Journal of Neuro-Ophthalmology最新文献

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Orbital Inflammatory Manifestations in a Patient With VEXAS (Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic) Syndrome. 一名 VEXAS(空泡、E1 酶、X-连锁、自身炎症、体质)综合征患者的眼眶炎症表现。
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-27 DOI: 10.1097/WNO.0000000000002270
Blake D Colman, Eliot D Smolyansky, Hemant A Parmar, Pratheepan Puvanakumar, Rogan G Fraser, Prashanth Ramachandran, Shivanand Sheth, Neil Shuey, Subahari Raviskanthan
{"title":"Orbital Inflammatory Manifestations in a Patient With VEXAS (Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic) Syndrome.","authors":"Blake D Colman, Eliot D Smolyansky, Hemant A Parmar, Pratheepan Puvanakumar, Rogan G Fraser, Prashanth Ramachandran, Shivanand Sheth, Neil Shuey, Subahari Raviskanthan","doi":"10.1097/WNO.0000000000002270","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002270","url":null,"abstract":"<p><strong>Abstract: </strong>An 84-year-old man with a genetically confirmed diagnosis of VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome treated with tocilizumab reported with a 3-day history of left eye pain, conjunctival chemosis and injection, and horizontal binocular diplopia. Examination revealed restriction of left eye ductions in all directions with mild unilateral proptosis. MRI of his brain and orbits demonstrated abnormal enhancement of the left posterior sclera and intraorbital optic nerve sheath, without involvement of the extraocular muscles, cavernous sinus, or optic nerve parenchyma. B-scan ultrasonography heralded a positive \"T-sign.\" Empiric treatment with high-dose intravenous methylprednisolone led to rapid clinical improvement. Workup for alternative causes was unremarkable. Oral prednisone dose and tocilizumab ultimately resulted in complete resolution after 4 weeks. The final diagnosis was consistent with orbital inflammatory manifestations of VEXAS syndrome.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729204","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}
引用次数: 0
Prognosticators of Optic Nerve Imaging in Malignant Pseudotumor Cerebri Syndrome. 恶性假性脑瘤综合征视神经成像的预后指标
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-27 DOI: 10.1097/WNO.0000000000002277
Alexandria L Chaulk, Jennifer L McCarty, Rajan P Patel, Alice Z Chuang, Ore-Ofe O Adesina
{"title":"Prognosticators of Optic Nerve Imaging in Malignant Pseudotumor Cerebri Syndrome.","authors":"Alexandria L Chaulk, Jennifer L McCarty, Rajan P Patel, Alice Z Chuang, Ore-Ofe O Adesina","doi":"10.1097/WNO.0000000000002277","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002277","url":null,"abstract":"<p><strong>Background: </strong>Pseudotumor cerebri (PTC) syndrome is a disorder of increased intracranial pressure, most commonly affecting overweight women of childbearing age. Malignant PTC (MPTC) is a rare presentation that involves rapidly worsening vision, often necessitating surgical intervention to prevent permanent vision loss. The goal of this study was to determine whether radiographic findings of PTC are predictive of MPTC and the final visual outcome.</p><p><strong>Methods: </strong>Charts of patients diagnosed with PTC based on the modified Dandy criteria were reviewed. Snellen best-corrected visual acuity (BCVA), automated perimetry mean deviation (APMD), and papilledema grade were documented from the initial and final follow-up examinations. The MRI images were read by 2 neuroradiologists blinded to the clinical diagnosis, and consensus findings were obtained. The patients were classified into malignant and nonmalignant PTC groups. Malignant was defined as BCVA ≤ 20/200 or APMD ≤ -7 dB, and acute onset of symptoms. The sensitivity and specificity of each MRI finding for detecting MPTC was determined. Generalized linear model with random effect and backward model selection was performed to identify which radiographic findings were predictive of final BCVA, APMD, and papilledema grade.</p><p><strong>Results: </strong>Overall, 114 eyes (57 malignant/57 nonmalignant) were included. No MRI finding has both sensitivity and specificity for MPTC reaching 60%. The highest sensitivity (86%) was flattening of the posterior globes and unilateral or bilateral transverse sinus stenosis. The highest specificities were completely empty sella (86%), enhancement (84%), and diffusion restriction (81%) of the prelaminar optic nerves. The presence of vertical tortuosity of the optic nerves was predictive of better final BCVA (P = 0.003) and better final APMD (P = 0.011). While papilledema grade was higher in MPTC, no MRI finding was predictive of papilledema grade.</p><p><strong>Conclusions: </strong>No single MRI finding has both high sensitivity and specificity for diagnosing MPTC. Vertical tortuosity of the optic nerves may be predictive of better final BCVA and APMD.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729258","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}
引用次数: 0
Chronic Atypical Optic Disc Edema in a Boy With STAT3 Gain-of-Function Syndrome. STAT3功能增益综合征男孩的慢性非典型视盘水肿
