclerosis, to some extent...

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

    OpenAIRE

    Andersen, Maria; Roar, Malte; Sejbaek,Tobias; Illes, Zsolt; Grauslund, Jakob

    2017-01-01

    Maria Rene Andersen,1 Malte Roar,2,3 Tobias Sejbaek,2,3 Zsolt Illes,2,3 Jakob Grauslund1,3 1Department of Ophthalmology, Odense University Hospital, Odense, Denmark; 2Department of Neurology, Odense University Hospital, Odense, Denmark; 3Department of Clinical Research, University of Southern Denmark, Odense, Denmark Purpose: To evaluate the long-term structural and functional outcome in patients with multiple sclerosis (MS) with and without a history of optic neuritis (ON).Methods: This wa...

  17. Mitochondrial Uncoupler Prodrug of 2,4-Dinitrophenol, MP201, Prevents Neuronal Damage and Preserves Vision in Experimental Optic Neuritis

    Directory of Open Access Journals (Sweden)

    Reas S. Khan

    2017-01-01

    Full Text Available The ability of novel mitochondrial uncoupler prodrug of 2,4-dinitrophenol (DNP, MP201, to prevent neuronal damage and preserve visual function in an experimental autoimmune encephalomyelitis (EAE model of optic neuritis was evaluated. Optic nerve inflammation, demyelination, and axonal loss are prominent features of optic neuritis, an inflammatory optic neuropathy often associated with the central nervous system demyelinating disease multiple sclerosis. Currently, optic neuritis is frequently treated with high-dose corticosteroids, but treatment fails to prevent permanent neuronal damage and associated vision changes that occur as optic neuritis resolves, thus suggesting that additional therapies are required. MP201 administered orally, once per day, attenuated visual dysfunction, preserved retinal ganglion cells (RGCs, and reduced RGC axonal loss and demyelination in the optic nerves of EAE mice, with limited effects on inflammation. The prominent mild mitochondrial uncoupling properties of MP201, with slow elimination of DNP, may contribute to the neuroprotective effect by modulating the entire mitochondria’s physiology directly. Results suggest that MP201 is a potential novel treatment for optic neuritis.

  18. Optical coherence tomography in optic neuritis and multiple sclerosis: a review.

    Science.gov (United States)

    Kallenbach, K; Frederiksen, J

    2007-08-01

    Optical coherence tomography (OCT) is a new noninvasive high-resolution method that measures the retinal nerve fiber layer (RNFL) thickness. An overview of the use in optic neuritis (ON) and multiple sclerosis (MS) is presented. Literature survey of PubMed was carried out. RNFL thickness in eyes of healthy control subjects was 102.9-111.11 microm, in eyes affected by ON 59.79-85 microm, and in fellow eyes 82.73-99.8 microm. All studies found a significant reduction in RNFL in eyes affected by ON compared with fellow eyes and eyes of healthy controls. Two out of three studies found a significant reduction in RNFL in fellow eyes compared with control eyes. RNFL thickness correlated with visual acuity, visual field, low-contrast letter acuity, contrast sensitivity, and color vision. Correlations were also found with the optic nerve area evaluated by magnetic resonance imaging, neurologic impairment score, and increasing disease duration. One of two studies found a significant correlation with amplitudes of visual evoked potentials, neither correlated with latencies. OCT is a promising new tool for evaluating atrophy in patients with ON and MS.

  19. Quantitative visual tests after poorly recovered optic neuritis due to multiple sclerosis.

    Science.gov (United States)

    Longbrake, Erin E; Lancia, Samantha; Tutlam, Nhial; Trinkaus, Kathryn; Naismith, Robert T

    2016-11-01

    Visual dysfunction in MS can be quantified using a variety of tests. Many vision tests have not been formally evaluated among MS patients with existing visual dysfunction. Evaluate several versions of visual acuity and contrast sensitivity tests, measures of central and peripheral vision, retina structure, electrophysiologic function, and quality of life among MS patients with moderate/severe visual dysfunction. Cross-sectional study of 46 patients with stable, incompletely recovered optic neuritis. Testing included Snellen eye charts, several Sloan low contrast charts, Pelli Robson (PR) contrast sensitivity charts, optical coherence tomography, visual fields, Farnsworth Munsell 100-hue test, visual evoked potentials (VEP), and visual function quality of life (VFQ-25) testing. 98% of eyes could read two lines of the PR chart, while only 43% read the 2.5% contrast chart. Low contrast tests correlated strongly with each other and with retinal nerve fiber layer (RNFL) thickness, visual fields, and color vision but not with VEPs. For patients with RNFL <75µm, VFQ-25 scores dropped by approximately 2 points for every 1µm decrease in RNFL. Among MS patients with visual impairment due to optic neuritis, PR contrast sensitivity could be utilized as a single chart. Visual quality of life was associated with RNFL thinning below 75µm. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Investigation of optic neuritis related examination for evaluating visual function and efficacy detection

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-01-01

    Full Text Available AIM: To study the reliability of visual electrophysiological examination(pattern visual evoked potentials, P-VEP,visual field,fundus photography and optical coherence tomography(OCTto patients with optic neuritis.METHODS: Visualelectrophysiological examination, visual field, fundus photography and OCT were used in 75 cases(103 eyes. The results of the positive rate of P-VEP, visual field examination,fundus photography and OCT were used to analyze the correlation.RESULTS: In 75 cases(103 eyes, the P-VEP successfully acquired positive case images in 78 eyes(75.7%, no obvious abnormal in 25 eyes(24.3%. Fundus photography successfully acquired positive case images in 89 eyes(86.4%, no obvious abnormal in 14 eyes(13.6%. Visual field examination successfully acquired positive case images in 85 eyes(82.5%, no obvious abnormal in 18 eyes(17.5%. OCT successfully acquired positive case images in 97 eyes(94.2%, no obvious abnormal in 6 eyes(5.8%. CONCLUSION: Visual electrophysiological detection, visual field examination, fundus photography and OCT can predict the visual acuity in patients with optic neuritis.

  1. 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.

  2. Experimental Optic Neuritis Induced by a Demyelinating Strain of Mouse Hepatitis Virus▿

    Science.gov (United States)

    Shindler, Kenneth S.; Kenyon, Lawrence C.; Dutt, Mahasweta; Hingley, Susan T.; Sarma, Jayasri Das

    2008-01-01

    Optic neuritis (ON), an inflammatory demyelinating optic nerve disease, occurs in multiple sclerosis (MS). Pathological mechanisms and potential treatments for ON have been studied via experimental autoimmune MS models. However, evidence suggests that virus-induced inflammation is a likely etiology triggering MS and ON; experimental virus-induced ON models are therefore required. We demonstrate that MHV-A59, a mouse hepatitis virus (MHV) strain that causes brain and spinal cord inflammation and demyelination, induces ON by promoting mixed inflammatory cell infiltration. In contrast, MHV-2, a nondemyelinating MHV strain, does not induce ON. Results reveal a reproducible virus-induced ON model important for the evaluation of novel therapies. PMID:18579591

  3. [Progression of nerve fiber layer defects in retrobulbar optic neuritis by the macular ganglion cell complex].

    Science.gov (United States)

    Hong, D; Bosc, C; Chiambaretta, F

    2017-11-01

    Recent studies with SD OCT had shown early axonal damage to the macular ganglion cell complex (which consists of the three innermost layers of the retina: Inner Plexiform Layer [IPL], Ganglion Cell Layer [GCL], Retinal Nerve Fibre layer [RNFL]) in optic nerve pathology. Retrobulbar optic neuritis (RBON), occurring frequently in demyelinating diseases, leads to atrophy of the optic nerve fibers at the level of the ganglion cell axons, previously described in the literature. The goal of this study is to evaluate the progression of optic nerve fiber defects and macular ganglion cell complex defects with the SPECTRALIS OCT via a reproducible method by calculating a mean thickness in each quadrant after an episode of retrobulbar optic neuritis. This is a prospective monocentric observational study including 8 patients at the Clermont-Ferrand university medical center. All patients underwent ocular examination with macular and disc OCT analysis and a Goldmann visual field at the time of inclusion (onset or recurrence of RBON), at 3 months and at 6 months. Patients were 40-years-old on average at the time of inclusion. After 6 months of follow-up, there was progression of the atrophy of the macular ganglion cell complex in the affected eye on (11.5% or 11μm) predominantly inferonasally (13.9% or 16μm) and superonasally (12.9% or 14μm) while the other eye remained stable. The decrease in thickness occurred mainly in the most internal 3 layers of the retina. On average, the loss in thickness of the peripapillary RNFL was predominantly inferotemporal (24.9% or 39μm) and superotemporal (21.8% or 28μm). In 3 months of progression, the loss of optic nerve fibers is already seen on macular and disc OCT after an episode of RBON, especially in inferior quadrants in spite of the improvement in the Goldmann visual field and visual acuity. Segmentation by quadrant was used here to compare the progression of the defect by region compared to the fovea in a global and reproducible

  4. Optic Neuritis

    Science.gov (United States)

    ... Corneal Abrasions Dilating Eye Drops Lazy eye (defined) Pink eye (defined) Retinopathy of Prematurity Strabismus Stye (defined) Vision ... Corneal Abrasions Dilating Eye Drops Lazy eye (defined) Pink eye (defined) Retinopathy of Prematurity Strabismus Stye (defined) Vision ...

  5. 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...... studies suggest that specific vestibular exercises improve vestibulo-spinal and vestibulo-ocular compensation in patients with vestibular neuritis. This review discusses the above and comments etiology, epidemiology, pathophysiology, diagnostic procedures and differential diagnosis Udgivelsesdato: 2008/5/19...

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

    Directory of Open Access Journals (Sweden)

    Andersen MR

    2017-08-01

    Full Text Available Maria Rene Andersen,1 Malte Roar,2,3 Tobias Sejbaek,2,3 Zsolt Illes,2,3 Jakob Grauslund1,3 1Department of Ophthalmology, Odense University Hospital, Odense, Denmark; 2Department of Neurology, Odense University Hospital, Odense, Denmark; 3Department of Clinical Research, University of Southern Denmark, Odense, Denmark Purpose: To evaluate the long-term structural and functional outcome in patients with multiple sclerosis (MS with and without a history of optic neuritis (ON.Methods: This was a cross-sectional study of 82 patients diagnosed with MS between 2000 and 2006 from a tertiary hospital center 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 30.7–72.6 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 fiber layer (RNFL thickness (56 vs 67 µm, P=0.01. In an age- and sex-adjusted logistic regression model, lower inferior and temporal RNFL were associated with a higher risk of ON (odds ratio [OR] 1.56 [95% confidence interval {CI} 1.01–2.41] and OR 1.74 [95% CI 1.10–2.77] per 10 µm decrement in RNFL 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 of ON did not have any functional loss of vision, structural neurodegeneration could be demonstrated in the affected eye. Keywords: optic neuritis

  7. Irreversible optic neuritis after infliximab treatment in a patient with ulcerative colitis.

    Science.gov (United States)

    Clemmensen, Kaare; Akrawi, Neven; Stawowy, Marek

    2015-01-01

    This article reports the first known case of permanent blindness due to irreversible unilateral optic neuritis (ON) related to infliximab (Remicade) treatment of a patient with ulcerative colitis. A young male, with a family history of inflammatory bowel disease, was diagnosed with ulcerative colitis at the age of 20. He was treated with steroids and a 5-aminosalicylic acid drug without considerable effect, and later admitted to our hospital due to a relapse during reduction of the prednisolone dosage. A new colonoscopy showed moderate ulcerative colitis activity and the patient was declared as a steroid nonresponder. A treatment of 400 mg intravenous infliximab was initiated along with 150 mg/day of azathioprine (Imurel). Three days after the second infliximab treatment the patient woke up with no vision on the left eye and with pain during ocular movement. Brain and orbitae magnetic resonance imaging showed ON on the left optical nerve without any abscess or thrombosis. The patient was treated with 1000 mg methylprednisolone (Solu-Medrol) intravenous for 3 days and afterward with 75 mg prednisolone orally without any effect. At the 3-month follow up, the patient's vision had not improved, and he was declared permanently blind on the left eye. A neurologist also examined the patient, but no abnormality or cause of the ON was found.

  8. Low conversion rate to multiple sclerosis in idiopathic optic neuritis patients in Taiwan.

    Science.gov (United States)

    Lin, Yen-Ching; Yen, May-Yung; Hsu, Wen-Ming; Lee, Hui-Chen; Wang, An-Guor

    2006-01-01

    To investigate the clinical characteristics of patients with idiopathic optic neuritis (ON) in Taiwan and to assess the conversion rate to multiple sclerosis (MS) in these patients. We studied the medical records of a total of 109 patients with a clinical diagnosis of idiopathic ON treated in the Taipei Veterans General Hospital during the period from January 1986 to May 2003. Clinical characteristics, management, and disease courses were retrospectively reviewed. Our main focus was on the development of multiple sclerosis after an ON attack. Univariate and multivariate analyses were used to evaluate the risk indicators for MS conversion. The patients (58 women, 51 men) had a mean age of 41.2 years at onset. ON was retrobulbar in 46.8% of the patients. Management with or without pulse therapy did not affect the final visual outcome. Female sex, retrobulbar type ON, recurrent cases, elevated cerebrospinal fluid (CSF) IgG index, and central nervous system (CNS) imaging abnormalities were identified as risk indicators for the development of MS (P older age at onset and a higher percentage of optic disc edema than reported in previous literature. The characteristic features of ON patients associated with a high risk of developing MS are female sex, retrobulbar type ON, CNS imaging abnormalities, elevated CSF IgG index, and recurrence. Idiopathic ON patients in Taiwan display a significantly lower conversion rate to MS.

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

    Science.gov (United States)

    Andersen, Maria Rene; Roar, Malte; Sejbaek, Tobias; Illes, Zsolt; Grauslund, Jakob

    2017-01-01

    To evaluate the long-term structural and functional outcome in patients with multiple sclerosis (MS) with and without a history of optic neuritis (ON). This was a cross-sectional study of 82 patients diagnosed with MS between 2000 and 2006 from a tertiary hospital center 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. Median age and MS duration at the time of the clinical examination were 49.9 years (range 30.7-72.6 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 fiber layer (RNFL) thickness (56 vs 67 μm, P=0.01). In an age- and sex-adjusted logistic regression model, lower inferior and temporal RNFL were associated with a higher risk of ON (odds ratio [OR] 1.56 [95% confidence interval {CI} 1.01-2.41] and OR 1.74 [95% CI 1.10-2.77] per 10 μm decrement in RNFL 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). Although patients with long-term MS and a previous history of ON did not have any functional loss of vision, structural neurodegeneration could be demonstrated in the affected eye.

  10. Clinical value of 4-hour delayed gadolinium-Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis.

    Science.gov (United States)

    Byun, Hayoung; Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won; Park, Dong Woo; Kim, Tae Yoon

    2018-01-13

    To investigate the clinical significance of 4-hour delayed-enhanced 3.0 Tesla three-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging in acute vestibular neuritis. A prospective observational study. Twenty-nine vestibular neuritis patients were enrolled between January 2017 and June 2017. Vestibular function tests, comprising the caloric and video head impulse tests and vestibular-evoked myogenic potential measurements, were performed. Precontrast, 10-minute, and 4-hour delayed-enhanced 3D-FLAIR MR images using double-dose IV gadolinium were obtained. After laterality and extent of inner ear enhancement were defined, the patients were divided into groups based on the patterns of enhancement, and clinical parameters were analyzed according to the groups. Twenty patients (20 of 29, 69.0%) had obviously asymmetric enhancement of the affected inner ear structures on 4-hour delayed images, whereas only three patients (10.3%) had marked enhancement on 10-minute delayed images. The duration of spontaneous nystagmus (DurSN) was significantly longer in the patients with enhancement, especially with enhancement of the whole inner ear, including the vestibule and semicircular canals (P < 0.033). Spontaneous nystagmus resolved within 12 days in patients without laterality of enhancement, and within 16 days in ipsilesional enhancement confined to the inner auditory canal and fundus. Other results of vestibular function tests did not reveal any significant associations with MR enhancement. Contrast enhancement of the vestibular nerve and inner ear structures can be identified on 4-hour delayed-enhanced 3T 3D-FLAIR MR images in acute vestibular neuritis. The extent of inner ear enhancement may be associated with the DurSN. IV. Laryngoscope, 2017. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Optic neuritis: Observation and experience at a tertiary care hospital in Qassim region, Saudi Arabia.

    Science.gov (United States)

    Alamgir, Mohammad Jawad; Ali, Syed Abrar; Hamdy, Nermin Aly; Khan, Moin Zafar; Mohammad, Elgamri E

    2017-01-01

    Optic neuritis (ON) can occur in isolation or association with multiple sclerosis (MS) or neuromyelitis optica. ON, is seen more commonly in Caucasians and interaction is found to exist between ethnic origin and the latitude at which the patient grows up. At present limited information is available about the profile of ON in Saudi patients. We aimed to analyze the records of ON patients, in regard to their presentation, natural history, treatment outcome, and risk and association with MS. Whether, ON in Saudi patients behaves differently from the Western and Asian patients? In this retrospective observational study; we retrieved the data from the medical records of the patients with ON, who attended the ophthalmology and neurology services of King Fahad Specialist Hospital Buraidah, Al Qassim, Saudi Arabia, from period 2006 to 2012. We recorded data of 60 patients of ON; 38 females (63.3%) and 22 males (36.7%). Color vision was affected in 66.7% of cases. Vision in the affected eye was 20/200 or worse in 74.97 % of our cases. Magnetic resonance imaging (MRI) brain revealed multiple lesions in 55% of cases; most of them developed MS on follow-up. Only 48.3% of patients had received systemic steroids. Vision improved in 85% of our cases. Most of our patients had idiopathic ON, and almost 85% had good visual recovery, in this regard our study is comparable with such studies done in other Asian countries. On the other hand, 55% of our patients had multiple MRI brain lesions, a high risk and association of MS, almost similar to the Western Europe and North American ON patients.

  12. 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...... derived from peripheral blood mononuclear cells (PBMC) was analysed in vitro. DC from ON patients had more mature phenotype compared with healthy controls (HC). Particularly the fraction of DC expressing CD1a and CD80 was significantly higher in ON than in HC (P...

  13. 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)....

  14. Optic neuritis and rapidly progressive necrotizing retinitis as the initial signs of subacute sclerosing panencephalitis: a case report with clinical and histopathologic findings.

    Science.gov (United States)

    Oray, Merih; Tuncer, Samuray; Kir, Nur; Karacorlu, Murat; Tugal-Tutkun, Ilknur

    2014-08-01

    We report a case of subacute sclerosing panencephalitis (SSPE) presenting first with optic neuritis and rapidly progressive necrotizing retinitis at the posterior pole. We reviewed the clinical, laboratory, photographic, angiographic, and histopathologic records of a patient with SSPE. A 15-year-old girl was referred after rapid loss of vision due to optic neuritis and macular necrosis in the right eye. She had a history of cardiac valve surgery, but had no systemic symptoms and extensive work-up was unrewarding. Contralateral involvement with rapidly progressive optic neuritis and macular necrotizing retinitis prompted retinochoroidal biopsy of the right eye, which revealed necrosis of inner retinal layers and perivascular lymphoplasmocytic infiltration with intact choroid and outer retina without any findings of inclusion bodies, microorganisms, or atypical cells. The diagnosis was based on histopathologic findings consistent with SSPE, and detection of elevated measles antibody titers in cerebrospinal fluid and serum. It was further confirmed by development of typical electroencephalography pattern at 6 months and neurological symptoms at 4-year follow-up. Clinicians need to be aware that optic neuritis and necrotizing retinitis at the posterior pole may be the presenting features of SSPE.

  15. 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.

  16. Aspects of cerebral plasticity related to clinical features in acute vestibular neuritis: a "starting point" review from neuroimaging studies.

    Science.gov (United States)

    Micarelli, A; Chiaravalloti, A; Schillaci, O; Ottaviani, F; Alessandrini, M

    2016-04-01

    Vestibular neuritis (VN) is one of the most common causes of vertigo and is characterised by a sudden unilateral vestibular failure (UVF). Many neuroimaging studies in the last 10 years have focused on brain changes related to sudden vestibular deafferentation as in VN. However, most of these studies, also due to different possibilities across diverse centres, were based on different times of first acquisition from the onset of VN symptoms, neuroimaging techniques, statistical analysis and correlation with otoneurological and psychological findings. In the present review, the authors aim to merge together the similarities and discrepancies across various investigations that have employed neuroimaging techniques and group analysis with the purpose of better understanding about how the brain changes and what characteristic clinical features may relate to each other in the acute phase of VN. Six studies that strictly met inclusion criteria were analysed to assess cortical-subcortical correlates of acute clinical features related to VN. The present review clearly reveals that sudden UVF may induce a wide variety of cortical and subcortical responses - with changes in different sensory modules - as a result of acute plasticity in the central nervous system. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  17. 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.

  18. No evidence of association between optic neuritis and secondary LHON mtDNA mutations in patients with multiple sclerosis.

    Science.gov (United States)

    Andalib, Sasan; Talebi, Mahnaz; Sakhinia, Ebrahim; Farhoudi, Mehdi; Sadeghi-Bazargani, Homayoun; Masoudian, Nooshin; Vafaee, Manouchehr Seyedi; Gjedde, Albert

    2017-09-01

    Leber's Hereditary Optic Neuropathy (LHON) shares features with Multiple Sclerosis (MS). Both diseases develop optic lesions. Frequent secondary LHON mutations in MS patients may explain the optic damage. Here, we tested the hypothesis that secondary LHON mutations are associated with optic neuritis (ON) in MS patients. We recruited 56 MS subjects with ON and 47 MS subjects without ON. DNA was extracted by salting out, after sampling of peripheral blood from each participant. We completed Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) analysis with appropriate primers and restriction endonucleases for seven secondary LHON mutations. Products were visualized using 3% agarose gel electrophoresis with the aid of DNA safe stain in a UV transilluminator. Accuracy of the genotyping procedure was confirmed by sequencing. Data was analyzed using chi square and Fisher exact tests and logistic regression analysis. There was no significant difference between the numbers of MS subjects with ON and without ON that carried secondary LHON mutations (T4216C [P=0.1], A4917G [P=0.2], G13708A [P=0.6], G15257A [P=1], G15812A [P=0.8], G15927A [P=1], G15928A [P=0.4]). The evidence from the present study are not consistent with the hypothesis that secondary LHON mutations are associated with ON in MS subjects. Copyright © 2017 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

  19. Hyperventilation-induced nystagmus in patients with vestibular neuritis in the acute and follow-up stages.

    Science.gov (United States)

    Park, Hong Ju; Shin, Jung Eun; Lee, Yeo Jin; Park, Mun Su; Kim, Jae Myung; Na, Bo Ra

    2011-01-01

    Our purposes were to characterize hyperventilation-induced nystagmus (HVIN) in patients with unilateral vestibular neuritis (VN) through follow-up examinations and to determine the effects of hyperventilation on vestibular imbalance in patients with VN. The horizontal eye movements in 35 patients with acute VN were recorded. The eye movements were analyzed and the maximum value of slow-phase eye velocity (SPV) was obtained during and after hyperventilation. Nineteen of 35 patients underwent follow-up examinations around 7 weeks later. When spontaneous nystagmus was present, the SPV of spontaneous nystagmus was subtracted from that of HVIN. A maximum SPV of HVIN of ≥4°/s was considered abnormal. The direction and SPV of HVIN were analyzed. The incidence of HVIN in patients with VN was significantly higher in the acute stage (18 of 35; 51%) than the follow-up stage (4 of 19; 21%). The direction of HVIN present in the follow-up stage was entirely towards the contralesional side (contralesional HVIN). However, the direction of HVIN in the acute stage was mixed, towards the contralesional side (10 of 35; 28%) and towards the ipsilesional side (8 of 35; 23%). The SPVs (49 ± 56°/s) of ipsilesional HVIN were significantly greater than the contralesional HVIN in the acute stage (8 ± 3°/s). Robust nystagmus (SPV ≥ 25°/s) was entirely ipsilesional HVIN, which was observed only in the acute stage. Our findings indicate that hyperventilation can result in aggravation of vestibular imbalance in the acute and follow-up stages in different ways. Hyperventilation resulted in contralesional HVIN in both the acute and follow-up stages, each in approximately a fourth of the patients, which suggests a disruption of central static compensatory mechanisms. However, ipsilesional HVIN was elicited only in the acute stage (in approximately a fourth of the patients). About half of the patients with ipsilesional HVIN showed robust responses, which is a characteristic finding

  20. Chromatic discrimination losses in multiple sclerosis patients with and without optic neuritis using the Cambridge Colour Test.

    Science.gov (United States)

    Moura, Ana Laura de Araújo; Teixeira, Rosani Aparecida Antunes; Oiwa, Nestor N; Costa, Marcelo F; Feitosa-Santana, Claudia; Callegaro, Dagoberto; Hamer, Russell D; Ventura, Dora Fix

    2008-01-01

    We assessed chromatic discrimination in multiple sclerosis (MS) patients both with (ON) and without (no ON) a history of optic neuritis using the Cambridge color test (CCT). Our goal was to determine the magnitude and chromatic axes of any color vision losses in both patient groups, and to evaluate age-related changes in chromatic discrimination in both patient groups compared to normals. Using the CCT, we measured chromatic discrimination along the protan, deutan and tritan axes in 35 patients with MS (17 ON eyes) and 74 age matched controls. Color thresholds for both patient groups were significantly higher than controls' along the protan and tritan axes (p color axes (p color discrimination impairment with age (along the deutan and tritan axes) that was almost two times faster than controls, even in the absence of ON. These findings suggest that demyelinating diseases reduce sensitivity to color vision in both red-green and blue-yellow axes, implying impairment in both parvocellular and koniocellular visual pathways. The CCT is a useful tool to help characterize vision losses in MS, and the relationship between these losses and degree of optic nerve involvement.

  1. 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

  2. Optic neuritis as isolated manifestation of leptomeningeal carcinomatosis: a case report and systematic review of ocular manifestations of neoplastic meningitis.

    Science.gov (United States)

    Lanfranconi, Silvia; Basilico, Paola; Trezzi, Ilaria; Borellini, Linda; Franco, Giulia; Civelli, Vittorio; Pallotti, Francesco; Bresolin, Nereo; Baron, Pierluigi

    2013-01-01

    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.

  3. 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.

  4. 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

    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...

  5. Comparison of spontaneous brain activity revealed by regional homogeneity in AQP4-IgG neuromyelitis optica-optic neuritis versus MOG-IgG optic neuritis patients: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Wang J

    2017-10-01

    Full Text Available Junqing Wang,1,* Yuan Tian,2,* Yi Shao,3,* Hui Feng,1 Limin Qin,1 Weiwei Xu,1 Hongjuan Liu,1 Quangang Xu,1 Shihui Wei,1 Lin Ma2 1Department of Ophthalmology, 2Department of Radiology, Chinese PLA General Hospital, Beijing, 3Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China *These authors contributed equally to this work Objective: Many previous studies have demonstrated that neuromyelitis optica (NMO patients have abnormalities of brain anatomy and function. However, differences in spontaneous brain activity between myelin oligodendrocyte glycoprotein (MOG-IgG ON and aquaporin 4(AQP4-neuromyelitis optica-optic neuritis (ON remain unknown. In the current study, we investigated the brain neural homogeneity in MOG-IgG ON versus AQP4-IgG NMO-ON subjects by regional homogeneity (ReHo method using magnetic resonance imaging (MRI. Patients and methods: A total of 32 NMO-ON and ON subjects (21 with AQP4-IgG+NMO-ON and 11 with MOG-IgG+ON and 34 healthy controls (HCs closely matched for age were recruited, and scans were performed for all subjects. A one-way analysis of variance (ANOVA was performed to determine the regions in which the ReHo was different across the three groups. NMO-ON and ON subjects were distinguished from HCs by a receiver operating characteristic (ROC curve. The relationship between the mean ReHo in many brain regions and clinical features in NMO subjects was calculated by Pearson correlation analysis. Results: Compared with HCs, MOG-IgG+ON subjects had significantly decreased ReHo values in the posterior lobe of the left cerebellum and increased ReHo values in the left inferior frontal gyrus, right prefrontal gyrus, and left precentral/postcentral gyrus. AQP4-IgG+NMO-ON subjects showed higher ReHo values in the left inferior frontal gyrus and right middle temporal/occipital gyrus. Compared with MOG-IgG+ON subjects, AQP4-IgG+NMO-ON subjects had lower Re

  6. 25-hydroxyvitamin D concentrations in patients with optic neuritis as a clinically isolated syndrome and healthy controls

    Directory of Open Access Journals (Sweden)

    Masoud Etemadifar

    2012-01-01

    Full Text Available Objectives: The onset of multiple sclerosis in the majority of the cases occurs as a clinically isolated syndrome (CIS. We sought to assess serum levels of 25-hydroxyvitamin D (25-OHD in CIS patients and healthy controls. Methods: In this cross-sectional study 40 patients (36 women and 4 men with CIS manifesting as a single isolated optic neuritis and 40 Age- and sex-matched healthy controls (35 women and 5 men were enrolled between late October 2010 and early March 2011. General vitamin D deficiency was defined as serum 25-OHD levels of lower than 20 ng/ml and was classified as mild (15 < 25-OHD <20 ng/ml, moderate (8 < 25-OHD <15 ng/ml, and severe (25-OHD <8 ng/ml. Results: We found no difference in the median interquartile range [IQR] between CIS patients and controls (17.95 [10.40-29.13] vs. 17.00 [12.25-31.00]; P=0.57. However, when stratified by the levels of deficiency, among CIS patients a significantly higher proportion had severe vitamin D deficiency in comparison to healthy controls (20% vs. 2.5%; P=0.034. Nevertheless, the frequency of general (62.5% vs. 60%, P=0.82, mild (25% vs. 30%, P=0.80, and moderate (17.5% vs. 27.5%, P=0.42 vitamin D deficiency were not different between the two groups. Conclusions: Our findings do not indicate any significant difference of serum 25-OHD between CIS patients and healthy controls. However, in our series severe vitamin D deficiency was more frequent among CIS patients.

  7. Repository corticotropin injection in a patient presenting with focal segmental glomerulosclerosis, rheumatoid arthritis, and optic neuritis: a case report

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    Madan A

    2015-03-01

    Full Text Available Arvind Madan Nephrology Associates of Central Florida, PA, Orlando, FL, USA Background: Focal segmental glomerulosclerosis (FSGS causes scarring or sclerosis of glomeruli that act as tiny filters in the kidneys, damage to which results in diminished ability to properly filter blood, resulting in the urinary loss of plasma proteins and subsequent proteinuria. Case presentation: A 60-year-old, white female with a history of intermittent proteinuria was referred by her primary care physician for renal dysfunction. Biopsy confirmed FSGS and she was treated with an angiotensin-converting enzyme inhibitor. She also had rheumatoid arthritis (RA but no active synovitis and was maintained on prednisone 5 mg/d. She also complained of worsening vision in her right eye and was diagnosed with optic neuritis (ON. She remained stable for about 8 months when examination indicated FSGS relapse, and she reported painful RA flares. She was treated with Acthar® Gel (40 mg biweekly for 6 months, after which proteinuria and urine protein-to-creatinine ratio decreased to about half. Her ON improved, and she reported that she had fewer RA flares and pain improved by 50%. This case of confirmed FSGS showed an improved response to treatment with Acthar Gel for FSGS with concomitant RA and ON. Conclusion: This referral case is relevant to primary care practitioners who treat disorders that may be responsive to corticosteroid therapy. The antiproteinuric effects and ancillary improvement in RA and ON symptoms during treatment with Acthar Gel are not entirely explained by its steroidogenic actions. ACTH is a bioactive peptide that, together with a-melanocyte-stimulating hormone, exhibits biologic efficacy by modulating proinflammatory cytokines and subsequent leukocyte extravasation and may have autocrine/paracrine effects in joints. While Acthar Gel was primarily administered in this case to treat proteinuria, it also showed ancillary benefits in patients with concomitant

  8. 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....

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

    DEFF Research Database (Denmark)

    Tsakiri, A; Ravanidis, S; Lagoudaki, R

    2015-01-01

    ). METHODS: Sixty-four patients between 18 and 59 years of age suffering by acute ON, onset of Blood and CSF samples were collected from untreated patients and from a gender- and age......OBJECTIVE: The aim of the study was to investigate the expression of different immunological mediators in blood and CSF in patients with acute ON and to estimate whether they were implicated in pro- or anti-inflammatory or even regulatory reactions in comparison with a healthy control group (HC...... to the blood in both ON and HC (P blood (P = 0.03). CONCLUSION: Our...

  10. 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

    ,443 neurologists and 6,099 ophthalmologists in the southeast-USA, Canada, Australia/New Zealand, Denmark, France, and Thailand. USA data were compared to those of other countries. RESULTS: We collected 3,142 surveys (1,449 neurologists/1,693 ophthalmologists) (29.8% response rate). In all countries, ON patients......-80% of ON patients; lumbar punctures were obtained mostly in Europe and Thailand. Although most patients received acute treatment with intravenous steroids, between 14% and 65% of neurologists and ophthalmologists still recommended oral prednisone (1 mg/kg/day) for the treatment of acute isolated ON. In all...... 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....

  11. Reduced retinal nerve fiber layer and macular thickness in patients with multiple sclerosis with no history of optic neuritis identified by the use of spectral domain high-definition optical coherence tomography.

    Science.gov (United States)

    Fjeldstad, Cecilie; Bemben, Michael; Pardo, Gabriel

    2011-11-01

    Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS), with both inflammatory and degenerative components. The visual system is frequently involved, often in the form of visual loss from optic neuritis (ON). Retinal nerve fiber layer (RNFL) loss has been demonstrated in individuals with MS, not only in those with previous ON but also in absence of historical evidence of previous acute inflammation/demyelination of the optic nerve. Peripapillary RNFL measurements of all quadrants, central macular thickness, and average macular thickness were performed in 32 eyes of healthy volunteers and 60 eyes of individuals with a diagnosis of relapsing remitting MS using high definition spectral domain optical coherence tomography (HD-OCT). Both the Macular Cube 512 × 128 scan and RNFL measurement by the Optic Disc Cube 200 × 200 protocol were performed on all eyes. Eyes of individuals with MS with no previous ON had significantly decreased overall RNFL thickness (89.1 μm) compared to controls (98.0 μm) (p < 0.05). MS mainly affected the temporal quadrant (56.6 μm versus [vs.] 67.8 μm) (p < 0.05), and inferior quadrant (117.9 μm vs. 132.1 μm) (p < 0.05), respectively. Also, the patients with MS demonstrated significantly decreased average macular thickness (280 μm) compared to the control group (287 μm) (p < 0.05). A significant correlation between RNFL and average macular thickness was also found in eyes of patients with MS (r = 0.69, p < 0.01). HD-OCT is a quick, inexpensive and promising tool to detect subclinical changes in RNFL and macular thickness in individuals with MS. Longitudinal studies should be encouraged to examine disease progression over time in individuals with MS. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. 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...

  13. No evidence of association between optic neuritis and secondary LHON mtDNA mutations in patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Andalib, Sasan; Talebi, Mahnaz; Sakhinia, Ebrahim

    2017-01-01

    primers and restriction endonucleases for seven secondary LHON mutations. Products were visualized using 3% agarose gel electrophoresis with the aid of DNA safe stain in a UV transilluminator. Accuracy of the genotyping procedure was confirmed by sequencing. Data was analyzed using chi square and Fisher...... neuritis (ON) in MS patients. We recruited 56 MS subjects with ON and 47 MS subjects without ON. DNA was extracted by salting out, after sampling of peripheral blood from each participant. We completed Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) analysis with appropriate...

  14. Three-way ROC validation of rs-fMRI visual information propagation transfer functions used to differentiate between RRMS and CIS optic neuritis patients.

    Science.gov (United States)

    Farahani, Ehsan Shahrabi; Choudhury, Samiul H; Cortese, Filomeno; Costello, Fiona; Goodyear, Bradley; Smith, Michael R

    2017-07-01

    Resting-state fMRI (rs-fMRI) measures the temporal synchrony between different brain regions while the subject is at rest. We present an investigation using visual information propagation transfer functions as potential optic neuritis (ON) markers for the pathways between the lateral geniculate nuclei, the primary visual cortex, the lateral occipital cortex and the superior parietal cortex. We investigate marker reliability in differentiating between healthy controls and ON patients with clinically isolated syndrome (CIS), and relapsing-remitting multiple sclerosis (RRMS) using a three-way receiver operating characteristics analysis. We identify useful and reliable three-way ON related metrics in the rs-fMRI low-frequency band 0.0 Hz to 0.1 Hz, with potential markers associated with the higher frequency harmonics of these signals in the 0.1 Hz to 0.2 Hz and 0.2 Hz to 0.3 Hz bands.

  15. 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

    predicted CDMS best. Neurofilament light-chain predicted long-term disability by the multiple sclerosis severity scale (p=0.0111) and nine-hole-peg-test (p=0.0202). Chitinase-3-like-1 predicted long-term cognitive impairment by the paced auditory serial addition test (p=0.0150). CONCLUSION: Neurofilament......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...

  16. 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.

  17. Pattern electroretinogram in neuromyelitis optica and multiple sclerosis with or without optic neuritis and its correlation with FD-OCT and perimetry.

    Science.gov (United States)

    Hokazono, Kenzo; Raza, Ali S; Oyamada, Maria K; Hood, Donald C; Monteiro, Mário L R

    2013-12-01

    To evaluate the ability of transient pattern electroretinogram (PERG) parameters to differentiate between eyes of patients with neuromyelitis optica (NMO), longitudinally extensive transverse myelitis (LETM), multiple sclerosis with optic neuritis (MS + ON), multiple sclerosis without optic neuritis (MS - ON), and controls, to compare PERG and OCT with regard to discrimination ability, and to assess the correlation between PERG, FD-OCT, and visual field measurements (VFs). Visual field measurements and full-field stimulation PERGs based on both 48- and 14-min checks were obtained from patients with MS (n = 28), NMO (n = 20), LETM (n = 18), and controls (n = 26). In addition, FD-OCT peripapillary retinal nerve fiber layer (RNFL) and segmented macular layer measurements were obtained and their correlation coefficients were determined. Compared to controls, PERG amplitude measurements were significantly reduced in eyes with NMO and MS + ON, but not in eyes with LETM and MS - ON. PERG amplitudes were significantly smaller in NMO and MS + ON eyes than in MS - ON eyes. PERG and OCT performance was similar except in NMO eyes where macular thickness parameters were more efficient at detecting abnormalities. A significant correlation was found between N95 amplitude values and OCT-measured macular ganglion cell layer thickness, total retinal thickness, and temporal peripapillary RNFL thickness. PERG amplitude was also significantly associated with VF sensitivity loss. No statistically significant difference was observed with regard to the best-performing parameters of the two methods. Pattern electroretinogram measurements were able to detect RNFL loss in MS + ON and NMO eyes, with a performance comparable to OCT. PERG amplitude measurements were reasonably well correlated with OCT-measured parameters.

  18. Clinical characteristics and long-term visual outcome of optic neuritis in neuromyelitis optica spectrum disorder: A comparison between Thai and American-Caucasian cohorts.

    Science.gov (United States)

    Vanikieti, Kavin; Poonyathalang, Anuchit; Jindahra, Panitha; Bouzika, Peggy; Rizzo, Joseph F; Cestari, Dean M

    2017-10-01

    Neuromyelitis optica spectrum disorder (NMOSD) occurs more commonly in Asian than Caucasian populations. Few studies have examined the clinical features and visual outcome of optic neuritis (ON) within NMOSD in different racial populations. The objective of this study was to compare the clinical characteristics and long-term visual outcome of a Thai and an American-Caucasian cohort with NMOSD-related ON. Medical records including brain and orbital magnetic resonance imaging (MRI) of 16 consecutive subjects who developed visual loss due to ON as part of NMOSD evaluated at a single American tertiary referral center between 2006 and 2015 were reviewed and compared to those of 16 consecutive similar subjects evaluated at a single Thai tertiary referral center between 2010 and 2016. These cohorts represented the total number of NMOSD-related ON subjects seen during that time at those institutions. Statistical analyses were used for continuous and categorical data sets, and multiple regression analysis was used to adjust for differences in duration of follow-up and number of episodes of ON in each affected eye. All subjects within the Thai cohort were Asian, while the American cohort initially consisted of 14 Caucasian, 1 Asian and 1 African-American subject, but the latter two were excluded from analysis. In the Thai cohort, ON occurred in 21 eyes, with a total of 19 episodes, while in the American-Caucasian cohort ON occurred in 22 eyes, with a total of 21 episodes. Aquaporin 4 (AQP4)-antibody was positive in all subjects except for one American-Caucasian subject. The mean follow-up time was 17.8 (± 16.0) and 52.8 (± 51.9) months for the Thai and American-Caucasian populations, respectively. There was no difference between the two cohorts with respect to gender, age of NMOSD and NMOSD-related ON onset, initial clinical presentation of NMOSD, initial visual acuity and automated visual fields, prevalence of swollen optic disc in the acute phase, presence of pain on the

  19. 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.)

