Journal of Neuro-Ophthalmology最新文献

{"title":"Progressive Cranial Polyneuropathy and Myelopathy as the Initial Manifestation of Leucine Zipper 4-Positive Paraneoplastic Syndrome in Previously Undiagnosed Metastatic Testicular Seminoma.","authors":"Zachary R Barry, Nicholas R Levergood, Cory D Owens, Devin D Mackay, Melissa W Ko, W Robert Bell, S Nicolas Paez, Benjamin R Gray, Kevin E Lai","doi":"10.1097/WNO.0000000000002552","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002552","url":null,"abstract":"<p><strong>Abstract: </strong>A 50-year-old man without a significant medical history developed progressive double vision from a partial right third nerve palsy, as well as right-sided hyperreflexia and decreased temperature sensation in his right hand. Initial contrast MRI of the brain revealed enhancement of the right oculomotor nerve. Cerebrospinal fluid and serologic studies were negative or normal. Over the next 6 weeks, he developed a left sixth nerve palsy and right-sided facial sensory changes, followed by a partial left third nerve palsy and right foot drop. The patient later disclosed a 2-year history of painful right hemiscrotum swelling. Abdominal imaging and testicular biopsy revealed a Stage IIA testicular seminoma and was treated with radical orchiectomy, steroids, intravenous immunoglobulin, and chemotherapy. He continued to deteriorate, with evidence of myelitis on thoracic MRI. Initial paraneoplastic studies were negative, and research-based antibody testing revealed leucine zipper 4 autoantibody positivity, indicating a paraneoplastic syndrome.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194581","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":"Re-evaluation of Patient Diagnosed With Multiple Sclerosis and Retinovascular Disease.","authors":"Matthew S Wieder, Joyce N Mbekeani, Phyllis L Faust, David J Monoky, Andria L Ford, John P Atkinson, Thomas L Slamovits","doi":"10.1097/WNO.0000000000002550","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002550","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075088","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":"Optical Coherence Tomography as an Objective Tool for Assessing Ocular Torsion in Fourth Cranial Nerve Palsy.","authors":"Marta Saint-Gerons, Esther Puig, Anna Camós-Carreras, Javier Armentia, Pablo Villoslada, Anna Matheu","doi":"10.1097/WNO.0000000000002531","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002531","url":null,"abstract":"<p><strong>Background: </strong>The aims of this prospective study were to evaluate ocular torsion in fourth cranial nerve palsy using optical coherence tomography (OCT), assess the influence of ocular dominance and interocular asymmetry, compare acute and chronic cases with healthy controls, determine diagnostic cutoff values, and analyze associations with clinical parameters and measurement reproducibility.</p><p><strong>Methods: </strong>In this prospective study, 12 patients with acute palsy, 23 with chronic palsy, and 43 healthy controls were examined. Ocular torsion was quantified by OCT using the disc-fovea angle, and a binocular torsion sum (OCT sum score) was calculated. Clinical parameters included vertical deviation in primary gaze, torticollis, and subjective torsion. Group comparisons and correlations were performed, and reproducibility was assessed in healthy subjects.</p><p><strong>Results: </strong>Greater excyclotorsion in the nonparetic eye was observed in 51.4% of patients and was significantly associated with palsy laterality (P = 0.0016). OCT sum scores were significantly higher in patients than in controls (18.3° vs 10.6°, P < 0.001), with no difference between acute and chronic groups. The OCT sum score showed excellent discrimination between patients with chronic palsy and healthy subjects (area under the curve = 0.927). Correlation with Maddox torsion was moderate, while associations with vertical deviation and torticollis were weak or nonsignificant. Measurement reproducibility in healthy controls was high (intraclass correlation coefficient = 0.86).</p><p><strong>Conclusions: </strong>Nonparetic-eye excyclotorsion is common in unilateral fourth nerve palsy and is influenced by palsy laterality, likely reflecting ocular dominance. The OCT sum score provides a reproducible, objective measure of binocular torsion and effectively distinguishes patients with chronic palsy from healthy subjects, although its relationship with clinical measures is limited.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075134","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":"Diplopia in Extramedullary Multiple Myeloma: Clinical Features, Management, and Outcomes at a Tertiary Cancer Center.","authors":"Arsalaan B Asad, Sami Younes, Dima Al-Mafrachi, Penny Q Fang, Nagham Al-Zubidi","doi":"10.1097/WNO.0000000000002542","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002542","url":null,"abstract":"<p><strong>Background: </strong>Extramedullary multiple myeloma (EMM) involving the skull base and orbit is an uncommon cause of diplopia. Prior reports, including our earlier series of 7 patients, are limited to small case series. The aim of this study was to characterize the clinical features, lesion patterns, management, and outcomes of EMM-associated diplopia in a large single-center cohort.</p><p><strong>Methods: </strong>We identified 250 patients with International Classification of Diseases, 10th Revision codes for multiple myeloma and diplopia who were evaluated at the MD Anderson Cancer Center between 2016 and 2025. Inclusion criteria required pathology or MRI confirmed EMM with associated binocular diplopia. We summarized demographics, myeloma characteristics, lesion sites, ophthalmologic findings, treatments, and diplopia outcomes following external-beam radiation therapy. Patients with complete resolution were compared with those with partial/no resolution using Fisher exact, χ2, and t test or Mann‑Whitney test as appropriate. Overall survival from the onset of diplopia was assessed using the Kaplan-Meier method.