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-27 DOI: 10.1097/WNO.0000000000002272
Tessnim R Ahmad, Alice Y Chan, Marc H Levin
{"title":"Chronic Atypical Optic Disc Edema in a Boy With STAT3 Gain-of-Function Syndrome.","authors":"Tessnim R Ahmad, Alice Y Chan, Marc H Levin","doi":"10.1097/WNO.0000000000002272","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002272","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729704","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}
引用次数: 0
Intracranial Hypotension-Related Bony Remodeling as a Cause of Optic Nerve Injury. 颅内低压导致的骨骼重塑是视神经损伤的原因之一。
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-27 DOI: 10.1097/WNO.0000000000002290
Marina Shenouda, Jessica R Chang, Ying Chen, Timothy J McCulley
{"title":"Intracranial Hypotension-Related Bony Remodeling as a Cause of Optic Nerve Injury.","authors":"Marina Shenouda, Jessica R Chang, Ying Chen, Timothy J McCulley","doi":"10.1097/WNO.0000000000002290","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002290","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729147","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}
引用次数: 0
Progressive Blurry Vision and Hearing Loss in a Young Male Patient. 一名年轻男性患者的渐进性视力模糊和听力损失。
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-25 DOI: 10.1097/WNO.0000000000002279
Marko K Oydanich, Larry P Frohman
{"title":"Progressive Blurry Vision and Hearing Loss in a Young Male Patient.","authors":"Marko K Oydanich, Larry P Frohman","doi":"10.1097/WNO.0000000000002279","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002279","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710310","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}
引用次数: 0
Sequential Vision Loss in a 67-Year-Old Patient. 一名 67 岁患者的连续性视力丧失。
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-25 DOI: 10.1097/WNO.0000000000002278
Mariana Arroyo, Juan M García, Claudia Hubbe-Tena, Jorge Cárdenas-Belaunzarán
{"title":"Sequential Vision Loss in a 67-Year-Old Patient.","authors":"Mariana Arroyo, Juan M García, Claudia Hubbe-Tena, Jorge Cárdenas-Belaunzarán","doi":"10.1097/WNO.0000000000002278","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002278","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710316","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}
引用次数: 0
Brain MRI Lesions in Alexia Without Agraphia: A Case-Control Study. 无书写障碍的亚历克西娅的脑磁共振成像病变:病例对照研究
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-25 DOI: 10.1097/WNO.0000000000002263
Jeremy N Shapiro, Aseem Sharma, Jonathan D Trobe, Ryan D Walsh, Sangeeta Khanna
{"title":"Brain MRI Lesions in Alexia Without Agraphia: A Case-Control Study.","authors":"Jeremy N Shapiro, Aseem Sharma, Jonathan D Trobe, Ryan D Walsh, Sangeeta Khanna","doi":"10.1097/WNO.0000000000002263","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002263","url":null,"abstract":"<p><strong>Background: </strong>Alexia without agraphia (AWA) is an acquired reading disturbance associated with left posterior cerebral artery (PCA) infarction. Based on autopsy and neuroimaging, there are two explanations for its pathogenesis: a visual cortex-language cortex disconnection and a visual word-form agnosia. Our goal was to discover if more refined brain imaging in a case-control study would provide further imaging support for either of these hypotheses.</p><p><strong>Methods: </strong>A neuroradiologist masked to the presence of AWA reviewed diffusion-weighted and fluid-attenuated inversion recovery brain MRIs in patients who had left PCA infarctions with AWA (9 patients) or without AWA (18 patients) to characterize lesions in the splenium, left forceps major, and left fusiform gyrus.</p><p><strong>Results: </strong>Patients with AWA had various combinations of lesions in the splenium, left forceps major, and left fusiform gyrus. One of these regions was involved in 3 patients, 2 were involved in 3 patients, and 3 were involved in 3 patients. Most (89%) patients without AWA lacked involvement of any of these 3 regions.</p><p><strong>Conclusions: </strong>Our data provide imaging evidence for the two existing hypotheses of AWA. Involvement of any of these lesions on MRI imaging should encourage clinicians to obtain further neuropsychological testing.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710224","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}
引用次数: 0
Late-Onset Mitochondrial Neurogastrointestinal Encephalopathy Presenting With Isolated Ophthalmic Findings. 晚发型线粒体神经胃肠道脑病伴有孤立的眼部症状
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-11 DOI: 10.1097/WNO.0000000000002287
Angelica Hanna, Edsel B Ing, Arun N Sundaram, Vera Bril, Rahul A Sharma
{"title":"Late-Onset Mitochondrial Neurogastrointestinal Encephalopathy Presenting With Isolated Ophthalmic Findings.","authors":"Angelica Hanna, Edsel B Ing, Arun N Sundaram, Vera Bril, Rahul A Sharma","doi":"10.1097/WNO.0000000000002287","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002287","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622320","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}
引用次数: 0