  20. 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.

  1. The dyschromatopsia of optic neuritis is determined in part by the foveal/perifoveal distribution of visual field damage.

    Science.gov (United States)

    Silverman, S E; Hart, W M; Gordon, M O; Kilo, C

    1990-09-01

    Most hypotheses of acquired dyschromatopsia invoke the mechanism of selective damage to specific components of the afferent visual system to explain the predominance of red-green and blue-yellow hue-discrimination defects found in neural and retinal disorders, respectively. However, this pattern of hue-discrimination disturbance in ocular disease may vary. There are frequent exceptions which are inadequately explained by existing hypotheses. In an effort to explain the pattern and pathogenesis of acquired dyschromatopsias better, the authors examined patients with nonproliferative diabetic retinopathy (DR) and late-stage retrobulbar neuritis (RBN) using age-corrected Farnsworth-Munsell 100-hue testing and threshold static perimetry. As expected, most DR eyes showed some degree of relative blue-yellow dyschromatopsia (89%) with few showing a greater weighting towards red-green dyschromatopsia (11%). However, an approximately equal number of RBN eyes had a relative blue-yellow (48%) versus red-green dyschromatopsia (52%). For RBN, the authors found a strong association between the spatial distribution of field defect and the type of relative hue-discrimination disturbance. Eyes with greater field depression at the fovea relative to the perifovea showed a relative preponderance of red-green dyschromatopsia (68%) as opposed to blue-yellow dyschromatopsia (32%), whereas eyes with greater relative perifoveal impairment showed a relative preponderance of blue-yellow dyschromatopsia (100%). This relationship between the relative spatial distribution of visual field damage and the relative hue-discrimination deficit in RBN was statistically significant (P = 0.002). Such an association was not found for DR.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Caracterização etiológica e clínica das neurites ópticas infecciosas Etiological and clinical characteristics of infectious optic neuritis

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Lana-Peixoto

    1997-06-01

    Full Text Available As neurites ópticas infecciosas (NOI foram estudadas em relação aos aspectos etiológicos, epidemiológicos e clínicos, com o intuito de detectar características que possam diferencia-las das neurites ópticas desmielinizantes (NOD, que apresentam nítida tendência para conversão em esclerose múltipla. Entre 105 casos de NOI, 51 não apresentavam qualquer evidência de envolvimento da coróide ou retina e poderiam ser confundidos com NOD. Envolvimento bilateral foi encontrado em 23 pacientes (45,1%, sendo simultâneo em 18 (78,3% casos. A relação entre sexos foi 2M: IF. As idades variaram ente 1 a 82 anos, com mediana de 34,8 anos. Um terço dos pacientes tinha idades até 20 anos, e em um terço dos pacientes as idades eram igual ou maior que 50 anos. Sífilis foi encontrada em 19 pacientes sendo a causa mais comum das NOI, enquanto infecções virais diversas foram responsabilizadas em 41,2%. A acuidade visual foi gravemente afetada na maioria dos casos, sendo pior que 20/200 em 57,3% dos olhos acometidos. Distúrbios da visão cromática foram encontrados em 91,8%, enquanto o exame do campo visual revelou anormalidades em 92,6% dos olhos, predominando os defeitos centrais (40,7%. O disco óptico estava anormal em 90,5% dos olhos examinados, sendo atrofia óptica o principal achado fundoscópico. O presente estudo demonstra que a maior tendência a bilateralidade e simultaneidade das NOI, sua maior prevalência no sexo masculino, na infância e em adultos após os 50 anos de idade, assim como a maior severidade do comprometimento das funções visuais diferem substancialmente das características relatadas nas NOD. O conhecimento destas diferenças pode auxiliar na diferente abordagem terapêutica e prognostica das duas distintas condições.Fifty-one patients with infectious optic neuritis (ION with no associated choroidal or retinal involvement were studied in relation to the etiologic agents, and to the epidemiological and

  3. 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...

  4. 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...

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. Wartenbergs migrerende sensoriske neuritis

    DEFF Research Database (Denmark)

    Colding-Jørgensen, Eskild

    2009-01-01

    Two patients with progressive multifocal sensory symptoms and signs are described. The sensory disturbances were bilateral, and mainly arose in the territory of the radial nerves. Stretching or touching the wrist elicited electrical sensations in the fingers. The diagnosis of Wartenberg's migrant...... sensory neuritis (WMSN) was suggested. Nerve conduction studies confirmed the presence of peripheral nerve affection, and the electrophysiological abnormalities corresponded to the pattern and progression of clinical abnormalities. Udgivelsesdato: 2009-Jan-26......Two patients with progressive multifocal sensory symptoms and signs are described. The sensory disturbances were bilateral, and mainly arose in the territory of the radial nerves. Stretching or touching the wrist elicited electrical sensations in the fingers. The diagnosis of Wartenberg's migrant...

  10. 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.

  11. Relapsing Ipsilateral Vestibular Neuritis

    OpenAIRE

    Emiliano De Schutter, Duilio; Pérez Fernández, Nicolás

    2017-01-01

    In 2013, a 70-year-old male was admitted with an acute episode of vertigo, nausea, and vomiting with duration of one day. The patient’s background included prehypertension, vitiligo, left ventricular hypertrophy, and Sjögren's syndrome. He denied any previous episode of vertigo or migraine manifestations. Neither hearing loss nor tinnitus or otorrhea was detected at the time of evaluation. No neurological symptoms were found. There was a left-beating spontaneous nystagmus Grade 3. The patient...

  12. Vestibular Restoration and Adaptation in Vestibular Neuritis and Ramsay Hunt Syndrome With Vertigo.

    Science.gov (United States)

    Martin-Sanz, Eduardo; Rueda, Almudena; Esteban-Sanchez, Jonathan; Yanes, Joaquin; Rey-Martinez, Jorge; Sanz-Fernandez, Ricardo

    2017-08-01

    To evaluate vestibular restoration and the evolution of the compensatory saccades in acute severe inflammatory vestibular nerve paralysis, including vestibular neuritis and Ramsay Hunt syndrome with vertigo. Prospective. Tertiary referral center. Vestibular neuritis (n = 18) and Ramsay Hunt syndrome patients with vertigo (n = 13) were enrolled. After treatment with oral corticosteroids, patients were followed up for 6 months. Functional recovery of the facial nerve was scored according to the House-Brackman grading system. Caloric and video head impulse tests were performed in every patient at the time of enrolment. Subsequently, successive video head impulse test (vHIT) exploration was performed at the 1, 3, and 6-month follow-up. Eighteen patients with vestibular neuritis and 13 with Ramsay Hunt syndrome and associated vertigo were included. Vestibular function was significantly worse in patients with Ramsay Hunt syndrome than in those with vestibular neuritis. Similar compensatory saccades velocity and latency values were observed in both groups, in both the caloric and initial vHIT tests. Successive vHIT results showed a significantly higher vestibulo-ocular reflex gain recovery in vestibular neuritis patients than in Ramsay Hunt syndrome patients. A significantly faster reduction in the latency, velocity, and organization of the compensatory saccades was observed in neuritis than in Ramsay Hunt syndrome patients. In addition to the recovery of the vestibulo-ocular reflex, the reduction of latency, velocity and the organization of compensatory saccades play a role in vestibular compensation.

  13. 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.

  14. 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.)

  15. Phosphorylated Neurofilament Heavy Chain Correlations to Visual Function, Optical Coherence Tomography, and Treatment

    Science.gov (United States)

    Pasol, Joshua; Feuer, William; Yang, Cui; Shaw, Gerry; Kardon, Randy; Guy, John

    2010-01-01

    Objective. To correlate visual and neurologic clinical scores and treatment of optic neuritis and multiple sclerosis (MS) patients with assays of serum phosphorylated neurofilament heavy chain (pNF-H) and optical coherence tomography (OCT) measurements of axonal loss. Design/Methods. The Optic Neuritis Treatment Trial (ONTT) randomized 457 patients with acute optic neuritis to intravenous methylprednisolone (IVMP) followed by oral prednisone, oral prednisone or placebo treatment arms. We quantified serum pNF-H levels in 175 ONTT patients 5 years after study entry. We performed OCT measurements of macular volume and the retinal nerve fiber layer (RNFL) in a subset of 51 patients at year 15. Results. Elevated pNF-H levels at year 5 correlated to poorer visual function at study entry. Lower 15 year macular volumes and RNFL thickness correlated better with follow-up than with baseline visual function measures. With IVMP treatment, 15 year RNFL differences of the fellow eye (FE) minus the affected eye (SE) RNFLFEmSE correlated with five-year pNF-H levels. PNF-H was reduced by half with IVMP relative to placebo or by 40% relative to prednisone. Conclusions/Relevance. Acute optic neuritis patients who have more severe visual loss during initial presentation have a higher incidence of axonal loss that was slightly suppressed with IVMP treatment. PMID:22096624

  16. 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.

  17. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 4: Afferent visual system damage after optic neuritis in MOG-IgG-seropositive versus AQP4-IgG-seropositive patients.

    Science.gov (United States)

    Pache, Florence; Zimmermann, Hanna; Mikolajczak, Janine; Schumacher, Sophie; Lacheta, Anna; Oertel, Frederike C; Bellmann-Strobl, Judith; Jarius, Sven; Wildemann, Brigitte; Reindl, Markus; Waldman, Amy; Soelberg, Kerstin; Asgari, Nasrin; Ringelstein, Marius; Aktas, Orhan; Gross, Nikolai; Buttmann, Mathias; Ach, Thomas; Ruprecht, Klemens; Paul, Friedemann; Brandt, Alexander U

    2016-11-01

    Antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported in patients with aquaporin-4 antibody (AQP4-IgG)-negative neuromyelitis optica spectrum disorders (NMOSD). The objective of this study was to describe optic neuritis (ON)-induced neuro-axonal damage in the retina of MOG-IgG-positive patients in comparison with AQP4-IgG-positive NMOSD patients. Afferent visual system damage following ON was bilaterally assessed in 16 MOG-IgG-positive patients with a history of ON and compared with that in 16 AQP4-IgG-positive NMOSD patients. In addition, 16 healthy controls matched for age, sex, and disease duration were analyzed. Study data included ON history, retinal optical coherence tomography, visual acuity, and visual evoked potentials. Eight MOG-IgG-positive patients had a previous diagnosis of AQP4-IgG-negative NMOSD with ON and myelitis, and eight of (mainly recurrent) ON. Twenty-nine of the 32 eyes of the MOG-IgG-positive patients had been affected by at least one episode of ON. Peripapillary retinal nerve fiber layer thickness (pRNFL) and ganglion cell and inner plexiform layer volume (GCIP) were significantly reduced in ON eyes of MOG-IgG-positive patients (pRNFL = 59 ± 23 μm; GCIP = 1.50 ± 0.34 mm(3)) compared with healthy controls (pRNFL = 99 ± 6 μm, p IgG-positive patients (0.35 ± 0.88 logMAR). There were no significant differences in any structural or functional visual parameters between MOG-IgG-positive and AQP4-IgG-positive patients (pRNFL: 59 ± 21 μm; GCIP: 1.41 ± 0.27 mm(3); Visual acuity = 0.72 ± 1.09 logMAR). Importantly, MOG-IgG-positive patients had a significantly higher annual ON relapse rate than AQP4-IgG-positive patients (median 0.69 vs. 0.29 attacks/year, p = 0.004), meaning that on average a single ON episode caused less damage in MOG-IgG-positive than in AQP4-IgG-positive patients. pRNFL and GCIP loss correlated with the number of ON episodes in MOG

  18. 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...

  19. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    Science.gov (United States)

    2010-07-01

    ... 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 of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

  20. 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.

  1. Dimethyl Fumarate Ameliorates Lewis Rat Experimental Autoimmune Neuritis and Mediates Axonal Protection

    Science.gov (United States)

    Pitarokoili, Kalliopi; Ambrosius, Björn; Meyer, Daniela; Schrewe, Lisa; Gold, Ralf

    2015-01-01

    Background 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. Methods and Findings 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. Conclusions We conclude that immunmodulatory and neuroprotective dimethyl fumarate may represent an innovative therapeutic option in human autoimmune neuropathies. PMID:26618510

  2. 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.

  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

    recovery (FLAIR), proton density and T2-weighted turbo spin echo, and T1-weighted spin echo after contrast. In addition, magnetization-prepared rapid acquisition gradient echo (MPRAGE) was obtained after contrast at 3.0 T. Lesion number and volumes were assessed by an observer blind to patient identity...

  4. [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.

  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. 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.)

  7. MULTIMODAL IMAGING OF ACUTE EXUDATIVE POLYMORPHOUS VITELLIFORM MACULOPATHY WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND ADAPTIVE OPTICS SCANNING LASER OPHTHALMOSCOPY.

    Science.gov (United States)

    Skondra, Dimitra; Nesper, Peter L; Fawzi, Amani A

    2017-05-16

    To report a case of acute exudative polymorphous vitelliform maculopathy including the findings of optical coherence tomography angiography and adaptive optics scanning laser ophthalmoscopy. Findings on clinical examination, color fundus photography, spectral-domain optical coherence tomography, infrared reflectance, autofluorescence, optical coherence tomography angiography, and adaptive optics scanning laser ophthalmoscopy. A 54-year-old white man with no significant medical history and history of smoking presented with bilateral multiple serous and vitelliform detachments consistent with acute exudative polymorphous vitelliform maculopathy. Extensive infectious, inflammatory, and malignancy workup was negative. Spectral-domain optical coherence tomography showed thickened, hyperreflective ellipsoid zone, subretinal fluid, and focal as well as diffuse subretinal hyperreflective material corresponding to the vitelliform lesions. Optical coherence tomography angiography showed normal retinal and choroidal vasculature, whereas adaptive optics scanning laser ophthalmoscopy showed circular focal "target" lesions at the level of the photoreceptors in the area of foveal detachment. Multimodal imaging is valuable in evaluating patients with acute exudative polymorphous vitelliform maculopathy.

  8. Optical Coherence Tomography Imaging in Acute Coronary Syndromes

    Directory of Open Access Journals (Sweden)

    Takashi Kubo

    2011-01-01

    Full Text Available Optical coherence tomography (OCT is a high-resolution imaging technique that offers microscopic visualization of coronary plaques. The clear and detailed images of OCT generate an intense interest in adopting this technique for both clinical and research purposes. Recent studies have shown that OCT is useful for the assessment of coronary atherosclerotic plaques, in particular the assessment of plaque rupture, erosion, and intracoronary thrombus in patients with acute coronary syndrome. In addition, OCT may enable identifying thin-cap fibroatheroma, the proliferation of vasa vasorum, and the distribution of macrophages surrounding vulnerable plaques. With its ability to view atherosclerotic lesions in vivo with such high resolution, OCT provides cardiologists with the tool they need to better understand the thrombosis-prone vulnerable plaques and acute coronary syndromes. This paper reviews the possibility of OCT for identification of vulnerable plaques in vivo.

  9. Early and phasic cortical metabolic changes in vestibular neuritis onset.

    Directory of Open Access Journals (Sweden)

    Marco Alessandrini

    Full Text Available Functional brain activation studies described the presence of separate cortical areas responsible for central processing of peripheral vestibular information and reported their activation and interactions with other sensory modalities and the changes of this network associated to strategic peripheral or central vestibular lesions. It is already known that cortical changes induced by acute unilateral vestibular failure (UVF are various and undergo variations over time, revealing different cortical involved areas at the onset and recovery from symptoms. The present study aimed at reporting the earliest change in cortical metabolic activity during a paradigmatic form of UVF such as vestibular neuritis (VN, that is, a purely peripheral lesion of the vestibular system, that offers the opportunity to study the cortical response to altered vestibular processing. This research reports [(18F]fluorodeoxyglucose positron emission tomography brain scan data concerning the early cortical metabolic activity associated to symptoms onset in a group of eight patients suffering from VN. VN patients' cortical metabolic activity during the first two days from symptoms onset was compared to that recorded one month later and to a control healthy group. Beside the known cortical response in the sensorimotor network associated to vestibular deafferentation, we show for the first time the involvement of Entorhinal (BAs 28, 34 and Temporal (BA 38 cortices in early phases of symptomatology onset. We interpret these findings as the cortical counterparts of the attempt to reorient oneself in space counteracting the vertigo symptom (Bas 28, 34 and of the emotional response to the new pathologic condition (BA 38 respectively. These interpretations were further supported by changes in patients' subjective ratings in balance, anxiety, and depersonalization/derealization scores when tested at illness onset and one month later. The present findings contribute in expanding

  10. Isolated cochlear neuritis from varicella reactivation mimicking a vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Adam D. Goodale

    2016-09-01

    Full Text Available We present a case of a patient with progressive unilateral sensorineural hearing loss and tinnitus with internal auditory canal enhancement on magnetic resonance imaging (MRI secondary to isolated cochlear neuritis from varicella reactivation. MRI following antiviral treatment showed resolution of enhancement. Varicella reactivation is commonly seen in the form of Ramsay Hunt syndrome, which is known to produce abnormal MRI enhancement from facial and vestibulocochlear neuritis; however, its characteristic clinical signs aid the diagnosis. This case is unique in that the only manifestation of varicella infection was unilateral hearing loss. This case outlines the importance of maintaining a broad differential diagnosis in the evaluation of unilateral hearing loss as well as recognizing the limited specificity of MRI. Keywords: Vestibular schwannoma, Acoustic neuroma, Vestibular neuritis, Ramsay Hunt syndrome, Varicella zoster virus

  11. Optical Coherence Tomography Angiography and En Face Optical Coherence Tomography Features of Paracentral Acute Middle Maculopathy.

    Science.gov (United States)

    Sridhar, Jayanth; Shahlaee, Abtin; Rahimy, Ehsan; Hong, Bryan K; Khan, M Ali; Maguire, Joseph I; Dunn, James P; Mehta, Sonia; Ho, Allen C

    2015-12-01

    To characterize the optical coherence tomography (OCT) angiography, en face OCT, and microperimetry features of paracentral acute middle maculopathy in both the acute phase and after resolution, and to propose a classification of distinct subtypes of this entity. Retrospective observational case series. Clinical histories, high-resolution digital color imaging, spectral-domain OCT images, fluorescein angiography, OCT angiography images, and en face OCT images of 16 patients with paracentral acute middle maculopathy were evaluated. Microperimetry was available in 6 patients. The most common referring diagnoses were isolated branch retinal arterial occlusion (5/16), combined central retinal vein and cilioretinal artery occlusion (4/16), and isolated central retinal vein occlusion (4/16). All patients demonstrated hyperreflective plaque-like lesions at the level of the inner nuclear layer on spectral-domain OCT, with no fluorescein angiographic correlate. OCT angiography demonstrated variable areas of capillary dropout within the superficial and deep retinal capillary plexi in these areas. En face OCT highlighted confluent areas of middle retina hyperreflectivity corresponding to these lesions. Three distinct en face OCT patterns were observed: arteriolar, fern-like, and globular. Microperimetry demonstrated relative scotomas mapping to the area of middle retinal hyperreflectivity seen on en face OCT. Paracentral acute middle maculopathy may be best evaluated with the use of en face OCT imaging, which corresponds to subjective and objective visual field defects. En face OCT appearance may be used to classify paracentral acute maculopathy into distinct subtypes. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. 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.

  13. Acute Solar Retinopathy Imaged With Adaptive Optics, Optical Coherence Tomography Angiography, and En Face Optical Coherence Tomography.

    Science.gov (United States)

    Wu, Chris Y; Jansen, Michael E; Andrade, Jorge; Chui, Toco Y P; Do, Anna T; Rosen, Richard B; Deobhakta, Avnish

    2018-01-01

    Solar retinopathy is a rare form of retinal injury that occurs after direct sungazing. To enhance understanding of the structural changes that occur in solar retinopathy by obtaining high-resolution in vivo en face images. Case report of a young adult woman who presented to the New York Eye and Ear Infirmary with symptoms of acute solar retinopathy after viewing the solar eclipse on August 21, 2017. Results of comprehensive ophthalmic examination and images obtained by fundus photography, microperimetry, spectral-domain optical coherence tomography (OCT), adaptive optics scanning light ophthalmoscopy, OCT angiography, and en face OCT. The patient was examined after viewing the solar eclipse. Visual acuity was 20/20 OD and 20/25 OS. The patient was left-eye dominant. Spectral-domain OCT images were consistent with mild and severe acute solar retinopathy in the right and left eye, respectively. Microperimetry was normal in the right eye but showed paracentral decreased retinal sensitivity in the left eye with a central absolute scotoma. Adaptive optics images of the right eye showed a small region of nonwaveguiding photoreceptors, while images of the left eye showed a large area of abnormal and nonwaveguiding photoreceptors. Optical coherence tomography angiography images were normal in both eyes. En face OCT images of the right eye showed a small circular hyperreflective area, with central hyporeflectivity in the outer retina of the right eye. The left eye showed a hyperreflective lesion that intensified in area from inner to middle retina and became mostly hyporeflective in the outer retina. The shape of the lesion on adaptive optics and en face OCT images of the left eye corresponded to the shape of the scotoma drawn by the patient on Amsler grid. Acute solar retinopathy can present with foveal cone photoreceptor mosaic disturbances on adaptive optics scanning light ophthalmoscopy imaging. Corresponding reflectivity changes can be seen on en face OCT, especially

  14. Benign-onset acute disseminated encephalomyelitis: a report on two cases.

    Science.gov (United States)

    Degirmenci, Eylem; Erdogan, Cagdas; Oguzhanoglu, Attila; Bir, Levent Sinan

    2013-05-30

    The signs and symptoms of acute disseminated encephalomyelitis are heterogeneous and dependent on the location and severity of the inflammatory process. The meningoencephalitic presentation may include meningism, impaired consciousness (occasionally leading to coma), seizures and confusion, or behavioral disturbances. Multifocal neurological features include a combination of optic neuritis, visual field defects, cranial neuropathy, sensorimotor impairment, ataxia, aphasia, and involuntary movements. One definition of acute disseminated encephalomyelitis is "an initial clinical event with a presumed inflammatory and demyelinating cause, with acute or sub-acute onset affecting multifocal areas of the central nervous system". Patients with acute disseminated encephalomyelitis frequently suffer from seizures, disturbances of consciousness, fever, and headaches, and occasionally there are focal signs and symptoms. Here, we report on two cases who presented with different symptoms, but the clinical findings that the patients showed were benign.

  15. Therapeutic Approach to the Management of Pediatric Demyelinating Disease: Multiple Sclerosis and Acute Disseminated Encephalomyelitis.

    Science.gov (United States)

    Brenton, J Nicholas; Banwell, Brenda L

    2016-01-01

    Acquired pediatric demyelinating diseases manifest acutely with optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, or with various other acute deficits in focal or polyfocal areas of the central nervous system. Patients may experience a monophasic illness (as in the case of acute disseminated encephalomyelitis) or one that may manifest as a chronic, relapsing disease [e.g., multiple sclerosis (MS)]. The diagnosis of pediatric MS and other demyelinating disorders of childhood has been facilitated by consensus statements regarding diagnostic definitions. Treatment of pediatric MS has been modeled after data obtained from clinical trials in adult-onset MS. There are now an increasing number of new therapeutic agents for MS, and many will be formally studied for use in pediatric patients. There are important efficacy and safety concerns regarding the use of these therapies in children and young adults. This review will discuss acute management as well as chronic immunotherapies in acquired pediatric demyelination.

  16. Acute disseminated encephalomyelitis, transverse myelitis, and neuromyelitis optica.

    Science.gov (United States)

    Wingerchuk, Dean M; Weinshenker, Brian G

    2013-08-01

    This review defines current clinical criteria for diagnosis, differential diagnosis, and clinical evaluation of acute disseminated encephalomyelitis, transverse myelitis, and neuromyelitis optica, and summarizes principles of treatment. Consensus criteria for transverse myelitis and acute disseminated encephalomyelitis have been proposed. A specific biomarker, aquaporin-4 autoantibody, has been discovered for neuromyelitis optica that allows for early and accurate diagnosis even in the absence of cardinal findings of optic neuritis and myelitis. The antibody is pathogenic and is facilitating an understanding of the pathophysiology of neuromyelitis optica and development of antigen-specific treatments. Clinical and radiologic findings combined with serologic findings may permit classification of syndromes of transverse myelitis and acute disseminated encephalomyelitis in ways that may predict risk of relapse, type of relapse, and prognosis. Treatment, especially to prevent relapse, is dependent on the specific disease context in which syndromes such as transverse myelitis occur.

  17. Optic neuritis complicating viral keratoconjunctivitis: a case report ...

    African Journals Online (AJOL)

    EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/abs.v3i1.40663 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

  18. Optic Nerve Sheath Diameter Increase on Ascent to High Altitude: Correlation With Acute Mountain Sickness.

    Science.gov (United States)

    Kanaan, Nicholas C; Lipman, Grant S; Constance, Benjamin B; Holck, Peter S; Preuss, James F; Williams, Sarah R

    2015-09-01

    Elevated optic nerve sheath diameter on sonography is known to correlate with increased intracranial pressure and is observed in acute mountain sickness. This study aimed to determine whether optic nerve sheath diameter changes on ascent to high altitude are associated with acute mountain sickness incidence. Eighty-six healthy adults enrolled at 1240 m (4100 ft), drove to 3545 m (11,700 ft) and then hiked to and slept at 3810 m (12,500 ft). Lake Louise Questionnaire scores and optic nerve sheath diameter measurements were taken before, the evening of, and the morning after ascent. The incidence of acute mountain sickness was 55.8%, with a mean Lake Louise Questionnaire score ± SD of 3.81 ± 2.5. The mean maximum optic nerve sheath diameter increased on ascent from 5.58 ± 0.79 to 6.13 ± 0.73 mm, a difference of 0.91 ± 0.55 mm (P = .09). Optic nerve sheath diameter increased at high altitude regardless of acute mountain sickness diagnosis; however, compared to baseline values, we observed a significant increase in diameter only in those with a diagnosis of acute mountain sickness (0.57 ± 0.77 versus 0.21 ± 0.76 mm; P = .04). This change from baseline, or Δ optic nerve sheath diameter, was associated with twice the odds of developing acute mountain sickness (95% confidence interval, 1.08-3.93). The mean optic nerve sheath diameter increased on ascent to high altitude compared to baseline values, but not to a statistically significant degree. The magnitude of the observed Δ optic nerve sheath diameter was positively associated with acute mountain sickness diagnosis. No such significant association was found between acute mountain sickness and diameter elevation above standard cutoff values, limiting the utility of sonography as a diagnostic tool. © 2015 by the American Institute of Ultrasound in Medicine.

  19. PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH BILATERAL OPTIC DISK SWELLING AND MENINGITIS.

    Science.gov (United States)

    Zhao, Zhenyang; Faith, Parker; Pakzad-Vaezi, Kaivon; Chu, Zhongdi; Wang, Ruikang K; Mudumbai, Raghu C; Rezaei, Kasra A

    2017-11-22

    To present a novel case of paracentral acute middle maculopathy associated with bilateral optic disk swelling. Retrospective case report. A 67-year-old woman presented with sudden onset of central vision loss and subsequent bilateral optic disk edema, retinal vessel attenuation, and anterior uveitis. Cerebrospinal fluid analysis showed signs of inflammation. Spectral domain optical coherence tomography demonstrated the pathognomonic hyperreflectivity of the middle retinal layers consistent with paracentral acute middle maculopathy. Swept-source optical coherence tomography angiography with custom vessel analysis demonstrated a 18.3% decrease in the deep retinal vascular density and 2.4 times increase in absent flow area in the affected eye compared with the fellow eye. This case demonstrates a novel association between paracentral acute middle maculopathy and bilateral optic disk swelling secondary to central nervous system inflammation and possible infection. Although spectral domain optical coherence tomography is valuable in detecting paracentral acute middle maculopathy, optical coherence tomography angiography with vessel analysis can provide additional insight into the disease mechanism.

  20. Neuritis of the cauda equina in a dog.

    Science.gov (United States)

    Saey, V; Martlé, V; Van Ham, L; Chiers, Koen

    2010-10-01

    This study presents the first case report of neuritis of the cauda equina in a dog, including characterisation of the inflammatory infiltrate. The dog in question, a 6-year-old Welsh springer spaniel, was presented with flaccid tail and faecal and urinary incontinence. The histological lesions included severe mononuclear cell infiltration of the nerve roots of the cauda equina and of the lumbar nerve roots. The infiltrate was composed of large numbers of T-lymphocytes and B-lymphocytes and small numbers of macrophages. Polymerase chain reactions of brain and spinal tissues were positive for Neospora caninum. © 2010 British Small Animal Veterinary Association.

  1. An Adult Case of Anti-Myelin Oligodendrocyte Glycoprotein (MOG) Antibody-associated Multiphasic Acute Disseminated Encephalomyelitis at 33-year Intervals.

    Science.gov (United States)

    Numa, Soichiro; Kasai, Takashi; Kondo, Takayuki; Kushimura, Yukie; Kimura, Ayaka; Takahashi, Hisashi; Morita, Kanako; Tanaka, Akihiro; Noto, Yu-Ichi; Ohara, Tomoyuki; Nakagawa, Masanori; Mizuno, Toshiki

    2016-01-01

    Acute disseminated encephalomyelitis (ADEM) followed by optic neuritis (ON) has been reported as a distinct phenotype associated with anti-myelin oligodendrocyte protein (MOG) antibody. We herein report the case of a 37-year-old woman who was diagnosed with ADEM at 4 years old of age and who subsequently developed ON followed by recurrent ADEM 33 years after the initial onset. A serum analysis showed anti-MOG antibody positivity. This phenotype has only previously been reported in pediatric cases. Neurologists thus need to be aware that the phenotype may occur in adult patients, in whom it may be assumed to be atypical multiple sclerosis.

  2. Vertical components of head-shaking nystagmus in vestibular neuritis, Meniere's disease and migrainous vertigo.

    Science.gov (United States)

    Kim, C H; Shin, J E; Song, C I; Yoo, M H; Park, H J

    2014-10-01

    To describe vertical and horizontal components of head-shaking nystagmus (HSN) in various vestibular disorders. Retrospective case review. Tertiary care academic referral centre. Head-shaking nystagmus was assessed in 66 vestibular neuritis (VN) patients at acute (vestibular disorders and compensation (94% in acute VN; 89% in FU VN; 78% in MD; 50% in MV). Paretic HSN with the nystagmus towards the lesioned side was the most common type in VN and MD; however, recovery HSN with the nystagmus towards the intact side could be rarely observed especially in patients with MD or compensated VN. Vertical nystagmus could be combined with horizontal HSN, and upbeat HSN was observed in most (83%) of the patients with acute VN, but downbeat HSN was common in follow-up VN (83%), MD (97%) and MV (85%). Weak perverted HSN, which is assumed to be a central nystagmus, was rarely observed in MD and MV (6-9%), but not in VN. Head-shaking nystagmus (HSN) in horizontal plane is a valuable tool in the assessment of vestibular imbalance. Common observation of upbeat HSN in acute VN and downbeat HSN in follow-up VN, MD and MV suggests that vertical components are possibly related to the involvement of vestibular apparatus and compensation. Weak perverted HSN and delayed-peak HSN were rarely observed in MD and MV, and never observed in VN, suggesting that it is possibly related to either asymmetrically impaired vertical canals or misorientation of the velocity-storage system. © 2014 John Wiley & Sons Ltd.

  3. MMP-mediated cleavage of beta-dystroglycan in myelin sheath is involved in autoimmune neuritis.

    Science.gov (United States)

    Zhao, Xiu Li; Li, Guo Zhong; Sun, Bo; Zhang, Zhong Ling; Yin, Yan Hong; Tian, Yu Shuang; Li, He; Li, Hu Lun; Wang, De Sheng; Zhong, Di

    2010-02-19

    Alpha-/beta-dystroglycans (DG) located at the outmost layer of myelin sheath play a critical role in its formation and stability in the peripheral nerve system. The demyelination of nerve fibers is present in autoimmune neuritis, however, it is not known about the molecular mechanisms underlying this pathological process. In an animal model of experimental autoimmune neuritis, we observed that beta-DG cleavage was associated with the demyelination of peripheral nerves. The neuritis and beta-DG cleavage were accompanied by matrix metalloproteinase (MMP)-2/-9 over-expressions and attenuated by captopril, a MMP inhibitor. The blockade of MMPs also improves clinical signs. Our results reveal a crucial role of MMP-mediated beta-DG cleavage in autoimmune neuritis, such as Guillain-Barre' syndrome, and bring insights into therapeutic strategies for autoimmune diseases. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  4. 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.

  5. Pain hypersensitivity in rats with experimental autoimmune neuritis, an animal model of human inflammatory demyelinating neuropathy.

    Science.gov (United States)

    Moalem-Taylor, Gila; Allbutt, Haydn N; Iordanova, Mihaela D; Tracey, David J

    2007-07-01

    Experimental autoimmune neuritis (EAN) is a T cell mediated autoimmune disease of the peripheral nervous system that serves as an animal model of the acute inflammatory demyelinating polyradiculoneuropathy in Guillain-Barre syndrome (GBS). Although pain is a common symptom of GBS occurring in 55-85% of cases, it is often overlooked and the underlying mechanisms are poorly understood. Here we examined whether animals with EAN exhibit signs of neuropathic pain including hyperalgesia and allodynia, and assessed their peripheral nerve autoimmune inflammation. We immunized Lewis rats with peripheral myelin P2 peptide (amino acids 57-81) emulsified with complete Freund's adjuvant, or with adjuvant only as control. P2-immunized rats developed mild to modest monophasic EAN with disease onset at day 8, peak at days 15-17, and full recovery by day 28 following immunization. Rats with EAN showed a significant decrease in withdrawal latency to thermal stimuli and withdrawal threshold to mechanical stimuli, in both hindpaws and forepaws, during the course of the disease. We observed a significant infiltration of T cells bearing alphabeta receptors, and a significant increase in antigen-presenting cells expressing MHC class II as well as macrophages, in EAN-affected rats. Our results demonstrate that animals with active EAN develop significant thermal hyperalgesia and mechanical allodynia, accompanied by pronounced autoimmune inflammation in peripheral nerves. These findings suggest that EAN is a useful model for the pain seen in many GBS patients, and may facilitate study of neuroimmune mechanisms underlying pain in autoimmune neuropathies.

  6. Autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    Energy Technology Data Exchange (ETDEWEB)

    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.).

  7. 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.

  8. OCT angiography of acute non-arteritic anterior ischemic optic neuropathy.

    Science.gov (United States)

    Rougier, M-B; Delyfer, M-N; Korobelnik, J-F

    2017-02-01

    To describe changes of the retinal peripapillary microvasculature on optical coherence tomography angiography (OCT-A) in non-arteritic anterior ischemic optic (NAION) neuropathy. Observational study of 10 patients at the acute phase of NAION. OCT-A was performed using a 3mm×3mm square centered on the optic disc (Cirrus HD-OCT with Angioplex, Carl Zeiss Meditec, Dublin, CA). A qualitative comparison was made with the healthy fellow eye of each patient. All patients had a fluorescein angiography (HRA2, Heidelberg, Germany) and a visual field examination (Octopus 101 ® , Haag-Streit, USA). In the affected eyes, OCT-A showed clear modifications in the radial peripapillary network. In all these eyes, a focal disappearance of the superficial capillary radial pattern was present, twisted and irregular. In 8 eyes, there was also a lack of vascularization in some focal areas, appearing as dark areas. No correlation was found between the topography of the vascular alteration shown on OCT-A and visual field pattern defects. OCT-A is a new imaging technology able to demonstrate easily and safely the changes in the peripapillary capillary network during the acute phase of NAION. These changes are likely related to a decrease of the prelaminar optic nerve blood flow during the acute phase of NAION. Visual field defects are not correlated with OCT-A images, suggesting that they may be due mainly to disturbances in posterior ciliary artery blood flow. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Concurrent acute disseminated encephalomyelitis and Guillain–Barré syndrome in a child

    Science.gov (United States)

    Deshmukh, Isha S.; Bang, Akash B.; Jain, Manish A.; Vilhekar, Krishna Y.

    2015-01-01

    Acute disseminated encephalomyelitis (ADEM) and Guillain–Barré 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. PMID:25878749

  10. Acute and chronic pain syndromes in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Knudsen, L; Jensen, K

    1991-01-01

    A representative sample of 117 patients with definite multiple sclerosis (MS) was interviewed on pain syndromes. Chronic syndromes lasting more than one month included dysaestesthesia, low back pain, spasms, tonic seizures, tightening and painful sensations in the extremities. Acute syndromes...... with pain at the time of the examination increased with age and duration of disease. Patients with pain were significantly more often spastic and significantly more often sought alternative treatment forms. No difference was found for mean age, sex, physical impairment, duration of disease from onset of MS...... 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...

  11. Single Intravitreal Aflibercept Injection for Unilateral Acute Nonarteritic Ischemic Optic Neuropathy

    OpenAIRE

    Ayhan, Ziya; Kocao?lu, Gamze; Yaman, Aylin; Bajin, Meltem S?ylev; Saatci, A. Osman

    2015-01-01

    Acute nonarteritic ischemic optic neuropathy (ANAION) is the most common optic neuropathy in the elderly population without a well-established treatment. A 67-year-old man with a sudden painless visual loss in his left eye of one-day duration was diagnosed to have left ANAION. Next day, 2 mg aflibercept injection was injected intravitreally in OS. Visual acuity improved to 7/10 from 1/10 a week after the injection. Mean retinal nerve fiber layer thickness (RNFLT) was reduced to 159,7 μm from ...

  12. Assessing Deep Retinal Capillary Ischemia in Paracentral Acute Middle Maculopathy by Optical Coherence Tomography Angiography.

    Science.gov (United States)

    Nemiroff, Julia; Kuehlewein, Laura; Rahimy, Ehsan; Tsui, Irena; Doshi, Rishi; Gaudric, Alain; Gorin, Michael B; Sadda, SriniVas; Sarraf, David

    2016-02-01

    To assess microvascular blood flow of the deep retinal capillary plexus in eyes with paracentral acute middle maculopathy using optical coherence tomography (OCT) angiography. Retrospective, multicenter observational case series. Clinical and multimodal imaging findings from 8 patients with paracentral acute middle maculopathy were reviewed and analyzed. OCT angiography scans were analyzed and processed, and vessel density was calculated. Eight patients (7 male, 1 female, aged 9-82 years) were included. OCT angiography was obtained at either the acute (4 cases) or old stage (4 cases). Scans of the deep capillary plexus showed preservation of perfusion in acute lesions and capillary attenuation in old cases. Cases of central retinal artery occlusion showed marked loss of the deep capillary plexus. The mean vessel density of the superficial capillary plexus in normal fellow eyes was 12.8 ± 1.8 mm(-1) vs 12.1 ± 1.9 mm(-1) in eyes with paracentral acute middle maculopathy (reduction -6.0%, P = .08). The mean vessel density of the deep capillary plexus in normal fellow eyes was 17.5 ± 1.4 mm(-1) vs 14.7 ± 3.5 mm(-1) in eyes with paracentral acute middle maculopathy (reduction -19.4%, P = .04). This significant difference was representative of the eyes with old lesions. Paracentral acute middle maculopathy lesions correspond to preservation of perfusion in focal acute lesions and to pruning of the plexus in old cases. Cases of central retinal artery occlusion demonstrate marked hypoperfusion of the deep capillary plexus. Our study further supports an ischemic pathogenesis of this retinal vasculopathy. Published by Elsevier Inc.

