Journal of Neuro-Ophthalmology最新文献

{"title":"Home Monitoring of Visual Functions in Neuro-Ophthalmic Diseases Using an AI-Assisted Virtual Reality Platform.","authors":"Amanda Tran, Tamara Juvier-Riesgo, Henar Albertos-Arranz, Liliana Rosello-Rodriguez, Giselle Ricur, Carlos E Mendoza-Santiesteban","doi":"10.1097/WNO.0000000000002461","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002461","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the feasibility and acceptability of a virtual reality platform (VRP) for home monitoring of visual function in patients with neuro-ophthalmic conditions.</p><p><strong>Methods: </strong>Fifteen patients with nonarteritic anterior ischemic optic neuropathy (NAAION), optic neuritis, or papilledema were enrolled and monitored remotely over 12 weeks. Visual acuity, color vision, and visual field testing were collected 3 times per week using the VRP. Compliance and satisfaction levels were analyzed.</p><p><strong>Results: </strong>A total of 21 eyes were included (38.1% NAAION, 42.9% optic neuritis, 19% papilledema). Most participants (71.4%) found weekly VRP use easy, and all felt confident using it at home. While 86% reported no technical issues, 21%-28% experienced transient symptoms such as blurred vision or dizziness. Compliance was highest in the NAAION group, with 75% completing the full 12-week period. In the optic neuritis group, 55.6% remained after Week 1 and 44.4% continued through Week 8. The papilledema group discontinued by Week 4. Main reasons for discontinuation included time constraints, scheduling conflicts, and stable vision after improvement. In general, visual acuity and visual field indices (mean deviation and pattern SD [PSD]) showed no significant changes over time, confirming good VRP'S reproducibility for home monitoring. This VRP also detected cases of visual function worsening, enabling earlier rescheduling of clinical appointments.</p><p><strong>Conclusion: </strong>The VRP is a feasible and well-accepted tool for home-based visual monitoring in neuro-ophthalmic patients as an alternative to in-person eye examinations. This approach enables early detection of changes and can improve long-term management.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Anemia and Pseudotumor Cerebri.","authors":"Alison B Gibbons, Ximin Li, Amanda D Henderson","doi":"10.1097/WNO.0000000000002469","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002469","url":null,"abstract":"<p><strong>Background: </strong>Contemporary literature suggests that anemia may be a risk factor for the development of pseudotumor cerebri (PTC) and associated with poorer visual outcomes. However, literature describing the association is limited, and whether laboratory testing for anemia should be done during a PTC work-up is frequently debated among neuro-ophthalmologists.</p><p><strong>Methods: </strong>International Classification of Diseases-10 codes were used to identify patients with PTC from the SOURCE database. Patients with PTC were matched for age, sex, and race with controls. Relative rates of anemia were compared between groups. A subgroup analysis compared demographic factors and outcomes for PTC patients with and without anemia.</p><p><strong>Results: </strong>Two-thousand two-hundred forty patients with PTC and 2,240 age-, race-, body mass index-, and sex-matched controls from a national, multicentered database were included in the study. Rates of anemia did not differ between PTC and non-PTC groups (23.4% vs 22.3%, P = 0.393). Among patients with PTC, anemia was associated with older age at onset (38.0 ± 14.1 vs 36.1 ± 13.6 [27.0-45.0] years, P = 0.013), male sex (16.2% vs 10.7%, P = 0.017), and lower visual acuity at presentation ( P < 0.001), but final visual acuities were similar when controlling for presenting acuity ( P = 0.123).</p><p><strong>Conclusions: </strong>Using the largest sample of patients with PTC and matched controls to date, anemia was not associated with PTC diagnosis. Among patients with PTC, anemia was associated with demographic features atypical for PTC.