Journal of Neuro-Ophthalmology最新文献

{"title":"Prevalence and Clinical Significance of Incidental Neuroimaging Findings in Neuro-Ophthalmology: A Retrospective Analysis of 5,000 Cases.","authors":"Samira Jafari, Edward A Margolin, Jonathan A Micieli","doi":"10.1097/WNO.0000000000002332","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002332","url":null,"abstract":"<p><strong>Background: </strong>Patients referred to ophthalmology and neuro-ophthalmology clinics often present with complex neurological and visual symptoms, such as headaches, double vision, and vision loss, requiring thorough history, comprehensive examinations, and neuroimaging to identify the underlying cause. While advances in neuroimaging have improved diagnostic accuracy, they have also introduced challenges with incidental findings and unexpected abnormalities. This study aimed to determine the prevalence, spectrum, and clinical relevance of incidental findings in neuro-ophthalmology patients evaluated at an academic center.</p><p><strong>Methods: </strong>A retrospective, observational cohort study included 5,000 patients (59% women, 41% men; mean age 53.7 years) who underwent neuroimaging (MRI and CT) for neuro-ophthalmic symptoms at an academic neuro-ophthalmology clinic between July 2008 and June 2024. Details of imaging type, region scanned, and reason for imaging were recorded from electronic medical records. Incidental findings were defined as abnormalities unrelated to the original reason for imaging and categorized into 4 follow-up categories (none, routine, urgent, and emergency). Imaging reports were independently reviewed and categorized by an ophthalmologist and a neuro-ophthalmologist. Descriptive statistics were used to assess the prevalence of incidental findings and their clinical significance. Chi-square tests and analysis of variance were applied to assess associations between imaging modalities, age, and the presence of incidental findings.</p><p><strong>Results: </strong>Incidental findings were present in 31% (n = 1,532) of patients; 20.6% required no follow-up, 9.6% required routine follow-up, 0.34% required urgent follow-up, and 0.1% required emergency follow-up. The most common incidental findings were microangiopathic changes (14.2%), sinus changes (6.96%), and brain atrophy (3.26%). MRI showed a higher prevalence of incidental findings than CT (31.8% vs 25.1%, P < 0.05). There was no difference in incidental findings between 1.5T vs 3T MRI. Age was significantly associated with certain findings, such as microangiopathy and brain atrophy. The most common findings by follow-up category were microangiopathic changes (no follow-up), meningiomas (routine follow-up), suspected neoplasms (urgent), and suspected metastasis (emergency).</p><p><strong>Conclusions: </strong>Incidental findings are common in neuro-ophthalmology imaging, with the majority requiring no or routine follow-up. However, a small percentage (0.44%) of cases required urgent or emergency attention, underscoring the need for careful evaluation and management protocols. These findings emphasize the importance of developing guidelines to manage incidentalomas in neuro-ophthalmology, particularly for older patients and those undergoing MRI.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615762","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":"On behalf of the North American Neuro-Ophthalmology Society, the editorial office of the Journal of Neuro-Ophthalmology acknowledges, with gratitude, our reviewers who dedicated their time and effort between January 1 and December 31, 2024.","authors":"","doi":"10.1097/WNO.0000000000002347","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002347","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585975","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":"Correlation Between Visual Acuity and Automated Visual Field Foveal Threshold.","authors":"Kamar S Abdullahi, Asyvia Powell, Ziou Jiang, Michael S Lee","doi":"10.1097/WNO.0000000000002326","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002326","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have determined a signficant correlation between, foveal threshold on automated visual field perimetry and best-corrected visual acuity. To our knowledge, these correlations have not been studied using the Octopus (Haag-Streit, Köniz, Switzerland) perimeter.</p><p><strong>Methods: </strong>Patients underwent Octopus automated visual field testing using the glaucoma tendency-oriented perimetry protocol where a foveal threshold value was collected. Visual acuity was determined in the patient's current refractive glasses and/or with pinhole acuity. Visual acuity was converted from Snellen to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Spearman correlation coefficient was used to determine correlation between visual acuity and foveal threshold value.