  13. Blocking LINGO-1 in vivo reduces degeneration and enhances regeneration of the optic nerve.

    Science.gov (United States)

    Gresle, Melissa M; Liu, Yaou; Kilpatrick, Trevor J; Kemper, Dennis; Wu, Qi-Zhu; Hu, Bing; Fu, Qing-Ling; So, Kwok-Fai; Sheng, Guoqing; Huang, Guanrong; Pepinsky, Blake; Butzkueven, Helmut; Mi, Sha

    2016-01-01

    Two ongoing phase II clinical trials (RENEW and SYNERGY) have been developed to test the efficacy of anti-LINGO-1 antibodies in acute optic neuritis and relapsing forms of multiple sclerosis, respectively. Across a range of experimental models, LINGO-1 has been found to inhibit neuron and oligodendrocyte survival, axon regeneration, and (re)myelination. The therapeutic effects of anti-LINGO-1 antibodies on optic nerve axonal loss and regeneration have not yet been investigated. In this series of studies we investigate if LINGO-1 antibodies can prevent acute inflammatory axonal loss, and promote axonal regeneration after injury in rodent optic nerves. The effects of anti-LINGO-1 antibody on optic nerve axonal damage were assessed using rodent myelin oligodendrocyte glycoprotein experimental autoimmune encephalomyelitis (EAE), and its effects on axonal regeneration were assessed in optic nerve crush injury models. In the optic nerve, anti-LINGO-1 antibody therapy was associated with improved optic nerve parallel diffusivity measures on MRI in mice with EAE and reduced axonal loss in rat EAE. Both anti-LINGO-1 antibody therapy and the genetic deletion of LINGO-1 reduced nerve crush-induced axonal degeneration and enhanced axonal regeneration. These data demonstrate that LINGO-1 blockade is associated with axonal protection and regeneration in the injured optic nerve.

  14. Recurrence of acute lymphoblastic leukemia manifesting as serous retinal detachments and optic disc swelling.

    Science.gov (United States)

    Yabas Kiziloglu, Ozge; Mestanoglu, Mert; Totuk Gedar, Ozgun Melike; Adiguzel, Cafer; Toygar, Okan

    2017-07-15

    The aim of this case report is to describe a patient with acute lymphoblastic leukemia (ALL) who developed bilateral serous retinal detachments and unilateral optic disc swelling. A 23-year-old woman with ALL presented to the ophthalmology clinic with bilateral subacute visual loss. Ophthalmologic examination revealed bilateral serous retinal detachments and unilateral optic disc swelling. Magnetic resonance imaging for differential diagnosis was inconclusive; however, cerebrospinal fluid sampling demonstrated leukemic involvement of the central nervous system. The patient's vision improved and fundus findings resolved with the institution of systemic and intrathecal chemotherapy. Serous retinal detachment and optic disc swelling are unusual ocular manifestations of ALL. They may occur due to leukemic infiltration of ocular structures and may indicate extramedullary recurrence of the disease. Early recognition and treatment is crucial to improve prognosis.

  15. 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.

  16. A study of the causes of bilateral optic disc swelling in Japanese patients

    Directory of Open Access Journals (Sweden)

    Iijima K

    2014-07-01

    Full Text Available Kei Iijima, Kimiya Shimizu, Yoshiaki Ichibe Department of Ophthalmology, Kitasato University, Kanagawa, Japan Purpose: To investigate the etiology of bilateral disc swelling in Japanese.Methods: Using Kitasato University’s Department of Neuro-Ophthalmology medical records and fundus photographs of the period December 1977 through November 2010, we retrospectively identified 121 outpatients who had been initially confirmed with bilateral disc swelling. Results: The most common cause of the bilateral disc swelling was increased intracranial pressure (ICP (59%; followed by pseudopapillitis (16%; uveitis (8%; hypertensive retinopathy (5%; bilateral optic neuritis, acute disseminated encephalomyelitis (ADEM and optic disc drusen (all at 2% each; and leukemia (1%. Unknown etiology accounted for 6% of the cases.Conclusion: Although increased ICP is the most common etiology for bilateral disc swelling, it can also be triggered by a variety of other causes. Pseudopapillitis is the most important progenitor of bilateral disc swelling in Japanese. Keywords: bilateral, disc swelling, papilledema, increased ICP, intracranial pressure

  17. CHARACTERIZING PHOTORECEPTOR CHANGES IN ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY USING ADAPTIVE OPTICS.

    Science.gov (United States)

    Roberts, Philipp K; Nesper, Peter L; Onishi, Alex C; Skondra, Dimitra; Jampol, Lee M; Fawzi, Amani A

    2018-01-01

    To characterize lesions of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) by multimodal imaging including adaptive optics scanning laser ophthalmoscopy (AOSLO). We included patients with APMPPE at different stages of evolution of the placoid lesions. Color fundus photography, spectral domain optical coherence tomography, infrared reflectance, fundus autofluorescence, and AOSLO images were obtained and registered to correlate microstructural changes. Eight eyes of four patients (two women) were included and analyzed by multimodal imaging. Photoreceptor reflectivity within APMPPE lesions was more heterogeneous than in adjacent healthy areas. Hyperpigmentation on color fundus photography appeared hyperreflective on infrared reflectance and on AOSLO. Irregularity of the interdigitation zone and the photoreceptor inner and outer segment junctions (IS/OS) on spectral domain optical coherence tomography was associated with photoreceptor hyporeflectivity on AOSLO. Interruption of the interdigitation zone or IS/OS was associated with loss of photoreceptor reflectivity on AOSLO. Irregularities in the reflectivity of the photoreceptor mosaic are visible on AOSLO even in inactive APMPPE lesions, where the photoreceptor bands on spectral domain optical coherence tomography have recovered. Adaptive optics scanning laser ophthalmoscopy combined with multimodal imaging has the potential to enhance our understanding of photoreceptor involvement in APMPPE.

  18. Resolvin D1 Programs Inflammation Resolution by Increasing TGF-β Expression Induced by Dying Cell Clearance in Experimental Autoimmune Neuritis.

    Science.gov (United States)

    Luo, Bangwei; Han, Fuyu; Xu, Kai; Wang, Jinsong; Liu, Zongwei; Shen, Zigang; Li, Jia; Liu, Yu; Jiang, Man; Zhang, Zhi-Yuan; Zhang, Zhiren

    2016-09-14

    Experimental autoimmune neuritis (EAN) is the animal model of human acute inflammatory demyelinating polyradiculoneuropathies (AIDP), an auto-immune inflammatory demyelination disease of the peripheral nervous system (PNS) and the world's leading cause of acute autoimmune neuromuscular paralysis. EAN and AIDP are characterized by self-limitation with spontaneous recovery; however, endogenous pathways that regulate inflammation resolution in EAN and AIDP remain elusive. A pathway of endogenous mediators, especially resolvins and clearance of apoptotic cells, may be involved. Here, we determined that resolvin D1 (RvD1), its synthetic enzyme, and its receptor were greatly increased in PNS during the recovery stage of EAN. Both endogenous and exogenous RvD1 increased regulatory T (Treg) cell and anti-inflammatory macrophage counts in PNS, enhanced inflammation resolution, and promoted disease recovery in EAN rats. Moreover, RvD1 upregulated the transforming growth factor-β (TGF-β) level and pharmacologic inhibition of TGF-β signaling suppressed RvD1-induced Treg cell counts, but not anti-inflammatory macrophage counts, and RvD1-improved inflammation resolution and disease recovery in EAN rats. Mechanistically, the RvD1-enhanced macrophage phagocytosis of apoptotic T cells leading to reduced apoptotic T-cell accumulation in PNS induced TGF-β production and caused Treg cells to promote inflammation resolution and disease recovery in EAN. Therefore, these data highlight the crucial role of RvD1 as an important pro-resolving molecule in EAN and suggest its potential as a therapeutic target in human neuropathies. Experimental autoimmune neuritis (EAN) is the animal model of human acute inflammatory demyelinating polyradiculoneuropathies, an auto-immune inflammatory demyelination disease of the peripheral nervous system (PNS) and the world's leading cause of acute autoimmune neuromuscular paralysis. Here, we demonstrated that resolvin D1 (RvD1) promoted macrophage

  19. 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.

  20. Bilateral Acute Anterior Uveitis and Optic Disc Edema Following a Snake Bite

    OpenAIRE

    Kumar, Praveen K; Ahuja, Shashi; Kumar, Praveen S

    2014-01-01

    The authors wish to report a case of bilateral acute anterior uveitis and optic disc edema following a hemotoxic snake bite, in order to highlight the concomitant occurrence of these conditions and the potential adverse effects of anti-snake venom (ASV). A 35-year-old male was bitten by a viper at seventeen thirty hours, and was started on ASV. Two days following treatment he experienced sudden onset redness and painful diminution of vision in both eyes (OU). On examination, the patient's vis...

  1. Optical Coherence Tomography Angiography of Paracentral Acute Middle Maculopathy Associated With Primary Antiphospholipid Syndrome.

    Science.gov (United States)

    Trese, Matthew G J; Thanos, Aristomenis; Yonekawa, Yoshihiro; Randhawa, Sandeep

    2017-02-01

    The authors present the first case of paracentral acute middle maculopathy as a manifestation of primary antiphospholipid syndrome (APS) with multimodal imaging, including optical coherence tomography angiography (OCTA). The association between APS and ophthalmic sequela is well-known. Recent advances in multimodal imaging, specifically OCTA, allow for better characterization of the mechanism and extent by which retinal arterial thrombosis can cause vision loss. Using advanced imaging modalities, the authors provide a comprehensive assessment of retinal ischemia, which showed not only localized capillary occlusion, but also ischemia of the deep retinal capillary plexus. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:175-178.]. Copyright 2017, SLACK Incorporated.

  2. Ischemic Optic Neuropathy in a Dog with Acute Bilateral Blindness and Primary Systemic Hypertension.

    Science.gov (United States)

    Mari, L; Stavinohova, R; Dominguez, E; Premont, J; Oliver, J; De Risio, L

    2017-11-12

    A 6-year-old neutered female Jack Russell terrier was investigated for sudden onset prechiasmatic bilateral blindness, left circling, reduced proprioception in the right pelvic limb and right facial allodynia. Electroretinography was normal. Magnetic resonance imaging (MRI) examination revealed that the right optic nerve and the optic chiasm were hyperintense on diffusion weighted imaging and hypointense on apparent diffusion coefficient map consistent with ischemic optic neuropathy. A concurrent lacunar infarct was detected in the left rostral colliculus. Primary systemic hypertension was diagnosed based on blood pressure measurement and no detectable abnormalities on hematology, comprehensive serum biochemistry, urinalysis including protein/creatinine and cortisol/creatinine ratios and thoracic/abdominal imaging. Prednisolone for 10 days and amlodipine long-term were administered. Vision was not recovered after 7 months. Repeat MRI supported the diagnosis of ischemic lesions and revealed a recent striatocapsular infarct. Ischemic optic neuropathy is a well-recognized cause of blindness in humans and should be included as a differential diagnosis for acute prechiasmatic blindness in dogs. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  3. CCR2 gene deletion and pharmacologic blockade ameliorate a severe murine experimental autoimmune neuritis model of Guillain-Barre syndrome.

    Directory of Open Access Journals (Sweden)

    Furong Yuan

    Full Text Available The molecular determinants and signaling pathways responsible for hematogenous leukocyte trafficking during peripheral neuroinflammation are incompletely elucidated. Chemokine ligand/receptor pair CCL2/CCR2 has been pathogenically implicated in the acute inflammatory demyelinating polyradiculoneuropathy variant of Guillain-Barré syndrome (GBS. We evaluated the role of CCR2 in peripheral neuroinflammation utilizing a severe murine experimental autoimmune neuritis (sm-EAN model. Sm-EAN was induced in 8-12 week old female SJL CCR2 knockout (CCR2KO, heterozygote (CCR2HT and wild type (CCR2WT mice, and daily neuromuscular severity scores and weights recorded. In vitro and in vivo splenocyte proliferation and cytokine expression assays, and sciatic nerve Toll-like receptor (TLR 2, TLR4 and CCL2 expression assays were performed to evaluate systemic and local innate immune activation at disease onset. Motor nerve electrophysiology and sciatic nerve histology were also performed to characterize the inflammatory neuropathy at expected peak severity. To further determine the functional relevance of CCR2 in sm-EAN, 20 mg/kg CCR2 antagonist, RS 102895 was administered daily for 5 days to a cohort of CCR2WT mice following sm-EAN disease onset, with efficacy compared to 400 mg/kg human intravenous immunoglobulin (IVIg. CCR2KO mice were relatively resistant to sm-EAN compared to CCR2WT and CCR2HT mice, associated with attenuated peripheral nerve demyelinating neuritis. Partial CCR2 gene deletion did not confer any protection against sm-EAN. CCR2KO mice demonstrated similar splenocyte activation or proliferation profiles, as well as TLR2, TLR4 and CCL2 expression to CCR2WT or CCR2HT mice, implying a direct role for CCR2 in sm-EAN pathogenesis. CCR2 signaling blockade resulted in rapid, near complete recovery from sm-EAN following disease onset. RS 102895 was significantly more efficacious than IVIg. CCR2 mediates pathogenic hematogenous monocyte trafficking

  4. 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.)

  5. Changes in Optical Coherence Tomography Findings in Acute Zonal Occult Outer Retinopathy

    Directory of Open Access Journals (Sweden)

    Shinji Makino

    2013-09-01

    Full Text Available Purpose: To report a case of acute zonal occult outer retinopathy (AZOOR in a 39-year-old woman. Methods: Images were obtained with fundus photography and optical coherence tomography (OCT. A multifocal electroretinogram (mfERG was also obtained to evaluate retinal function. Results: The patient's right visual acuity was 0.8. Fundus photographs showed no specific abnormal findings. OCT showed attenuation of the photoreceptor inner segment/outer segment (IS/OS line and the cone outer segment tip (COST line in the right eye. The mfERG showed corresponding amplitude reductions. One month after the initial visit, her right visual acuity improved to 1.2. There was partial recovery of the IS/OS line; however, the COST line was still absent, and there was no apparent improvement in the mfERG responses. Conclusions: Our findings showed a discrepancy between the microstructural findings and visual function during recovery of AZOOR.

  6. Optical Coherence Tomography Guidance in Management of Acute Coronary Syndrome Caused by Plaque Erosion.

    Science.gov (United States)

    Jia, Haibo; Kubo, Takashi; Akasaka, Takashi; Yu, Bo

    2018-01-25

    For several decades, most physicians have believed that acute coronary syndrome (ACS) is caused by coronary thrombosis resulting from rupture of vulnerable plaque characterized by a thin fibrous cap overlying a large necrotic core and massive inflammatory cell infiltration. However, nearly one-third of ACS cases are caused by plaque erosion characterized by intact fibrous cap, less or absent necrotic core, less inflammation, and large lumen. Because of the limitations of current imaging modalities, including angiography and intravascular ultrasound, the importance of plaque erosion as a cause of acute coronary events is less well known. Optical coherence tomography (OCT) as an emerging modality with extremely high resolution is the only intravascular imaging modality available for identification of plaque erosion in vivo, which provides new insight into the mechanism of ACS. More importantly, the introduction of OCT to clinical practice enables us to differentiate the patients with ACS caused by plaque erosion from those caused by plaque rupture, thereby providing precise and personalized therapy based on the different underlying mechanisms. We systematically review the morphological characteristics of plaque erosion identified by OCT and its implications for the management of ACS.

  7. [Optic nerve lesions in diabetes mellitus].

    Science.gov (United States)

    Ignat, Florica; Bărăscu, Doina; Perovic, Iliya; Munteanu, Alina

    2002-01-01

    The present paper is a retrospective study revealing some optic nerve lesions on a group of 1.700 diabetic patients which belonged to the common casuistry of the Ophthalmologic Clinic and Diabetic and Nutrition Diseases Clinic in Craiova. A reduced frequency of optic neuropathy in diabetic persons was established such as: 27 patients (1.58%). Affected optic nerve may present various clinical aspects among which ischemic optic neuropathy is predominant (59.20%) followed by secondary optic atrophy, ischemic optic post neuropathy (33.40%) and juxtabulbar optic neuritis (7.40%).

  8. Treatment of Orbital Complications Following Acute Rhinosinusitis in Children.

    Science.gov (United States)

    Wan, Yuzhu; Shi, Guanggang; Wang, Haibo

    2016-07-01

    The orbital complications account for about 80% of all complications secondary to acute rhinosinusitis. If the treatment is not correct and in time, orbital complications could progress rapidly, leading to optic neuritis, cavernous sinus thrombophlebitis or life-threatening intracranial complications. To evaluate the therapeutic efficacy of conservative therapy for the patients with orbital cellulitis and endoscopic sinus surgery (ESS) performed on patients with subperiosteal abscess (SPA) secondary to acute rhinosinusitis in children. Retrospective cross-sectional study. The retrospective study included 31 pediatric patients with orbital complications secondary to acute rhinosinusitis. In all cases, intensive treatment was initiated with a combination of oral or intravenous antibiotics, glucocorticoid and gelomyrtol forte after admission. ESS was performed if an improvement in the condition of patients did not occur after 48 hours. However, the patients with orbital SPA, motility disorders of eyeball or decreased vision received ESS immediately within 24 hours. Sixteen patients were cured by conservative therapy and 15 patients by ESS. All of the signs and symptoms disappeared after conservative therapy or ESS. There were no recurrences within the follow-up period of 1 to 8 years. Conservative therapy is an effective method for patients with inflammatory edema and most cases of orbital cellulitis in children. SPA can be cured by ESS.

  9. Anti-aquaporin 4 antibody-positive acute disseminated encephalomyelitis.

    Science.gov (United States)

    Okumura, Akihisa; Nakazawa, Mika; Igarashi, Ayuko; Abe, Shinpei; Ikeno, Mitsuru; Nakahara, Eri; Yamashiro, Yuichiro; Shimizu, Toshiaki; Takahashi, Toshiyuki

    2015-03-01

    To describe the clinical and neuroimaging features of a young female patient with acute disseminated encephalomyelitis associated with anti-aquaporin-4 antibodies. The patient had mild encephalopathy 14 days after influenza vaccination. Cerebrospinal fluid analysis revealed an increased cell count and a marked increase in myelin basic protein. Magnetic resonance imaging (MRI) demonstrated multiple lesions in the juxtacortical white matter. The patient was diagnosed with acute disseminated encephalomyelitis and treated with methylprednisolone pulse therapy. She recovered in 1 month. However, right retrobulbar optic neuritis appeared 2 months after discharge, and serum anti-aquaporin 4 antibodies were measured with a cell-based assay. Anti-aquaporin 4 antibodies were present in the patient's serum. She was treated with a prolonged course of oral prednisolone. The patient was negative for serum anti-aquaporin 4 antibodies 8 months after the second clinical event, and prednisolone was discontinued 13 months after the second clinical event. Serum anti-aquaporin 4 antibodies remained negative 4 months after the discontinuation of prednisolone. There was no evidence of relapse at 9 months after discontinuation of steroids. This case will expand the spectrum of anti-aquaporin-4 antibody-related central nervous system disorders. The measurement of anti-aquaporin 4 antibody may be considered in patients with a clinical diagnosis of acute disseminated encephalomyelitis and a second clinical event within a short interval. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  10. Bilateral acute anterior uveitis and optic disc edema following a snake bite.

    Science.gov (United States)

    Kumar, Praveen K; Ahuja, Shashi; Kumar, Praveen S

    2014-04-01

    The authors wish to report a case of bilateral acute anterior uveitis and optic disc edema following a hemotoxic snake bite, in order to highlight the concomitant occurrence of these conditions and the potential adverse effects of anti-snake venom (ASV). A 35-year-old male was bitten by a viper at seventeen thirty hours, and was started on ASV. Two days following treatment he experienced sudden onset redness and painful diminution of vision in both eyes (OU). On examination, the patient's visual acuity (VA) in OU was 20/200. Examination revealed fresh keratic precipitates, cells, and flare in the anterior chamber (AC), posterior synechiae, sluggish and ill-sustained pupillary reaction, and hyperemic, edematous disc with blurred margins in OU. He was started on topical steroids, cycloplegics and intravenous methylprednisolone. Following treatment, the patient showed improvement and was continued on topical medications and oral prednisolone tapered over 3 weeks, after which VA OU improved, the AC showed no cells and flare and disc edema resolved. Uveitis and optic disc edema in snake bite can either be due to the direct toxic effects of the venom or the effect of ASV. Steroids have a beneficial role in the management of these symptoms.

  11. An Evaluation Of Acupuncture As A Modality Of Treatment Of Leprous Neuritis

    OpenAIRE

    Chattopadhyay S P; Neogi Bidisa Guha

    1995-01-01

    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 an...

  12. Wartenberg?s migrant sensory neuritis: a prospective follow-up study

    OpenAIRE

    Stork, Abraham C. J.; van der Meulen, Marjon F. G.; van der Pol, W.-Ludo; Vrancken, Alexander F. J. E.; Franssen, Hessel; Notermans, Nicolette C.

    2010-01-01

    Migrant sensory neuropathy (Wartenberg?s migrant sensory neuritis) is characterized by sudden numbness in the distribution of one or multiple cutaneous nerves. To study disease course and outcome, we prospectively followed 12 patients who presented to our tertiary referral neuromuscular outpatient clinic between January 2003 and January 2004. Medical history, neurological, laboratory and electrophysiological examinations were obtained from all patients. All patients were reviewed a second tim...

  13. [Bilateral leukemic optic nerve infiltration as the first manifestation of extramedullary relapse in T-cell acute lymphoblastic leukemia].

    Science.gov (United States)

    Amer, Radgonde; David, Ran; Dotan, Shlomo

    2013-02-01

    T-cell acute lymphoblastic leukemia is a hematologic malignancy with propensity to involve extramedullary organs including the eyes. Optic nerve infiltration is relatively rare. This is the case study of a 25-year-old- man who was in full remission following treatment for T-cell acute lymphoblastic leukemia and presented with bilateral leukemic optic nerve infiltration as the first manifestation of extramedullary relapse. The patient was treated with urgent radiotherapy and systemic dexamethasone. Over the following period, gradual resolution of optic disc swelling was noted in both eyes with marked improvement in vision in the right eye. Unfortunately, a few weeks later, a full blown hematological relapse was diagnosed. Salvage chemotherapy was instituted but was complicated by tumor lysis syndrome and septicemia that proved to be fatal. Ophthalmic assessment is essential in patients with hematological malignancies in order to diagnose ocular involvement as a result of malignant infiltration, hematological disturbances or as a complication of systemic therapy.

  14. Correlation of spectral domain optical coherence tomography findings in acute central serous chorioretinopathy with visual acuity

    Directory of Open Access Journals (Sweden)

    Nair U

    2012-11-01

    Full Text Available Unnikrishnan Nair,1 Sunil Ganekal,2 Manoj Soman,1 KGR Nair11Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India; 2Nayana Super Specialty Eye Hospital and Research Center, Davangere, Karnataka, IndiaPurpose: To evaluate the structural changes in the acute phase of central serous chorioretinopathy and after its resolution, using spectral domain optical coherence tomography, to correlate these tomographic changes with visual acuity (VA.Method: This was a prospective study of 100 consecutive patients with acute central serous chorioretinopathy. It was based on presenting the best-corrected VA, divided into three groups (Group 1, n = 36, VA 6/6; Group 2, n = 49, VA 6/9–6/18; Group 3, n = 15, VA > 6/18. All patients underwent fundus evaluation followed by fluorescein angiography and spectral domain optical coherence tomography.Results: The mean age of the patients was 40 ± 7.17 years. The mean log MAR VA was 0.176 ± 0.0185. Single pigment epithelial detachment (PED, and multiple discrete and multiple confluent PEDs were seen in 21%, 17%, and 32% of the eyes, respectively. The location of the PED was subfoveal in 35% of the eyes. The presence of subretinal fibrin and a rough undersurface of the neurosensory retina were noted in 61% and 64% of the eyes, respectively. On en-face scanning, a break in the walls of the PED and overlying fibrin were seen in 32.8% and 45% of the eyes, respectively. The mean subretinal fluid height at the fovea was 279.11 ± 148.78 µ. The mean outer nuclear layer thickness during the active stage was 95.10 µ and during the resolved stage, it was 77.69 µ (P = 0.012. The average photoreceptor lengths were 73.1 µ, 84.6 µ, and 94.9 µ in groups 1, 2, and 3, respectively, in the acute phase; and 69.5 µ, 70.8 µ, and 61.6 µ, respectively, after resolution (P = 0.013, P = 0.010, and P = 0.011.Conclusion: In the acute phase of the disease, poorer VA showed statistically significant association with

  15. 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.

  16. OPTICAL IMAGING OF LIPOPOLYSACCHARIDE-INDUCED OXIDATIVE STRESS IN ACUTE LUNG INJURY FROM HYPEROXIA AND SEPSIS

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    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.

  17. 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.

  18. 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.

  19. Spectral domain optical coherence tomographic findings at convalescent stage of acute zonal occult outer retinopathy

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    Kouichi Ohta

    2009-07-01

    Full Text Available Kouichi Ohta, Atsuko Sato Emi FukuiDepartment of Ophthalmology, Matsumoto Dental University, Shiojiri, Nagano, JapanPurpose: To describe the morphology of the retina at the convalescent stage of acute zonal occult outer retinopathy (AZOOR from images obtained by spectral domain optical coherence tomography (SD-OCT.Methods: The visual fields, electroretinograms (ERGs, and OCT images were reviewed in two women aged 24 and 33 years. The patients were followed for one and four years, respectively.Results: In both cases, the anterior and posterior segments were almost normal, although both patients had a sudden unilateral vision decrease and photopsia. Goldmann perimetry revealed enlarged blind spots and scotomas. The ERGs were reduced in both cases. SD-OCT showed that the junction of the inner and outer segment, the IS/OS line, of the photoreceptors was irregular or lost in the affected retinas. The retina in these areas was thinner due to a decrease in the thickness of both the outer nuclear layer (ONL and inner nuclear layer (INL in Case 2. Conclusions: The decrease in retinal thickness at the convalescent stage of AZOOR is most likely due to a shortening of not only the photoreceptors and ONL but also to a thinning of the INL in a severe case.Keywords: AZOOR, SD-OCT, IS/OS, ONL

  20. 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.

  1. Recovery of canine retina and optic nerve function after acute elevation of intraocular pressure: implications for canine glaucoma treatment.

    Science.gov (United States)

    Grozdanic, Sinisa D; Matic, Milan; Betts, Daniel M; Sakaguchi, Donald S; Kardon, Randy H

    2007-01-01

    To characterize the timing and extent of functional recovery in healthy canine eyes exposed to acute elevation of intraocular pressure (IOP). Acute elevation of IOP was induced in 14 healthy Beagles by elevating IOP above the levels of systolic blood pressure for 60 min (average elevation was between 100 and 160 mmHg). Menace, dazzle and pupillary light reflexes (PLR) were tested at 1, 7, 14 and 28 days post elevation. Optical coherence tomography was used to evaluate retinal thickness preoperatively and at 15 and 30 days post elevation. One day post elevation all animals were blind in the operated eye (no positive menace), 5/14 had positive PLR and 10/14 had positive dazzle response. Seven days post elevation 4/14 animals had positive menace response and all animals (14/14) had positive dazzle and PLR responses. Fourteen and 28 days post elevation all animals had positive menace, PLR and dazzle responses. Optical coherence tomography analysis revealed significant thinning of the inferior retina (pre elevation: 156.3 +/- 4.8 microm; 15 days post elevation: 125 +/- 10.4 microm; 30 days post elevation 123 +/- 11.9 microm; P information about retinal damage after acute elevation of IOP. Canine retina has the capacity to recover at least some visual function even at 14 days after acute elevation of the IOP. More aggressive medical and surgical treatment of canine glaucomatous patients may be indicated despite complete loss of visual function, PLR and dazzle responses in early days after development of an acute glaucomatous attack.

  2. PARACENTRAL ACUTE MIDDLE MACULOPATHY IN A PERIVENULAR FERN-LIKE DISTRIBUTION WITH EN FACE OPTICAL COHERENCE TOMOGRAPHY.

    Science.gov (United States)

    Garrity, Sean T; Tseng, Victoria L; Sarraf, David

    2017-11-22

    To report a case of central retinal vein occlusion resulting in a perivenular pattern of paracentral acute middle maculopathy lesions best identified with en face optical coherence tomography (OCT). Retrospective case report. Optos ultra-widefield fluorescein angiography, spectral domain OCT, en face OCT, and OCT angiography were performed. A 41-year-old man presented with decreased vision in the right eye for 2 weeks. Funduscopic examination of the affected right eye was notable for subtle retinal whitening in the macula, mild retinal venous dilation and tortuosity, and few scattered retinal dot and blot hemorrhages consistent with an acute central retinal vein occlusion. Widefield fluorescein angiography demonstrated delayed arterial and venous filling but no evidence of significant peripheral retinal vascular ischemia. En face OCT segmented at the inner nuclear layer illustrated a remarkable and precise perivenular distribution of fern-like paracentral acute middle maculopathy with periarterial sparing, whereas en face OCT segmented at the outer nuclear layer demonstrated florid cystoid macular edema. At 6-week follow-up, OCT demonstrated patchy areas of atrophic inner nuclear layer and spontaneous resolution of the cystoid macular edema. Optical coherence tomography angiography at the level of the deep capillary plexus illustrated remarkable flow reduction of the deep capillary plexus in mainly a perivenular distribution. The authors report a case of a central retinal vein occlusion with mild retinal findings associated with a remarkable perivenular pattern of paracentral acute middle maculopathy with en face OCT. Follow-up OCT angiography demonstrated significant flow reduction of the deep capillary plexus in a perivenular pattern. The perivenular pattern of paracentral acute middle maculopathy lesions with en face OCT can be an important finding suggestive of a central retinal vein occlusion.

  3. [Retinal atrophy using optical coherence tomography (OCT) in 15 patients with multiple sclerosis and comparison with healthy subjects].

    Science.gov (United States)

    Jeanjean, L; Castelnovo, G; Carlander, B; Villain, M; Mura, F; Dupeyron, G; Labauge, P

    2008-11-01

    Multiple sclerosis is a common disabling progressive neurological disorder. Axonal loss is thought to be a likely cause of persistent disability after a multiple sclerosis relapse. Retinal nerve fiber layer (RNFL) imaging by optical coherence tomography (OCT) seems to be a non-invasive way of detecting optical axonal loss following optic neuritis. To determine whether multiple sclerosis affects retinal nerve fiber layer measurements obtained with optical coherence tomography (OCT3-Carl Zeiss Meditec, Dublin, California, USA). Diagnosis of MS was based on the MacDonald criteria. The cohort was divided into two groups based on their clinical course (multiple sclerosis with [n=8; 16 eyes] or without [n=7; 14 eyes] optic neuritis antecedents). The disease-free controls were matched for age and gender (n=15; 30 eyes). Retinal nerve fiber layer thickness was measured using optical coherence tomography (OCT; fastRNFL and RNFL thickness software protocol). Visual acuity, visual field, color vision were also noted. There were highly significant reductions (pcolor vision were globally less altered than OCT. There were no significant relationships among RNFL thickness and visual acuity, visual field, or color vision. This study has demonstrated the anatomic changes of the retinal nerve fiber layer of patients with multiple sclerosis with optic neuritis antecedents. Thus axonal loss following optic neuritis can be detected with OCT. But the retinal nerve fiber layer of patients without optic neuritis is also thinner than disease-free controls so that chronic optic axonal loss can be frequent in multiple sclerosis. Additionally, OCT was more sensitive than the common ophthalmological explorations to detect optical nerve impairment during multiple sclerosis. Finally, we demonstrated that two procedures fastRNFL and RNFL could be used to detect optic nerve impairment.

  4. Vitreous Hyper-Reflective Dots in Optical Coherence Tomography and Retinal Tear in Patients with Acute Posterior Vitreous Detachment.

    Science.gov (United States)

    Oh, Jong-Hyun; Oh, Jaeryung; Roh, Hyun Cheol

    2017-08-01

    To report the presence of hyper-reflective dots in the vitreous cavity using spectral-domain optical coherence tomography (SD-OCT) in patients with acute symptomatic posterior vitreous detachment (PVD) and investigate their association with the presence of retinal tear. The medical records of 77 patients with acute symptomatic PVD, who were examined between March 2013 and February 2015, were reviewed. The severity of vitreous hyper-reflective dots (VHDs) was graded using SD-OCT images, and the presence of retinal tear was assessed. Forty-one (53.2%) eyes had mild VHDs, 13 (16.9%) eyes had moderate VHDs, and 14 (18.2%) eyes had severe VHDs. Retinal tear was found in 21 (27.3%) eyes. The presence of severe VHDs was associated with an increased likelihood of retinal tear (positive likelihood ratio, 9.78; 95% confidence interval, 3.02-31.63). In 14 (66.7%) eyes with retinal tear, the mean number of VHDs significantly decreased from 23.2 ± 20.27 to 2.3 ± 2.66 at a mean follow-up interval of 2.8 ± 1.48 weeks (P = 0.002). The presence of severe VHDs is suggestive of retinal tear in patients with acute symptomatic PVD. However, this SD-OCT finding should be limited to the acute phase of PVD.

  5. 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

    Patient Registry (1998-2006), we identified 1677 patients with ON and compared them with 6708 randomly selected citizens matched for age, sex and geography. A societal perspective is taken towards the cost analyses. Costs included in the analysis are those of the health sector, including all contacts...... transfer income of €1175 and €4619. ON/ON+MS patients presented social and economic consequences up to 8 years before diagnosis, and these increased after the diagnosis was established. CONCLUSIONS: ON, especially if combined with a diagnosis of MS, has a significant socioeconomic consequence...

  6. The neutrophil-to-lymphocyte ratio as disease actvity marker in multiple sclerosis and optic neuritis

    DEFF Research Database (Denmark)

    Bisgaard, A K; Pihl-Jensen, G; Frederiksen, J L

    2017-01-01

    retrospectively. The NLRs were compared for all participants by Student's t-test. The comparison of NLR between relapse and remission, SPMS and PPMS, and RRMS and progressive MS were all adjusted for age, gender, EDSS and disease duration by using the linear regression model. Pearson correlation analysis was made......BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). The neutrophil-to-lymphocyte ratio (NLR) has been identified as a disease activity marker in several diseases. We aim to evaluate the significance of the NLR in the different subtypes of MS...... between NLR and time of blood sampling. Logistic regression models were constructed for EDSS ≥ 4.0 as outcome. RESULTS: The NLR was significantly higher (p

  7. 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

    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...... 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...

  8. 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 affected and unaffected eye diminished during recovery, and after 180 days the difference was no longer significant (P = 0.59). The decreased difference during recovery was mainly due to an increase in the fMRI signal when stimulating the affected eye, but included a component of a decreasing fMRI signal...

  9. Pupillometric evaluation of the melanopsin containing retinal ganglion cells in mitochondrial and non-mitochondrial optic neuropathies

    DEFF Research Database (Denmark)

    Ba-Ali, Shakoor; Lund-Andersen, Henrik

    2017-01-01

    of pupillary light reflex is primarily driven by the ipRGCs. Optic neuropathies i.e. Leber hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (ADOA), nonarteritic anterior ischemic optic neuropathy (NAION), glaucoma, optic neuritis and idiopathic intracranial hypertension (IIH) are among...... the diseases, which have been subject to pupillometric studies. The ipRGCs are differentially affected in these various optic neuropathies. In mitochondrial optic neuropathies, the ipRGCs are protected against degeneration, whereas in glaucoma, NAION, optic neuritis and IIH the ipRGCs are damaged. Here, we...... will review the results of pupillometric, histopathological and animal studies evaluating the ipRGCs in mitochondrial and non-mitochondrial optic neuropathies....

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. Lipooligosaccharide of Campylobacter jejuni prevents myelin-specific enteral tolerance to autoimmune neuritis--a potential mechanism in Guillain-Barre syndrome?

    Science.gov (United States)

    Jung, Stefan; Zimmer, Sabine; Lüneberg, Edeltraud; Frosch, Matthias; Karch, Helge; Korn, Thomas; Toyka, Klaus V

    Campylobacter jejuni-induced enteritis is the most common infection preceding Guillain-Barre syndrome (GBS), an immune-mediated polyradiculoneuritis. The acute autoimmune attack is thought to be based on C. jejuni antigens which may mimick antigens of the peripheral nervous system. Additional pathomechanisms, like disturbance of natural T cell immunoregulation by C. jejuni, have not been evaluated so far. In experimental autoimmune neuritis (EAN), a T lymphocyte-mediated animal model of human GBS, tolerance to myelin-derived autoantigens can be induced by oral feeding of the respective antigen. Here we investigated whether the lipooligosaccharide (LOS) fraction of C. jejuni may directly alter immunologic tolerance through gastrointestinal pathways. While EAN, actively induced by immunization with bovine peripheral nerve myelin could be ameliorated by precedent feeding of myelin, feeding of C. jejuni LOS along with the myelin antigen not only prevented the tolerizing effects of oral myelin but even accelerated the onset of overt EAN and augmented the myelin-specific B cell response. These findings provide evidence that LOS of C. jejuni, as produced in the gut during C. jejuni-induced enteritis, can disturb natural tolerance to definite proteins which may be or may mimic peripheral nerve antigens. In human patients this may be one of the potential mechanisms to explain why C. jejuni enteritis is a common trigger of GBS.

  15. Optics

    CERN Document Server

    Mathieu, Jean Paul

    1975-01-01

    Optics, Parts 1 and 2 covers electromagnetic optics and quantum optics. The first part of the book examines the various of the important properties common to all electromagnetic radiation. This part also studies electromagnetic waves; electromagnetic optics of transparent isotropic and anisotropic media; diffraction; and two-wave and multi-wave interference. The polarization states of light, the velocity of light, and the special theory of relativity are also examined in this part. The second part is devoted to quantum optics, specifically discussing the classical molecular theory of optical p

  16. 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

  17. 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

  18. 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

  19. Optical coherence tomography: a reliable alternative to invasive histological assessment of acute wound healing in human skin?

    Science.gov (United States)

    Greaves, N S; Benatar, B; Whiteside, S; Alonso-Rasgado, T; Baguneid, M; Bayat, A

    2014-04-01

    Gold-standard assessment of acute wound healing has traditionally been through histological analysis of biopsied tissue. However, this process is invasive with recognized side-effects. Optical coherence tomography (OCT) is a noninvasive technique generating high-resolution real-time images of cutaneous architecture. To compare OCT with histological assessment of in vivo acute wound healing and ascertain the level of agreement between modalities for measurement of defined cutaneous structures. Punch biopsies (5 mm) were harvested from 50 healthy volunteers. Wounds healed by secondary intention until they were re-excised 7, 14, 21 or 28 days later depending on random group allocation. Wounds were assessed weekly for 6 weeks using OCT and compared with histological findings derived from time-matched biopsies. Dimensions of four cutaneous structures were measured using both modalities and the level of agreement was established by Bland-Altman analysis. The mean greyscale value (MGV) of the upper reticular dermis was derived from OCT images at all time points. Both techniques showed anatomical congruity in normal and wounded skin with correlating architectural changes associated with inflammatory, proliferative and remodelling wound healing phases. MGV was significantly increased 6 weeks after wounding (P = 0·001) and may represent a novel measure of wound fibrosis. Despite good association of histomorphometric values with low but consistent bias (range -4·181 to 0·431 μm), Bland-Altman plots demonstrated poor agreement between OCT and histology. Optical coherence tomography enabled accurate assessment of healing tissue comparable with histological analysis of biopsy specimens. This noninvasive tool is highly suited to wound assessment and may represent a diagnostic alternative to punch biopsies. © 2013 British Association of Dermatologists.

  20. 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

    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. 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. 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. 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.

  1. 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. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Multiple sclerosis and acute disseminated encephalomyelitis diagnosed in children after long-term follow-up: comparison of presenting features

    Science.gov (United States)

    Alper, Gulay; Heyman, Rock; Wang, Li

    2008-01-01

    The aim of this study was to compare the characteristics of the first demyelinating event between acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). Children with acute demyelinating disease of the central nervous system and an abnormal brain magnetic resonance image (MRI) were studied. Patients were assigned a final diagnosis after long-term follow-up. Comparisons were made between the MS and ADEM groups. Proposed definitions by the Pediatric MS Study Group were applied to our cohort in retrospect and are discussed. Fifty-two children and adolescents with a documented abnormal brain MRI were identified (24 females, 28 males; mean age 10y 11mo [SD 5y 4mo] range 1y 10mo–19y 7mo). To date, 26 children have been diagnosed with MS, and 24 with ADEM. One child has relapsing neuromyelitis optica and one child has clinically isolated optic neuritis. Follow-up duration was 6 years 8 months in monophasic patients, and 5 years 6 months in relapsing patients. None of the patients with MS had encephalopathy while encephalopathy was present in 42% of patients with ADEM. Cerebrospinal fluid oligoclonal bands, an elevated immunoglobulin G index, and the periventricular perpendicular ovoid lesions correlated with MS outcome. Several clinical characteristics differ between ADEM and MS at first presentation; encephalopathy, when present, strongly suggests the diagnosis of ADEM. PMID:19018840

  3. 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.