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Compressive Optic Neuropathy Secondary to Severe Vitamin A Deficiency in an Adolescent With Autism Spectrum Disorder.","authors":"Priscila Correia de Farias, Matheus Andrighetti Rossi, Lucas Almeida Linhares, Daniel Gurgel Fernandes Távora, Natália Nogueira Carvão Aguiar Valle Rossi","doi":"10.1097/WNO.0000000000002470","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002470","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracanalicular Optic Nerve Sheath Schwannoma Masquerading as Atypical Optic Neuritis.","authors":"Shikha T Bassi, Krishnakumar Subramanian, Olma V Noronha, Roopesh V Kumar","doi":"10.1097/WNO.0000000000002460","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002460","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebound Intracranial Hypertension With Papilledema and Sixth Nerve Palsy After Embolization of a Cerebrospinal Fluid-Venous Fistula: A Neuro-Ophthalmic Perspective.","authors":"Niv Levy, Eef J Hendriks, Richard I Farb, Edward Margolin","doi":"10.1097/WNO.0000000000002457","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002457","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abduction-Release Sign in Heavy Eye Syndrome.","authors":"Idan Hecht, Sasha A Mansukhani","doi":"10.1097/WNO.0000000000002471","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002471","url":null,"abstract":"<p><strong>Background: </strong>Heavy eye syndrome (HES) is characterized by progressive esotropia and hypotropia with high myopia. Diagnosis is based on the clinical presentation and is often supported by imaging. In this study we describe a novel clinical sign observed in patients with HES.</p><p><strong>Methods: </strong>We conducted a cross-sectional, retrospective analysis of patients with limitation in elevation in adduction, examined between February 2025 and June 2025. Examinations were not masked to diagnosis. Presence of the Abduction-Release Sign on examination was recorded and compared between patients with HES and those with other diagnoses who served as controls. The sign is elicited when the patient is asked to abduct the eye, then in a slow circular motion bring the eye upward and into an adducted position.</p><p><strong>Results: </strong>We identified 14 cases with limitation in elevation in which the sign was tested. Four had HES and 10 had other diagnoses (60% had thyroid eye disease, 20% had Brown syndrome, and 20% other diagnoses). Mean spherical equivalent was -17.8 ± 8.0 D in the HES group and +0.17 ± 2.3 D in the control group. Of the 4 patients with HES, all had a positive Abduction-Release Sign on examination, compared with none in the control group (P = 0.001).</p><p><strong>Conclusions: </strong>Among this cohort of patients with limitation in elevation, the presence of the Abduction-Release Sign was significantly associated with HES. This examination finding might be useful in the evaluation of patients with HES together with traditional examination and imaging findings. Its utility may be limited in severe cases, because abduction may be insufficient to elicit the sign. It might also offer insights into the structural and functional changes that occur in this syndrome.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DOK7 Congenital Myasthenia Syndrome Presenting as an Isolated Complex Ophthalmoplegia.","authors":"Thilan P Subasinghe Arachchige, Karl K Ng, Kate Eliza Ahmad","doi":"10.1097/WNO.0000000000002459","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002459","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report and Review of an Atypical Presentation in the Oldest Documented Patient With Susac Syndrome.","authors":"Dana H Chung, Jonathan Amaro-Barron, Jaqueline Stoutin, Erika L Weil, Emily A Eton","doi":"10.1097/WNO.0000000000002438","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002438","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"iCare HOME2 Monitoring of Diurnal Ocular Perfusion Pressure in Patients With Nonarteritic Ischemic Optic Neuropathy.","authors":"Benjamin V Packard, Meghan Sharma, Andy Renschler, Catherine J Johnson, Chase E Paulson, Blessing S Ofori-Atta, Susan Chortkoff, Sravanthi Vegunta, Barbara M Wirostko, Judith E A Warner","doi":"10.1097/WNO.0000000000002450","DOIUrl":"10.1097/WNO.0000000000002450","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated time-of-day differences in intraocular pressure (IOP), mean arterial pressure (MAP), and ocular perfusion pressure (OPP) in eyes affected by nonarteritic anterior ischemic optic neuropathy (NAION), and compared these measures between NAION-affected and unaffected eyes at each time period.