</p><p><strong>Results: </strong>A total of 332 eyes (243 diseased eyes and 89 healthy eyes) were assessed. A statistically significant negative correlation was found between visual acuity and foveal threshold (P < 0.001). The estimated foveal threshold was statistically significantly decreased by 1.2 dB per every 0.1 logMAR increase of visual acuity (P < 0.001). A foveal threshold of 27.47 or higher predicted a visual acuity of 20/40 or better with 90% confidence.</p><p><strong>Conclusions: </strong>Patient best-corrected logMAR visual acuity has a negative correlation with foveal threshold in automated (Octopus) visual field testing. Our findings suggest that foveal threshold may predict measured visual acuity. We created a website application to predict visual acuity based on foveal threshold, age, and presence or absence of ocular pathology. Foveal threshold may represent a surrogate estimate of acuity for patients who are unable to read the Snellen chart and for patients with functional vision loss.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537153","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":"Kelch-Like Protein 11 Paraneoplastic Autoimmune Encephalitis in Primary Retroperitoneal Müllerian Adenocarcinoma.","authors":"Hanna L Tso, Swetak Pradhan, Pamela A Davila-Siliezar, Peter W Mortensen, Andrew G Lee","doi":"10.1097/WNO.0000000000002106","DOIUrl":"10.1097/WNO.0000000000002106","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"e23-e25"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139741265","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":"Complete Binasal Hemianopia-Associated With Pituitary Microadenoma or Idiopathic?-A Case Report.","authors":"Marta Świerczyńska, Lech Sedlak, Agnieszka Tronina, Mateusz Winder","doi":"10.1097/WNO.0000000000002072","DOIUrl":"10.1097/WNO.0000000000002072","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"e1-e3"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087260","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 Angiography Retinal Imaging Associations With Burden of Small Vessel Disease and Amyloid Positivity in the Brain.","authors":"Camilo Bermudez, Timothy G Lesnick, Swati S More, Vijay K Ramanan, David S Knopman, Alejandro A Rabinstein, Petrice M Cogswell, Clifford R Jack, Prashanthi Vemuri, Ronald C Petersen, Jonathan Graff-Radford, John J Chen","doi":"10.1097/WNO.0000000000002230","DOIUrl":"10.1097/WNO.0000000000002230","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer disease (AD) and other dementias are associated with vascular changes and amyloid deposition, which may be reflected as density changes in the retinal capillaries. These changes may can be directly visualized and quantified with optical coherence tomography angiography (OCTA), making OCTA a potential noninvasive preclinical biomarker of small vessel disease and amyloid positivity. Our objective was to investigate the feasibility of retinal imaging metrics as noninvasive biomarkers of small vessel disease and amyloid positivity in the brain.</p><p><strong>Methods: </strong>We investigated associations between OCTA and neuroimaging and cognitive metrics in 41 participants without dementia from the Mayo Clinic Study of Aging and Alzheimer's Disease Research Center. OCTA metrics included superficial, deep, and full retina capillary density of the fovea, parafovea, and macula as well as the area of the foveal avascular zone (FAZ). Neuroimaging metrics included a high burden of white matter hyperintensity (WMH), presence of cerebral microbleeds (CMB), lacunar infarcts, and amyloid positivity as evidenced on positron emission tomography (PET), whereas cognitive metrics included mini-mental status examination (MMSE) score. We performed generalized estimating equations to account for measurements in each eye while controlling for age and sex to estimate associations between OCTA metrics and neuroimaging and cognitive scores.</p><p><strong>Results: </strong>Associations between OCTA and neuroimaging metrics were restricted to the fovea. OCTA showed decreased capillary density with high burden of WMH in both the superficial ( P = 0.003), deep ( P = 0.004), and full retina ( P = 0.01) in the fovea but not the parafovea or whole macula. Similarly, participants with amyloid PET positivity had significantly decreased capillary density in the superficial fovea ( P = 0.027) and deep fovea ( P = 0.03) but higher density in the superficial parafovea ( P = 0.038). Participants with amyloid PET positivity also had a significantly larger FAZ ( P = 0.031), whereas in those with high WMH burden the difference did not reach statistical significance ( P = 0.075). There was also a positive association between MMSE and capillary density of the full retina within the fovea ( P = 0.037) and in the superficial parafovea ( P = 0.046). No associations were found between OCTA metrics and presence of CMB or presence of lacunar infarcts.