  4. Clinically Isolated Syndromes Suggestive of Multiple Sclerosis: An Optical Coherence Tomography Study

    OpenAIRE

    Oreja-Guevara, Celia; Noval, Susana; Alvarez-Linera, Juan; Gabaldón, Laura; Manzano, Beatriz; Chamorro, Beatriz; Diez-Tejedor, Exuperio

    2012-01-01

    BACKGROUND: Optical coherence tomography (OCT) is a simple, high-resolution technique to quantify the thickness of retinal nerve fiber layer (RNFL), which provides an indirect measurement of axonal damage in multiple sclerosis (MS). This study aimed to evaluate RNFL thickness in patients at presentation with clinically isolated syndromes (CIS) suggestive of MS. METHODOLOGY: This was a cross-sectional study. Twenty-four patients with CIS suggestive of MS (8 optic neuritis [ON], 6 spinal cord s...

  5. 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.

  6. case report successful treatment of bilateral visual loss caused by

    African Journals Online (AJOL)

    2011-12-02

    Dec 2, 2011 ... Sweeney BJ, Manji H, Gilson RJC, Harrison MJG. Optic neuritis and HIV-1 infection. J Neurol Neurosurg Psychiatry 1993;56:705-707. 13. Larsen M, Toft PB, Bernhard P, Henning M. Bilateral optic neuritis in acute immunodeficiency infection. Acta Ophthalmol Scand 1998;76:737-738. 14. Brack MJ, Cleland ...

  7. 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

  8. [Microcirculation and permeability of the pulmonary capillaries in the dynamics of experimental neuritis of the vagus nerve].

    Science.gov (United States)

    Kolosov, V V

    1983-04-01

    Intravital biomicroscopy was used to study permeability and microcirculation of pulmonary vessels during experimental neuritis of the vagus nerve. The study lasted 14 days. Vascular permeability was evaluated from the changes in adhesion capacity of capillary endothelium with respect to India ink. The microhemodynamics was explored by visual observation and appraisal of the photo and film documents. The most pronounced changes were noticed on the 3d day. In the following days the changes were phasic in nature, repeating on days 6, 9 and 12. All the changes were synchronous.

  9. Effective treatment of cytomegalovirus retinitis and neuritis with retrobulbar ganciclovir after treosulfan-based autologous bone marrow transplant.

    Science.gov (United States)

    Raciborska, Anna; Ussowicz, Marek; Prost, Marek; Bilska, Katarzyna; Rodriguez-Galindo, Carlos; Rychlowska-Pruszynska, Magdalena

    2015-01-01

    We describe the case of a 16-month-old girl with neuroblastoma and chronic lymphocytopenia due to chemotherapy and treosulfan-containing megatherapy who developed cytomegalovirus retinitis and neuritis. Intravenous ganciclovir and anti-cytomegalovirus immunoglobulin were used with a transient benefit; however, retrobulbar gancyclovir resulted in a complete remission. This report emphasizes the need for close monitoring of viral infections in patients undergoing treosulfan-containing megatherapy, highlighting the immunosuppressive effects of this agent, and indicates the potential use of retrobulbar ganciclovir as the alternative method of drug delivery.

  10. Dominant foot could affect the postural control in vestibular neuritis perceived by dynamic body balance.

    Science.gov (United States)

    Yoshida, Tomoe; Tanaka, Toshitake; Tamura, Yuya; Yamamoto, Masahiko; Suzuki, Mitsuya

    2018-01-01

    During attacks of vestibular neuritis (VN), patients typically lose postural balance, with resultant postural inclination, gait deviation toward the lesion side, and tendency to fall. In this study, we examined and analyzed static and dynamic postural control during attacks of VN to characterize differences in postural control between right and left VN. Subjects were patients diagnosed with VN at the Department of Otolaryngology, Toho University Sakura Medical Center, and underwent in-patient treatment. Twenty-five patients who had spontaneous nystagmus were assessed within 3days after the onset; all were right-foot dominant. Right VN was detected in nine patients (men: 4, women: 5; mean age: 57.6±17.08years [range: 23-82]) and left VN in 16 patients (men: 10, women: 6; mean age: 58.4±14.08years [range: 23-85 years]); the percentages of canal paresis of right and left VN were 86.88±18.1% and 86.02±15.0%, respectively. Statistical comparisons were conducted using the independent t-test. In stabilometry, with eyes opened, no significant differences were found between patients with right and left VN. However, with eyes closed, the center of horizontal movement significantly shifted ipsilateral (p<0.01). The differences in the lateral and anteroposterior body tracking test (BTT) were statistically significant (p=0.0039 and p=0.0376, respectively), with greater changes in cases with right VN. Thus, the dominant foot might contribute to the postural control mechanism. Copyright © 2017 Elsevier B.V. All rights reserved.

  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. [Nonarteritic ischemic optic neuropathy animal model and its treatment applications].

    Science.gov (United States)

    Chuman, Hideki

    2014-04-01

    Nonarteritic ischemic optic neuropathy (NAION) is one of the most common acute unilaterally onset optic nerve diseases. One management problem in terms of NAION is the difficulty of differential diagnosis between NAION and anterior optic neuritis (ON). A second problem is that there is no established treatment for the acute stage of NAION. A third problem is that there is no preventive treatment for a subsequent attack on the fellow eye, estimated to occur in 15 to 25% of patients with NAION. For differentiation of acute NAION from anterior optic neuritis, we investigated the usefulness of laser speckle flowgraphy (LSFG). In the normal control group, the tissue blood flow did not significantly differ between the right and left eyes. In the NAION group, all 6 patients had 29.5% decreased mean blur rate (MBR), which correlates to optic disc blood flow, of the NAION eye compared with the unaffected eye. In the anterior ON group, all 6 cases had 15.9% increased MBR of the anterior ON eye compared with the unaffected eye. Thus, LSFG showed a difference of the underlying pathophysiology between NAION and anterior ON despite showing disc swelling in both groups and could be useful for differentiating both groups. For the treatment of acute stage of NAION, we tried to reproduce the rodent model of NAION (rNAION) developed by Bernstein and colleagues. To induce rNAION, after the administration of rose bengal(RB) (2.5 mM) into the tail vein of SD rats, the small vessels of the left optic nerve were photoactivated using a 514 nm argon green laser (RB-laser-induction). In the RB-laser-induction eyes, the capillaries within the optic disc were reduced markedly, the optic disc became swollen, and fluorescein angiography showed filling defect in the choroid and the optic disc at an early stage, followed by hyperfluorescence at a late stage. Electrophysiological evaluation revealed that visual evoked potential (VEP) amplitude was significantly decreased but an electroretinogram

  13. Nonculprit Plaque Characteristics in Patients With Acute Coronary Syndrome Caused by Plaque Erosion vs Plaque Rupture: A 3-Vessel Optical Coherence Tomography Study.

    Science.gov (United States)

    Sugiyama, Tomoyo; Yamamoto, Erika; Bryniarski, Krzysztof; Xing, Lei; Lee, Hang; Isobe, Mitsuaki; Libby, Peter; Jang, Ik-Kyung

    2018-02-07

    Patients with culprit plaque rupture are known to have pancoronary plaque vulnerability. However, the characteristics of nonculprit plaques in patients with acute coronary syndromes caused by plaque erosion are unknown. To investigate the nonculprit plaque phenotype in patients with acute coronary syndrome according to culprit plaque pathology (erosion vs rupture) by 3-vessel optical coherence tomography imaging. In this observational cohort study, between August 2010 and May 2014, 82 patients with ACS who underwent preintervention optical coherence tomography imaging of all 3 major epicardial coronary arteries were enrolled at the Massachusetts General Hospital Optical Coherence Tomography Registry database. Analysis of the data was conducted between November 2016 and July 2017. Patients were classified into 2 groups based on the culprit lesion pathology: 17 patients with culprit plaque erosion and 34 patients with culprit plaque rupture. Thirty-one patients with the absence of culprit rupture or erosion were excluded from further analysis. Preintervention 3-vessel optical coherence tomography imaging. Plaque characteristics at the culprit and nonculprit lesions evaluated by optical coherence tomography. In 51 patients (37 men; mean age, 58.7 years), the characteristics of 51 culprit plaques and 216 nonculprit plaques were analyzed. In patients with culprit erosion, the mean (SD) number of nonculprit plaques per patient was smaller (3.4 [1.9] in erosion vs 4.7 [2.1] in rupture, P = .05). Patient-based analysis showed that none of 17 patients with culprit plaque erosion had nonculprit plaque rupture, whereas 26% of the patients (9 of 34) with culprit plaque rupture had nonculprit plaque rupture (P = .02). Plaque-based analysis showed that, compared with the culprit rupture group (n = 158), the culprit erosion group (n = 58) had lower prevalence of plaque rupture (0% vs 8%; P erosion had a smaller number of nonculprit plaques and the lower levels

  14. Acute opthalmologic complications during the use of oral contraceptives.

    Science.gov (United States)

    Friedman, S; Golan, A; Shoenfeld, A; Goldman, J

    1974-12-01

    This is a report of 3 cases of ocular damage which occurred during t he use of oral contraceptives. A 21-year-old woman experienced sudden loss of vision in her right eye after 4 months of combination type oral contraceptive therapy. Ocular tension was normal; the fundus showed occlusion of the central retinal artery. The other eye was normal. Anticoagulant medications were given iv and orally. The next day vision was improved and some restoration of circulation to the retina was noted. After 18 months vision and visual fields were normal in both eyes. In another case a 42-year-old patient experienced sudden loss of vision in her left eye. She had been taking contraceptive pills for 14 months. The right eye was normal. The fundus of the left eye showed evidence of acute occlusion of the central artery of the retina with only the temporal side of the field of vision retained. The oral contraceptive was discontinued and anticoagulation medication given. No improvement occurred. After 6 months total occlusion of the lower temporal artery remained. The third case, 1 21-year-old woman, complained of progressive blurring vision in the right eye for 2 weeks. She had taken oral contraceptives following a normal delivery 7 months previously but had stopped medication 1 month before admission. The affected eye showed a central scotoma and a markedly restricted visual field. Anticoaguland drugs and vitamin-B were given. After 7 days vision was markedly improved and the central scotoma had decreased in size. After another week vision and visual fields were normal. In this case an optic neuritis due to occlusion of a branch of the retinal artery was thought to have been present. Immediate therapy for such cases is important. Since estrogens have been implicated in the etiology of thromboembolic disease, smaller doses of this steroid (50 instead of 80 mcg) are recommended.

  15. 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

    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...... on the presence of white matter lesions did not reveal differences. The association between OCT measures and brain volumes previously found could not be confirmed at the time of the first clinical event. VEP latency was significantly prolonged in patients with white matter lesions compared to those without...... lesions. A trend towards a relationship between VEP amplitude of fellow eyes and brain volumes was noted. CONCLUSIONS: In this cohort we were not able to show atrophic features in the retina or the brain, and the association between structural measures of the retina and the brain as indicated in the later...

  16. 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

    Multiple sclerosis (MS) is an autoimmune disease where myelin-reactive lymphocytes and their activation depend on interactions with antigen presenting cells (APCs). Dendritic cells (DC) are professional APCs dependent on maturation to attain full T-cell priming capacity. The immunomodulatory...

  17. A unilateral optic perineuritis in a teenager - A case report.

    Science.gov (United States)

    Ameilia, Ahmad; Shatriah, Ismail; Wan-Hitam, Wan Hazabbah; Yunus, Rohaizan

    2015-06-01

    Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineuritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  18. 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 ( P erosion 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.

  19. Differential Involvement during Latent Herpes Simplex Virus 1 Infection of the Superior and Inferior Divisions of the Vestibular Ganglia: Implications for Vestibular Neuritis

    Science.gov (United States)

    Lindemann, Anja; Sinicina, Inga; Horn, Anja K. E.; Brandt, Thomas; Strupp, Michael; Hüfner, Katharina

    2017-01-01

    ABSTRACT Controversy still surrounds both the etiology and pathophysiology of vestibular neuritis (VN). Especially uncertain is why the superior vestibular nerve (SVN) is more frequently affected than the inferior vestibular nerve (IVN), which is partially or totally spared. To address this question, we developed an improved method for preparing human vestibular ganglia (VG) and nerve. Subsequently, macro- and microanatomical as well as PCR studies were performed on 38 human ganglia from 38 individuals. The SVN was 2.4 mm longer than the IVN, and in 65% of the cases, the IVN ran in two separate bony canals, which was not the case for the SVN. Anastomoses between the facial and cochlear nerves were more common for the SVN (14/38 and 9/38, respectively) than for the IVN (7/38 and 2/38, respectively). Using reverse transcription-quantitative PCR (RT-qPCR), we found only a few latently herpes simplex virus 1 (HSV-1)-infected VG (18.4%). In cases of two separate neuronal fields, infected neurons were located in the superior part only. In summary, these PCR and micro- and macroanatomical studies provide possible explanations for the high frequency of SVN infection in vestibular neuritis. IMPORTANCE Vestibular neuritis is known to affect the superior part of the vestibular nerve more frequently than the inferior part. The reason for this clinical phenomenon remains unclear. Anatomical differences may play a role, or if latent HSV-1 infection is assumed, the etiology may be due to the different distribution of the infection. To shed further light on this subject, we conducted different macro- and microanatomical studies. We also assessed the presence of HSV-1 in VG and in different sections of the VG. Our findings add new information on the macro- and microanatomy of the VG as well as the pathophysiology of vestibular neuritis. We also show that latent HSV-1 infection of VG neurons is less frequent than previously reported. PMID:28446678

  20. Demyeliniserende sygdom hos børn med akutte neurologiske symptomer

    DEFF Research Database (Denmark)

    Olofsson, Isa Amalie; Skov, Liselotte; Miranda, Maria Jose

    2015-01-01

    Demyelinating diseases in children is a broad group of illnesses, which affect the central nervous system. Demyelinating diseases can be monophasic or chronic and comprise acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, multiple sclerosis and neuromyelitis optica...

  1. Vertical eye movements during horizontal head impulse test: a new clinical sign of superior vestibular neuritis

    OpenAIRE

    D'Onofrio, F

    2013-01-01

    SUMMARY In some patients suffering from acute unilateral peripheral vestibular deficit, the head impulse test performed towards the affected side reveals the typical catch-up saccade in the horizontal plane, and an oblique, mostly vertical, upward catch-up saccade after the rotation of the head towards the healthy side. Three cases are reported herein, which have been studied using slow motion video analysis of the eye movements captured by a high-speed webcam (90 fps). The clinical evidence ...

  2. Clinical characteristics of nonglaucomatous optic disc cupping.

    Science.gov (United States)

    Zhang, Yi-Xin; Huang, Hou-Bin; Wei, Shi-Hui

    2014-04-01

    Pathological optic disc cupping (ODC) is predominantly referred to as glaucoma; however, it is not only glaucoma that leads to pathological optic disc excavation. A number of other nonglaucomatous diseases also result in optic atrophy and excavation of the optic disc. Therefore, in the present study, the etiology of nonglaucomatous optic disc cupping (NGODC) was analyzed and differentiated from glaucomatous optic disc cupping (GODC). The morphology and clinical data of 19 eyes, from 12 patients exhibiting NGODC, were analyzed. Of the 12 cases, none were diagnosed with glaucoma, four presented with optic neuritis, one with Devic's disease, one with Leber's hereditary optic neuropathy, two with pituitary adenoma, one with basal ganglia cerebral hemorrhage, one with cilioretinal artery occlusion associated with central retinal vein occlusion, one with central retinal artery occlusion and the remaining patient exhibited optic nerve injuries. The key features that differentiated NGODC from GODC were the color of the optic disc rim and the correlation between visual field defects and the disc appearance. The focally notched disc also aided in distinguishing between the two disorders. The results of the present study indicated that it is critical to acknowledge that nonglaucomatous diseases also lead to ODC and that distinguishing between them is necessary.

  3. Spectral domain optical coherence tomography and B-scan ultrasonography in the evaluation of retinal tears in acute, incomplete posterior vitreous detachment.

    Science.gov (United States)

    Abdolrahimzadeh, Solmaz; Piraino, Domenica Carmen; Scavella, Vittorio; Abdolrahimzadeh, Barmak; Cruciani, Filippo; Gharbiya, Magda; Recupero, Santi Maria

    2016-05-23

    The purpose of this study was to evaluate the extension and traction effects of posterior vitreous detachment (PVD) complicated with retinal tears using spectral domain optical coherence tomography (OCT) and B-scan ultrasonography. Complete ophthalmological examination, B-scan ultrasonography and spectral domain OCT were performed in patients with acute PVD and retinal tears. Vitreous detachment was classified as complete or incomplete, based on extent of posterior pole or peripheral vitreous detachment. Retinal tear location and persistent traction on the retinal flap was evaluated with B-scan ultrasonography and OCT. Categorical data were evaluated with Fisher's exact test. Statistical significance was considered as P vitreous detachment. The impact of complete or incomplete PVD can be of clinical value when evaluating patients with retinal tears.

  4. Dynamic changes of photorecrptor layer in eyes with acute central serous chorioretinopathy after laser treatment by fourier-domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Li-Qin Zhou

    2014-10-01

    Full Text Available AIM: To dynamically observe the feeling change of the photorecrptor layer in the eyes with acute central serous chorioretinopathy(CSCRkrypton laser treatment by fourier-domain optical coherence tomography(FD-OCT, and to study their correlation with the chang of vision.METHODS: This is a retrospective case series study. The clinical diagnosis of 52 patients with monocular initial onset of central serous chorioretinopathy, krypton laser photocoagulation before treatment, after 1, 2, 4, 6, 8wk, 6mo, FD-OCT were performed to observe the morphological changes characteristic of photoreceptor layer and changes in vision. RESULTS: After 1wk treatment, all cases were improved; 2wk, 6 cases were cured; 4wk, 38 cases were cured; 6wk, 41 cases were cured; 8wk, 45 cases were cured, the OCT showed macular retinal neuroepithelial layer(RNLfrom fully absorbed; 6mo with the same 8wk. Before and after treatment in patients with best corrected visual acuity and from the height difference between the macular region of RNL was statistically significant(PPPCONCLUSION: FD-OCT can dynamicaly observed acute central serous chorioretinopathy krypton laser treatment of photoreceptor ultrastruture changes. Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant(P<0.01.

  5. Neuromyelitis optica antibody in Leber hereditary optic neuropathy: case report.

    Science.gov (United States)

    Simão, Luciano Mesquita

    2012-01-01

    Neuromyelitis optica antibody (or aquaporin-4 antibody) is a well established serum marker associated to high-risk neuromyelitis optica syndrome that presents as an inflammatory demyelinating disease characterized by the occurrence of bilateral and simultaneous optic neuritis without complete visual recovery or it occurs as an isolated episode of transverse myelitis accompanied by longitudinally extensive spinal cord lesions. On the other hand, Leber hereditary optic neuropathy is a primarily hereditary disorder that affects all tissues of the body and its clinical presentation is tissue-specific for the optic nerve and, eventually, it might reach the spinal cord. Overlapping clinical features of neuromyelitis optica and Leber hereditary optic neuropathy may suggest common target organ diseases. The case report described herein emphasizes the coexistence of serum markers of both diseases, and suggests that further investigation of this challenging clinical presentation is warranted to confirm or rule out this association.

  6. Neuromyelitis optica antibody in Leber hereditary optic neuropathy: case report

    Directory of Open Access Journals (Sweden)

    Luciano Mesquita Simão

    2012-08-01

    Full Text Available Neuromyelitis optica antibody (or aquaporin-4 antibody is a well stablished serum marker associated to high-risk neuromyelitis optica syndrome that presents as an inflammatory demyelinating disease characterized by the occurrence of bilateral and simultaneous optic neuritis without complete visual recovery or it occurs as an isolated episode of transverse myelitis accompanied by longitudinally extensive spinal cord lesions. On the other hand, Leber hereditary optic neuropathy is a primarily hereditary disorder that affects all tissues of the body and its clinical presentation is tissue-specific for the optic nerve and, eventually, it might reach the spinal cord. Overlapping clinical features of neuromyelitis optica and Leber hereditary optic neuropathy may suggest common target organ diseases. The case report described herein emphasizes the coexistence of serum markers of both diseases, and suggests that further investigation of this challenging clinical presentation is warranted to confirm or rule out this association.

  7. A 2-step optical coherence tomography guided therapeutic approach to acute myocardial infarction secondary to stent thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Bogale, Nigussie, E-mail: nigussie.bogale@lyse.net [Vancouver General Hospital, Division of Cardiology University of British Columbia, Vancouver, BC (Canada); Stavanger University Hospital, Department of Cardiology, Stavanger (Norway); Lempereur, Mathieu; Fung, Anthony Y. [Vancouver General Hospital, Division of Cardiology University of British Columbia, Vancouver, BC (Canada)

    2016-07-15

    Myocardial infarction secondary to stent thrombosis has high mortality and recurrence rate. Emergency PCI has high risk of no-reflow. We used a 2-step approach of early recanalization with minimal mechanical intervention followed by delayed PCI 1–2 days later guided by Optical Coherence Tomography (OCT). From October 2011 to December 2013, we treated 5 patients with this approach. Time from early recanalization to the delayed definitive PCI was 1 day (median, range 1–3 days). All the OCT images were diagnostic with a clear view of the underlying structures. Summary: A 2-step approach to treat stent thrombosis appears beneficial with low incidence of peri-procedural thrombosis or no-reflow phenomena during the second step, and superb OCT imaging.

  8. [Emergency diagnosis of the acute vestibular syndrome].

    Science.gov (United States)

    Tamás, T László; Garai, Tibor; Király, István; Mike, Andrea; Nagy, Csaba; Paukovics, Ágnes; Schmidt, Péter; Szatmári, Ferenc; Tompos, Tamás; Vadvári, Árpád; Szirmai, Ágnes

    2017-12-01

    To diagnose acute vestibular syndrome (AVS) in a prospective study by a new bedside test (providing 1A evidence) based on oculomotor analysis and assessment of hearing loss. To assess the frequency of central and peripheral causes of acute vestibular syndrome in the emergency room. To establish the diagnostic accuracy of acute cranial computed tomography as compared to oculomotor analysis done by video oculography goggles and audiometry. Between 1st March 2016 and 1st March 2017 we documented 125 patients (62 women, 63 men, average age 53 years) in the emergency room of the Petz Aladár County Teaching Hospital using the above bedside and instrumental testing. Diagnosis was verified by cranial magnetic resonance imaging. According to the results of the instrumental examination in AVS in 67% we found a peripheral cause and in 33% a central pathology. In 62% isolated posterior circulation stroke manifested itself by isolated vertigo without additional focal signs and the acute cranial computed tomography showed negative results in 96%. The instrumental examination increased diagnostic accuracy by making the diagnosis of isolated inferior semicircular canal vestibular neuritis possible. The new bedside oculomotor test is suitable for the diagnosis of posterior circulation stroke manifesting with isolated vertigo in early cases, when the routine neuroradiologic methods have a lower sensitivity or are not available. Orv Hetil. 2017; 158(51): 2029-2040.

  9. Effect of Early Pitavastatin Therapy on Coronary Fibrous-Cap Thickness Assessed by Optical Coherence Tomography in Patients With Acute Coronary Syndrome: The ESCORT Study.

    Science.gov (United States)

    Nishiguchi, Tsuyoshi; Kubo, Takashi; Tanimoto, Takashi; Ino, Yasushi; Matsuo, Yoshiki; Yamano, Takashi; Terada, Kosei; Emori, Hiroki; Katayama, Yosuke; Taruya, Akira; Ozaki, Yuichi; Shiono, Yasutsugu; Shimamura, Kunihiro; Kameyama, Takeyoshi; Kitabata, Hironori; Yamaguchi, Tomoyuki; Tanaka, Atsushi; Hozumi, Takeshi; Akasaka, Takashi

    2017-09-09

    The aim of the present study was to assess the effect of early statin therapy on fibrous-cap thickness in coronary plaques of patients with acute coronary syndrome (ACS) by using optical coherence tomography. Statins can contribute to the stabilization of coronary plaques. This is a prospective, randomized, active-controlled, single-center study. Patients with ACS and untreated dyslipidemia were enrolled and randomly allocated (ratio 1:1) to either the early statin group (received pitavastatin 4 mg/day from baseline) or the late statin group (received pitavastatin 4 mg/day from 3 weeks after the baseline). Optical coherence tomography was performed at baseline, 3-week, and 36-week follow-up to assess nonculprit coronary plaques in 53 patients. Between baseline and 3-week follow-up, fibrous-cap thickness increased in the early statin group (140 μm [interquartile range (IQR):120 to 170 μm] to 160 μm [IQR: 130 to 190 μm]; p = 0.017), but decreased in the late statin group (135 μm [IQR: 110 to 183 μm] to 130 μm [IQR: 108 to 160 μm]; p = 0.020). The percentage of increase in fibrous-cap thickness between baseline and 3-week follow-up was significantly greater in the early statin group compared with the late statin group (8.3% [IQR: 0.0% to 21.4%] vs. -5.8% [IQR: -16.0% to 0.0%]; p thickness increased comparably in the 2 groups. Early therapy with pitavastatin 4 mg/day for patients with ACS provided an increase in fibrous-cap thickness in coronary plaques during the first 3 weeks of follow-up and a further increase during 36 weeks of follow-up. The study was registered with UMIN Clinical Trial Registry (Effect of PitavaStatin on Coronary Fibrous-cap Thickness - Assessment by Fourier-Domain Optical CoheRence Tomography (ESCORT): UMIN000002678). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Optical coherence tomography based microangiography for quantitative monitoring of structural and vascular changes in a rat model of acute uveitis in vivo: a preliminary study.

    Science.gov (United States)

    Choi, Woo June; Pepple, Kathryn L; Zhi, Zhongwei; Wang, Ruikang K

    2015-01-01

    Uveitis models in rodents are important in the investigation of pathogenesis in human uveitis and the development of appropriate therapeutic strategies for treatment. Quantitative monitoring of ocular inflammation in small animal models provides an objective metric to assess uveitis progression and/or therapeutic effects. We present a new application of optical coherence tomography (OCT) and OCT-based microangiography (OMAG) to a rat model of acute anterior uveitis induced by intravitreal injection of a killed mycobacterial extract. OCT/OMAG is used to provide noninvasive three-dimensional imaging of the anterior segment of the eyes prior to injection (baseline) and two days post-injection (peak inflammation) in rats with and without steroid treatments. OCT imaging identifies characteristic structural and vascular changes in the anterior segment of the inflamed animals when compared to baseline images. Characteristics of inflammation identified include anterior chamber cells, corneal edema, pupillary membranes, and iris vasodilation. In contrast, no significant difference from the control is observed for the steroid-treated eye. These findings are compared with the histology assessment of the same eyes. In addition, quantitative measurements of central corneal thickness and iris vessel diameter are determined. This pilot study demonstrates that OCT-based microangiography promises to be a useful tool for the assessment and management of uveitis in vivo.

  11. Optical projection tomography reveals dynamics of HEV growth after immunization with protein plus CFA and features shared with HEVs in acute autoinflammatory lymphadenopathy.

    Science.gov (United States)

    Kumar, Varsha; Chyou, Susan; Stein, Jens V; Lu, Theresa T

    2012-01-01

    The vascular-stromal compartment of lymph nodes is important for lymph node function, and high endothelial venules (HEVs) play a critical role in controlling the entry of recirculating lymphocytes. In autoimmune and autoinflammatory diseases, lymph node swelling is often accompanied by apparent HEV expansion and, potentially, targeting HEV expansion could be used therapeutically to limit autoimmunity. In previous studies using mostly flow cytometry analysis, we defined three differentially regulated phases of lymph node vascular-stromal growth: initiation, expansion, and the re-establishment of vascular quiescence and stabilization. In this study, we use optical projection tomography to better understand the morphologic aspects of HEV growth upon immunization with ovalbumin/CFA (OVA/CFA). We find HEV elongation as well as modest arborization during the initiation phase, increased arborization during the expansion phase, and, finally, vessel narrowing during the re-establishment of vascular quiescence and stabilization. We also examine acutely enlarged autoinflammatory lymph nodes induced by regulatory T cell depletion and show that HEVs are expanded and morphologically similar to the expanded HEVs in OVA/CFA-stimulated lymph nodes. These results reinforce the idea of differentially regulated, distinct phases of vascular-stromal growth after immunization and suggest that insights gained from studying immunization-induced lymph node vascular growth may help to understand how the lymph node vascular-stromal compartment could be therapeutically targeted in autoimmune and autoinflammatory diseases.

  12. Optical coherence tomography based microangiography for quantitative monitoring of structural and vascular changes in a rat model of acute uveitis in vivo: a preliminary study

    Science.gov (United States)

    Choi, Woo June; Pepple, Kathryn L.; Zhi, Zhongwei; Wang, Ruikang K.

    2015-01-01

    Uveitis models in rodents are important in the investigation of pathogenesis in human uveitis and the development of appropriate therapeutic strategies for treatment. Quantitative monitoring of ocular inflammation in small animal models provides an objective metric to assess uveitis progression and/or therapeutic effects. We present a new application of optical coherence tomography (OCT) and OCT-based microangiography (OMAG) to a rat model of acute anterior uveitis induced by intravitreal injection of a killed mycobacterial extract. OCT/OMAG is used to provide noninvasive three-dimensional imaging of the anterior segment of the eyes prior to injection (baseline) and two days post-injection (peak inflammation) in rats with and without steroid treatments. OCT imaging identifies characteristic structural and vascular changes in the anterior segment of the inflamed animals when compared to baseline images. Characteristics of inflammation identified include anterior chamber cells, corneal edema, pupillary membranes, and iris vasodilation. In contrast, no significant difference from the control is observed for the steroid-treated eye. These findings are compared with the histology assessment of the same eyes. In addition, quantitative measurements of central corneal thickness and iris vessel diameter are determined. This pilot study demonstrates that OCT-based microangiography promises to be a useful tool for the assessment and management of uveitis in vivo.

  13. Optical projection tomography reveals dynamics of HEV growth after immunization with protein plus CFA and features shared with HEVs in acute autoinflammatory lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Varsha eKumar

    2012-09-01

    Full Text Available The vascular-stromal compartment of lymph nodes is important for lymph node function, and high endothelial venules (HEVs play a critical role in controlling the entry of recirculating lymphocytes. In autoimmune and autoinflammatory diseases, lymph node swelling is often accompanied by apparent HEV expansion and, potentially, targeting HEV expansion could be used therapeutically to limit autoimmunity. In previous studies using mostly flow cytometry analysis, we defined 3 differentially regulated phases of lymph node vascular-stromal growth: initiation, expansion, and the re-establishment of vascular quiescence and stabilization. In this study, we use optical projection tomography to better understand the morphologic aspects of HEV growth upon immunization with ovalbumin/CFA. We find HEV elongation as well as modest arborization during the initiation phase, increased arborization during the expansion phase, and, finally, vessel narrowing during the re-establishment of vascular quiescence and stabilization. We also examine acutely enlarged autoinflammatory lymph nodes induced by regulatory T cell depletion and show that HEVs are expanded and morphologically similar to the expanded HEVs in OVA/CFA-stimulated lymph nodes. These results reinforce the idea of differentially regulated, distinct phases of vascular-stromal growth after immunization and suggest that insights gained from studying immunization-induced lymph node vascular growth may help to understand how the lymph node vascular-stromal compartment could be therapeutically targeted in autoimmune and autoinflammatory diseases.

  14. Label-Free Optical Detection of Acute Myocardial Infarction Based on Blood Plasma Surface-Enhanced Raman Spectroscopy

    Science.gov (United States)

    Chen, Y. X.; Chen, M. W.; Lin, J. Y.; Lai, W. Q.; Huang, W.; Chen, H. Y.; Weng, G. X.

    2016-11-01

    This study is intended to explore the potential of silver (Ag) nanoparticle-based plasma surface-enhanced Raman spectroscopy (SERS) for providing a rapid and simple "Yes/No" assessment to detect acute myocardial infarction (AMI). A simple, rapid, and accurate method of diagnosing AMI is critical to reduce mortality and improve prognosis. Techniques such as electrocardiography examination and use of cardiac troponins have not yet met the current clinical need. Therefore, alternative approaches need to be developed. Plasma samples from 32 patients with AMI and 32 healthy control (Clt) subjects were assessed. Multivariate statistical techniques, including principal component (PC) analysis and linear discriminant analysis (PCA-LDA), were employed to develop a diagnostic algorithm for differentiating between patients with AMI and Clt subjects. Furthermore, the receiver operating characteristic was tested to evaluate the performance of the PCA-LDA algorithm for AMI detection. Each plasma sample was mixed with an equal volume of Ag colloidal solution, and the SERS measurement of each plasma sample was performed. The plasma SERS spectrum showed much stronger and sharper peaks compared with the normal Raman spectrum. Tentative assignments of Raman spectroscopy bands showed specific biomolecular (e.g., proteins, adenosine, adenine, and uric acid) changes. PC analysis and LDA were employed to discriminate patients with AMI from Clt subjects, yielding a sensitivity of 87.5% and a specificity of 93.8%. The findings of this study suggest that plasma SERS has a great potential for improving AMI in the future, and this will certainly reduce the difficulty, time to draw blood, and patients' pain to a great extent.

  15. Paradoxical reaction in tubercular meningitis resulting in involvement of optic radiation

    Directory of Open Access Journals (Sweden)

    Monga Parveen

    2009-01-01

    Full Text Available A 25-year-old woman was diagnosed to have tubercular meningitis (TBM with a right parietal infarct. She responded well to four-drug anti-tubercular treatment (ATT, systemic steroids and pyridoxine. Steroids were tapered off in one and a half months; she was put on two-drug ATT after two months. Six months after initial diagnosis she presented with sudden, bilateral visual loss. Vision was 3/200 with afferent pupillary defect and un-recordable field in the right eye; vision was 20/60 in the left eye, pupillary reaction was sluggish and the field showed a temporal hemianopia. On reintroduction of systemic corticosteroids vision improved (20/120 in right eye and 20/30 in left eye within three days; the field defects improved sequentially to a left homonymous hemianopia, then a left homonymous inferior quadrantonopia. A diagnosis of TBM, on treatment, with bilateral optic neuritis, and right optic radiation involvement was made. Since the patient had been off ethambutol for four months, the optic neuritis and optic radiation lesion were attributed to a paradoxical reaction to tubercular allergen, corroborated by prompt recovery in response to corticosteroids. This is the first report of optic radiation involvement in a paradoxical reaction in neuro-tuberculosis in a young adult.

  16. Optical coherence tomography evaluation of retinal nerve fiber layer in longitudinally extensive transverse myelitis

    Directory of Open Access Journals (Sweden)

    Frederico C. Moura

    2011-02-01

    Full Text Available OBJECTIVE: To compare optical coherence tomography (OCT measurements on the retinal nerve fiber layer (RNFL of healthy controls and patients with longitudinally extensive transverse myelitis (LETM without previous optic neuritis. METHOD: Twenty-six eyes from 26 patients with LETM and 26 control eyes were subjected to automated perimetry and OCT for comparison of RNFL measurements. RESULTS: The mean deviation values from perimetry were significantly lower in patients with LETM than in controls (p<0.0001. RNFL measurements in the nasal quadrant and in the 3-o'clock segment were significantly smaller in LETM eyes than in controls. (p=0.04 and p=0.006, respectively. No significantly differences in other RNFL measurements were found. CONCLUSION: Patients with LETM may present localized RNFL loss, particularly on the nasal side of the optic disc, associated with slight visual field defects, even in the absence of previous episodes of optic neuritis. These findings emphasize the fact that patients with LETM may experience attacks of subclinical optic nerve damage.

  17. A quantitative analysis of gait patterns in vestibular neuritis patients using gyroscope sensor and a continuous walking protocol.

    Science.gov (United States)

    Kim, Soo Chan; Kim, Joo Yeon; Lee, Hwan Nyeong; Lee, Hwan Ho; Kwon, Jae Hwan; Kim, Nam Beom; Kim, Mi Joo; Hwang, Jong Hyun; Han, Gyu Cheol

    2014-04-11

    Locomotion involves an integration of vision, proprioception, and vestibular information. The parieto-insular vestibular cortex is known to affect the supra-spinal rhythm generators, and the vestibular system regulates anti-gravity muscle tone of the lower leg in the same side to maintain an upright posture through the extra-pyramidal track. To demonstrate the relationship between locomotion and vestibular function, we evaluated the differences in gait patterns between vestibular neuritis (VN) patients and normal subjects using a gyroscope sensor and long-way walking protocol. Gyroscope sensors were attached to both shanks of healthy controls (n=10) and age-matched VN patients (n = 10). We then asked the participants to walk 88.8 m along a corridor. Through the summation of gait cycle data, we measured gait frequency (Hz), normalized angular velocity (NAV) of each axis for legs, maximum and minimum NAV, up-slope and down-slope of NAV in swing phase, stride-swing-stance time (s), and stance to stride ratio (%). The most dominant walking frequency in the VN group was not different compared to normal control. The NAVs of z-axis (pitch motion) were significantly larger than the others (x-, y-axis) and the values in VN patients tended to decrease in both legs and the difference of NAV between both group was significant in the ipsi-lesion side in the VN group only (p=0.03). Additionally, the gait velocity of these individuals was decreased relatively to controls (1.11 ± 0.120 and 0.84 ± 0.061 m/s in control and VN group respectively, p<0.01), which seems to be related to the significantly increased stance and stride time of the ipsi-lesion side. Moreover, in the VN group, the maximum NAV of the lesion side was less, and the minimum one was higher than control group. Furthermore, the down-slope and up-slope of NAV decreased on the impaired side. The walking pattern of VN patients was highly phase-dependent, and NAV of pitch motion was significantly decreased in the ipsi

  18. Bilateral idiopathic optic perineuritis with severe vision loss: A case report

    Directory of Open Access Journals (Sweden)

    Wee-Min Teh

    2015-07-01

    Full Text Available Optic perineuritis is an orbital inflammatory disorder that is either idiopathic or secondary to other conditions such as infection or systemic inflammatory disorders. This condition is very similar to demyelinating optic neuritis, but certain features of the history and magnetic resonance imaging findings are characteristic for and aid in the diagnosis of optic perineuritis. Vision loss varies greatly, from minimal clouding of vision up to only light perception. We report a case of a 44-year-old female with idiopathic bilateral optic perineuritis with vision loss of up to no light perception in both eyes. Radio imaging studies were typical of optic perineuritis and she was started on systemic corticosteroids. She responded very well to steroid therapy and achieved nearly complete visual recovery. There had been no relapse despite cessation of therapy.

  19. Correlation between morphological characteristics in spectral-domain-optical coherence tomography, different functional tests and a patient's subjective handicap in acute central serous chorioretinopathy.