</p><p><strong>Results: </strong>The mean age at diplopia onset was 63.6 ± 9.5 years; 51.9% of patients were female and 75.0% had relapsed or refractory disease. IgG was the most common isotype (57.7%) followed by kappa light chain (55.8%). The majority of patients were Revised International Staging System stage 2 or 3. MRI commonly revealed skull-base involvement in 63.5% and orbital involvement in 42.3% of patients. Among 34 patients who underwent ophthalmologic examination, 82.4% had cranial nerve palsy, most commonly with sixth nerve palsy (61.8%). Fifty-one patients received external-beam radiation (median 2,000 cGy in 8 fractions). Of these, 60.8% achieved complete resolution of diplopia and 11.8% partial resolution, typically within 2 months. No clinical, anatomic, or treatment variables were found to be associated with diplopia resolution. The median overall survival after diplopia onset was approximately 15 months.</p><p><strong>Conclusions: </strong>EMM-related diplopia is often indicative of skull-base or orbital involvement in patients with advanced myeloma. Although radiation frequently improves or resolves diplopia, survival following symptom onset remains limited (median 15 months), notably shorter than that observed in general relapsed/refractory myeloma. EMM-related diplopia serves as a high-risk clinical marker that necessitating urgent neuroimaging and multidisciplinary management.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069680","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":"Vertical Half-and-Half Syndrome With Unilateral Upward Pursuit-Saccadic Dissociation and Associated Collier Sign.","authors":"Nour Talmi, Moncef Ould Hamou, Souhila Tadjer, Tom Buelens","doi":"10.1097/WNO.0000000000002551","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002551","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069691","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":"Acute Anterior Uveitis Following Percutaneous Radiofrequency Rhizotomy for Trigeminal Neuralgia: A Rare Case of Neurogenic Inflammation.","authors":"Huei-Ling Huang, Jin-Jhe Wang, Chen-Wei Lin","doi":"10.1097/WNO.0000000000002535","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002535","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069534","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":"Checkpoint Inhibitor-Induced Orbital Myositis Mimicking Extraocular Muscle Metastasis.","authors":"Victoria A Dezard, Chatchawal Aramrat, Laila Alshafai, Edward A Margolin","doi":"10.1097/WNO.0000000000002517","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002517","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069657","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":"Ocular Myasthenia, Myositis, and Myocarditis Syndrome in a Woman Treated With Immune Checkpoint Inhibitors.","authors":"Chatchawal Aramrat, Joseph Hanna, Edward Margolin","doi":"10.1097/WNO.0000000000002536","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002536","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069706","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":"Optical Coherence Tomography-Based Differentiation of Nonarteritic Anterior Ischemic Optic Neuropathy and Central Retinal Artery Occlusion: Longitudinal Analysis of Inner Retinal Layer Thinning.","authors":"Can Kocasarac, Elyse R Corpuz, Sandra S Stinnett, Gregory S McElroy","doi":"10.1097/WNO.0000000000002538","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002538","url":null,"abstract":"<p><strong>Background: </strong>Nonarteritic anterior ischemic optic neuropathy (NAION) and central retinal artery occlusion (CRAO) are both causes of acute vision loss. When patients present within the first several weeks of symptom onset, clinical signs such as optic disc or inner retinal edema often allow differentiation. However, as time progresses and edema resolves, both diseases lead to optic atrophy and retinal thinning, sometimes making them difficult to distinguish. Clinical experience suggests that CRAO results in more significant thinning of the inner retinal layers, particularly the ganglion cell layer (GCL), compared with NAION. This study seeks to investigate whether these differences remain detectable months after symptom onset and whether optical coherence tomography (OCT) imaging can reliably distinguish these entities in the chronic phase.</p><p><strong>Methods: </strong>This is a retrospective single-center cohort study comparing OCT-derived ganglion cell thickness, total retinal thickness, and asymmetry of inferior/superior hemiretinas in patients with NAION and CRAO who presented early after vision loss and underwent follow-up imaging at approximately 3, 6, or 12 months.</p><p><strong>Results: </strong>At all time points, GCL and retina thinning were more severe in the CRAO group. The ratio of GCL to total retina was significantly lower in the CRAO group. More asymmetry was observed in the NAION group, with the superior hemiretina more frequently affected.</p><p><strong>Conclusions: </strong>OCT average GCL thickness determined by automatic segmentation is an excellent discriminator between prior CRAO and prior NAION eyes at 3, 6, and 12 months.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069668","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 1+1 Syndrome: Complete Paralysis of Horizontal Gaze as a First Presentation of Multiple Sclerosis.","authors":"Gerard Mullane, Simon Cronin","doi":"10.1097/WNO.0000000000002537","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002537","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039281","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}