Differentiation of Horner Syndrome and Physiological Anisocoria by Automated Pupillometry. 通过自动瞳孔测量法区分霍纳综合征和生理性斜视
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-08 DOI: 10.1097/WNO.0000000000002262
Leah R Disse, Christopher J Bockisch, Konrad P Weber, Fabienne C Fierz
{"title":"Differentiation of Horner Syndrome and Physiological Anisocoria by Automated Pupillometry.","authors":"Leah R Disse, Christopher J Bockisch, Konrad P Weber, Fabienne C Fierz","doi":"10.1097/WNO.0000000000002262","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002262","url":null,"abstract":"<p><strong>Background: </strong>The differentiation of Horner syndrome from physiological anisocoria is important yet clinically challenging. We investigated the diagnostic accuracy of pupillometry to discriminate Horner syndrome from physiological anisocoria compared to pharmacological testing with the alpha-2-agonist apraclonidine, which is considered the current gold standard.</p><p><strong>Methods: </strong>Forty-four adult patients, mostly referred to our neuro-ophthalmology service for evaluation of anisocoria, were included. Automated binocular pupillometry was performed under standardized light conditions before and >30 minutes after instillation of 1% apraclonidine eye drops. A positive apraclonidine test indicating unilateral Horner syndrome was defined as an increase of pupil size in the smaller pupil and decrease of size in the larger pupil. Receiver operator characteristic curves were calculated to find the best pupillometric parameter discriminating Horner syndrome from physiological anisocoria.</p><p><strong>Results: </strong>We found that the parameters measuring the pupillary dilation lag using pupillometry could reliably discriminate Horner syndrome from physiological anisocoria compared to pharmacological testing. Calculating the change of anisocoria at 3-4 seconds after light-off relative to the anisocoria at the end of the light-on period (Δ3-4) may be most suitable to rule out Horner syndrome reaching a sensitivity of 95% and specificity of 68% using a cutoff of 0.35 mm.</p><p><strong>Conclusions: </strong>Our results indicate that pupillometry is a robust tool to measure the dilation lag in Horner syndrome and, therefore, to distinguish pathological from physiological anisocoria obviating pharmacological testing. The high sensitivity of the test will allow to identify the patients with Horner syndrome requiring further investigation.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622275","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}
引用次数: 0
Accuracy of the Image Interpretation Capability of ChatGPT-4 Vision in Analysis of Hess Screen and Visual Field Abnormalities. ChatGPT-4 Vision 在分析赫斯筛查和视野异常时的图像解读能力的准确性。
IF 2 4区 医学
Journal of Neuro-Ophthalmology Pub Date : 2024-11-07 DOI: 10.1097/WNO.0000000000002267
Mojgan Nikdel, Hadi Ghadimi, Donny W Suh, Mehdi Tavakoli
{"title":"Accuracy of the Image Interpretation Capability of ChatGPT-4 Vision in Analysis of Hess Screen and Visual Field Abnormalities.","authors":"Mojgan Nikdel, Hadi Ghadimi, Donny W Suh, Mehdi Tavakoli","doi":"10.1097/WNO.0000000000002267","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002267","url":null,"abstract":"<p><strong>Background: </strong>OpenAI, the owner of ChatGPT, publicly released the GPT-4 Vision in September 2023. This multimedia chatbot has the capability to receive and analyze various images presented to it by the user. We assessed the accuracy of its interpretation of 2 of the images commonly used in neuro-ophthalmology, namely Hess screen and automated visual field images.</p><p><strong>Methods: </strong>We separately uploaded typical images of 5 abnormal Hess screen charts related to third, fourth, and sixth cranial nerve palsy, Brown syndrome, and inferior orbital wall fracture with entrapment of the inferior rectus muscle. Likewise, 5 classic images of automated visual field grayscale maps related to lesions of the optic nerve, the chiasma, the optic tract, the optic radiations, and the occipital lobe were presented. The chatbot was instructed to select the best option among the 5 choices presented in each question.</p><p><strong>Results: </strong>The GPT-4 Vision was able to select the right choice in 2/5 questions on Hess screens and 3/5 of the visual field questions. Despite selection of the correct option, qualitative evaluation of GPT-4 responses revealed flawed analysis of certain aspects of some image findings, such as the side of involvement or the misinterpretation of the physiologic blind spot as a central scotoma.</p><p><strong>Conclusions: </strong>The performance of GPT-4 Vision in the interpretation of abnormalities of Hess screen and visual field involvement was highly variable, even with simple typical cases of classic disorders. As the chatbot's image recognition is currently evolving, its capacity to accurately interpret ophthalmologic images is still limited at this time.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604668","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}
引用次数: 0
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