    Science.gov (United States)

    Gerendas, Bianca S; Kroisamer, Julia-Sophie; Buehl, Wolf; Rezar-Dreindl, Sandra M; Eibenberger, Katharina M; Pablik, Eleonore; Schmidt-Erfurth, Ursula; Sacu, Stefan

    2018-01-16

    The purpose of this study was to identify quantitatively measurable morphologic optical coherence tomography (OCT) characteristics in patients with an acute episode of central serous chorioretinopathy (CSC) and evaluate their correlation to functional and psychological variables for their use in daily clinical practice. Retinal thickness (RT), the height, area and volume of subretinal fluid (SRF)/pigment epithelium detachments were evaluated using the standardized procedures of the Vienna Reading Center. These morphologic characteristics were compared with functional variables [best-corrected visual acuity (BCVA), contrast sensitivity (CS), retinal sensitivity/microperimetry, fixation stability], and patients' subjective handicap from CSC using the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25). Data from 39 CSC patients were included in this analysis. Three different SRF height measures showed a high negative correlation (r = -0.7) to retinal sensitivity within the central 9°, which was also negatively correlated with SRF area and volume (r = -0.6). The CS score and fixation stability (fixation points within 2°) showed a moderate negative correlation (r = -0.4) with SRF height variables. Comparison of the subjective handicap with morphological characteristics in spectral-domain (SD)-OCT showed SRF height had the highest correlation (r = -0.4) with the subjective problems reported and overall NEI VFQ-25 score. In conclusion, SRF height measured in SD-OCT showed the best correlation with functional variables and patients' subjective handicap caused by the disease and therefore seems to be the best variable to look at in daily clinical routine. Even though area and volume also show a correlation, these cannot be so easily measured as height and are therefore not suggested for daily clinical routine. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  1. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  2. Case of acute zonal occult outer retinopathy with abnormal pattern visual evoked potentials

    Directory of Open Access Journals (Sweden)

    Chai Y

    2011-09-01

    Full Text Available Yuzhu Chai1, Hiroko Yamazaki1, Kaoru Fujinami2, Kazushige Tsunoda2, Shuichi Yamamoto31Department of Ophthalmology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan; 2National Institute of Sensory Organs, Tokyo, Japan; 3Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, JapanAbstract: Electrophysiological and morphological findings were studied in a case of acute zonal occult outer retinopathy (AZOOR showing abnormal pattern visual evoked potentials (VEPs at the onset and significant functional recovery in the natural course.  A 21-year-old woman presented with acute onset of photopsia and a large scotoma in the right eye of 2 weeks duration. Her visual acuity was 20/20 in both eyes with no ophthalmoscopic and fluorescein angiographic abnormalities. However, a relative afferent pupillary defect and an enlarged blind spot were found in the right eye. The pattern VEPs were severely reduced when the right eye was stimulated. The amplitudes of both rod and cone full-field electroretinographics (ERGs were reduced in the right eye. The amplitudes of the multifocal ERGs were reduced in the area of the enlarged blind spot. Irregularities in the inner segment/outer segment (IS/OS line of the photoreceptors were observed over the nasal fovea by optical coherence tomography (OCT. The patient was followed without treatment. The enlarged blind spot disappeared in 3 months after the onset. At 5 months, reappearance of the IS/OS line was detected by OCT. At 6 months, the P100 recovered to normal values. At 1 year, the reduced full-field ERGs were almost normal size and the multifocal ERGs in the area corresponding to the enlarged blind spot were also improved. ERG findings are crucial for differentiating AZOOR from retrobulbar neuritis, especially in patients with abnormal pattern VEPs. The pattern VEPs, full-field ERGs, multifocal ERGs, and OCT images can be abnormal in the early

  3. [Past, present, and future in Leber's hereditary optic neuropathy].

    Science.gov (United States)

    Oguchi, Y

    2001-12-01

    neuritis, the latency was very much delayed and the amplitude was diminished. Therefore, I deduced that not only demyelination of the optic nerve fibers but also papilla-macula bundle defects may play an important role. In flash VEP, only the amplitude was low, but latency was normal. 3. Image analysis of the optic nerve In high resolution T2-weighted fast spin-echo magnetic resonance imaging(MRI), the image of the optic nerve can be clearly demonstrated within a short operation time. In MRI in the acute stage of Leber's disease, the image of the optic nerve appeared almost normal. But in the course of time, patients with Leber's disease showed markedly high signals in the optic nerve on the T2-weighted fast spin-echo MRI, and in the atrophic stage the image of the optic nerve showed thinning. The results in this study support the hypothesis that a primary lesion in Leber's disease may be intraocular. 4. Possibility of therapy at the present time The effectiveness of using idebenone combined with vitamin B2, vitamin C, and isopropyl unoprostone(Rescula) for recovery of the circulation of the optic nerve head for patients in the acute stage was compared with untreated patients. In patients with visual acuity of 0.3 and more, there was no statistical difference between the two groups. The recovery interval up to 0.3 was significantly shorter in the treated group than in the untreated group. I suggest that this kind of treatment may aid spontaneous recovery. Among 15 cases of Leber's disease which occurred in the patients teens, at least one eye in 8 cases(53%) recovered to 0.3 or more. Among the 8 recovered cases, 5 cases were from the treated group. On the other hand, 6 cases were treated and 5 cases recovered visual acuity. It is said that the patients developing the disease at younger ages have a tendency toward visual recovery. Pharmacological treatment can aid recovery. 5. Visual function after the recovery of visual acuity The recovery of visual acuity in Leber

  4. Optics/Optical Diagnostics Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Optics/Optical Diagnostics Laboratory supports graduate instruction in optics, optical and laser diagnostics and electro-optics. The optics laboratory provides...

  5. Recurrent subacute visual loss presenting in a 52-year-old Caucasian woman with chronic relapsing inflammatory optic neuropathy: a case report

    Directory of Open Access Journals (Sweden)

    Samra Amrit

    2012-01-01

    Full Text Available Abstract Introduction Chronic relapsing inflammatory optic neuropathy is a recently described form of recurrent isolated subacute optic neuropathy. The condition is highly responsive to systemic steroid treatment and prone to relapse on steroid withdrawal. A complete work up for demyelination, autoimmune disease and sarcoidosis must be made before considering chronic relapsing inflammatory optic neuropathy. Case presentation We describe the case of a 52-year-old Caucasian woman who presented with isolated subacute optic neuropathy. There was no evidence of demyelination, autoimmunity or sarcoidosis. There was an abrupt and prompt response to systemic corticosteroids and a relapse of the condition on steroid withdrawal. Conclusions Chronic relapsing inflammatory optic neuropathy requires careful consideration and differentiation from demyelinating optic neuritis and ischemic optic neuropathy since the treatment is different and the outcome without treatment is likely to be poor. The importance of identifying these patients has considerable clinical implications as the condition is highly responsive to steroids.

  6. Isolated acute dysphagia due to varicella-zoster virus.

    Science.gov (United States)

    Mantero, Vittorio; Rigamonti, Andrea; Valentini, Sergio; Fiumani, Anna; Piamarta, Francesca; Bonfanti, Paolo; Salmaggi, Andrea

    2014-04-01

    We present a case of zoster sine herpete causing isolated acute dysphagia in an immunocompetent patient. The interest of this paper is the atypical presentation of varicella-zoster virus reactivation. A 77-year-old woman presented with a 3-day history of fever and worsening dysphagia for both liquid and solid foods. Cerebrospinal fluid examination revealed lymphocytic pleocytosis and PCR amplified varicella-zoster virus DNA with high antibody titers in both serum and cerebrospinal fluid. The panel was suggestive of a cranial neuritis due to varicella-zoster virus, involved cranial nerves, even in the absence of a cutaneous and mucosal rash. Varicella-zoster virus reactivation should be included in the differential diagnosis of isolated or multiple cranial nerve palsies, with or without zosteriform skin lesions. A prompt etiologic diagnosis can lead to early administration of antiviral therapy. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Skin substitute-assisted repair shows reduced dermal fibrosis in acute human wounds validated simultaneously by histology and optical coherence tomography.

    Science.gov (United States)

    Greaves, Nicholas S; Iqbal, Syed A; Hodgkinson, Tom; Morris, Julie; Benatar, Brian; Alonso-Rasgado, Teresa; Baguneid, Mohamed; Bayat, Ardeshir

    2015-01-01

    Skin substitutes are heterogeneous biomaterials designed to accelerate wound healing through provision of replacement extracellular matrix. Despite growing evidence for their use in chronic wounds, the role of skin substitutes in acute wound management and their influence on fibrogenesis remains unclear. Skin substitute characteristics including biocompatibility, porosity, and elasticity strongly influence cellular behavior during wound healing. Thus, we hypothesize that structural and biomechanical variation between biomaterials may induce differential scar formation after cutaneous injury. The following human prospective cohort study was designed to investigate this premise. Four 5-mm full thickness punch biopsies were harvested from 50 volunteers. In all cases, site 1 healed by secondary intention, site 2 was treated with collagen-GAG scaffold (CG), and decellularised dermis (DCD) was applied to site 3 while tissue extracted from site 4 was replaced (autograft). Healing tissue was assessed weekly with optical coherence tomography (OCT), before being excised on days 7, 14, 21, or 28 depending on study group allocation for later histological and immunohistochemical evaluation. Extracted RNA was used in microarray analysis and polymerase chain reaction of highlighted genes. Autograft treatment resulted in minimal fibrosis confirmed immunohistochemically and with OCT through significantly lower collagen I levels (p = 0.047 and 0.03) and reduced mean grayscale values (p = 0.038 and 0.015), respectively. DCD developed intermediate scar formation with partial rete ridge reformation and reduced fasiculonodular fibrosis. It was uniquely associated with late up-regulation of matrix metalloproteinases 1 and 3, oncostatin M, and interleukin-10 (p = 0.007, 0.04, 0.019, 0.019). Regenerated dermis was significantly thicker in DCD and autografts 28 days post-injury compared with control and CG samples (p = 0.003 and < 0.0001). In conclusion, variable fibrotic outcomes were

  8. Vestibular perception following acute unilateral vestibular lesions.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  9. Constructing a statistical atlas of the radii of the optic nerve and cerebrospinal fluid sheath in young healthy adults

    Science.gov (United States)

    Harrigan, Robert L.; Plassard, Andrew J.; Mawn, Louise A.; Galloway, Robert L.; Smith, Seth A.; Landman, Bennett A.

    2015-03-01

    Optic neuritis is a sudden inflammation of the optic nerve (ON) and is marked by pain on eye movement, and visual symptoms such as a decrease in visual acuity, color vision, contrast and visual field defects. The ON is closely linked with multiple sclerosis (MS) and patients have a 50% chance of developing MS within 15 years. Recent advances in multi-atlas segmentation methods have omitted volumetric assessment. In the past, measuring the size of the ON has been done by hand. We utilize a new method of automatically segmenting the ON to measure the radii of both the ON and surrounding cerebrospinal fluid (CSF) sheath to develop a normative distribution of healthy young adults. We examine this distribution for any trends and find that ON and CSF sheath radii do not vary between 20-35 years of age and between sexes. We evaluate how six patients suffering from optic neuropathy compare to this distribution of controls. We find that of these six patients, five of them qualitatively differ from the normative distribution which suggests this technique could be used in the future to distinguish between optic neuritis patients and healthy controls

  10. Constructing a statistical atlas of the radii of the optic nerve and cerebrospinal fluid sheath in young healthy adults.

    Science.gov (United States)

    Harrigan, Robert L; Plassard, Andrew J; Mawn, Louise A; Galloway, Robert L; Smith, Seth A; Landman, Bennett A

    2015-03-20

    Optic neuritis is a sudden inflammation of the optic nerve (ON) and is marked by pain on eye movement, and visual symptoms such as a decrease in visual acuity, color vision, contrast and visual field defects. The ON is closely linked with multiple sclerosis (MS) and patients have a 50% chance of developing MS within 15 years. Recent advances in multi-atlas segmentation methods have omitted volumetric assessment. In the past, measuring the size of the ON has been done by hand. We utilize a new method of automatically segmenting the ON to measure the radii of both the ON and surrounding cerebrospinal fluid (CSF) sheath to develop a normative distribution of healthy young adults. We examine this distribution for any trends and find that ON and CSF sheath radii do not vary between 20-35 years of age and between sexes. We evaluate how six patients suffering from optic neuropathy compare to this distribution of controls. We find that of these six patients, five of them qualitatively differ from the normative distribution which suggests this technique could be used in the future to distinguish between optic neuritis patients and healthy controls.

  11. Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Meyden, C.H. van der (Dept. of Neurology, Univ. of the Orange Free State, Bloemfontein (South Africa)); Villiers, J.F.K. de (Dept. of Radiology, Univ. of the Orange Free State, Bloemfontein (South Africa)); Middlecote, B.D. (Dept. of Anatomical Pathology, Univ. of the Orange Free State, Bloemfontein (South Africa)); Terblanche, J. (Dept. of Neurology, Univ. of the Orange Free State, Bloemfontein (South Africa))

    1994-04-01

    A 9-year-old boy presented with a subacute history of optic neuritis followed by brainstem involvement, with fever and a lymphocytic pleocytosis in the cerebrospinal fluid. Gadolinium-enhancing ring lesions were demonstrated in the white matter of the cerebrum, brainstem and cerebellum on day 17 of the illness, all appearing simultaneously as part of a monophasic illmess. A parietal lesion exerted mass effect. Needling and biopsy yielded no evidence of a pyogenic lesion, tumour or tuberculosis and showed vasculitis. There was insufficient material for myelin staining. Dexamethasone therapy lead to rapid improvement of the radiological lesions: MRI and CT on day 34 of the illness showed complete clearing of the lesions except for residual abnormality at the biopsy site. (orig.)

  12. Optical Coherence Tomography in Multiple Sclerosis and Neuromyelitis Optica: An Update

    Directory of Open Access Journals (Sweden)

    Susana Noval

    2011-01-01

    Full Text Available Optical coherence tomography (OCT uses light interference patterns to produce a cross-sectional image of the retina. It is capable of measuring the unmyelinated axons of the retinal ganglionar cells as they converge on the optic disc. In a disease like multiple sclerosis (MS, in which axonal loss has been identified as an important cause of sustained disability, it may prove an invaluable tool. OCT has demonstrated that axonal loss occurs after each episode of optic neuritis and that the degree of axonal loss is correlated to visual outcomes. Furthermore, axonal loss occurs in MS even in the absence of inflammatory episodes, and the degree of this loss is correlated with the duration of the disease process, with more thinning as the disease advances and in progressive forms. Thus, OCT retinal nerve fiber layer measurements may represent an objective outcome measure with which to evaluate the effect of treatment.

  13. 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...

  14. ECHOGRAPHIC PICTURE OF OPTIC NERVE GLIOMA IN NEUROFIBROMATOSIS TYPE-1

    Directory of Open Access Journals (Sweden)

    Biljana Kuzmanović

    2002-12-01

    Full Text Available Background. Authors want to present echographic picture of orbital part of low-grade pilocytic astrocytoma involving the optic nerve and/or chiasm and optic tract (optic pathway glioma or visual pathway glioma.Methods. 4 children with neurofibromatosis type-1 complicated with optic pathway glioma diagnosed earlier with magnetic resonance were examined by ultrasound. Standardised A-scan technique was used for optic nerve width measurement. The 30° test and B-scan (axial, transverse and longitudinal sections of both eyes and orbits were performed as well.Results. The optic nerve diameter in our cases ranged from 4.48 to 8.5 mm. Two children had the left side optic pathway glioma, one boy had the right side optic pathway glioma and in one tumour was bilateral. The transversal section of the nerve revealed dark oval and in more perpendicular sections round void of the nerve. As the beam is swept towards the orbital apex void becomes more fusiform. The nerve and its sheaths are markedly widened. An abnormal increase in reflectivity and irregularity of the spike’s pattern is exhibited as well. No calcification along the sheaths is noticed. The transverse section of the tumour demonstrated an »inverse doughnut« sign. The outer whiter outline of the widened sheaths surrounds an inner darker circle. The longitudinal section revealed the optic nerve head continuing into the widened optic nerve. The 30° test was negative. The differential diagnosis of meningeoma, optic neuritis and orbital cysticercosis should be considered.Conclusions. Ultrasound as a cheap, safe, easily repeatable imaging method should become a method of choice for screening optic nerve tumours in neurofibromatosis type-1, especially in children, as well as for follow-up after treatment.

  15. A mouse ocular explant model that enables the study of living optic nerve head events after acute and chronic intraocular pressure elevation: Focusing on retinal ganglion cell axons and mitochondria.

    Science.gov (United States)

    Kimball, Elizabeth C; Pease, Mary E; Steinhart, Matthew R; Oglesby, Ericka N; Pitha, Ian; Nguyen, Cathy; Quigley, Harry A

    2017-07-01

    We developed an explant model of the mouse eye and optic nerve that facilitates the study of retinal ganglion cell axons and mitochondria in the living optic nerve head (ONH) in an ex vivo environment. Two transgenic mouse strains were used, one expressing yellow fluorescent protein in selected axons and a second strain expressing cyan fluorescent protein in all mitochondria. We viewed an explanted mouse eye and optic nerve by laser scanning microscopy at and behind the ONH, the site of glaucoma injury. Explants from previously untreated mice were studied with the intraocular pressure (IOP) set artificially at normal or elevated levels for several hours. Explants were also studied from eyes that had undergone chronic IOP elevation from 14 h to 6 weeks prior to ex vivo study. Image analysis in static images and video of individual mitochondria or axonal structure determined effects of acute and chronic IOP elevation. At normal IOP, fluorescent axonal structure was stable for up to 3 h under ex vivo conditions. After chronic IOP elevation, axonal integrity index values indicated fragmentation of axon structure in the ONH. In mice with fluorescent mitochondria, the normal density decreased with distance behind the ONH by 45% (p = 0.002, t-test). Density increased with prior chronic IOP elevation to 21,300 ± 4176 mitochondria/mm 2 compared to control 16,110 ± 3159 mitochondria/mm 2 (p = 0.025, t-test), but did not increase significantly after 4 h, acute IOP elevation (1.5% decrease in density, p = 0.83, t-test). Mean normal mitochondrial length of 2.3 ± 1.4 μm became 13% smaller after 4 h of IOP elevation ex vivo compared to baseline (p = 0.015, t-test, N-10). Normal mitochondrial speed of movement was significantly slower in the anterograde direction (towards the brain) than retrograde, but there were more mitochondria in motion and traveling longer lengths in anterograde direction. The percent of mitochondria in motion decreased by >50

  16. A method for estimating the accuracy of measurements of optical characteristics of the nuclei of blood cells in the diagnosis of acute leukemia

    Science.gov (United States)

    Polyakov, E. V.; Nikitaev, V. G.

    2017-01-01

    The work is devoted to investigation of the random component of the measurement error of the nuclei structure characteristics, which are used in the method of structural elements to measure the differences of blood cells of different types. This method is realized in information-measuring system of the analysis of micropreparations of blood cells in the diagnosis of acute leukemia and its variants.

  17. Acute Bronchitis

    Science.gov (United States)

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  18. Optic glioma

    Science.gov (United States)

    Glioma - optic; Optic nerve glioma; Juvenile pilocytic astrocytoma; Brain cancer - optic glioma ... Optic gliomas are rare. The cause of optic gliomas is unknown. Most optic gliomas are slow-growing ...

  19. Clinical Outcomes and Complications of Percutaneous Achilles Repair System Versus Open Technique for Acute Achilles Tendon Ruptures.

    Science.gov (United States)

    Hsu, Andrew R; Jones, Carroll P; Cohen, Bruce E; Davis, W Hodges; Ellington, J Kent; Anderson, Robert B

    2015-11-01

    Limited incision techniques for acute Achilles tendon ruptures have been developed in recent years to improve recovery and reduce postoperative complications compared with traditional open repair. The purpose of this retrospective cohort study was to analyze the clinical outcomes and postoperative complications between acute Achilles tendon ruptures treated using a percutaneous Achilles repair system (PARS [Arthrex, Inc, Naples, FL]) versus open repair and evaluate the overall outcomes for operatively treated Achilles ruptures. Between 2005 and 2014, 270 consecutive cases of operatively treated acute Achilles tendon ruptures were reviewed (101 PARS, 169 open). Patients with Achilles tendinopathy, insertional ruptures, chronic tears, or less than 3-month follow-up were excluded. Operative treatment consisted of a percutaneous technique (PARS) using a 2-cm transverse incision with FiberWire (Arthrex, Inc, Naples, FL) sutures or open repair using a 5- to 8-cm posteromedial incision with FiberWire in a Krackow fashion reinforced with absorbable sutures. Patient demographics were recorded along with medical comorbidities, activity at injury, time from injury to surgery, length of follow-up, return to baseline activities by 5 months, and postoperative complications. The most common activity during injury for both groups was basketball (PARS: 39%, open: 47%). A greater number of patients treated with PARS were able to return to baseline physical activities by 5 months compared with the open group (PARS: 98%, open: 82%; P = .0001). There were no significant differences (P > .05) between groups in rates of rerupture (P = 1.0), sural neuritis (P = .16), wound dehiscence (P = .74), superficial (P = .29) and/or deep infection (P = .29), or reoperation (P = .13). There were no deep vein thromboses (DVTs) or reruptures in either group. In the PARS group, there were no cases of sural neuritis, 3 cases (3%) of superficial wound dehiscence, and 2 reoperations (2%) for superficial

  20. Neuromyelitis Optica Spectrum Disorder with Tumefactive Demyelination mimicking Multiple Sclerosis: A Rare Case

    OpenAIRE

    UJJAWAL eROY; Dinesh eSatyanarayan; Koushik ePan; Alak ePandit; Goutam eGanguly; Ajay ePanwar

    2016-01-01

    Neuromyelitis optica spectrum disorder (NMOSD) is a diverse condition which not only encompasses isolated longitudinally extensive transverse myelitis and optic neuritis but also includes area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic clinical syndrome, and symptomatic cerebral syndrome. Imaging may reveal periependymal lesions surrounding the ventricular system or involvement of corticospinal tracts, area postrema, diencephalon and corpus callo...

  1. The REMEDEE-OCT Study: An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody-Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography Imaging Analysis

    NARCIS (Netherlands)

    Jaguszewski, Milosz; Aloysius, Romila; Wang, Wei; Bezerra, Hiram G.; Hill, Jonathan; de Winter, Robbert J.; Karjalainen, Pasi P.; Verheye, Stefan; Wijns, William; Lüscher, Thomas F.; Joner, Michael; Costa, Marco; Landmesser, Ulf

    2017-01-01

    The aim of the present study was to evaluate vascular healing of the bioengineered COMBO Dual Therapy Stent compared with a cobalt-chromium (CoCr) everolimus-eluting stent (EES) as assessed by optical coherence tomography in patients with acute coronary syndromes. CD34+ cells promote endothelial

  2. CASE REPORT Acute pituitary apoplexy complicating a pituitary ...

    African Journals Online (AJOL)

    associated sub-arachnoid haemorrhage can sometimes be present. On T1W MR imaging, in the early acute stage, an enlarged gland that is iso- or hypointense to brain can be seen, while in the late acute or sub-acute stage, a hyperintense gland is seen. Acute compression of the hypothalamus and optic chiasm may cause ...

  3. An approach to acute vertigo

    African Journals Online (AJOL)

    last for months. Patients who have residual symptoms at 6 weeks may benefit from vestibular rehabilitation therapy. Although vestibular neuritis tends not to recur, it may be followed by BPPV. (in 5%), which may prove more difficult to treat than usual.[13,14]. If hearing loss is present, the likely diagnosis is labyrinthitis, and.

  4. Recovery of Visual Function in a Patient with an Onodi Cell Mucocele Compressive Optic Neuropathy Who Had a 5-Week Interval between Onset and Surgical Intervention: A Case Report

    Directory of Open Access Journals (Sweden)

    Wencan Wu

    2010-01-01

    Full Text Available Purpose. To report on a patient with compressive optic neuropathy secondary to an Onodi cell mucocele, who fully recovered visual function following surgery. Method. Case report. Results. A 28-year-old male was admitted with a right visual acuity of 20/100 following treatment for an initial diagnosis of optic neuritis. Subsequent examination suggested compressive optic neuropathy, and neuroimaging confirmed the presence of an Onodi mucocele compressing the optic nerve. The patient underwent a right endonasal sphenoethmoidectomy with decompression 5 weeks after the initial onset of symptoms. Three weeks following surgery, the visual acuity was 20/20, and there was complete resolution of the visual field defect, which has remained stable at 1 year. Conclusion. Onodi cell mucocele should be included in the differential diagnosis of a young patient with compressive optic neuropathy. Surgical decompression should be considered even when symptoms have been present for over a month.

  5. Bronchitis - acute

    Science.gov (United States)

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflamed tissue in the main ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  6. Acute cholecystitis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000264.htm Acute cholecystitis To use the sharing features on this page, please enable JavaScript. Acute cholecystitis is sudden swelling and irritation of the gallbladder. ...

  7. Acute axonal damage predicts clinical outcome in patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Lim, E.T; Sellebjerg, F; Jensen, C.V

    2005-01-01

    The objectives of this study were (1) to determine how cerebrospinal fluid (CSF) neurofilament heavy chain (NfH(SM134) and NfH(SM135)) levels relate to clinical outcome in optic neuritis (ON) and multiple sclerosis (MS) relapse patients treated with high dose oral methylprednisolone; and (2...... in the MS attack trial were treated with oral methylprednisolone. In the MS attack trial group, CSF NfH(SM134) and NfH(SM135) measured at week 3 and deltaCSF NfH(SMI34) levels from baseline to week 3 were predictive of clinical outcome at week 8 and 52. In the ON group, no such association was seen. When...... both groups were combined, baseline CSF NfH(SHM134) and NfH(SM135) correlated positively with baseline enhancing lesion volume (ELV) (r(s) =0.50, P

  8. Spectral domain optical coherence tomography findings in long-term silicone oil-related visual loss.

    Science.gov (United States)

    Shalchi, Zaid; Mahroo, Omar A; Shunmugam, Manoharan; Mohamed, Moin; Sullivan, Paul M; Williamson, Tom H

    2015-03-01

    To investigate spectral domain optical coherence tomography findings in long-term silicone oil-related visual loss. Four symptomatic patients were reviewed 4 years to 9 years after vitrectomy with silicone oil tamponade for macula-on retinal detachment. Three lost vision with oil in situ, with one at the time of oil removal. Eleven control eyes with good vision were included. Patients underwent assessment of best-corrected visual acuity, contrast sensitivity, Farnsworth-Munsell 100 Hue testing, static perimetry, and spectral domain optical coherence tomography imaging of the macula and disk. Long-term best-corrected visual acuity was significantly reduced in affected eyes (range, 0.44-1.02), as was contrast sensitivity (0.75-1.35) and color discrimination (Farnsworth-Munsell-100 Hue score, 151-390). Static perimetry showed a central scotoma in all affected eyes. Optical coherence tomography revealed microcystic macular changes in the inner nuclear layer of all affected eyes associated with severe loss of the papillofoveal retinal nerve fiber layer. In one patient, serial optical coherence tomography images showed development of microcystic macular changes 18 months after oil removal. Control eyes lacked these features, except two asymptomatic eyes that showed microcystic changes on optical coherence tomography with a corresponding paracentral scotoma. We have demonstrated microcystic macular changes in the inner nuclear layer of affected eyes, as well as focal severe loss of the papillofoveal projection. These changes share significant morphologic features reported in multiple sclerosis-associated optic neuritis and Leber hereditary optic neuropathy.

  9. Optic nerve involvement in a borderline lepromatous leprosy patient on multidrug therapy.

    Science.gov (United States)

    Prabha, Neel; Mahajan, Vikram K; Sharma, Surinder K; Sharma, Vikas; Chauhan, Pushpinder S; Mehta, Karaninder S; Abhinav, C; Khatri, Gaytri; Chander, Bal; Tuli, Rajiv

    2013-12-01

    Amidst the plethora of ocular complications of leprosy, involvement of the posterior segment or optic nerve is extremely rare. The mechanism of optic neuritis in leprosy is poorly understood. A 47 year-old man presented with a single lesion suggestive of mid-borderline (BB) leprosy over left periorbital region; the histology showed borderline lepromatous (BL) leprosy with a BI of 3+. After initial improvement with WHO MDT-MB and prednisolone (40 mg/d) he developed sudden and painless diminished vision in the left eye, about 3 weeks later. His visual acuity was 6/9 in the left and 6/6 in the right eye, and there was left optic disc edema, hyperemia and blurred disc margins. Treatment with prednisolone (60 mg/d) along with WHO MDT-MB continued. A month later he returned with painless diminished vision in the other eye as well. Visual acuity was 6/6 in the right and 6/12 in the left eye, and there was right optic disc edema and left optic disc atrophy. CT of the head and MRI of the brain were normal. Inflammatory edema of the orbital connective tissue or other surrounding structures, or direct infiltration of vasa nervosa with resultant vascular occlusion leading to optic nerve ischemia, seems the most plausible explanation of optic nerve involvement in this case.

  10. Acute Cocaine Induces Fast Activation of D1 Receptor and Progressive Deactivation of D2 Receptor Strial Neurons: In Vivo Optical Microprobe [Ca(superscript)2+]subscript)i Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Du, C.; Luo, Z.; Volkow, N.D.; Heintz, N.; Pan, Y.; Du, C.

    2011-09-14

    Cocaine induces fast dopamine increases in brain striatal regions, which are recognized to underlie its rewarding effects. Both dopamine D1 and D2 receptors are involved in cocaine's reward but the dynamic downstream consequences of cocaine effects in striatum are not fully understood. Here we used transgenic mice expressing EGFP under the control of either the D1 receptor (D1R) or the D2 receptor (D2R) gene and microprobe optical imaging to assess the dynamic changes in intracellular calcium ([Ca{sup 2+}]{sub i} ) responses (used as marker of neuronal activation) to acute cocaine in vivo separately for D1R- versus D2R-expressing neurons in striatum. Acute cocaine (8 mg/kg, i.p.) rapidly increased [Ca{sup 2+}]{sub i} in D1R-expressing neurons (10.6 {+-} 3.2%) in striatum within 8.3 {+-} 2.3 min after cocaine administration after which the increases plateaued; these fast [Ca{sup 2+}]{sub i} increases were blocked by pretreatment with a D1R antagonist (SCH23390). In contrast, cocaine induced progressive decreases in [Ca{sup 2+}]{sub i} in D2R-expressing neurons (10.4 {+-} 5.8%) continuously throughout the 30 min that followed cocaine administration; these slower [Ca{sup 2+}]{sub i} decreases were blocked by pretreatment with a D2R antagonist (raclopride). Since activation of striatal D1R-expressing neurons (direct-pathway) enhances cocaine reward, whereas activation of D2R expressing neurons suppresses it (indirect-pathway) (Lobo et al., 2010), this suggests that cocaine's rewarding effects entail both its fast stimulation ofD1R (resulting in abrupt activation of direct-pathway neurons) and a slower stimulation of D2R (resulting in longer-lasting deactivation of indirect-pathway neurons). We also provide direct in vivo evidence of D2R and D1R interactions in the striatal responses to acute cocaine administration.

  11. Improved tympanic thermometer based on a fiber optic infrared radiometer and an otoscope and its use as a new diagnostic tool for acute otitis media

    Science.gov (United States)

    Fishman, Gadi; DeRowe, Ari; Ophir, Eyal; Scharf, Vered; Shabtai, Abraham; Ophir, Dov; Katzir, Abraham

    1999-06-01

    Clinical diagnosis of acute otitis media (AOM) in children is not easy. It was assumed that there is a difference ΔT between the Tympanic Membrane (TM) temperatures in the two ears in unilateral AOM and that an accurate measurement of ΔT may improve the diagnosis accuracy. An IR transmitting fiber, made of AgClBr, was coupled into a hand held otoscope and was used for the non-contact (radiometric) measurements of TT, the TM temperature. Experiments were carried out, first, on a laboratory model that simulated the human ear, including an artificial tympanic membrane and an artificial ear canal. Measurements carried out using commercially available tympanic thermometers shown that the temperature Tc of the ear canal affected the results. Tc did not affect the fiberoptic radiometer, and this device accurately measured the true temperature, TT of the tympanic membrane. A prospective blinded sampling of the TM temperature was then performed on 48 children with suspected AOM. The mean temperature difference between the ears, for children with unilateral AOM was ΔT = (0.68 +/- 0.27)°C. For children with bilateral AOM it was ΔT = (0.14+/-0.10)°C (pmeasurements of the TM can be a useful non-invasive diagnostic tool for AOM, when combined with other data.

  12. Optical coherence tomography as a biomarker in multiple sclerosis.

    Science.gov (United States)

    Fjeldstad, Anette Simble; Carlson, Noel G; Rose, John W

    2012-11-01

    Multiple sclerosis (MS) is a disease of the central nervous system (CNS) that leads to axonal dysfunction and neuronal loss and often presents optic neuritis (ON). Decreased thickness of the retinal nerve fiber layer (RNFL) is a classic finding on ophthalmoscopic examination of patients with MS and especially noted in those patients with a history of ON. The thickness of the RNFL can be measured by a non-invasive technique, optical coherence tomography (OCT). This review will cover the history and development of the OCT technology and the advantages of a potential clinical application as a biomarker for axonal loss in MS. The use of OCT to quantify axonal loss in the RNFL is a promising tool to evaluate disease progression in MS and ON patients. OCT measurements may also correlate with MRI measured brain atrophy and could provide an easily quantified and highly reproducible method in clinical trials to monitor the efficacy of both immune- and neuroprotective therapies. Potential correlations between OCT with other biomarkers that include low contrast vision, visual evoked potentials, color vision and diffusion tensor imaging of the brain and advanced imaging of the optic nerve are promising new frontiers of research.

  13. Genotype–phenotype correlations in Leber hereditary optic neuropathy

    National Research Council Canada - National Science Library

    Tońska, Katarzyna; Kodroń, Agata; Bartnik, Ewa

    2010-01-01

    Leber hereditary optic neuropathy (LHON), acute or subacute vision loss due to retinal ganglion cell death which in the long run leads to optic nerve atrophy is one of the most widely studied maternally inherited diseases caused...

  14. Acute Porphyrias.

    Science.gov (United States)

    Besur, Siddesh; Schmeltzer, Paul; Bonkovsky, Herbert L

    2015-09-01

    Porphyrias are a group of eight metabolic disorders characterized by defects in heme biosynthesis. Porphyrias are classified into two major categories: 1) the acute or inducible porphyrias and 2) the chronic cutaneous porphyrias. The acute hepatic porphyrias are further classified into acute intermittent porphyria (AIP), hereditary coproporphyria, variegate porphyria, and porphyria due to severe deficiency of delta-aminolevulinic acid (ALA) dehydratase (ALADP). AIP is the most common, and ALADP is the least common acute porphyria. The clinical presentations of acute porphyrias are nonspecific. There are no pathognomonic signs or symptoms. The most frequent presenting symptom is abdominal pain, but pain in the chest, back, or lower extremities may also occur. Hyponatremia is the most common electrolyte abnormality during acute attacks, and hypomagnesemia is also common. Both are risk factors for development of seizures, which occur in ∼ 20-30% of acute attacks. Once suspected, the diagnosis of porphyria can be rapidly established by checking random urinary porphobilinogen. Initial management of acute porphyria includes discontinuation of all potentially harmful drugs and management of symptoms. Acute attacks should be treated emergently with intravenous heme and glucose to avoid considerable morbidity and mortality. Acute attacks last a few days, and the majority of patients are asymptomatic between attacks. Prognosis is good if the condition is recognized early and treated aggressively. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. PARACENTRAL ACUTE MIDDLE MACULOPATHY IN PURTSCHER RETINOPATHY.

    Science.gov (United States)

    Rivera-De La Parra, David; Fromow-Guerra, Jans

    2017-12-27

    To describe paracentral acute middle maculopathy associated with Purtscher retinopathy, particularly in Purtscher flecken lesions as a retinal complication in a case secondary to fractures of long bones. Case report. A 16-year-old boy with bilateral paracentral scotomata presented with bilateral paracentral acute middle maculopathy as part of Purtscher retinopathy in both eyes as consequence of tibia and fibula fractures. Paracentral acute middle maculopathy is one of the optical coherence tomography findings in Purtscher retinopathy.

  16. Comprehensive evaluation of peripheral nerve regeneration in the acute healing phase using tissue clearing and optical microscopy in a rodent model.

    Directory of Open Access Journals (Sweden)

    Yookyung Jung

    Full Text Available Peripheral nerve injury (PNI, a common injury in both the civilian and military arenas, is usually associated with high healthcare costs and with patients enduring slow recovery times, diminished quality of life, and potential long-term disability. Patients with PNI typically undergo complex interventions but the factors that govern optimal response are not fully characterized. A fundamental understanding of the cellular and tissue-level events in the immediate postoperative period is essential for improving treatment and optimizing repair. Here, we demonstrate a comprehensive imaging approach to evaluate peripheral nerve axonal regeneration in a rodent PNI model using a tissue clearing method to improve depth penetration while preserving neural architecture. Sciatic nerve transaction and end-to-end repair were performed in both wild type and thy-1 GFP rats. The nerves were harvested at time points after repair before undergoing whole mount immunofluorescence staining and tissue clearing. By increasing the optic depth penetration, tissue clearing allowed the visualization and evaluation of Wallerian degeneration and nerve regrowth throughout entire sciatic nerves with subcellular resolution. The tissue clearing protocol did not affect immunofluorescence labeling and no observable decrease in the fluorescence signal was observed. Large-area, high-resolution tissue volumes could be quantified to provide structural and connectivity information not available from current gold-standard approaches for evaluating axonal regeneration following PNI. The results are suggestive of observed behavioral recovery in vivo after neurorrhaphy, providing a method of evaluating axonal regeneration following repair that can serve as an adjunct to current standard outcomes measurements. This study demonstrates that tissue clearing following whole mount immunofluorescence staining enables the complete visualization and quantitative evaluation of axons throughout

  17. Impact of Plaque Rupture Detected by Optical Coherence Tomography on Transmural Extent of Infarction After Successful Stenting in ST-Segment Elevation Acute Myocardial Infarction.

    Science.gov (United States)

    Satogami, Keisuke; Ino, Yasushi; Kubo, Takashi; Tanimoto, Takashi; Orii, Makoto; Matsuo, Yoshiki; Ota, Shingo; Yamaguchi, Tomoyuki; Shiono, Yasutsugu; Shimamura, Kunihiro; Katayama, Yosuke; Aoki, Hiroshi; Nishiguchi, Tsuyoshi; Ozaki, Yuichi; Yamano, Takashi; Kameyama, Takeyoshi; Kuroi, Akio; Kitabata, Hironori; Tanaka, Atsushi; Hozumi, Takeshi; Akasaka, Takashi

    2017-05-22

    The aim of the present study was to investigate the association between plaque rupture (PR) assessed by optical coherence tomography (OCT), and the transmural extent of infarction (TEI) assessed by contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PCI). PR is associated with larger infarct size as assessed by cardiac enzymes in STEMI patients. CE-CMR is a favorable method to assess TEI, which can predict the prognosis of STEMI patients. First, STEMI patients with primary PCI within 12 h after onset were enrolled and divided into 2 groups according to presence (n = 71) or absence (n = 32) of PR at the culprit lesion as assessed by pre-intervention OCT. CE-CMR was performed at 1 week after primary PCI. The frequency of no-reflow phenomenon (37% vs. 16%; p = 0.032) and distal embolization (24% vs. 6%; p = 0.032) was significantly higher in the rupture group compared with the non-rupture group. TEI grade was significantly greater in the rupture group (28% vs. 15% in grade 3 and 45% vs. 13% in grade 4; p < 0.001). Microvascular obstruction was more frequently seen in the rupture group (39% vs. 19%; p = 0.039). Multivariate analysis identified PR (odds ratio: 6.60, 95% confidence interval: 2.19 to 21.69; p < 0.001) and no statin use before admission (odds ratio: 3.37, 95% confidence interval: 1.06 to 11.19; p = 0.039) as independent predictors of TEI grade 3 or 4. PR as assessed by OCT is associated with greater TEI as assessed by CE-CMR in STEMI patients after primary PCI. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. Acute cholecystitis

    OpenAIRE

    Fialkowski, Elizabeth; Halpin, Valerie; Whinney, Robb R

    2008-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the bile duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  19. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  20. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie; Gupta, Aditya

    2011-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the bile duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  1. 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

    of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. METHODS: 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...... (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 multiple sclerosis after a median follow-up of 2·0 years (range 0·5-5 years). Patients with a p...

  2. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome

    Science.gov (United States)

    Carmona, Sergio; Martínez, Carlos; Zalazar, Guillermo; Moro, Marcela; Batuecas-Caletrio, Angel; Luis, Leonel; Gordon, Carlos

    2016-01-01

    The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient’s age. Grade 2–3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2–3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate. PMID:27551274

  3. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome

    Directory of Open Access Journals (Sweden)

    Sergio Carmona

    2016-08-01

    Full Text Available The head impulse, nystagmus type, test of skew (HINTS protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS. The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests and negative MRI, and the rest with Stroke: 32 in the PICA territory (positive HINTS findings, positive MRI and 10 in the AICA territory (variable findings and grade 3 Ataxia, positive MRI. Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture.When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38, 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.

  4. Optical Computing

    Indian Academy of Sciences (India)

    tal computers are still some years away, however a number of devices that can ultimately lead to real optical computers have already been manufactured, including optical logic gates, optical switches, optical interconnections, and opti- cal memory. The most likely near-term optical computer will really be a hybrid composed ...