</p><p><strong>Conclusions: </strong>The associations of lower foveal capillary density with cerebral WMH and amyloid positivity suggest that further research is warranted to evaluate for shared mechanisms of disease between small vessel disease and AD pathologies.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"63-70"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860050","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":"Assessment of Reversibility of Transverse Venous Sinus Stenosis in Patients With Papilledema.","authors":"Armin Handzic, Brendan K Tao, Roisin M O'Cearbhaill, Patrick J Nicholson, Edward A Margolin, Jonathan A Micieli","doi":"10.1097/WNO.0000000000002090","DOIUrl":"10.1097/WNO.0000000000002090","url":null,"abstract":"<p><strong>Background: </strong>Bilateral transverse venous sinus stenosis (TVSS) or stenosis of a dominant venous sinus has been found to be very sensitive radiological findings in patients with intracranial hypertension (IH), yet there is still an ongoing debate whether they constitute reversible or permanent phenomena. Thus, the purpose of this study was to investigate the reversibility of TVSS in patients with IH, including conservatively treated patients with signs of IH as defined by the presence of papilledema.</p><p><strong>Methods: </strong>This was a retrospective chart review of all patients diagnosed with IH between 2016 and 2022, assessed from 2 tertiary university-affiliated neuro-ophthalmology practices. Inclusion criteria were the presence of papilledema, as quantified by optical coherence tomography, and bilateral TVSS, which is considered typical of IH on neuroimaging. During follow-up, included patients must have had confirmation of papilledema resolution as well as subsequent neuroimaging after conservative treatment or cerebrospinal fluid flow diversion. Patients with dural sinus vein thrombosis or intrinsic stenosis from sinus trabeculations or significant arachnoid granulations were excluded from the study. Either CT venography or MRI/MR venography was reviewed by a fellowship-trained neuroradiologist, and the degree of stenosis was scored through the combined conduit score (CCS), as described by Farb et al. The primary outcome was to assess TVSS changes after resolution or improvement of papilledema.</p><p><strong>Results: </strong>From 435 patients, we identified a subset of 10 who satisfied all inclusion criteria. Our cohort comprised entirely women with a median age of 29.5 years and a median BMI of 32.5 kg/m 2 . Treatment consisted of acetazolamide in 7 patients, of which 1 had additional topiramate and 2 underwent cerebrospinal fluid flow diversion. Furthermore, 6 patients demonstrated significant weight loss during follow-up. For the primary outcome, 5 of 10 patients exhibited no appreciable TVSS change, and 5 patients demonstrated significant improvement in TVSS, of which 4 received conservative treatment only. Papilledema resolution or improvement was statistically significantly associated with increasing average CCS, TVSS diameter, and grade.</p><p><strong>Conclusions: </strong>We were able to demonstrate that TVSS can be both irreversible and reversible in patients with resolved papilledema. The finding of TVSS reversibility from conservative treatment alone is novel and has important implications to optimize patient care. Future studies should work to identify factors associated with irreversible TVSS for subsequent targeted intervention and prevention.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"4-9"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900040","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":"Facilitators and Barriers to Weight Loss Among Patients With Idiopathic Intracranial Hypertension.","authors":"Olivia J Killeen, Lizbeth A Gonzalez, Amy E Rothberg, Sangeeta Khanna, Wayne T Cornblath, Tatiana Deveney, Sui H Wong, Lindsey B De Lott","doi":"10.1097/WNO.0000000000002133","DOIUrl":"10.1097/WNO.0000000000002133","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Little is known about motivation for weight loss and barriers to weight loss among patients with idiopathic intracranial hypertension (IIH). Such information is crucial for developing tailored weight management recommendations and novel interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We administered a survey to patients with IIH presenting to neuro-ophthalmology clinics at The University of Michigan Kellogg Eye Center (Michigan, USA) and St. Thomas' Hospital (London, England). Participants