</p><p><strong>Methods: </strong>Adults aged 18-90 years with a confirmed diagnosis of NAION were enrolled in this nonrandomized prospective observational cohort study. Participants were trained to measure blood pressure (BP) and IOP using an automated BP cuff and the iCare HOME2 rebound tonometer. In participants with only 1 eye affected by NAION, the unaffected eye was used as a control. Measurements were collected at 7 predefined daily time points (4:00, 6:00, 9:00, 12:00, 15:00, 18:00, and 21:00) for at least 7 consecutive days. MAP and OPP were calculated as 1/3 systolic + 2/3 diastolic pressure and 2/3 × (MAP - IOP), respectively. Early morning (4:00, 6:00), midday (9:00, 12:00, 15:00), and evening (18:00, 21:00) measurements were compared using linear mixed-effects models. The main outcome measures were intraday measurements of IOP, MAP, and OPP.</p><p><strong>Results: </strong>A total of 27 eyes of 15 patients were included in the study. Among NAION-affected eyes, mean OPP and MAP were lowest in the early morning. No IOP elevations were noted in the early waking hours. On average, OPP was 1.69 mm Hg higher and MAP was 2.70 mm Hg higher at midday than in the morning, while IOP increased by 0.76 mm Hg (all 95% confidence interval [CI]). In the evening, OPP was 1.83 mm Hg higher and MAP was 2.49 mm Hg higher than in the morning (both 95% CI). Evening IOP was 0.31 mm Hg lower than in the morning, but this difference was not statistically significant ( P = 0.08).</p><p><strong>Conclusions: </strong>Early morning low OPP in nonglaucomatous eyes with NAION seems to be correlated with low MAP, rather than elevated IOP. These findings help support a role for impaired local perfusion in the early waking hours in the pathogenesis of NAION and highlight the potential utility of IOP and BP diurnal monitoring in at-risk patients.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic Atrophy in Wolfram Syndrome Type 1: A Retrospective Analysis of Visual Outcomes and Biomarker Correlates.","authors":"Bradley J McNeely, Abby F Tang, Fumihiko Urano, Nicholas R Levergood, Melissa W Ko, Devin D Mackay, Gregory P Van Stavern, Yunshuo Tang","doi":"10.1097/WNO.0000000000002451","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002451","url":null,"abstract":"<p><strong>Background: </strong>Wolfram syndrome type 1 (WS1) is a rare autosomal recessive disorder classically associated with diabetes mellitus (DM) and optic atrophy (OA). We aimed to characterize OA in WS1 and evaluate optical coherence tomography (OCT) and genetic biomarkers as tools for disease monitoring and prognostication.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of genetically confirmed patients with WS1 seen at Washington University or Indiana University neuro-ophthalmology clinics between July 2017 and 2024. Data included demographics, clinical history, best corrected visual acuity (BCVA), OCT retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness, and WFS1 mutation severity scores. Linear regression analyses assessed correlations between BCVA and clinical, structural, and genetic variables.</p><p><strong>Results: </strong>Thirty-six patients (22 women, 14 men; median age 20 years) were identified. Median mutation severity score was 3.5. Vision loss occurred in 31 patients; in 3 patients it was the only major symptom, in 5 patients it preceded DM, and in 6 patients it occurred without DM. Mean and median BCVA were 20/125 and 20/80, respectively. BCVA correlated inversely with RNFL thickness (P = 0.0017, R2 = 0.14), GCC thickness (P = 0.0018, R2 = 0.29), and mutation severity score (P = 0.031, R2 = 0.14).</p><p><strong>Conclusions: </strong>OA was the most common and sometimes earliest WS1 manifestation. Correlations between BCVA, OCT metrics, and mutation severity score support their potential value as biomarkers and prognostic tools. Findings also support considering genetic screening for WFS1 mutations in patients presenting with otherwise unexplained OA.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}