  5. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2015-01-01

    Acute bronchitis affects more than 40 in 1000 adults per year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.One third of people may have longer-term symptoms or recurrence.

  6. Acute nierschade

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; van Heurn, L.W.E.; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  7. Disease: H01717 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H01717 Optic neuritis Optic neuritis is a demyelinating inflammatory disease of th...feron or glatiramer acetate is recommended. Nervous system disease ... Methylprednisolone [DR:D00751] Inter

  8. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  9. Acute Cholecystitis

    National Research Council Canada - National Science Library

    Schuld, Jochen; Glanemann, Matthias

    2015-01-01

    The treatment of acute cholecystitis has been controversially discussed in the literature as there are no high-evidence-level data yet for determining the optimal point in time for surgical intervention...

  10. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  11. The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism.

    Science.gov (United States)

    Becker-Bense, Sandra; Dieterich, Marianne; Buchholz, Hans-Georg; Bartenstein, Peter; Schreckenberger, Mathias; Brandt, Thomas

    2014-07-01

    The human vestibular system is represented in the brain bilaterally, but it has functional asymmetries, i.e., a dominance of ipsilateral pathways and of the right hemisphere in right-handers. To determine if acute right- or left-sided unilateral vestibular neuritis (VN) is associated with differential patterns of brain metabolism in areas representing the vestibular network and the visual-vestibular interaction, patients with acute VN (right n = 9; left n = 13) underwent resting state (18)F-FDG PET once in the acute phase and once 3 months later after central vestibular compensation. The contrast acute vs. chronic phase showed signal differences in contralateral vestibular areas and the inverse contrast in visual cortex areas, both more pronounced in VN right. In VN left additional regions were found in the cerebellar hemispheres and vermis bilaterally, accentuated in severe cases. In general, signal changes appeared more pronounced in patients with more severe vestibular deficits. Acute phase PET data of patients compared to that of age-matched healthy controls disclosed similarities to these patterns, thus permitting the interpretation that the signal changes in vestibular temporo-parietal areas reflect signal increases, and in visual areas, signal decreases. These data imply that brain activity in the acute phase of right- and left-sided VN exhibits different compensatory patterns, i.e., the dominant ascending input is shifted from the ipsilateral to the contralateral pathways, presumably due to the missing ipsilateral vestibular input. The visual-vestibular interaction patterns were preserved, but were of different prominence in each hemisphere and more pronounced in patients with right-sided failure and more severe vestibular deficits.

  12. High resolution spectral domain optical coherence tomography (SD-OCT in multiple sclerosis: the first follow up study over two years.

    Directory of Open Access Journals (Sweden)

    Nermin Serbecic

    Full Text Available BACKGROUND: "Non-invasive, faster and less expensive than MRI" and "the eye is a window to the brain" are recent slogans promoting optical coherence tomography (OCT as a new surrogate marker in multiple sclerosis (MS. Indeed, OCT allows for the first time a non-invasive visualization of axons of the central nervous system (CNS. Reduction of retina nerve fibre layer (RNFL thickness was suggested to correlate with disease activity and duration. However, several issues are unclear: Do a few million axons, which build up both optic nerves, really resemble billions of CNS neurons? Does global CNS damage really result in global RNFL reduction? And if so, does global RNFL reduction really exist in all MS patients, and follow a slowly but steadily ongoing pattern? How can these (hypothesized subtle global RNFL changes be reliably measured and separated from the rather gross RNFL changes caused by optic neuritis? Before generally being accepted, this interpretation needs further critical and objective validation. METHODOLOGY: We prospectively studied 37 MS patients with relapsing remitting (n = 27 and secondary progressive (n = 10 course on two occasions with a median interval of 22.4±0.5 months [range 19-27]. We used the high resolution spectral domain (SD-OCT with the Spectralis 3.5 mm circle scan protocol with locked reference images and eye tracking mode. Patients with an attack of optic neuritis within 12 months prior to the onset of the study were excluded. PRINCIPAL FINDINGS: Although the disease was highly active over the observation period in more than half of the included relapsing remitting MS patients (19 patients/32 relapses and the initial RNFL pattern showed a broad range, from normal to markedly reduced thickness, no significant changes between baseline and follow-up examinations could be detected. CONCLUSIONS: These results show that caution is required when using OCT for monitoring disease activity and global axonal injury in

  13. Modern optics

    CERN Document Server

    Guenther, B D

    2015-01-01

    Modern Optics is a fundamental study of the principles of optics using a rigorous physical approach based on Maxwell's Equations. The treatment provides the mathematical foundations needed to understand a number of applications such as laser optics, fiber optics and medical imaging covered in an engineering curriculum as well as the traditional topics covered in a physics based course in optics. In addition to treating the fundamentals in optical science, the student is given an exposure to actual optics engineering problems such as paraxial matrix optics, aberrations with experimental examples, Fourier transform optics (Fresnel-Kirchhoff formulation), Gaussian waves, thin films, photonic crystals, surface plasmons, and fiber optics. Through its many pictures, figures, and diagrams, the text provides a good physical insight into the topics covered. The course content can be modified to reflect the interests of the instructor as well as the student, through the selection of optional material provided in append...

  14. Relation between thoracic aortic inflammation and features of plaque vulnerability in the coronary tree in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. An FDG-positron emission tomography and optical coherence tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Taglieri, Nevio; Ghetti, Gabriele; Saia, Francesco; Bacchi Reggiani, Maria Letizia; Rapezzi, Claudio [Alma Mater Studiorum Universita di Bologna, Istituto di Cardiologia, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Bologna (Italy); Nanni, Cristina; Bonfiglioli, Rachele; Lima, Giacomo Maria; Fanti, Stefano [Alma Mater Studiorum Universita di Bologna, Istituto di Medicina Nucleare, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Bologna (Italy); Marco, Valeria [CLI Foundation, Rome (Italy); Prati, Francesco [CLI Foundation, Rome (Italy); Ettore Sansavini Health Science Foundation, GVM Care and Research, Cotignola (Italy)

    2017-10-15

    To evaluate the relationship between aortic inflammation as assessed by {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG-PET) and features of plaque vulnerability as assessed by frequency domain-optical coherence tomography (FD-OCT). We enrolled 30 consecutive non-ST-segment elevation acute coronary syndrome patients undergoing percutaneous coronary intervention. All patients underwent three-vessel OCT before intervention and {sup 18}F-FDG-PET before discharge. Univariable and C-reactive protein (CRP)-adjusted linear regression analyses were performed between features of vulnerability [namely:lipid-rich plaques with and without macrophages and thin cap fibroatheromas (TCFA)] and {sup 18}F-FDG uptake in both ascending (AA) and descending aorta (DA) [measured either as averaged mean and maximum target-to-blood ratio (TBR) or as active slices (TBR{sub max} ≥ 1.6)]. Mean age was 62 years, and 26 patients were male. On univariable linear regression analysis TBR{sub mean} and TBR{sub max} in DA was associated with the number of lipid-rich plaques (β = 4.22; 95%CI 0.05-8.39; p = 0.047 and β = 3.72; 95%CI 1.14-6.30; p = 0.006, respectively). TBR{sub max} in DA was also associated with the number of lipid-rich plaques containing macrophages (β = 2.40; 95%CI 0.07-4.72; p = 0.044). A significant CRP adjusted linear association between the TBR{sub max} in DA and the number of lipid-rich plaques was observed (CRP-adjusted β = 3.58; 95%CI -0.91-6.25; p = 0.01). TBR{sub max} in DA showed a trend towards significant CRP-adjusted association with number of lipid-rich plaques with macrophages (CRP-adjusted β = 2.30; 95%CI -0.11-4.71; p = 0.06). We also observed a CRP-adjusted (β = 2.34; 95%CI 0.22-4.47; p = 0.031) linear association between the number of active slices in DA and the number of lipid-rich plaques. No relation was found between FDG uptake in the aorta and the number of TCFAs. In patients with first NSTEACS{sup ,} {sup 18}F-FDG uptake in

  15. Engineering Optics

    CERN Document Server

    Iizuka, Keigo

    2008-01-01

    Engineering Optics is a book for students who want to apply their knowledge of optics to engineering problems, as well as for engineering students who want to acquire the basic principles of optics. It covers such important topics as optical signal processing, holography, tomography, holographic radars, fiber optical communication, electro- and acousto-optic devices, and integrated optics (including optical bistability). As a basis for understanding these topics, the first few chapters give easy-to-follow explanations of diffraction theory, Fourier transforms, and geometrical optics. Practical examples, such as the video disk, the Fresnel zone plate, and many more, appear throughout the text, together with numerous solved exercises. There is an entirely new section in this updated edition on 3-D imaging.

  16. Electron optics

    CERN Document Server

    Grivet, Pierre; Bertein, F; Castaing, R; Gauzit, M; Septier, Albert L

    1972-01-01

    Electron Optics, Second English Edition, Part I: Optics is a 10-chapter book that begins by elucidating the fundamental features and basic techniques of electron optics, as well as the distribution of potential and field in electrostatic lenses. This book then explains the field distribution in magnetic lenses; the optical properties of electrostatic and magnetic lenses; and the similarities and differences between glass optics and electron optics. Subsequent chapters focus on lens defects; some electrostatic lenses and triode guns; and magnetic lens models. The strong focusing lenses and pris

  17. Acute Pancreatitis

    DEFF Research Database (Denmark)

    Bertilsson, Sara; Håkansson, Anders; Kalaitzakis, Evangelos

    2017-01-01

    Aims: We aimed to evaluate the potential relation between the incidence of (alcoholic and non-alcoholic) acute pancreatitis (AP) and alcohol consumption in the general population, and whether the occurrence of AP shows any seasonal variation, particularly in relation to periods with expected...... consumption in the general population do not appear to be related to changes in the incidence of AP and there are no significant seasonal differences in the occurrence of AP in Sweden. Short summary: The incidence of acute pancreatitis (AP) is increasing, and alcohol is still recognized as one of the most...

  18. Acute Sinusitis

    Science.gov (United States)

    ... Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve within a week to 10 days. In ... sinusitis is most often caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops. Risk factors You may ...

  19. Acute pancreatitis.

    Science.gov (United States)

    Munsell, Melissa A; Buscaglia, Jonathan M

    2010-04-01

    Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self-limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. (c) 2010 Society of Hospital Medicine.

  20. Acute Bronchitis.

    Science.gov (United States)

    Kinkade, Scott; Long, Natalie A

    2016-10-01

    Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure. The cough associated with acute bronchitis typically lasts about two to three weeks, and this should be emphasized with patients. Acute bronchitis is usually caused by viruses, and antibiotics are not indicated in patients without chronic lung disease. Antibiotics have been shown to provide only minimal benefit, reducing the cough or illness by about half a day, and have adverse effects, including allergic reactions, nausea and vomiting, and Clostridium difficile infection. Evaluation and treatment of bronchitis include ruling out secondary causes for cough, such as pneumonia; educating patients about the natural course of the disease; and recommending symptomatic treatment and avoidance of unnecessary antibiotic use. Strategies to reduce inappropriate antibiotic use include delayed prescriptions, patient education, and calling the infection a chest cold.

  1. Evaluation of the optic nerve using strain and shear wave elastography in patients with multiple sclerosis and healthy subjects.

    Science.gov (United States)

    İnal, Mikail; Tan, Sinan; Yumusak, Erhan M; Şahan, Mehmet Hamdi; Alpua, Murat; Örnek, Kemal

    2017-01-31

    Our aim was to evaluate the elasticity features of the optic nerve using strain (SE) and shear wave elastography (SWE) in multiple sclerosis (MS) patients in comparison with healthy subjects. One hundred and seven optic nerves from 54 MS patients and 118 optic nerves from 59 healthy subjects were examined prospectively by SE and SWE. Optic nerves were divided into three types in accordance to the elasticity designs, as follows: type 1 predominantly blue (hardest tissue); type 2 predominantly blue/green (hard tissue); and type 3 predominantly green (intermediate tissue). Quantitative measurements of optic nerve hardness with SWE were analyzed in kilopascals. Elastographic images from healthy volunteers showed mostly type 3 optic nerves (61.9%); type 2 was also found (38.1%), but type 1 was not observed. Elastographic examination of MS patients showed mostly type 2 optic nerves (88%), while some type 1 (4.6%) and type 3 optic nerves (6.5%) were rarely observed. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p<0.001). Statistically significant differences were observed between patients and healthy volunteers in the analysis of SWE values (10.381±3.48 kPa and 33.87±11.64 p<0.001). The receiver operating characteristic curve analysis was perfect (0.993; 95% confidence interval [CI]=0.971-0.999), and a cut-off value of 18.3 kPa shear had very high sensitivity and specificity for the patient group. No significant differences were observed between patients with and without previous optic neuritis. SE and SWE examination findings concerning the optic nerve in MS patients demonstrated remarkable differences according to the healthy group.

  2. Nonlinear optics

    CERN Document Server

    Boyd, Robert W

    2013-01-01

    Nonlinear Optics is an advanced textbook for courses dealing with nonlinear optics, quantum electronics, laser physics, contemporary and quantum optics, and electrooptics. Its pedagogical emphasis is on fundamentals rather than particular, transitory applications. As a result, this textbook will have lasting appeal to a wide audience of electrical engineering, physics, and optics students, as well as those in related fields such as materials science and chemistry.Key Features* The origin of optical nonlinearities, including dependence on the polarization of light* A detailed treatment of the q

  3. Optical fibres

    CERN Document Server

    Geisler, J; Boutruche, J P

    1986-01-01

    Optical Fibers covers numerous research works on the significant advances in optical fibers, with particular emphasis on their application.This text is composed of three parts encompassing 15 chapters. The first part deals with the manufacture of optical fibers and the materials used in their production. The second part describes optical-fiber connectors, terminals and branches. The third part is concerned with the major optoelectronic components encountered in optical-communication systems.This book will be of value to research scientists, engineers, and patent workers.

  4. Optical interconnects

    CERN Document Server

    Chen, Ray T

    2006-01-01

    This book describes fully embedded board level optical interconnect in detail including the fabrication of the thin-film VCSEL array, its characterization, thermal management, the fabrication of optical interconnection layer, and the integration of devices on a flexible waveguide film. All the optical components are buried within electrical PCB layers in a fully embedded board level optical interconnect. Therefore, we can save foot prints on the top real estate of the PCB and relieve packaging difficulty reduced by separating fabrication processes. To realize fully embedded board level optical

  5. Unusual ocular presentation of acute toxoplasmosis.

    Science.gov (United States)

    Willerson, D; Aaberg, T M; Reeser, F; Meredith, T A

    1977-01-01

    Four patients with toxoplasmosis are reported with unusual presenting ocular lesions. One patient had an active lesion that appeared to involve the optic nerve as well as focal toxoplasmosis chorioretinitis at the macula. A second patient had a pale optic nerve in association with the classical chorioretinal scars of toxoplasmosis. The third patient had toxoplasmosis chorioretinitis of the macula with subretinal neovascularisation. The fourth patient had a branch artery occlusion complicating acute retinitis. Images PMID:588525

  6. A Functional and Neuropathological Testing Paradigm Reveals New Disability-Based Parameters and Histological Features for P0180-190-Induced Experimental Autoimmune Neuritis in C57BL/6 Mice.

    Science.gov (United States)

    Gonsalvez, David G; De Silva, Mithraka; Wood, Rhiannon J; Giuffrida, Lauren; Kilpatrick, Trevor J; Murray, Simon S; Xiao, Junhua

    2017-02-01

    We assessed novel disability-based parameters and neuropathological features of the P0180-190 peptide-induced model of experimental autoimmune neuritis (EAN) in C57BL/6 mice. We show that functional assessments such as running capacity provide a more sensitive method for detecting alterations in disease severity than a classical clinical scoring paradigm. We performed detailed ultrastructural analysis and show for the first time that tomaculous neuropathy is a neuropathological feature of this disease model. In addition, we demonstrate that ultrastructural assessments of myelin pathology are sufficiently sensitive to detect significant differences in both mean G-ratio and mean axon diameter between mice with EAN induced with different doses of pertussis toxin. In summary, we have established a comprehensive assessment paradigm for discriminating variations in disease severity and the extent of myelin pathology in this model. Our findings indicate that this model is a powerful tool to study the pathogenesis of human peripheral demyelinating neuropathies and that this assessment paradigm could be used to determine the efficacy of potential therapies that aim to promote myelin repair and protect against nerve damage in autoimmune neuritides. © 2017 American Association of Neuropathologists, Inc. All rights reserved.

  7. Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?

    Directory of Open Access Journals (Sweden)

    Sirel Gür Güngör

    2017-12-01

    Full Text Available Objectives: In this study, we investigated the patients who were referred to our clinic with a prediagnosis of glaucoma based on retinal nerve fiber layer (RNFL defects on optic coherence tomography (OCT but were determined to have nonglaucomatous RNLF defects upon detailed examination. Materials and Methods: The ophthalmic examination notes, OCT images, Heidelberg retinal tomography (HRT II and fundus photographs of 357 patients were retrospectively evaluated. Final diagnoses of these patients were investigated. Results: Of the 357 patients, 216 (60.5% were diagnosed as open angle glaucoma, 33 (9.2% as low-tension glaucoma, 39 (10.9% as pre-perimetric glaucoma. The ophthalmic examinations of 14 patients (3.9% were normal and there were no RNFL defects in OCT examinations after dilatation. In 39 patients (10.9%, the ophthalmic and optic disc examinations were completely normal and no etiologic factor explaining RNFL defects was found. Twenty-two eyes of 16 patients (4.5% were included in this study (the mean age was 53.8±11.5 years; 9 men and 7 women. After detailed questioning of the medical history and systemic and neurologic examinations, a diagnosis of ischemic optic neuropathy was made in 11 eyes (10 patients (2.8%, optic neuritis in 3 eyes (2 patients (0.6%, optic disc drusen in 4 eyes (2 patients (0.6%, pseudotumor cerebri in 2 eyes (1 patient (0.3%, and cerebral palsy in 2 eyes (1 patient (0.3%. Conclusion: Decrease in RNFL thickness on OCT images alone may be misleading in glaucoma examination. In cases where optic disc cupping is not evident, diagnosis should not be based on OCT RNFL examinations alone, and the patient’s medical history, detailed ophthalmic examination, OCT optic disc parameters, HRT, and visual field tests should all be carefully evaluated together.

  8. The REMEDEE-OCT Study: An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody-Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography Imaging Analysis.

    Science.gov (United States)

    Jaguszewski, Milosz; Aloysius, Romila; Wang, Wei; Bezerra, Hiram G; Hill, Jonathan; De Winter, Robbert J; Karjalainen, Pasi P; Verheye, Stefan; Wijns, William; Lüscher, Thomas F; Joner, Michael; Costa, Marco; Landmesser, Ulf

    2017-03-13

    The aim of the present study was to evaluate vascular healing of the bioengineered COMBO Dual Therapy Stent compared with a cobalt-chromium (CoCr) everolimus-eluting stent (EES) as assessed by optical coherence tomography in patients with acute coronary syndromes. CD34+ cells promote endothelial repair after vascular injury. The bioengineered COMBO Dual Therapy Stent combines CD34+ cell-capturing technology with abluminal sirolimus release, but more data from clinical studies evaluating the vascular response are needed. In a prospective randomized multicenter clinical trial, 60 patients with acute coronary syndromes were randomized 1:1 to COMBO or CoCr EES implantation. The primary endpoint was the percentage of uncovered stent struts per stent. Stent assessment by optical coherence tomography was performed at baseline and at 60 days, followed by independent core laboratory analysis. The percentage of uncovered struts per stent was higher with the COMBO than the CoCr EES at 60 days (median 14.7% vs. 7.7%; p = 0.04). However, no significant difference in uncovered stent struts was observed in the strut level-based analysis at 60 days, which also accounted for clustering (COMBO vs. CoCr EES; 13.6% vs. 6.9%; p = 0.09; generalized linear mixed models-adjusted analysis). Neointimal thickness at 60 days was lower with the COMBO compared with the CoCr EES (median 30.17 vs. 50.26 μm; p = 0.02; stent-level analysis). There were no significant differences in the frequency of major adverse cardiac events and each component of major adverse cardiac events within the study population between the 2 groups at 30, 60, 180, 360, and 540 days post-procedure. No target vessel stent thrombosis has been documented within 540 days. The present multicenter, prospective clinical study for the first time compared the vascular response of the bioengineered COMBO Dual Therapy Stent with a CoCr EES in patients early after acute coronary syndrome by using intracoronary optical coherence

  9. Acute abdomen

    Directory of Open Access Journals (Sweden)

    Wig J

    1978-01-01

    Full Text Available 550 cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. More than 45% of patients presented after 48 hours of onset of symptoms. Intestinal obstruction was the commonest cause of acute abdomen (47.6%. External hernia was responsible for 26% of cases of intestinal obstruction. Perforated peptic ulcer was the commonest cause of peritonitis in the present series (31.7% while incidence of biliary peritonitis was only 2.4%.. The clinical accuracy rate was 87%. The mortality in operated cases was high (10% while the over-all mortality rate was 7.5%.

  10. [Acute cholangiocholecystitis].

    Science.gov (United States)

    Gavrilescu, S; Rădulescu, D

    1991-01-01

    In analysis of a group of 48 patients, the authors describe an entity they call acute cholangio-cholecystitis (or acute cholecystitis of choledochal origin) and define it by 4 obligatory criteria: 1. vesicular lesion of acute cholecystitis type; 2. the obstruction of the main bile duct in the direction of its junction with the cystic duct; 3. free duct communication between the gallbladder and the main bile ducts; 4. fluid content (purulent gallbladder) found identical over the whole biliary territory (the gallbladder the main bile ducts the intrahepatic bile ducts). This entity represents 7.6% of the total of acute cholecystitis and was met in 2.8% of the total of the interventions for the main bile ducts obstruction. The deficient biological background of the patients (60% over 60 years old), and other seriousness factors--vesicular destructive lesions associated with biliary peritonitis (7/48), the existence of the duct obstruction, usually calculous (42/48), but also hydatic (3/48) or tumoural (3/48), the multitude and seriousness of the associated lesions are emphasized. The surgery, performed in over 80% emergent cases, was directed to the decomprimation of the main biliary axis to which the increase of the gangrenous cholecyst, treatment of the duct obstructive factor, repair of the internal biliary fistulas, treatment of the consequent peritonitis were added. The results, very often good (71%), were shadowed by a series of complications (29%) which ended in deaths (14.5%). The paper pleads for the early surgery of the lithiasic biliary disease, before the appearance of the inevitable complications.

  11. Applied optics and optical design

    CERN Document Server

    Conrady, Alexander Eugen

    1957-01-01

    ""For the optical engineer it is an indispensable work."" - Journal, Optical Society of America""As a practical guide this book has no rival."" - Transactions, Optical Society""A noteworthy contribution,"" - Nature (London)Part I covers all ordinary ray-tracing methods, together with the complete theory of primary aberrations and as much of higher aberration as is needed for the design of telescopes, low-power microscopes and simple optical systems. Chapters: Fundamental Equations, Spherical Aberration, Physical Aspect of Optical Images, Chromatic Aberration, Design of Achromatic Object-Glass

  12. Applied optics and optical design

    CERN Document Server

    Conrady, A E

    2011-01-01

    ""For the optical engineer it is an indispensable work."" - Journal, Optical Society of America""As a practical guide this book has no rival."" - Transactions, Optical Society""A noteworthy contribution,"" - Nature (London)Part I covers all ordinary ray-tracing methods, together with the complete theory of primary aberrations and as much of higher aberration as is needed for the design of telescopes, low-power microscopes and simple optical systems. Chapters: Fundamental Equations, Spherical Aberration, Physical Aspect of Optical Images, Chromatic Aberration, Design of Achromatic Object-Glass

  13. Sinusitis (acute)

    Science.gov (United States)

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  14. Bronchitis (acute).

    Science.gov (United States)

    Wark, Peter

    2011-06-20

    Acute bronchitis affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens. The role of smoking or of environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear. One third of people may have longer-term symptoms or recurrence. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute bronchitis in people without chronic respiratory disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics (macrolides, tetracyclines, cephalosporins, penicillins, or trimethoprim-sulfamethoxazole [co-trimoxazole]), antihistamines, antitussives, beta(2) agonists (inhaled or oral), and expectorants/mucolytics.

  15. Color vision versus pattern visual evoked potentials in the assessment of subclinical optic pathway involvement in multiple sclerosis.

    Science.gov (United States)

    Gundogan, Fatih C; Tas, Ahmet; Altun, Salih; Oz, Oguzhan; Erdem, Uzeyir; Sobaci, Gungor

    2013-03-01

    Optic pathway involvement in multiple sclerosis is frequently the initial sign in the disease process. In most clinical applications, pattern visual evoked potential (PVEP) is used in the assessment of optic pathway involvement. To question the value of PVEP against color vision assessment in the diagnosis of subclinical optic pathway involvement. This prospective, cross-sectional study included 20 multiple sclerosis patients without a history of optic neuritis, and 20 healthy control subjects. Farnsworth-Munsell (FM) 100-Hue testing and PVEPs to 60-min arc and 15-min arc checks by using Roland-Consult RetiScan® system were performed. P 100 amplitude, P 100 latency in PVEP and total error scores (TES) in FM 100-Hue test were assessed. Expanded Disability Status Scale score and the time from diagnosis were 2.21 ± 2.53 (ranging from 0 to 7) and 4.1 ± 4.4 years. MS group showed significantly delayed P 100 latency for both checks (P 0.05 for all). 14 MS patients (70%) had an increased TESs in FM-100 Hue, 11 (55%) MS patients had delayed P 100 latency and 9 (45%) had reduced P 100 amplitude. The areas under the ROC curves were 0.944 for FM-100 Hue test, 0.753 for P 100 latency, and 0.173 for P 100 amplitude. Color vision testing seems to be more sensitive than PVEP in detecting subclinical visual pathway involvement in MS.

  16. Optical electronics

    CERN Document Server

    Yariv, Amnon

    1991-01-01

    This classic text introduces engineering students to the first principles of major phenomena and devices of optoelectronics and optical communication technology. Yariv's "first principles" approach employs real-life examples and extensive problems. The text includes separate chapters on quantum well and semiconductor lasers, as well as phase conjugation and its applications. Optical fiber amplification, signal and noise considerations in optical fiber systems, laser arrays and distributed feedback lasers all are covered extensively in major sections within chapters.

  17. Measurement of retinal nerve fiber layer thickness in eyes with optic disc swelling by using scanning laser polarimetry and optical coherence tomography.

    Science.gov (United States)

    Hata, Masayuki; Miyamoto, Kazuaki; Oishi, Akio; Kimura, Yugo; Nakagawa, Satoko; Horii, Takahiro; Yoshimura, Nagahisa

    2014-01-01

    The retinal nerve fiber layer thickness (RNFLT) in patients with optic disc swelling of different etiologies was compared using scanning laser polarimetry (SLP) and spectral-domain optical coherence tomography (OCT). Forty-seven patients with optic disc swelling participated in the cross-sectional study. Both GDx SLP (enhanced corneal compensation) and Spectralis spectral-domain OCT measurements of RNFLT were made in 19 eyes with papilledema (PE), ten eyes with optic neuritis (ON), and 18 eyes with nonarteritic anterior ischemic optic neuropathy (NAION) at the neuro-ophthalmology clinic at Kyoto University Hospital. Differences in SLP (SLP-RNFLT) and OCT (OCT-RNFLT) measurements among different etiologies were investigated. No statistical differences in average OCT-RNFLT among PE, ON, and NAION patients were noted. Average SLP-RNFLT in NAION patients was smaller than in PE (P<0.01) or ON (P=0.02) patients. When RNFLT in each retinal quadrant was compared, no difference among etiologies was noted on OCT, but on SLP, the superior quadrant was thinner in NAION than in PE (P<0.001) or ON (P=0.001) patients. Compared with age-adjusted normative data of SLP-RNFLT, average SLP-RNFLT in PE (P<0.01) and ON (P<0.01) patients was greater. Superior SLP-RNFLT in NAION patients was smaller (P=0.026). The ratio of average SLP-RNFLT to average OCT-RNFLT was smaller in NAION than in PE (P=0.001) patients. In the setting of RNFL thickening, despite increased light retardance in PE and ON eyes, SLP revealed that NAION eyes have less retardance, possibly associated with ischemic axonal loss.

  18. Acute leukemia.

    Science.gov (United States)

    Rose-Inman, Hayley; Kuehl, Damon

    2014-08-01

    Although great progress has been made in the understanding and treatment of acute leukemia, this disease has not been conquered. For emergency providers (EPs), the presentation of these patients to an emergency department presents a host of challenges. A patient may present with a new diagnosis of leukemia or with complications of the disease process or associated chemotherapy. It is incumbent on EPs to be familiar with the manifestations of leukemia in its various stages and maintain some suspicion for this diagnosis, given the nebulous and insidious manner in which leukemia can present. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Optical Detectors

    Science.gov (United States)

    Tabbert, Bernd; Goushcha, Alexander

    Optical detectors are applied in all fields of human activities from basic research to commercial applications in communication, automotive, medical imaging, homeland security, and other fields. The processes of light interaction with matter described in other chapters of this handbook form the basis for understanding the optical detectors physics and device properties.

  20. Optical Computing

    Indian Academy of Sciences (India)

    Division Multiplexing (DWDM) and can be used to signifi- cantly improve the bandwidth efficiency. Typical DWDM is a fiber-optic transmission technique that employs light wavelengths to transmit data parallel-by-bit or serial-by-character. This technology puts data from different sources together on an optical fiber, with each ...

  1. Optical biosensors.

    Science.gov (United States)

    Damborský, Pavel; Švitel, Juraj; Katrlík, Jaroslav

    2016-06-30

    Optical biosensors represent the most common type of biosensor. Here we provide a brief classification, a description of underlying principles of operation and their bioanalytical applications. The main focus is placed on the most widely used optical biosensors which are surface plasmon resonance (SPR)-based biosensors including SPR imaging and localized SPR. In addition, other optical biosensor systems are described, such as evanescent wave fluorescence and bioluminescent optical fibre biosensors, as well as interferometric, ellipsometric and reflectometric interference spectroscopy and surface-enhanced Raman scattering biosensors. The optical biosensors discussed here allow the sensitive and selective detection of a wide range of analytes including viruses, toxins, drugs, antibodies, tumour biomarkers and tumour cells. © 2016 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  2. Lagrangian optics

    CERN Document Server

    Lakshminarayanan, Vasudevan; Thyagarajan, K

    2002-01-01

    Ingeometrical optics, light propagation is analyzed in terms of light rays which define the path of propagation of light energy in the limitofthe optical wavelength tending to zero. Many features oflight propagation can be analyzed in terms ofrays,ofcourse, subtle effects near foci, caustics or turning points would need an analysis based on the wave natureoflight. Allofgeometric optics can be derived from Fermat's principle which is an extremum principle. The counterpart in classical mechanics is of course Hamilton's principle. There is a very close analogy between mechanics ofparticles and optics oflight rays. Much insight (and useful results) can be obtained by analyzing these analogies. Asnoted by H. Goldstein in his book Classical Mechanics (Addison Wesley, Cambridge, MA, 1956), classical mechanics is only a geometrical optics approximation to a wave theory! In this book we begin with Fermat's principle and obtain the Lagrangian and Hamiltonian pictures of ray propagation through various media. Given the ...

  3. GREAT optics

    Science.gov (United States)

    Wagner-Gentner, Armin; Graf, Urs U.; Philipp, Martin; Rabanus, David; Stutzki, Jürgen

    2004-10-01

    The German REceiver for Astronomy at Terahertz frequencies (GREAT) is a first generation PI instrument for the SOFIA telescope, developed by a collaboration between the MPIfR, KOSMA, DLR, and the MPAe. The first three institutes each contribute one heterodyne receiver channel to operate at 1.9, 2.7 and 4.7 THz, respectively. A later addition of a e.g. 1.4 THz channel is planned. The GREAT instrument is developed to carry two cryostats at once. That means that any two of the three frequencies can be observed simultaneously. Therefore, we need to be able to quickly exchange the optics benches, the local oscillator (LO) subsystems, and the cryostats containing the mixer devices. This demands a high modularity and flexibility of our receiver concept. Our aim is to avoid the need for realignment when swapping receiver channels. After an overview of the common GREAT optics, a detailed description of several parts (optics benches, calibration units, diplexer, focal plane imager) is given. Special emphasis is given to the LO optics of the KOSMA 1.9 THz channel, because its backward wave oscillator has an astigmatic output beam profile, which has to be corrected for. We developed astigmatic off-axis mirrors to compensate this astigmatism. The mirrors are manufactured in-house on a 5 axis CNC milling machine. We use this milling machine to obtain optical components with highest surface accuracy (about 5 microns) appropriate for these wavelengths. Based on the CNC machining capabilities we present our concept of integrated optics, which means to manufacture optical subsystems monolithically. The optics benches are located on three point mounts, which in conjunction with the integrated optics concept ensure the required adjustment free optics setup.

  4. Acute cerebellar ataxia

    Science.gov (United States)

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, particularly younger than age 3, may occur several weeks after an illness caused by a virus. ...

  5. Acute Liver Failure

    Science.gov (United States)

    Acute liver failure Overview Acute liver failure is loss of liver function that occurs rapidly — in days or weeks — usually in a person who has no pre-existing liver disease. Acute liver failure is less common than ...

  6. Fiber optic coupled optical sensor

    Science.gov (United States)

    Fleming, Kevin J.

    2001-01-01

    A displacement sensor includes a first optical fiber for radiating light to a target, and a second optical fiber for receiving light from the target. The end of the first fiber is adjacent and not axially aligned with the second fiber end. A lens focuses light from the first fiber onto the target and light from the target onto the second fiber.

  7. Contrast sensitivity, first-order motion and Initial ocular following in demyelinating optic neuropathy.

    Science.gov (United States)

    Rucker, Janet C; Sheliga, Boris M; Fitzgibbon, Edmond J; Miles, Frederick A; Leigh, R John

    2006-09-01

    The ocular following response (OFR) is a measure of motion vision elicited at ultra-short latencies by sudden movement of a large visual stimulus. We compared the OFR to vertical sinusoidal gratings (spatial frequency 0.153 cycles/ degrees or 0.458 cycles/ degrees) of each eye in a subject with evidence of left optic nerve demyelination due to multiple sclerosis (MS). The subject showed substantial differences in vision measured with stationary low-contrast Sloan letters (20/63 OD and 20/200 OS at 2.5% contrast) and the Lanthony Desaturated 15-hue color test (Color Confusion Index 1.11 OD and 2.14 OS). Compared with controls, all of the subject's OFR to increasing contrast showed a higher threshold. The OFR of each of the subject's eyes were similar for the 0.153 cycles/ degrees stimulus, and psychophysical measurements of his ability to detect these moving gratings were also similar for each eye. However, with the 0.458 cycles/ degrees stimulus, the subject's OFR was asymmetric and the affected eye showed decreased responses (smaller slope constant as estimated by the Naka-Rushton equation). These results suggest that, in this case, optic neuritis caused a selective deficit that affected parvocellular pathways mediating higher spatial frequencies, lower-contrast, and color vision, but spared the field-holding mechanism underlying the OFR to lower spatial frequencies. The OFR may provide a useful method to study motion vision in individuals with disorders affecting anterior visual pathways.

  8. Assesment of the Retinal Nerve Fiber Layer Thickness with Optical Coherence Tomography in Patients with Psoriasis

    Directory of Open Access Journals (Sweden)

    Emine Nur Rifaioğlu

    2014-12-01

    Full Text Available Objective: Psoriasis is an auto inflammatory disorder that affects the skin and joints. Psoriasis-related conditions that involve the eye are mainly blepharitis, conjunctivitis and keratitis and these conditions are seen in about 10% of psoriasis patients. However optic neuritis and pathologies of visual fields are rarely seen. Our study aims to investigate the mean retinal nerve fibres layer (RNFL thickness using OCT in patient psoriasis. Methods: A total of 40 patients with psoriasis and 35 controls were included in our study. The average retinal nerve fibre layer thickness was measured using the optic disc cube protocol (200x200 and the Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, CA device. The statistical analyses were performed using the SPSS v 19 software programme. Results: The mean psoriasis area and severity index (PASI was 8.04 and the mean disease duration was 8.9 years. The average RNFL thickness was not statistically different between the patients and the controls, and there was no correlation between the mean RNFL thickness and the severity and duration of the disease. Conclusion: To our knowledge this study is the first assessment of RNFL thickness in patient with psoriasis. However, of greater scope are needed to investigate possible retinal changes in such patients.

  9. Acute Appendicitis

    DEFF Research Database (Denmark)

    Tind, Sofie; Qvist, Niels

    2017-01-01

    BACKGROUND: The classification of acute appendicitis (AA) into various grades is not consistent, partly because it is not clear whether the perioperative or the histological findings should be the foundation of the classification. When comparing results from the literature on the frequency...... patients were included. In 116 (89 %) of these cases, appendicitis was confirmed histological. There was low concordance between the perioperative and histological diagnoses, varying from 16 to 76 % depending on grade of AA. Only 44 % of the patients receiving antibiotics postoperatively had a positive...... peritoneal fluid cultivation. CONCLUSION: There was a low concordance in clinical and histopathological diagnoses of the different grades of appendicitis. Perioperative cultivation of the peritoneal fluid as a standard should be further examined. The potential could be a reduced postoperative antibiotic use...

  10. Treatment-induced neuropathy of diabetes: an acute, iatrogenic complication of diabetes

    National Research Council Canada - National Science Library

    Gibbons, Christopher H; Freeman, Roy

    2015-01-01

    Treatment-induced neuropathy in diabetes (also referred to as insulin neuritis) is considered a rare iatrogenic small fibre neuropathy caused by an abrupt improvement in glycaemic control in the setting of chronic hyperglycaemia...

  11. Acute kidney failure

    Science.gov (United States)

    ... kidney injury. Alternative Names Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute Images Kidney anatomy References Devarajan P. Biomarkers for assessment of renal ...

  12. Nonlinear optics

    CERN Document Server

    Bloembergen, Nicolaas

    1996-01-01

    Nicolaas Bloembergen, recipient of the Nobel Prize for Physics (1981), wrote Nonlinear Optics in 1964, when the field of nonlinear optics was only three years old. The available literature has since grown by at least three orders of magnitude.The vitality of Nonlinear Optics is evident from the still-growing number of scientists and engineers engaged in the study of new nonlinear phenomena and in the development of new nonlinear devices in the field of opto-electronics. This monograph should be helpful in providing a historical introduction and a general background of basic ideas both for expe

  13. Optical holography

    CERN Document Server

    Collier, Robert J; Lin, Lawrence H

    1971-01-01

    Optical Holography deals with the use of optical holography to solve technical problems, with emphasis on the properties of holograms formed with visible light. Topics covered include the Fourier transform, propagation and diffraction, pulsed-laser holography, and optical systems with spherical lenses. A geometric analysis of point-source holograms is also presented, and holograms and hologram spatial filters formed with spatially modulated reference waves are described. This book is comprised of 20 chapters and begins with an introduction to concepts that are basic to understanding hologr

  14. Quantum Optics

    CERN Document Server

    Vogel, Werner

    2006-01-01

    This is the third, revised and extended edition of the acknowledged "Lectures on Quantum Optics" by W. Vogel and D.-G. Welsch.It offers theoretical concepts of quantum optics, with special emphasis on current research trends. A unified concept of measurement-based nonclassicality and entanglement criteria and a unified approach to medium-assisted electromagnetic vacuum effects including Van der Waals and Casimir Forces are the main new topics that are included in the revised edition. The rigorous development of quantum optics in the context of quantum field theory and the attention to details makes the book valuable to graduate students as well as to researchers

  15. Retinal and Optic Nerve Degeneration in Patients with Multiple Sclerosis Followed up for 5 Years.

    Science.gov (United States)

    Garcia-Martin, Elena; Ara, Jose R; Martin, Jesus; Almarcegui, Carmen; Dolz, Isabel; Vilades, Elisa; Gil-Arribas, Laura; Fernandez, Francisco J; Polo, Vicente; Larrosa, Jose M; Pablo, Luis E; Satue, Maria

    2017-05-01

    To quantify retinal nerve fiber layer (RNFL) changes in patients with multiple sclerosis (MS) and healthy controls with a 5-year follow-up and to analyze correlations between disability progression and RNFL degeneration. Observational and longitudinal study. One hundred patients with relapsing-remitting MS and 50 healthy controls. All participants underwent a complete ophthalmic and electrophysiologic exploration and were re-evaluated annually for 5 years. Visual acuity (Snellen chart), color vision (Ishihara pseudoisochromatic plates), visual field examination, optical coherence tomography (OCT), scanning laser polarimetry (SLP), and visual evoked potentials. Expanded Disability Status Scale (EDSS) scores, disease duration, treatments, prior optic neuritis episodes, and quality of life (QOL; based on the 54-item Multiple Sclerosis Quality of Life Scale score). Optical coherence tomography (OCT) revealed changes in all RNFL thicknesses in both groups. In the MS group, changes were detected in average thickness and in the mean deviation using the GDx-VCC nerve fiber analyzer (Laser Diagnostic Technologies, San Diego, CA) and in the P100 latency of visual evoked potentials; no changes were detected in visual acuity, color vision, or visual fields. Optical coherence tomography showed greater differences in the inferior and temporal RNFL thicknesses in both groups. In MS patients only, OCT revealed a moderate correlation between the increase in EDSS and temporal and superior RNFL thinning. Temporal RNFL thinning based on OCT results was correlated moderately with decreased QOL. Multiple sclerosis patients exhibit a progressive axonal loss in the optic nerve fiber layer. Retinal nerve fiber layer thinning based on OCT results is a useful marker for assessing MS progression and correlates with increased disability and reduced QOL. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  16. Quantum optics

    DEFF Research Database (Denmark)

    Andersen, Ulrik Lund

    2013-01-01

    Further sensitivity improvements are required before advanced optical interferometers will be able to measure gravitational waves. A team has now shown that introducing quantum squeezing of light may help to detect these elusive waves.......Further sensitivity improvements are required before advanced optical interferometers will be able to measure gravitational waves. A team has now shown that introducing quantum squeezing of light may help to detect these elusive waves....