rated importance and motivation to lose weight (1-10 scale; 10 = extremely important/motivated). Facilitators and barriers to weight loss were assessed using open-ended survey questions informed by motivational interviewing methodology. Open-ended responses were coded by 2 team members independently using a modified grounded theory approach. Demographic data were extracted from medical records. Descriptive statistics were used to analyze quantitative responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 221 (43 Michigan and 178 London) patients with IIH ( Table 1 ), most were female (n = 40 [93.0%] Michigan and n = 167 [94.9%] London). The majority of patients in the United States were White (n = 35 [81.4%] Michigan), and the plurality were Black in the United Kingdom (n = 67 [37.6%] London]) with a mean (SD) BMI of 38.9 kg/m 2 (10.6 kg/m 2 ) Michigan and 37.5 kg/m 2 (7.7 kg/m 2 ) London. Participants' mean (SD) level of importance to lose weight was 8.5 (2.2) (8.1 [2.3] Michigan and 8.8 [2.1] London), but their mean (SD) level of motivation to lose weight was 7.2 (2.2) (6.8 [2.4] Michigan and 7.4 [2.1] London). Nine themes emerged from the 992 open-ended coded survey responses grouped into 3 actionable categories: self-efficacy, professional resources (weight loss tools, diet, physical activity level, mental health, and physical health), and external factors (physical/environmental conditions, social influences, and time constraints). Most responses (55.6%; n = 551) were about barriers to weight loss. Lack of self-efficacy was the most discussed single barrier (N = 126; 22.9% total, 28.9% Michigan, and 20.4% London) and facilitator (N = 77; 17.5% total, 15.9% Michigan, and 18.7% London) to weight loss. Other common barriers were related to physical activity level (N = 79; 14.3% total, 13.2% Michigan, and 14.8% London) and diet (N = 79; 14.3% total, 9.4% Michigan, and 16.3% London). Commonly reported facilitators included improvements in physical activity level (N = 73; 16.6% total, 18.5% Michigan, and 15.1% London) and dietary changes (N = 76; 17.2% total, 16.4% Michigan, and 17.9% London).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients with IIH believe weight loss is important. Self-efficacy was the single most mentioned important patient-identified barrier or facilitator of weight loss, but professional resource needs and external factors vary widely at the individual level. These factors should be assessed to guide selection of weig","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"23-29"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Literature Commentary.","authors":"","doi":"10.1097/WNO.0000000000002321","DOIUrl":"10.1097/WNO.0000000000002321","url":null,"abstract":"<p><p>In this issue of JNO , Drs. Deborah I. Friedman and Mark L. Moster discuss the following 4 articles: Al Kasab S, Almallouhi E, Shu L, Kicielinski KP, Salehi Omran S, Liebeskind DS, Zubair AS, Vedovati MC, Paciaroni M, Antonenko K, Heldner MR, de Havenon A, Henninger N, Yaghi S. Outcomes and recurrence rates among patients with provoked and cryptogenic cerebral venous thrombosis: analysis of the ACTION CVT. Neurol Clin Pract. 2025;15:e200381 [Epub ahead of print].Kwon YN, Kim B, Kim JS, Park KS, Seo DY, Kim H, Lee EJ, Lim YM, Ju H, Chung YH, Min JH, Nam TS, Kim S, Sohn E, Shin KJ, Seok JM, Kim S, Bae JS, Lee S, Oh SI, Jung YJ, Park J, Kim SH, Kim KH, Kim HJ, Jung JH, Kim SJ, Kim SW, Jang MJ, Sung JJ, Waters P, Shin HY, Kim SM. Time to treat first acute attack of myelin oligodendrocyte glycoprotein antibody-associated disease. JAMA Neurol. 2024;81:1073-1084.Akosman S, Li R, Asahi M, Kwon B, Dossantos J, Tavakoli M, Chen JJ. Trends in plasma exchange use in optic neuritis hospitalizations in the United States. Ophthalmology. 2024;131:1207-1214.Chou CC, Pan SY, Sheen YJ, Lin JF, Lin CH, Lin HJ, Wang IJ, Weng CH. Association between semaglutide and non-arteritic anterior ischemic optic neuropathy: a multinational population-based real-world study. Ophthalmology. 2024:S0161-6420(24)00685-7 [Epub ahead of print].</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"118-123"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066067","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":"Anti-Immunoglobulin-Like Cell Adhesion Molecule-5 (IgLON5) Associated Neurological Disease Presenting With Bilateral Intraocular Optic Neuritis as an Initial Presentation: Expanding Clinical Phenotype of the Disease.","authors":"Aditi Varma-Doyle, Bart K Chwalisz, Jenny Linnoila","doi":"10.1097/WNO.0000000000002114","DOIUrl":"10.1097/WNO.0000000000002114","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"e35-e37"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028249","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}