  17. Applied Optics

    OpenAIRE

    Poon, Ting-Chung; Qi, Y.

    2003-01-01

    To replace the film recording aspect of performing optical correlation, conventional real-time joint-transform correlation (JTC) optical systems make use of a spatial light modulator (SLM) located in the Fourier plane to record the joint-transform power spectrum (JPS) to achieve real-time processing. The use of an SLM in the Fourier plane, however, is a major drawback in these systems because SLMs are limited in resolution, phase uniformity, and contrast ratio, which are, therefore, not desir...

  18. Windshield optics.

    Science.gov (United States)

    Irland, M J

    1969-09-01

    Windshield design involves compromises among mechanical, aerodynamic, aesthetic, thermal, and safety requirements, yet the windshield must be considered as an optical element. Four types of optical errors to be controlled by proper design are discussed, viz., astigmatism, binocular differential deviation of the line of sight, relative angular acceleration of image elements, and ghost images. Empirical limiting values for the last three and procedures for their control are given.

  19. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis Questions to Ask Your Doctor about Acute Bronchitis ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  20. Acute lower extremity ischaemia

    African Journals Online (AJOL)

    In a nutshell. • A patient with sudden onset of a cold, weak, numb and painful foot has acute lower extremity ischaemia (ALEXI) until proven otherwise. Labelling patients as acute gout, acute phlegmasia (deep vein thrombosis), acute sciatica, etc. may result in unnecessary delays in treatment, with tragic consequences.

  1. Gerstmann's syndrome and unilateral optic ataxia in the emergency department.

    Science.gov (United States)

    Barbosa, Breno José Alencar Pires; de Brito, Marcelo Houat; Rodrigues, Júlia Chartouni; Kubota, Gabriel Taricani; Parmera, Jacy Bezerra

    2017-01-01

    A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke.

  2. QUANTUM OPTICS. Universal linear optics.

    Science.gov (United States)

    Carolan, Jacques; Harrold, Christopher; Sparrow, Chris; Martín-López, Enrique; Russell, Nicholas J; Silverstone, Joshua W; Shadbolt, Peter J; Matsuda, Nobuyuki; Oguma, Manabu; Itoh, Mikitaka; Marshall, Graham D; Thompson, Mark G; Matthews, Jonathan C F; Hashimoto, Toshikazu; O'Brien, Jeremy L; Laing, Anthony

    2015-08-14

    Linear optics underpins fundamental tests of quantum mechanics and quantum technologies. We demonstrate a single reprogrammable optical circuit that is sufficient to implement all possible linear optical protocols up to the size of that circuit. Our six-mode universal system consists of a cascade of 15 Mach-Zehnder interferometers with 30 thermo-optic phase shifters integrated into a single photonic chip that is electrically and optically interfaced for arbitrary setting of all phase shifters, input of up to six photons, and their measurement with a 12-single-photon detector system. We programmed this system to implement heralded quantum logic and entangling gates, boson sampling with verification tests, and six-dimensional complex Hadamards. We implemented 100 Haar random unitaries with an average fidelity of 0.999 ± 0.001. Our system can be rapidly reprogrammed to implement these and any other linear optical protocol, pointing the way to applications across fundamental science and quantum technologies. Copyright © 2015, American Association for the Advancement of Science.

  3. Optical Coherence and Quantum Optics

    Science.gov (United States)

    Mandel, Leonard; Wolf, Emil

    1995-09-01

    The advent of lasers in the 1960s led to the development of many new fields in optical physics. This book is a systematic treatment of one of these fields--the broad area that deals with the coherence and fluctuation of light. The authors begin with a review of probability theory and random processes, and follow this with a thorough discussion of optical coherence theory within the framework of classical optics. They next treat the theory of photoelectric detection of light and photoelectric correlation. They then discuss in some detail quantum systems and effects. The book closes with two chapters devoted to laser theory and one on the quantum theory of nonlinear optics. The sound introduction to coherence theory and the quantum nature of light and the chapter-end exercises will appeal to graduate students and newcomers to the field. Researchers will find much of interest in the new results on coherence-induced spectral line shifts, nonclassical states of light, higher-order squeezing, and quantum effects of down-conversion. Written by two of the world's most highly regarded optical physicists, this book is required reading of all physicists and engineers working in optics.

  4. EDITORIAL: Transformation optics Transformation optics

    Science.gov (United States)

    Shalaev, Vladimir M.; Pendry, John

    2011-02-01

    Metamaterials are artificial materials with versatile properties that can be tailored to fit almost any practical need and thus go well beyond what can be obtained with `natural' materials. Recent progress in developing optical metamaterials allows unprecedented extreme control over the flow of light at both the nano- and macroscopic scales. The innovative field of transformation optics, which is enabled by metamaterials, inspired researchers to take a fresh look at the very foundations of optics and helped to create a new paradigm for the science of light. Similar to general relativity, where time and space are curved, transformation optics shows that the space for light can also be bent in an almost arbitrary way. Most importantly, the optical space can be designed and engineered, opening up the fascinating possibility of controlling the flow of light with nanometer spatial precision. This new paradigm enables a number of novel optical devices guiding how, using metamaterials, the space for light can be curved in a pre-designed and well-controlled way. Metamaterials which incorporate the innovative theories of transformation optics are pertinent to the important areas of optical cloaking, optical black holes, super-resolution imaging, and other sci-fi-like devices. One such exciting device is an electromagnetic cloak that can bend light around itself, similar to the flow of water around a stone, making invisible both the cloak and the object hidden inside. Another important application is a flat hyperlens that can magnify the nanometer-scale features of an object that cannot be resolved with conventional optics. This could revolutionize the field of optical imaging, for instance, because such a meta-lens could become a standard add-on tool for microscopes. By enabling nanoscale resolution in optical microscopy, metamaterial-based transformation optics could allow one to literally see extremely small objects with the eye, including biological cells, viruses, and

  5. Acute otitis externa

    OpenAIRE

    Hui, Charles PS

    2013-01-01

    Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  6. Quantum Optics in Optical Nanofibers

    Science.gov (United States)

    Solano Palma, Pablo Andres

    The study of atom-light interaction is a key element of quantum optics and a central part of atomic physics. Systems composed of atoms interacting with each other through the electromagnetic field can be used for studies from fundamental research to practical applications. Experimental realizations of these systems benefit from three distinct attributes: large atom-light coupling, trapping and control of atomic ensembles, and engineering and manipulation of the electromagnetic field. Optical waveguides provide a platform that achieves these three goals. In particular, optical nanofibers are an excellent candidate. They produce a high confinement of the electromagnetic field that improves atom-light coupling, guiding the field that mediates the interactions between atoms, while allowing trapping of the atoms close to it. This thesis describes the uses of an optical nanofiber for quantum optics experiments, demonstrating its possibilities for enabling special atom-light interactions. We trap atoms near the optical nanofiber surface, and characterize the trap in a non-destructive manner. We show how the presence of the nanofiber modifies the fundamental atomic property of spontaneous emission, by altering the electromagnetic environment of the atom. Finally, we use the nanofiber to prepare collective states of atoms around it. These states can radiate faster or slower than a single atom (superradiance and subradiance). The observation of subradiance of a few atoms, a rather elusive effect, evidences nanofibers as a strong candidate for future quantum optics experiments. Moreover, we show how the guided field mediates interaction between atoms hundreds of wavelengths apart, creating macroscopically delocalized collective states.

  7. Statistical optics

    CERN Document Server

    Goodman, Joseph W

    2015-01-01

    This book discusses statistical methods that are useful for treating problems in modern optics, and the application of these methods to solving a variety of such problems This book covers a variety of statistical problems in optics, including both theory and applications.  The text covers the necessary background in statistics, statistical properties of light waves of various types, the theory of partial coherence and its applications, imaging with partially coherent light, atmospheric degradations of images, and noise limitations in the detection of light. New topics have been introduced i

  8. Neuromyelitis Optica in Pregnancy Complicated by Posterior Reversible Encephalopathy Syndrome, Eclampsia and Fetal Death

    OpenAIRE

    Igel, Catherine; Garretto, Diana; Robbins, Matthew S.; Swerdlow, Michael; Judge, Nancy; Dayal, Ashlesha

    2014-01-01

    Neuromyelitis optica (NMO) is a demyelinating syndrome characterized by optic neuritis and acute myelitis with poor recovery and a progressive course. We report a poor outcome complicated by posterior reversible encephalopathy syndrome (PRES) and eclampsia and review available literature and current evidence for anticipation of adverse fetal and maternal effects. After a pregnancy complicated by multiple admissions for painful NMO exacerbations, a primiparous patient with seropositive NMO pre...

  9. Demyeliniserende sygdom hos børn med akutte neurologiske symptomer

    DEFF Research Database (Denmark)

    Olofsson, Isa Amalie; Skov, Liselotte; Miranda, Maria Jose

    2015-01-01

    Demyelinating diseases in children is a broad group of illnesses, which affect the central nervous system. Demyelinating diseases can be monophasic or chronic and comprise acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, multiple sclerosis and neuromyelitis optica....... Demyelinating diseases are rare, but it is important for the physician to recognize these diseases, as well as to understand the differential diagnoses. This review summarizes the current knowledge of demyelinating disorders in children, focusing on an approach to diagnosis and management....

  10. Optical twisters

    DEFF Research Database (Denmark)

    Daria, Vincent R.; Palima, Darwin; Glückstad, Jesper

    2010-01-01

    in radius but with a scalable OAM. Furthermore, we characterize the OAM in terms of its capacity to introduce spiral motion on particles trapped along its orbit. We also show that our "optical twister" maintains a high concentration of photons at the focus even as the topological charge is increased...

  11. Optical correlation

    NARCIS (Netherlands)

    Boden, J.A.

    1974-01-01

    A survey is given of the most common types of coherent optical correlators, which are classified as spatial plane correlators, frequency plane correlators and special reference correlators. Only the spatial plane correlators are dealt with rather thoroughly. Basic principles, some special features,

  12. Optical Fibers

    Science.gov (United States)

    Ghatak, Ajoy; Thyagarajan, K.

    With the development of extremely low-loss optical fibers and their application to communication systems, a revolution has taken fiber glass place during the last 40 years. In 2001, using glass fibers as the transmission medium and lightwaves as carrier wave waves, information was transmitted at a rate more than 1 Tbit/s (which is roughly equivalent to transmission of about 15 million simultaneous telephone conversations) through one hair thin optical fiber. Experimental demonstration of transmission at the rate of 14 Tbit/s over a 160 km long single fiber was demonstrated in 2006, which is equivalent to sending 140 digital high definition movies in 1 s. Very recently record transmission of more than 100 Tbit/s over 165 km single mode fiber has been reported. These can be considered as extremely important technological achievements. In this chapter we will discuss the propagation characteristics of optical fibers with special applications to optical communication systems and also present some of the noncommunication applications such as sensing.

  13. Diophantine Optics

    Science.gov (United States)

    Rouan, D.

    2016-09-01

    What I call Diophantine optics is the exploitation in optics of some remarkable algebraic relations between powers of integers. The name comes from Diophantus of Alexandria, a greek mathematician, known as the father of algebra. He studied polynomial equations with integer coefficients and integer solutions, called diophantine equations. Since constructive or destructive interferences are playing with optical path differences which are multiple integer (odd or even) of λ/2 and that the complex amplitude is a highly non-linear function of the optical path difference (or equivalently of the phase), one can understand that any Taylor development of this amplitude implies powers of integers. This is the link with Diophantine equations. We show how, especially in the field of interferometry, remarkable relations between powers of integers can help to solve several problems, such as achromatization of a phase shifter or deep nulling efficiency. It appears that all the research that was conducted in this frame of thinking, relates to the field of detection of exoplanets, a very active domain of astrophysics today.

  14. Optical metrology

    CERN Document Server

    Gåsvik, Kjell J

    2003-01-01

    New material on computerized optical processes, computerized ray tracing, and the fast Fourier transform, Bibre-Bragg sensors, and temporal phase unwrapping.* New introductory sections to all chapters.* Detailed discussion on lasers and laser principles, including an introduction to radiometry and photometry.* Thorough coverage of the CCD camera.

  15. Optical fibres

    CERN Multimedia

    1992-01-01

    These optical fibres are used to detect particles passing through in bunches. Made from scintillating material, the fibres glow when a high energy particle passes through them. These detectors are known as spaghetti detectors and are used to measure the energy of particles.

  16. Optical Coherence and Quantum Optics

    CERN Document Server

    Mandel, Leonard

    1995-01-01

    This book presents a systematic account of optical coherence theory within the framework of classical optics, as applied to such topics as radiation from sources of different states of coherence, foundations of radiometry, effects of source coherence on the spectra of radiated fields, coherence theory of laser modes, and scattering of partially coherent light by random media. The book starts with a full mathematical introduction to the subject area and each chapter concludes with a set of exercises. The authors are renowned scientists and have made substantial contributions to many of the topi

  17. Optical Magnetometry

    Science.gov (United States)

    Budker, Dmitry; Kimball, Derek F. Jackson

    2013-03-01

    Part I. Principles and Techniques: 1. General principles and characteristics of optical magnetometers D. F. Jackson Kimball, E. B. Alexandrov and D. Budker; 2. Quantum noise in atomic magnetometers M. V. Romalis; 3. Quantum noise, squeezing, and entanglement in radio-frequency optical magnetometers K. Jensen and E. S. Polzik; 4. Mx and Mz magnetometers E. B. Alexandrov and A. K. Vershovskiy; 5. Spin-exchange-relaxation-free (serf) magnetometers I. Savukov and S. J. Seltzer; 6. Optical magnetometry with modulated light D. F. Jackson Kimball, S. Pustelny, V. V. Yashchuk and D. Budker; 7. Microfabricated atomic magnetometers S. Knappe and J. Kitching; 8. Optical magnetometry with nitrogen-vacancy centers in diamond V. M. Acosta, D. Budker, P. R. Hemmer, J. R. Maze and R. L. Walsworth; 9. Magnetometry with cold atoms W. Gawlik and J. M. Higbie; 10. Helium magnetometers R. E. Slocum, D. D. McGregor and A. W. Brown; 11. Surface coatings for atomic magnetometry S. J. Seltzer, M.-A. Bouchiat and M. V. Balabas; 12. Magnetic shielding V. V. Yashchuk, S.-K. Lee and E. Paperno; Part II. Applications: 13. Remote detection magnetometry S. M. Rochester, J. M. Higbie, B. Patton, D. Budker, R. Holzlöhner and D. Bonaccini Calia; 14. Detection of nuclear magnetic resonance with atomic magnetometers M. P. Ledbetter, I. Savukov, S. J. Seltzer and D. Budker; 15. Space magnetometry B. Patton, A. W. Brown, R. E. Slocum and E. J. Smith; 16. Detection of biomagnetic fields A. Ben-Amar Baranga, T. G. Walker and R. T. Wakai; 17. Geophysical applications M. D. Prouty, R. Johnson, I. Hrvoic and A. K. Vershovskiy; Part III. Broader Impact: 18. Tests of fundamental physics with optical magnetometers D. F. Jackson Kimball, S. K. Lamoreaux and T. E. Chupp; 19. Nuclear magnetic resonance gyroscopes E. A. Donley and J. Kitching; 20. Commercial magnetometers and their application D. C. Hovde, M. D. Prouty, I. Hrvoic and R. E. Slocum; Index.

  18. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    Science.gov (United States)

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  19. Applied optics and optical engineering v.9

    CERN Document Server

    Shannon, Robert

    1983-01-01

    Applied Optics and Optical Engineering, Volume IX covers the theories and applications of optics and optical engineering. The book discusses the basic algorithms for optical engineering; diffraction gratings, ruled and holographic; and recording and reading of information on optical disks. The text also describes the perfect point spread function; the multiple aperture telescope diffraction images; and the displays and simulators. Ophthalmic optics, as well as the canonical and real-space coordinates used in the theory of image formation are also encompassed. Optical engineers and students tak

  20. Optic nerve atrophy

    Science.gov (United States)

    Optic atrophy; Optic neuropathy ... There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. ...

  1. Optical Communication over Plastic Optical Fibers Integrated Optical Receiver Technology

    CERN Document Server

    Atef, Mohamed

    2013-01-01

    This book presents high-performance data transmission over plastic optical fibers (POF) using integrated optical receivers having good properties with multilevel modulation, i.e. a higher sensitivity and higher data rate transmission over a longer plastic optical fiber length. Integrated optical receivers and transmitters with high linearity are introduced for multilevel communication. For binary high-data rate transmission over plastic optical fibers, an innovative receiver containing an equalizer is described leading also to a high performance of a plastic optical fiber link. The cheap standard PMMA SI-POF (step-index plastic optical fiber) has the lowest bandwidth and the highest attenuation among multimode fibers. This small bandwidth limits the maximum data rate which can be transmitted through plastic optical fibers. To overcome the problem of the plastic optical fibers high transmission loss, very sensitive receivers must be used to increase the transmitted length over POF. The plastic optical fiber li...

  2. Acute respiratory distress syndrome

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

  3. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... of Celiac Disease Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Assistant Professor and Program ... Abdominal Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  4. Acute Bronchitis - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Acute Bronchitis URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Acute Bronchitis - Multiple Languages To use the sharing features on ...

  5. Weight Loss & Acute Porphyria

    Science.gov (United States)

    ... APF You are here Home Diet and Nutrition Weight loss & acute Porphyria Being overweight is a particular problem ... of carbohydrate and energy in an effort to lose weight can worsen these diseases. Severe acute attacks have ...

  6. PARACENTRAL ACUTE MIDDLE MACULOPATHY IN SUSAC SYNDROME.

    Science.gov (United States)

    Haider, Ali S; Viswanathan, Deepa; Williams, David; Davies, Peter

    2017-10-09

    To present the first reported case of paracentral acute middle maculopathy in association with Susac syndrome. Case report. A young female patient presented with unilateral sudden loss of vision of her right eye to count fingers. There were numerous cotton wool spots in a multifocal pattern concentrated around the right macula and optic disk. Clinical examination and spectral domain optical coherence tomography imaging were consistent with paracentral acute middle maculopathy, and fluorescein angiography showed features of retinal arteriole vasculitis. Magnetic resonance imaging demonstrated multiple white matter lesions in a pericallosal distribution. High-dose corticosteroid therapy was commenced, and visual acuity gradually improved to 6/6 corrected. The patient reported hearing impairment and was diagnosed with Susac syndrome for which she has responded extremely well to long-term immunosuppressive therapy. Paracentral acute middle maculopathy can occur in association with Susac syndrome. Susac syndrome may present only with multifocal retinal ischemia, and such patients with paracentral acute middle maculopathy should be checked for characteristic magnetic resonance imaging lesions and hearing loss.

  7. An Atypical Case of Paracentral Acute Middle Maculopathy.

    Science.gov (United States)

    Haskes, Cheryl; Santapaola, Shannon; Zinn, Jordan

    2017-08-01

    This is a case presentation of paracentral acute middle maculopathy in a 33-year-old white man with borderline hyperlipidemia. Paracentral acute middle maculopathy was originally thought to be a variant of acute macular neuroretinopathy; however, it is now generally accepted that these two conditions are separate disease entities. The etiology, evolution, and pathophysiology of acute macular neuroretinopathy and paracentral acute middle maculopathy are discussed, as well as current diagnostic techniques. A 33-year-old white man with borderline hyperlipidemia presented with an acute, small paracentral scotoma involving the left eye. Clinical examination revealed a small wedge-shaped retinal lesion that corresponded to scotoma. Spectral domain-optical coherence tomography of the lesion demonstrated irregularity in the middle retina, whereas fluorescein angiography showed subtle hypofluorescence of the lesion. Spectral domain-optical coherence tomography was facilitated in monitoring retinal changes as the patient continued to have a persistent scotoma despite resolution of the retinal lesion. Clinically, acute macular neuroretinopathy and paracentral acute middle maculopathy present in very similar fashions with localized scotomas, blurry vision, and subtle retinal lesions that can be difficult to discern funduscopically. At this time, there is no ocular treatment for either condition, but observation and patient education regarding possibly persistent scotomas are necessary. This atypical case highlights paracentral acute middle maculopathy in a relatively young man with a systemic history significant only for borderline hyperlipidemia. Eye care providers should be familiar with acute macular neuroretinopathy and paracentral acute middle maculopathy to enable them to perform appropriate diagnostic testing and to identify patients who require a systemic disease evaluation.

  8. Optical Spectroscopy

    DEFF Research Database (Denmark)

    Thyrhaug, Erling

    containing systems using simple instrumentation and well-known and understood theoretical concepts. Overall it is attempted to achieve this goal by presenting five research projects that I have been involved in during my Ph.D. studies which collectively demonstrate some of the many possibilities of gaining......The work presented in this thesis is broadly concerned with how complexation reactions and molecular motion can be characterized with the standard techniques in optical spectroscopy. The thesis aims to show a relatively broad range of methods for probing physico-chemical properties in fluorophore...... information about chemical equilibria, kinetics and molecular motion by monitoring changes in optical properties of the system. The five presented research projects are largely unrelated to each other both in aim and in what property is probed, however they are all connected in that they are fluorophore...

  9. Radiology of acute phlebothrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Richter, E.I.; Zeitler, E.

    1980-09-01

    The difference in technique of phlebography in acute phlebothrombosis and that in chronic venous insufficiency is demonstrated. Since acute phlebothrombosis can be cured with good results by thrombectomy and fibrinolysis in the first few days of the disease, phlebography should be performed early, preferably the day on which the presence of acute thrombosis is suspected.

  10. Radiopharmaceuticals in Acute Porphyria

    NARCIS (Netherlands)

    Schreuder, Nanno; Mamedova, Ilahä; Jansman, Frank G A

    2016-01-01

    PURPOSE: The acute porphyrias are a group of rare metabolic disorders of the heme biosynthetic pathway. Carriers of the acute porphyria gene are prone to potentially fatal acute attacks, which can be precipitated by drug exposure. It is therefore important to know whether a drug is safe for carriers

  11. Acute mastoiditis in children

    DEFF Research Database (Denmark)

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute...

  12. Optical Processing.

    Science.gov (United States)

    1986-06-01

    and evaluation of technologies suitable for discrete optical computing is described, where particular emphasis has applied to ZnSe non- linea :, and...met. The processes are similar to that used in proving an algebraic theorem. Among the daunting practical difficulties encount- ered are:- (a) Formal...implementation of algorithms. Usually, such algorithms exhibit a highly regular S- structure as typified by linear algebra problems, and are generally

  13. Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non-Haemorrhagic Brain Lesions

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Kotíková, K.; Vaněčková, M.; Seidl, Z.; Nurieva, O.; Navrátil, Tomáš; Caganová, B.; Pelclová, D.

    2016-01-01

    Roč. 119, č. 2 (2016), s. 228-238 ISSN 1742-7835 Institutional support: RVO:61388955 Keywords : ACUTE OPTIC NEUROPATHY * FORMATE CONCENTRATIONS * PROGNOSTIC-FACTORS Subject RIV: CG - Electrochemistry Impact factor: 3.176, year: 2016

  14. Retinal ganglion cell dysfunction in asymptomatic G11778A: Leber hereditary optic neuropathy.

    Science.gov (United States)

    Guy, John; Feuer, William J; Porciatti, Vittorio; Schiffman, Joyce; Abukhalil, Fawzi; Vandenbroucke, Ruth; Rosa, Potyra R; Lam, Byron L

    2014-02-10

    To report the serial evaluation of asymptomatic eyes of subjects with mutated G11778A mitochondrial DNA. Forty-five asymptomatic G11778A Leber hereditary optic neuropathy (LHON) carriers and two patients with the mutation who developed unilateral visual loss underwent testing that included visual acuity, automated visual field, pattern electroretinogram (PERG), and spectral-domain optical coherence tomography every 6 months between September 2008 and March 2012. Visual acuity, visual fields, and retinal nerve fiber layer thickness remained stable within the normal range. Mean PERG amplitudes of carriers dropped progressively by ∼ 40% from baseline to 36 months. In addition, comparisons with the fellow eyes of patients with unilateral optic neuritis revealed a 3.4 ETDRS (Early Treatment Diabetic Retinopathy Study) letter loss in the LHON carriers. A single carrier developed visual loss, with PERG amplitudes dropping by half. In one of two LHON cases who presented with unilateral visual loss, visual acuity in the asymptomatic eye was ∼ 20/40 at baseline. The PERG amplitude of this eye was reduced to ∼ 30% of normal. Six months later, his visual acuity had dropped to ∼ 20/500. A second patient who was ∼ 20/20 and had a visual field defect in the asymptomatic eye at baseline remained at this level for the 18 months of follow-up. His PERG amplitudes were similar to those of asymptomatic carriers, with 0.78 μV at baseline that did not decline with follow-up. Declines of the PERG amplitude suggest subclinical retinal ganglion cell dysfunction in asymptomatic G11778A subjects, which is progressive.

  15. Bilateral orbital and optic nerve endoscopic endonasal decompression for nonspecific inflammatory orbital disease: case report.

    Science.gov (United States)

    Aldea, Sorin; Bică, Dorin; Gobej, Ionuţ; Bennis, Saad; Baussart, Bertrand; Mireau, Etienne; Bourdain, Frederic; Gaillard, Stephan

    2013-12-01

    Endoscopic endonasal optic nerve decompression (EEOND) is indicated in traumatic and endocrine orbitopathies as well as in idiopathic intracranial hypertension. We present a patient with bilateral nonspecific inflammatory orbitopathy (NSIO) and optic nerve compression presenting with acute severe visual loss. Bilateral orbital and optic nerve decompression was performed as an emergency procedure with a favorable ophthalmological result. EEOND is an effective and safe technique in acute orbitopathies and should be taken in consideration in atypical clinical settings causing severe acute visual loss. Georg Thieme Verlag KG Stuttgart · New York.

  16. Complete Vision Loss following Orbital Cellulitis Secondary to Acute Dacryocystitis

    Directory of Open Access Journals (Sweden)

    Margaret L. Pfeiffer

    2016-01-01

    Full Text Available We present a case of a 50-year-old woman with acute dacryocystitis that was complicated by posterior rupture of the lacrimal sac causing an orbital cellulitis with subsequent visual acuity of no light perception. Upon presentation, she was immediately started on broad-spectrum antibiotics and underwent surgical incision and drainage of the lacrimal sac abscess but never regained vision. There are 4 cases in the literature of permanent severe vision loss from acute dacryocystitis. Prompt diagnosis and close monitoring of acute dacryocystitis are therefore essential to prevent extension into the orbit and possible optic nerve compromise.

  17. CHIRALITY IN NONLINEAR OPTICS AND OPTICAL SWITCHING

    NARCIS (Netherlands)

    Meijer, E.W.; Feringa, B.L.

    1993-01-01

    Chirality in molecular opto-electronics is limited sofar to the use of optically active liquid crystals and a number of optical phenomena are related to the helical macroscopic structure obtained by using one enantiomer, only. In this paper, the use of chirality in nonlinear optics and optical

  18. Alteraciones anatomofuncionales en la coriorretinopatía serosa central aguda, detectadas por tomografía de coherencia óptica y microperimetría Anatomical and functional alterations detected by optical coherence tomography and microperimetry in the acute central serose chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Eva R Santana Alas

    2010-01-01

    Full Text Available OBJETIVO: Determinar las alteraciones anatómicas y funcionales retinales en pacientes con coriorretinopatía serosa central aguda y su repercusión en los resultados visuales. MÉTODOS: Estudio observacional, transversal de 24 ojos con coriorretinopatía serosa central aguda, unilateral. Se realizó, Snellen, microperimetría y tomografía de coherencia óptica, y se calculó el grosor macular central. RESULTADOS: La agudeza visual mejor corregida media fue 0,5. Se encontró desprendimiento seroso neurosensorial en el 100 % de los casos y desprendimiento del epitelio pigmentario en el 29,8 %. El grosor retinal promedio por tomografía de coherencia óptica, fue 388,2 ± 112 µm. La sensibilidad macular total promedio de 11,9 ±5,2 dB, con una sensibilidad macular central (2º de 10,9 ± 4,87 dB, no se encontró diferencias significativas entre ellas (p= 0,23. Existió correlación inversa entre la sensibilidad central y el grosor macular (r = -0,76, lo que estadísticamente es significativo (p OBJECTIVE: To determine the functional and anatomical alterations of the retina in patients with acute central serous chorioretinopathy. METHODS: Cross-sectional observational study of 24 eyes (24 patients with acute unilateral central serous chorioretinopathy. Snelle´s chart, microperimetry and optical coherence tomography was used and the central macular thickness was estimated. RESULTS: The best average corrected visual acuity was 0.5. All the cases presented with neurosensoral serous detachment and pigmentary epithelium detachment was found in 29.8%. The average retinal thickness according to the optical coherence tomography figures was 388.2 ± 112 µm. The average total macular sensitivity was 11.9 ± 5.2 dB, with central macular sensitivity (2o of 10.9 ± 4.87 dB. There were no significant differences between them (p= 0.23. Central sensitivity and macular thickness were inversely correlated (r=-0.76, which is statistically significant; however

  19. Optical Specifications And Tolerances For Large Optics

    Science.gov (United States)

    Parks, Robert E.

    1983-12-01

    The term "large" has specific implications about types of optics and their uses. In this paper large optics are defined and figure, beauty, and blank characteristics are specified with tolerances for each. Because it is useless to discuss specifications for properties that cannot be measured, tests for each specification are described. The specification of a large optic takes far more thought and insight than is the case for small optics because of the high cost and demanding applications of large optics.

  20. Cloud optics

    CERN Document Server

    Kokhanovsky, A

    2006-01-01

    Clouds affect the climate of the Earth, and they are an important factor in the weather. Therefore, their radiative properties must be understood in great detail. This book summarizes current knowledge on cloud optical properties, for example their ability to absorb, transmit, and reflect light, which depends on the clouds' geometrical and microphysical characteristics such as sizes of droplets and crystals, their shapes, and structures. In addition, problems related to the image transfer through clouds and cloud remote sensing are addressed in this book in great detail. This book can be an im

  1. Acute luchtweginfecties en acute coronaire syndromen

    NARCIS (Netherlands)

    Keller, T. T.; Mairuhu, A. T. A.; Gerdes, V. E. A.; Brandjes, D. P. M.; Peters, R. J. G.; van Gorp, E. C. M.

    2005-01-01

    Epidemiological research indicates a correlation between respiratory-tract infections and acute cardiovascular events. Chronic infections have been linked to the development of atherosclerosis. As a result of chronic infections a prolonged and elevated inflammatory activity arises. Inflammation and

  2. EDITORIAL: Optical orientation Optical orientation

    Science.gov (United States)

    SAME ADDRESS *, Yuri; Landwehr, Gottfried

    2008-11-01

    priority of the discovery in the literature, which was partly caused by the existence of the Iron Curtain. I had already enjoyed contact with Boris in the 1980s when the two volumes of Landau Level Spectroscopy were being prepared [2]. He was one of the pioneers of magneto-optics in semiconductors. In the 1950s the band structure of germanium and silicon was investigated by magneto-optical methods, mainly in the United States. No excitonic effects were observed and the band structure parameters were determined without taking account of excitons. However, working with cuprous oxide, which is a direct semiconductor with a relative large energy gap, Zakharchenya and his co-worker Seysan showed that in order to obtain correct band structure parameters, it is necessary to take excitons into account [3]. About 1970 Boris started work on optical orientation. Early work by Hanle in Germany in the 1920s on the depolarization of luminescence in mercury vapour by a transverse magnetic field was not appreciated for a long time. Only in the late 1940s did Kastler and co-workers in Paris begin a systematic study of optical pumping, which led to the award of a Nobel prize. The ideas of optical pumping were first applied by Georges Lampel to solid state physics in 1968. He demonstrated optical orientation of free carriers in silicon. The detection method was nuclear magnetic resonance; optically oriented free electrons dynamically polarized the 29Si nuclei of the host lattice. The first optical detection of spin orientation was demonstrated by with the III-V semiconductor GaSb by Parsons. Due to the various interaction mechanisms of spins with their environment, the effects occurring in semiconductors are naturally more complex than those in atoms. Optical detection is now the preferred method to detect spin alignment in semiconductors. The orientation of spins in crystals pumped with circularly polarized light is deduced from the degree of circular polarization of the recombination

  3. Acute corneal hydrops in keratoconus

    Directory of Open Access Journals (Sweden)

    Prafulla K Maharana

    2013-01-01

    Full Text Available Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation.

  4. Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

    Science.gov (United States)

    2013-01-22

    Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  5. Bilateral acute visual loss from Rathke's cleft cyst apoplexy in a patient with dengue fever

    Directory of Open Access Journals (Sweden)

    Ana Cláudia De Franco Suzuki

    2014-10-01

    Full Text Available Hemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever.

  6. Color vision versus pattern visual evoked potentials in the assessment of subclinical optic pathway involvement in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Fatih C Gundogan

    2013-01-01

    Full Text Available Background: Optic pathway involvement in multiple sclerosis is frequently the initial sign in the disease process. In most clinical applications, pattern visual evoked potential (PVEP is used in the assessment of optic pathway involvement. Objective: To question the value of PVEP against color vision assessment in the diagnosis of subclinical optic pathway involvement. Materials and Methods: This prospective, cross-sectional study included 20 multiple sclerosis patients without a history of optic neuritis, and 20 healthy control subjects. Farnsworth-Munsell (FM 100-Hue testing and PVEPs to 60-min arc and 15-min arc checks by using Roland-Consult RetiScan® system were performed. P 100 amplitude, P 100 latency in PVEP and total error scores (TES in FM 100-Hue test were assessed. Results: Expanded Disability Status Scale score and the time from diagnosis were 2.21 ± 2.53 (ranging from 0 to 7 and 4.1 ± 4.4 years. MS group showed significantly delayed P 100 latency for both checks (P 0.05 for all. 14 MS patients (70% had an increased TESs in FM-100 Hue, 11 (55% MS patients had delayed P 100 latency and 9 (45% had reduced P 100 amplitude. The areas under the ROC curves were 0.944 for FM-100 Hue test, 0.753 for P 100 latency, and 0.173 for P 100 amplitude. Conclusions: Color vision testing seems to be more sensitive than PVEP in detecting subclinical visual pathway involvement in MS.

  7. Advances in nonlinear optics

    CERN Document Server

    Chen, Xianfeng; Zeng, Heping; Guo, Qi; She, Weilong

    2015-01-01

    This book presents an overview of the state of the art of nonlinear optics from weak light nonlinear optics, ultrafast nonlinear optics to electro-optical theory and applications. Topics range from the fundamental studies of the interaction between matter and radiation to the development of devices, components, and systems of tremendous commercial interest for widespread applications in optical telecommunications, medicine, and biotechnology.

  8. Acute renal failure associated with nonfulminant acute viral hepatitis A

    OpenAIRE

    Sarawgi, S.; Gupta, A K; Arora, D S; Jasuja, S.

    2008-01-01

    Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

  9. Integrated optics for fiber optic sensors

    Science.gov (United States)

    Minford, W. J.; Depaula, R. P.

    1991-01-01

    Recent progress achieved in the field of fiber-optic sensor applications is discussed with emphasis placed on LiNbO3-based integrated optics (IO). Particular consideration is given to advanced electromagnetic-field sensors, an integrated laser vibrometer system, and a fiber-optic gyroscope system. It is shown that the multifunction IO chips have enabled high perforamance fiber-optic sensors (e.g., fiber-optic gyros), provided advanced and unique signal processing capabilities and advanced architectures, and have a potential of making fiber-optic sensors at low cost.

  10. Acute Idiopathic Scrotal Edema

    Directory of Open Access Journals (Sweden)

    Micheál Breen

    2013-01-01

    Full Text Available We report a case of acute idiopathic scrotal edema (AISE in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

  11. Acute recurrent polyhydramnios

    DEFF Research Database (Denmark)

    Rode, Line; Bundgaard, Anne; Skibsted, Lillian

    2007-01-01

    Acute recurrent polyhydramnios is a rare occurrence characterized by a poor fetal outcome. This is a case report describing a 34-year-old woman presenting with acute recurrent polyhydramnios. Treatment with non-steroidal anti-inflammatory drugs (NSAID) and therapeutic amniocenteses was initiated...... an enzyme-linked immunosorbent assay. As in normal pregnancies, amniotic prolactin levels decreased by 80% from highest to lowest value in this case of resolving acute recurrent polyhydramnios....

  12. Acute periodontal lesions

    OpenAIRE

    Herrera Gonzalez, David; Alonso Álvarez, Bettina; Arriba de la Fuente, Lorenzo; Santa- Cruz Astorqui, Isabel; Serrano, Cristina; Sanz Alonso, Mariano

    2014-01-01

    This is a review and update on acute conditions affecting the gingival tissues, including abscesses in the periodontium, necrotizing periodontal diseases, and other acute conditions that cause gingival lesions with acute presentation, such as infectious process not associated with oral bacterial biofilms, muco-cutanenous disorders, and traumatic and allergic lesions. A periodontal abscess is clinically important since it is a relatively frequent dental emergency, it can compromise the periodo...

  13. Medical Management of Hereditary Optic Neuropathies

    Science.gov (United States)

    La Morgia, Chiara; Carbonelli, Michele; Barboni, Piero; Sadun, Alfredo Arrigo; Carelli, Valerio

    2014-01-01

    Hereditary optic neuropathies are diseases affecting the optic nerve. The most common are mitochondrial hereditary optic neuropathies, i.e., the maternally inherited Leber’s hereditary optic neuropathy (LHON) and dominant optic atrophy (DOA). They both share a mitochondrial pathogenesis that leads to the selective loss of retinal ganglion cells and axons, in particular of the papillo-macular bundle. Typically, LHON is characterized by an acute/subacute loss of central vision associated with impairment of color vision and swelling of retinal nerve fibers followed by optic atrophy. DOA, instead, is characterized by a childhood-onset and slowly progressive loss of central vision, worsening over the years, leading to optic atrophy. The diagnostic workup includes neuro-ophthalmologic evaluation and genetic testing of the three most common mitochondrial DNA mutations affecting complex I (11778/ND4, 3460/ND1, and 14484/ND6) for LHON and sequencing of the nuclear gene OPA1 for DOA. Therapeutic strategies are still limited including agents that bypass the complex I defect and exert an antioxidant effect (idebenone). Further strategies are aimed at stimulating compensatory mitochondrial biogenesis. Gene therapy is also a promising avenue that still needs to be validated. PMID:25132831

  14. Medical management of hereditary optic neuropathies

    Directory of Open Access Journals (Sweden)

    Chiara eLa Morgia

    2014-07-01

    Full Text Available Hereditary optic neuropathies are diseases of the optic nerve. The most common are mitochondrial hereditary optic neuropathies, i.e. the maternally inherited Leber’s Hereditary Optic Neuropathy (LHON and Dominant Optic Atrophy (DOA. They both share a mitochondrial pathogenesis that leads to the selective loss of retinal ganglion cells and axons, in particular of the papillo-macular bundle. Typically, LHON is an acute/subacute loss of central vision associated with impairment of color vision and swelling of retinal nerve fibers followed by optic atrophy. DOA, instead, is characterized by a childhood-onset and slowly progressive loss of central vision, worsening over the years, leading to optic atrophy. The diagnostic workup includes neuro-ophthalmologic evaluation and genetic testing of the three most common mitochondrial DNA mutations affecting complex I (11778/ND4, 3460/ND1 and 14484/ND6 for LHON and sequencing of the nuclear gene OPA1 for DOA. Therapeutic strategies are limited including agents that bypass the complex I defect and exert an antioxidant effect (idebenone. Further strategies are aimed at stimulating compensatory mitochondrial biogenesis. Gene therapy is also a promising venue that still needs to be validated.

  15. Acute rhinosinusitis in adults.

    Science.gov (United States)

    Aring, Ann M; Chan, Miriam M

    2011-05-01

    Rhinosinusitis is one of the most common conditions for which patients seek medical care. Subtypes of rhinosinusitis include acute, subacute, recurrent acute, and chronic. Acute rhinosinusitis is further specified as bacterial or viral. Most cases of acute rhinosinusitis are caused by viral infections associated with the common cold. Symptomatic treatment with analgesics, decongestants, and saline nasal irrigation is appropriate in patients who present with nonsevere symptoms (e.g., mild pain, temperature less than 101°F [38.3°C]). Narrow-spectrum antibiotics, such as amoxicillin or trimethoprim/sulfamethoxazole, are recommended in patients with symptoms or signs of acute rhinosinusitis that do not improve after seven days, or that worsen at any time. Limited evidence supports the use of intranasal corticosteroids in patients with acute rhinosinusitis. Radiographic imaging is not recommended in the evaluation of uncomplicated acute rhinosinusitis. Computed tomography of the sinuses should not be used for routine evaluation, although it may be used to define anatomic abnormalities and evaluate patients with suspected complications of acute bacterial rhinosinusitis. Rare complications of acute bacterial rhinosinusitis include orbital, intracranial, and bony involvement. If symptoms persist or progress after maximal medical therapy, and if computed tomography shows evidence of sinus disease, referral to an otolaryngologist is warranted.

  16. Fulminant Acute Disseminated Encephalomyelitis

    National Research Council Canada - National Science Library

    Hassan A Alayafi; Faisal R Jahangiri; Mukki Almuntashri

    2014-01-01

      Acute disseminated encephalomyelitis, or post infectious encephalomyelitis is an immunologically mediated demyelinating disorder affecting the central nervous system after infection or vaccination...

  17. Introduction to biomedical optics

    CERN Document Server

    Splinter, Robert

    2006-01-01

    GENERAL BIOMEDICAL OPTICS THEORYIntroduction to the Use of Light for Diagnostic and Therapeutic ModalitiesWhat Is Biomedical Optics?Biomedical Optics TimelineElementary Optical DiscoveriesHistorical Events in Therapeutic and Diagnostic Use of LightLight SourcesCurrent State of the ArtSummaryAdditional ReadingProblemsReview of Optical Principles: Fundamental Electromagnetic Theory and Description of Light SourcesDefinitions in OpticsKirchhoff's Laws of RadiationElectromagnetic Wave TheoryLight SourcesApplications of Various LasersSummaryAdditional ReadingProblemsReview of Optical Principles: Classical OpticsGeometrical OpticsOther Optical PrinciplesQuantum PhysicsGaussian OpticsSummaryAdditional ReadingProblemsReview of Optical Interaction PropertiesAbsorption and ScatteringSummaryAdditional ReadingProblemsLight-Tissue Interaction VariablesLaser VariablesTissue VariablesLight Transportation TheoryLight Propagation under Dominant AbsorptionSummaryNomenclatureAdditional ReadingProblemsLight-Tissue Interaction Th...

  18. Coding for optical channels

    CERN Document Server

    Djordjevic, Ivan; Vasic, Bane

    2010-01-01

    This unique book provides a coherent and comprehensive introduction to the fundamentals of optical communications, signal processing and coding for optical channels. It is the first to integrate the fundamentals of coding theory and optical communication.

  19. A comparison of Simplified Acute Physiology Score II, Acute ...

    African Journals Online (AJOL)

    A comparison of Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation II and Acute Physiology and Chronic Health Evaluation III scoring system in predicting mortality and length of stay at surgical intensive care unit.

  20. Applied optics and optical design, part two

    CERN Document Server

    Conrady, A E

    2014-01-01

    Classic detailed treatment for practical designer. Fundamental concepts, systematic study and design of all types of optical systems. Reader can then design simpler optical systems without aid. Part Two of Two.

  1. Clinical features of MS associated with Leber hereditary optic neuropathy mtDNA mutations.

    Science.gov (United States)

    Pfeffer, Gerald; Burke, Ailbhe; Yu-Wai-Man, Patrick; Compston, D Alastair S; Chinnery, Patrick F

    2013-12-10

    To determine whether the association between multiple sclerosis (MS) and Leber hereditary optic neuropathy (LHON) (known as "Harding disease") is a chance finding, or the 2 disorders are mechanistically linked. We performed a United Kingdom-wide prospective cohort study of prevalent cases of MS with LHON mitochondrial DNA (mtDNA) mutations. The new cases were compared with published cases, enabling a comprehensive clinical description. We also performed a meta-analysis of studies screening patients with MS for LHON mtDNA mutations to find evidence of a genetic association. Twelve new patients were identified from 11 pedigrees, and 44 cases were identified in the literature. The combined cohort had the following characteristics: multiple episodes of visual loss, predominance for women, and lengthy time interval before the fellow eye is affected (average 1.66 years), which is very atypical of LHON; conversely, most patients presented without eye pain and had a poor visual prognosis, which is unusual for optic neuritis associated with MS. The number of UK cases of LHON-MS fell well within the range predicted by the chance occurrence of MS and the mtDNA mutations known to cause LHON. There was no association between LHON mtDNA mutations and MS in a meta-analysis of the published data. Although the co-occurrence of MS and LHON mtDNA mutations is likely to be due to chance, the resulting disorder has a distinct phenotype, implicating a mechanistic interaction. Patients with LHON-MS have a more aggressive course, and prognostication and treatment should be guarded.

  2. Comparison of Optical Coherence Tomography and Scanning Laser Polarimetry Measurements in Patients with Multiple Sclerosis

    Science.gov (United States)

    Quelly, Amanda; Cheng, Han; Laron, Michal; Schiffman, Jade S.; Tang, Rosa A.

    2010-01-01

    Purpose To compare optical coherence tomography (OCT) and scanning laser polarimetry (GDx) measurements of the retinal nerve fiber layer (RNFL) in multiple sclerosis (MS) patients with and without optic neuritis (ON). Methods OCT and GDx were performed on 68 MS patients. Qualifying eyes were divided into two groups: 51 eyes with an ON history ≥ 6 months prior (ON eyes), and 65 eyes with no history of ON (non-ON eyes). Several GDx and OCT parameters and criteria were used to define an eye as abnormal, for example, GDx nerve fiber indicator (NFI) above 20 or 30, OCT average RNFL thickness and GDx temporal-superior-nasal-inferior-temporal average (TSNIT) below 5% or 1% of the instruments’ normative database. Agreement between OCT and GDx parameters was reported as percent of observed agreement, along with the AC1 statistic. Linear regression analyses were used to examine the relationship between OCT average RNFL thickness and GDx NFI and TSNIT. Results All OCT and GDx measurements showed significantly more RNFL damage in ON than in non-ON eyes. Agreement between OCT and GDx parameters ranged from 69–90% (AC1 0.37–0.81) in ON eyes, and 52–91% (AC1 = 0.21–0.90) in non-ON eyes. Best agreement was observed between OCT average RNFL thickness (P 30) in ON eyes (90%, AC1 = 0.81), and between OCT average RNFL thickness (P < 0.01) and GDx TSNIT average (P < 0.01) in non-ON eyes (91%, AC1 = 0.90). In ON eyes, the OCT average RNFL thickness showed good linear correlation with NFI (R2 = 0.69, P < 0.0001) and TSNIT (R2 = 0.55, P < 0.0001). Conclusions OCT and GDx show good agreement and can be useful in detecting RNFL loss in MS/ON eyes. PMID:20495500

  3. Tunable laser optics

    CERN Document Server

    Duarte, FJ

    2015-01-01

    This Second Edition of a bestselling book describes the optics and optical principles needed to build lasers. It also highlights the optics instrumentation necessary to characterize laser emissions and focuses on laser-based optical instrumentation. The book emphasizes practical and utilitarian aspects of relevant optics including the essential theory. This revised, expanded, and improved edition contains new material on tunable lasers and discusses relevant topics in quantum optics.

  4. Optical Robotics in Mesoscopia

    DEFF Research Database (Denmark)

    Glückstad, Jesper

    2012-01-01

    of optical forces and optical torques that, in turn, requires optimization of the underlying light-matter interactions. The requirement of having tightly focused beams in optical tweezer systems exemplifies the need for optimal light-shaping in optical trapping. On the other hand, the recently demonstrated...... deflections that are exploited in conventional optical trapping and manipulation. We also proposed designing micro-structures for so-called structure-mediated access to the nanoscale and a completely new concept: waveguided optical waveguides....

  5. Optical absorption measurement system

    Science.gov (United States)

    Draggoo, Vaughn G.; Morton, Richard G.; Sawicki, Richard H.; Bissinger, Horst D.

    1989-01-01

    The system of the present invention contemplates a non-intrusive method for measuring the temperature rise of optical elements under high laser power optical loading to determine the absorption coefficient. The method comprises irradiating the optical element with a high average power laser beam, viewing the optical element with an infrared camera to determine the temperature across the optical element and calculating the absorption of the optical element from the temperature.

  6. PARACENTRAL ACUTE MIDDLE MACULOPATHY IN PRIMARY CONGENITAL GLAUCOMA.

    Science.gov (United States)

    Aribas, Yavuz K; Aktas, Zeynep; Bayrakceken, Kemal; Atalay, Tuba; Ozdek, Sengul

    2017-11-16

    To report a case of primary congenital glaucoma associated with paracentral acute middle maculopathy. A case report. A 14-year-old girl with undiagnosed primary congenital glaucoma was referred for the evaluation of sudden vision loss a week after the initial symptoms. Visual acuity was counting fingers at 2 m in the right eye. Examination of her right eye revealed corneal stromal scar like Haab striae, splinter hemorrhage at the temporal border of the optic disk, perivenular hemorrhage, and fern-like white area at the macula. On optical coherence tomography of the right eye, hyperreflective plaques at the level of the inner nuclear layer/outer plexiform layer were present, corresponding to the opaque areas in fundoscopy. On optical coherence tomography angiography of the right eye, ischemic areas in deep capillary plexuses were present. These findings in optical coherence tomography angiography and optical coherence tomography were consistent with paracentral acute middle maculopathy. This is the first case of primary congenital glaucoma associated with paracentral acute middle maculopathy in the literature, and primary congenital glaucoma might be a predisposing factor.

  7. CHIRALITY IN NONLINEAR OPTICS AND OPTICAL SWITCHING

    OpenAIRE

    Meijer, E. W.; Feringa, B. L.

    1993-01-01

    Chirality in molecular opto-electronics is limited sofar to the use of optically active liquid crystals and a number of optical phenomena are related to the helical macroscopic structure obtained by using one enantiomer, only. In this paper, the use of chirality in nonlinear optics and optical switching is demonstrated. The additional options offered by the combination of circularly polarized light and chiral molecules gives rise to the observation of Second Harmonic Generation from centrosym...

  8. Acute disseminated encephalomyelitis mimicking acute meningoencephalitis.

    Science.gov (United States)

    Ashrafi, Mahmoud Reza; Amirkashani, Davood; Hirbod-Mobarakeh, Armin; Yaghmaei, Bahareh; Tavassoli, Alireza; Manafi, Farzad; Rezaei, Nima

    2013-12-01

    Acute disseminated encephalomyelitis is an inflammatory demyelinating disease of the central nervous system that usually occurs following an antecedent infection or vaccination. Children and young adults are predominantly affected, but it has low incidence in children younger than 3 years. The disease manifests with a wide range of neurological abnormalities and a variable combination of fever, headache, meningism, convulsion and cranial nerve palsies, and there are no pathognomonic clinical or laboratory findings. So, establishment of definitive diagnosis is challenging in infants. This challenge may result in delayed diagnosis and consequently delayed treatment of acute disseminated encephalomyelitis, which may cause permanent neurological disability. Herein, we report an infant with acute disseminated encephalomyelitis, who mimicked the symptoms of meningoencephalitis and the correct diagnosis and treatment were delayed till the development of a severe phase of the disease.

  9. Intelligent Optics Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Intelligent Optics Laboratory supports sophisticated investigations on adaptive and nonlinear optics; advancedimaging and image processing; ground-to-ground and...

  10. Fibre-optic communications

    CERN Document Server

    Lecoy, Pierre

    2010-01-01

    This book describes in a comprehensive manner the components and systems of fiber optic communications and networks. The first section explains the theory of multimode and single-mode fibers, then the technological features, including manufacturing, cabling, and connecting. The second section describes the various components (passive and active optical components, integrated optics, opto-electronic transmitters and receivers, and optical amplifiers) used in fiber optic systems. Finally, the optical transmission system design is explained, and applications to optical networks and fiber optic se

  11. Optical Remote Sensing Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Optical Remote Sensing Laboratory deploys rugged, cutting-edge electro-optical instrumentation for the collection of various event signatures, with expertise in...

  12. Ultrafast Nonlinear Optical Spectroscopy

    National Research Council Canada - National Science Library

    Wagner, Kelvin

    1999-01-01

    We have developed an Ultrafast optical nonlinear spectroscopy facility with the motivation of studying spatio-temporal soliton interactions for all-optical switching application and several associated...

  13. Gerstmann's syndrome and unilateral optic ataxia in the emergency department

    Directory of Open Access Journals (Sweden)

    Breno José Alencar Pires Barbosa

    Full Text Available ABSTRACT. A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke.

  14. Terson syndrome with bilateral optic nerve sheath hemorrhage.

    Science.gov (United States)

    Gauntt, Chiaki D; Sherry, Richard G; Kannan, Chithra

    2007-09-01

    A 53-year-old man presented with an acute headache and mental status changes due to rupture of an anterior choroidal artery aneurysm. A preoperative CT scan demonstrated subarachnoid hemorrhage, bilateral optic nerve sheath hemorrhage, and bilateral intraocular hemorrhage. Ophthalmoscopy and B-scan ocular ultrasound disclosed vitreous hemorrhages, features consistent with Terson syndrome. This is the first CT report of Terson syndrome showing bilateral optic nerve sheath hemorrhage.

  15. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  16. [Acute kidney injury

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; Heurn, L.W. van; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  17. Pediatric acute lung injury

    NARCIS (Netherlands)

    Dahlem, P.; van Aalderen, W. M. C.; Bos, A. P.

    2007-01-01

    Among ventilated children, the incidence of acute lung injury (ALI) was 9%; of that latter group 80% developed the acute respiratory distress syndrome (ARDS). The population-based prevalence of pediatric ARDS was 5.5 cases/100.000 inhabitants. Underlying diseases in children were septic shock (34%),

  18. [Nonocclusive acute mesenteric ischemia].

    Science.gov (United States)

    Vasile, I; Meşină, C; Paşalega, M; Calotă, F; Vâlcea, I D

    2008-01-01

    The authors present one case of acute mesenteric ischemia appeared to the patient 70 years old, with HTA and coronary heart disease with heart arrhythmia treated with angiotensin-converting-enzyme inhibitor, anti arrhythmia agents and antithrombin therapy (trombostop). Acute mesenteric ischemia is not an isolated clinical entity, but a complex of diseases, including acute mesenteric arterial embolus and thrombus, mesenteric venous thrombus and nonocclusive mesenteric ischemia. These diseases have common clinical features caused by impaired blood perfusion of the intestine, bacterial translocation and systemic inflammatory response syndrome. Reperfusion injury is another important feature of nonocclusive mesenteric ischemia. We discuss about the nonocclusive mesenteric ischemia is the most lethal form of acute mesenteric ischemia because of the poor understanding of its pathophysiology and its nonspecific symptoms, which often delay its diagnosis. Although acute mesenteric ischemia is still lethal and in-hospital mortality rates have remained high over the last few decades, accumulated knowledge on this condition is expected to improve its prognosis.

  19. [Advances in acute pancreatitis].

    Science.gov (United States)

    Domínguez-Muñoz, J Enrique

    2008-10-01

    The present article reports the most recent evidence on the latest advances in the definition, diagnosis and treatment of acute pancreatitis. The concept of acute pancreatitis and its complications is changing and the presence of persistent organ failure is essential to classify a patient as having severe disease. In this context, increased intestinal permeability is seen as an early phenomenon with important prognostic repercussions. Endoscopic ultrasonography is confirmed as the investigation of choice in patients with idiopathic acute pancreatitis or suspected acute biliary pancreatitis. Aggressive water and electrolyte replacement in the first few hours after onset is the key to a favorable clinical course. Conservative treatment and the use of endoscopic necrosectomy are replacing surgery as the treatment of choice of infected pancreatic necrosis. Lastly, the present article discusses the latest evidence on the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis.

  20. Transformation optics and metamaterials.

    Science.gov (United States)

    Chen, Huanyang; Chan, C T; Sheng, Ping

    2010-05-01

    Underpinned by the advent of metamaterials, transformation optics offers great versatility for controlling electromagnetic waves to create materials with specially designed properties. Here we review the potential of transformation optics to create functionalities in which the optical properties can be designed almost at will. This approach can be used to engineer various optical illusion effects, such as the invisibility cloak.

  1. Optic Nerve Pit

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  2. Acute Hepatic Porphyria

    Science.gov (United States)

    Bissell, D. Montgomery; Wang, Bruce

    2015-01-01

    The porphyrias comprise a set of diseases, each representing an individual defect in one of the eight enzymes mediating the pathway of heme synthesis. The diseases are genetically distinct but have in common the overproduction of heme precursors. In the case of the acute (neurologic) porphyrias, the cause of symptoms appears to be overproduction of a neurotoxic precursor. For the cutaneous porphyrias, it is photosensitizing porphyrins. Some types have both acute and cutaneous manifestations. The clinical presentation of acute porphyria consists of abdominal pain, nausea, and occasionally seizures. Only a small minority of those who carry a mutation for acute porphyria have pain attacks. The triggers for an acute attack encompass certain medications and severely decreased caloric intake. The propensity of females to acute attacks has been linked to internal changes in ovarian physiology. Symptoms are accompanied by large increases in delta-aminolevulinic acid and porphobilinogen in plasma and urine. Treatment of an acute attack centers initially on pain relief and elimination of inducing factors such as medications; glucose is administered to reverse the fasting state. The only specific treatment is administration of intravenous hemin. An important goal of treatment is preventing progression of the symptoms to a neurological crisis. Patients who progress despite hemin administration have undergone liver transplantation with complete resolution of symptoms. A current issue is the unavailability of a rapid test for urine porphobilinogen in the urgent-care setting. PMID:26357631

  3. [Hereditary optic neuropathies].

    Science.gov (United States)

    Milea, D; Verny, C

    2012-10-01

    Hereditary optic neuropathies are a group of heterogeneous conditions affecting both optic nerves, with an autosomal dominant, autosomal recessive, X-related or mitochondrial transmission. The two most common non-syndromic hereditary optic neuropathies (Leber's hereditary optic neuropathy and autosomal dominant optic atrophy) are very different in their clinical presentation and their genetic transmission, leading however to a common, non-specific optic nerve atrophy. Beyond the optic atrophy-related visual loss, which is the clinical hallmark of this group of diseases, other associated neurological signs are increasingly recognized. Copyright © 2012. Published by Elsevier Masson SAS.

  4. Fiber optic temperature sensor

    Science.gov (United States)

    Sawatari, Takeo (Inventor); Gaubis, Philip A. (Inventor)

    2000-01-01

    A fiber optic temperature sensor uses a light source which transmits light through an optical fiber to a sensor head at the opposite end of the optical fiber from the light source. The sensor head has a housing coupled to the end of the optical fiber. A metallic reflective surface is coupled to the housing adjacent the end of the optical fiber to form a gap having a predetermined length between the reflective surface and the optical fiber. A detection system is also coupled to the optical fiber which determines the temperature at the sensor head from an interference pattern of light which is reflected from the reflective surface.

  5. Optics for dummies

    CERN Document Server

    Duree, Galen C

    2011-01-01

    The easy way to shed light on Optics In general terms, optics is the science of light. More specifically, optics is a branch of physics that describes the behavior and properties of light?including visible, infrared, and ultraviolet?and the interaction of light with matter. Optics For Dummies gives you an approachable introduction to optical science, methods, and applications. You'll get plain-English explanations of the nature of light and optical effects; reflection, refraction, and diffraction; color dispersion; optical devices, industrial, medical, and military applicatio

  6. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  7. Principles of adaptive optics

    CERN Document Server

    Tyson, Robert

    2010-01-01

    History and BackgroundIntroductionHistoryPhysical OpticsTerms in Adaptive OpticsSources of AberrationsAtmospheric TurbulenceThermal BloomingNonatmospheric SourcesAdaptive Optics CompensationPhase ConjugationLimitations of Phase ConjugationArtificial Guide StarsLasers for Guide StarsCombining the LimitationsLinear AnalysisPartial Phase ConjugationAdaptive Optics SystemsAdaptive Optics Imaging SystemsBeam Propagation Syst

  8. Optical imaging and spectroscopy

    CERN Document Server

    Brady, David J

    2009-01-01

    An essential reference for optical sensor system design This is the first text to present an integrated view of the optical and mathematical analysis tools necessary to understand computational optical system design. It presents the foundations of computational optical sensor design with a focus entirely on digital imaging and spectroscopy. It systematically covers: Coded aperture and tomographic imaging Sampling and transformations in optical systems, including wavelets and generalized sampling techniques essential to digital system analysis Geometric, wave, and statis

  9. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Olfa Kassar

    2015-01-01

    Full Text Available Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patient and conservative treatment was attempted in the other patient. None treatment measures were effective and two patients died. Acute acalculous cholecystitis is a serious complication in neutropenic patients. Earlier diagnosis could have expedited the management of these patients.

  10. Design of optical switches by illusion optics

    Science.gov (United States)

    Shoorian, H. R.; Abrishamian, M. S.

    2013-05-01

    In this paper, illusion optics theory is employed to form Bragg gratings in an optical waveguide in order to design an optical switch. By using an illusion device at a certain distance from the waveguide, the effective refractive index of the waveguide is remotely modulated, turning the waveguide into a distributed Bragg reflector (DBR) which blocks the waves at a stop band. By removing the illusion device, the waves propagate through the waveguide again. In addition, this method is used to remotely tune DBR optical properties such as resonant frequency and bandwidth in a wide range, which leads to a tunable filter for optical switching applications. Finally, using an illusion device at a distance, an optical cavity is created by inserting defects remotely in a DBR without any physical damage in the primary device.

  11. Acute myocardial infarction.

    Science.gov (United States)

    Reed, Grant W; Rossi, Jeffrey E; Cannon, Christopher P

    2017-01-14

    Acute myocardial infarction has traditionally been divided into ST elevation or non-ST elevation myocardial infarction; however, therapies are similar between the two, and the overall management of acute myocardial infarction can be reviewed for simplicity. Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide, despite substantial improvements in prognosis over the past decade. The progress is a result of several major trends, including improvements in risk stratification, more widespread use of an invasive strategy, implementation of care delivery systems prioritising immediate revascularisation through percutaneous coronary intervention (or fibrinolysis), advances in antiplatelet agents and anticoagulants, and greater use of secondary prevention strategies such as statins. This seminar discusses the important topics of the pathophysiology, epidemiological trends, and modern management of acute myocardial infarction, focusing on the recent advances in reperfusion strategies and pharmacological treatment approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Acute coronary syndrome

    Science.gov (United States)

    ... Have plenty of fruits, veggies, whole grains, and lean meats. Try to limit foods high in cholesterol ... et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary ...

  13. Acute Kidney Failure

    Science.gov (United States)

    ... breath Acute kidney failure Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  14. [Acute dyspnea in children].

    Science.gov (United States)

    Gerson, P; Orliaguet, G

    2003-07-01

    Diagnosis of an acute obstructive dyspnea in children is very difficult, especially in the prehospital setting, because there are many possible causes. However, some of them may rapidly become life-threatening and therefore require a rapid prehospital management by a team staffed by a physician. The main causes of acute dyspnea in children usually include: obstructive dyspnea (acute laryngitis, foreign body aspiration, bronchiolotis, acute asthma), pulmonary infections and cardiac dyspnea, as well as dyspnea from other origins (cardiovascular collapse, hyperthermia, acidosis, intoxication, deshydratation). Following the assessment of the severity of the illness, the prehospital management should aimed at restoring an optimal oxygenation, before initiating a treatment adapted to the cause of the disease.

  15. Acute Lymphocytic Leukemia

    Science.gov (United States)

    ... of radiation, such as survivors of a nuclear reactor accident, have an increased risk of developing acute ... 18, 2015. Mesa RA (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. May 30, 2015. Cook AJ. Decision ...

  16. Acute Lymphocytic Leukemia

    Science.gov (United States)

    ... al. Clinical manifestations and treatment of acute lymphoblastic leukemia in children. In: Hematology: Basic Principles and Practice. 6th ed. ... National Cancer Institute. http://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq#section/all. Accessed June 5, ...

  17. Acute Disseminated Encephalomyelitis: Outcome

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-11-01

    Full Text Available The clinical and neuroimaging findings in 84 consecutive children with acute disseminated encephalomyelitis (ADEM were studied prospectively, between March 1988 and July 2000, in relation to outcome at the National Pediatric Hospital, Buenos Aires, Argentina.

  18. Acute Radiation Syndrome

    Science.gov (United States)

    ... Matters Information on Specific Types of Emergencies Acute Radiation Syndrome (ARS): A Fact Sheet for the Public ... is called the radiation dose. People exposed to radiation will get ARS only if: The radiation dose ...

  19. Acute management of stones

    DEFF Research Database (Denmark)

    Jung, Helene; Osther, Palle J S

    2015-01-01

    INTRODUCTION: Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention. MATERIAL AND METHODS......: In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood. RESULTS: Acute stone management should be planned...

  20. Acute liver failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....

  1. Acute Leukemia in Children

    Directory of Open Access Journals (Sweden)

    K.V. Vilchevska

    2014-11-01

    Full Text Available The lecture presents current data on the etiology, pathogenesis, clinical manifestations, observation methods and principles of treatment of children with acute lymphoblastic leukemia. own clinical observation of development of the acute lymphoblastic leukemia clinical picture in a child aged 4 years old has been described. This case is characterized by late diagnosis and inappropriate prescription of steroids in combination with antipyretic agents that led to tumor resistance to the treatment.

  2. Acute Myeloid Leukemia Presenting as Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Sherri Rauenzahn

    2013-01-01

    Full Text Available Appendicitis in leukemic patients is uncommon but associated with increased mortality. Additionally, leukemic cell infiltration of the appendix is extremely rare. While appendectomy is the treatment of choice for these patients, diagnosis and management of leukemia have a greater impact on remission and survival. A 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML with nonsuppurative appendicitis. In the setting of AML, prior cases described the development of appendicitis with active chemotherapy. Of these cases, less than ten patients had leukemic infiltration of the appendix, leading to leukostasis and nonsuppurative appendicitis. Acute appendicitis with leukemic infiltration as the initial manifestation of AML has only been described in two other cases in the literature with an average associated morbidity of 32.6 days. The prompt management in this case of appendicitis and AML resulted in an overall survival of 185 days.

  3. Fabrication of freeform optics

    Science.gov (United States)

    Blalock, Todd; Medicus, Kate; DeGroote Nelson, Jessica

    2015-08-01

    Freeform surfaces on optical components have become an important design tool for optical designers. Non-rotationally symmetric optical surfaces have made solving complex optical problems easier. The manufacturing and testing of these surfaces has been the technical hurdle in freeform optic's wide-spread use. Computer Numerically Controlled (CNC) optics manufacturing technology has made the fabrication of optical components more deterministic and streamlined for traditional optics and aspheres. Optimax has developed a robust freeform optical fabrication CNC process that includes generation, high speed VIBE polishing, sub-aperture figure correction, surface smoothing and testing of freeform surfaces. Metrology of freeform surface is currently achieved with coordinate measurement machines (CMM) for lower resolution and interferometry with computer generated holograms (CGH) for high resolution irregularity measurements.

  4. Nonlinear Optics and Applications

    Science.gov (United States)

    Abdeldayem, Hossin A. (Editor); Frazier, Donald O. (Editor)

    2007-01-01

    Nonlinear optics is the result of laser beam interaction with materials and started with the advent of lasers in the early 1960s. The field is growing daily and plays a major role in emerging photonic technology. Nonlinear optics play a major role in many of the optical applications such as optical signal processing, optical computers, ultrafast switches, ultra-short pulsed lasers, sensors, laser amplifiers, and many others. This special review volume on Nonlinear Optics and Applications is intended for those who want to be aware of the most recent technology. This book presents a survey of the recent advances of nonlinear optical applications. Emphasis will be on novel devices and materials, switching technology, optical computing, and important experimental results. Recent developments in topics which are of historical interest to researchers, and in the same time of potential use in the fields of all-optical communication and computing technologies, are also included. Additionally, a few new related topics which might provoke discussion are presented. The book includes chapters on nonlinear optics and applications; the nonlinear Schrodinger and associated equations that model spatio-temporal propagation; the supercontinuum light source; wideband ultrashort pulse fiber laser sources; lattice fabrication as well as their linear and nonlinear light guiding properties; the second-order EO effect (Pockels), the third-order (Kerr) and thermo-optical effects in optical waveguides and their applications in optical communication; and, the effect of magnetic field and its role in nonlinear optics, among other chapters.

  5. [Lymphotropic therapy for acute purulent odontogenic jaw periostitis].

    Science.gov (United States)

    Maĭborodin, I V; Lĭubarskiĭ, M S; Loĭko, E R; Sheplev, B V

    2003-01-01

    The structure of the gingival mucosa was studied by optic microscopy in patients with acute purulent odontogenic maxillary periostitis treated traditionally and receiving lymphotropic therapy. Lymphotropic administration of the antibiotic during 2 days resulted in less pronounced dilatation of the interstitial spaces and lymph vessels adjacent to the molars and higher counts of lymphocytes, monocytes, and macrophages. This indicated high efficiency of lymphotropic therapy of acute purulent maxillary periostitis for molars. Microcirculation parameters and tissue leukocyte cytogram in gingival mucosal tissue adjacent to the canines and premolars differed negligibly in patients treated by different methods.

  6. Nonlinear fiber optics

    CERN Document Server

    Agrawal, Govind P

    2001-01-01

    The Optical Society of America (OSA) and SPIE - The International Society for Optical Engineering have awarded Govind Agrawal with an honorable mention for the Joseph W. Goodman Book Writing Award for his work on Nonlinear Fiber Optics, 3rd edition.Nonlinear Fiber Optics, 3rd Edition, provides a comprehensive and up-to-date account of the nonlinear phenomena occurring inside optical fibers. It retains most of the material that appeared in the first edition, with the exception of Chapter 6, which is now devoted to the polarization effects relevant for light propagation in optical

  7. Organic nonlinear optical materials

    Science.gov (United States)

    Umegaki, S.

    1987-01-01

    Recently, it became clear that organic compounds with delocalized pi electrons show a great nonlinear optical response. Especially, secondary nonlinear optical constants of more than 2 digits were often seen in the molecular level compared to the existing inorganic crystals such as LiNbO3. The crystallization was continuously tried. Organic nonlinear optical crystals have a new future as materials for use in the applied physics such as photomodulation, optical frequency transformation, opto-bistabilization, and phase conjugation optics. Organic nonlinear optical materials, e.g., urea, O2NC6H4NH2, I, II, are reviewed with 50 references.

  8. Latching micro optical switch

    Science.gov (United States)

    Garcia, Ernest J; Polosky, Marc A

    2013-05-21

    An optical switch reliably maintains its on or off state even when subjected to environments where the switch is bumped or otherwise moved. In addition, the optical switch maintains its on or off state indefinitely without requiring external power. External power is used only to transition the switch from one state to the other. The optical switch is configured with a fixed optical fiber and a movable optical fiber. The movable optical fiber is guided by various actuators in conjunction with a latching mechanism that configure the switch in one position that corresponds to the on state and in another position that corresponds to the off state.

  9. Introduction to nonimaging optics

    CERN Document Server

    Chaves, Julio

    2015-01-01

    Introduction to Nonimaging Optics covers the theoretical foundations and design methods of nonimaging optics, as well as key concepts from related fields. This fully updated, revised, and expanded Second Edition: Features a new and intuitive introduction with a basic description of the advantages of nonimaging opticsAdds new chapters on wavefronts for a prescribed output (irradiance or intensity), infinitesimal étendue optics (generalization of the aplanatic optics), and Köhler optics and color mixingIncorporates new material on the simultaneous multiple surface (SMS) design method in 3-D, int

  10. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

  11. Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.

    Science.gov (United States)

    Desai, Jay; Mitchell, Wendy G

    2012-11-01

    Acute cerebellar ataxia and acute cerebellitis represent a process characterized by parainfectious, postinfectious, or postvaccination cerebellar inflammation. There is considerable overlap between these entities. The mildest cases of acute cerebellar ataxia represent a benign condition that is characterized by acute truncal and gait ataxia, variably with appendicular ataxia, nystagmus, dysarthria, and hypotonia. It occurs mostly in young children, presents abruptly, and recovers over weeks. Neuroimaging is normal. Severe cases of cerebellitis represent the other end of the spectrum, presenting with acute cerebellar signs often overshadowed by alteration of consciousness, focal neurological deficits, raised intracranial pressure, hydrocephalus, and even herniation. Neuroimaging is abnormal and the prognosis is less favorable than in acute cerebellar ataxia. Acute disseminated encephalomyelitis may be confused with acute cerebellitis when the clinical findings are predominantly cerebellar, but lesions on neuroimaging are usually widespread. Paraneoplastic opsoclonus-myoclonus syndrome is often initially misdiagnosed as acute cerebellar ataxia, but has very specific features, course, and etiopathogensis.

  12. A modular optical sensor

    Science.gov (United States)

    Conklin, John Albert

    This dissertation presents the design of a modular, fiber-optic sensor and the results obtained from testing the modular sensor. The modular fiber-optic sensor is constructed in such manner that the sensor diaphragm can be replaced with different configurations to detect numerous physical phenomena. Additionally, different fiber-optic detection systems can be attached to the sensor. Initially, the modular sensor was developed to be used by university of students to investigate realistic optical sensors and detection systems to prepare for advance studies of micro-optical mechanical systems (MOMS). The design accomplishes this by doing two things. First, the design significantly lowers the costs associated with studying optical sensors by modularizing the sensor design. Second, the sensor broadens the number of physical phenomena that students can apply optical sensing techniques to in a fiber optics sensor course. The dissertation is divided into seven chapters covering the historical development of fiber-optic sensors, a theoretical overview of fiber-optic sensors, the design, fabrication, and the testing of the modular sensor developed in the course of this work. Chapter 1 discusses, in detail, how this dissertation is organized and states the purpose of the dissertation. Chapter 2 presents an historical overview of the development of optical fibers, optical pressure sensors, and fibers, optical pressure sensors, and optical microphones. Chapter 3 reviews the theory of multi-fiber optic detection systems, optical microphones, and pressure sensors. Chapter 4 presents the design details of the modular, optical sensor. Chapter 5 delves into how the modular sensor is fabricated and how the detection systems are constructed. Chapter 6 presents the data collected from the microphone and pressure sensor configurations of the modular sensor. Finally, Chapter 7 discusses the data collected and draws conclusions about the design based on the data collected. Chapter 7 also

  13. Peptide Optical waveguides.

    Science.gov (United States)

    Handelman, Amir; Apter, Boris; Shostak, Tamar; Rosenman, Gil

    2017-02-01

    Small-scale optical devices, designed and fabricated onto one dielectric substrate, create integrated optical chip like their microelectronic analogues. These photonic circuits, based on diverse physical phenomena such as light-matter interaction, propagation of electromagnetic waves in a thin dielectric material, nonlinear and electro-optical effects, allow transmission, distribution, modulation, and processing of optical signals in optical communication systems, chemical and biological sensors, and more. The key component of these optical circuits providing both optical processing and photonic interconnections is light waveguides. Optical confinement and transmitting of the optical waves inside the waveguide material are possible due to the higher refractive index of the waveguides in comparison with their surroundings. In this work, we propose a novel field of bionanophotonics based on a new concept of optical waveguiding in synthetic elongated peptide nanostructures composed of ordered peptide dipole biomolecules. New technology of controllable deposition of peptide optical waveguiding structures by nanofountain pen technique is developed. Experimental studies of refractive index, optical transparency, and linear and nonlinear waveguiding in out-of-plane and in-plane diphenylalanine peptide nanotubes have been conducted. Optical waveguiding phenomena in peptide structures are simulated by the finite difference time domain method. The advantages of this new class of bio-optical waveguides are high refractive index contrast, wide spectral range of optical transparency, large optical nonlinearity, and electro-optical effect, making them promising for new applications in integrated multifunctional photonic circuits. Copyright © 2016 European Peptide Society and John Wiley & Sons, Ltd. Copyright © 2016 European Peptide Society and John Wiley & Sons, Ltd.

  14. Achromatic optical diode in fiber optics

    CERN Document Server

    Berent, Michal; Vitanov, Nikolay V

    2013-01-01

    We propose a broadband optical diode, which is composed of one achromatic reciprocal quarter-wave plate and one non-reciprocal quarter-wave plate, both placed between two crossed polarizers. The presented design of achromatic wave plates relies on an adiabatic evolution of the Stokes vector, thus, the scheme is robust and efficient. The possible simple implementation using fiber optics is suggested.

  15. Optical Computing-Optical Components and Storage Systems

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 6. Optical Computing - Optical Components and Storage Systems ... Keywords. Advanced materials. optical switching. pulse shaping. optical storage device. high-performance computing. imaging; nanotechnology. photonics. telecommunications ...

  16. Optical Quantum Computing

    National Research Council Canada - National Science Library

    Jeremy L. O'Brien

    2007-01-01

    In 2001, all-optical quantum computing became feasible with the discovery that scalable quantum computing is possible using only single-photon sources, linear optical elements, and single-photon detectors...

  17. Optic Nerve Atrophy

    Science.gov (United States)

    ... cord (hydrocephalus) may prevent further optic nerve damage. Spectacles may be prescribed to correct refractive error. When optic atrophy is unilateral protection of the good eye is essential and wearing of protective lenses should ...

  18. The Scanning Optical Microscope.

    Science.gov (United States)

    Sheppard, C. J. R.

    1978-01-01

    Describes the principle of the scanning optical microscope and explains its advantages over the conventional microscope in the improvement of resolution and contrast, as well as the possibility of producing a picture from optical harmonies generated within the specimen.

  19. Fiber Optics Instrumentation Development

    Science.gov (United States)

    Chan, Patrick Hon Man; Parker, Allen R., Jr.; Richards, W. Lance

    2010-01-01

    This is a general presentation of fiber optics instrumentation development work being conducted at NASA Dryden for the past 10 years and recent achievements in the field of fiber optics strain sensors.

  20. Optical application of electrowetting

    Science.gov (United States)

    He, Mei; Peng, Runling; Chen, Jiabi

    2017-02-01

    Since electrowetting has been proposed, researchers began to apply eletrowetting into different fields, such as lab-on-chip systems, display technologies, printings and optics etc. This paper mainly introduced structure, theory and application of optical devices based on electrowetting. The optical devices include liquid optical prism, liquid optical lens and display. The paper introduced their principle, specific application and many advantages in optical applications. When they are applied to optical system, production and experiment, they can reduce mechanical moving parts, simplify the structure, operate easily, decrease manufacturing cost and energy consumption, improve working efficiency, and so on. We learn and research them in detail that will contribute to research and develop optical eletrowetting in the future.