Neuro-Ophthalmology最新文献

{"title":"Letter to the Editor: Comment on Takai et al.'s \"Age-Associated Differences in Optic Disc Findings of Leber's Hereditary Optic Neuropathy\".","authors":"Lubhavni Dewan, Sneha Pal, Shailja Tibrewal","doi":"10.1080/01658107.2026.2642121","DOIUrl":"10.1080/01658107.2026.2642121","url":null,"abstract":"<p><p>This letter comments on the study by Takai et al examining age-related differences in acute phase optic disc morphology in Leber hereditary optic neuropathy. We highlight methodological considerations in subjective fundus photograph assessment, and discuss additional factors such as refractive status and timing of presentation that may influence the presence of optic disc edema. These points may aid in refining phenotypic interpretation in future LHON studies.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 3","pages":"292-293"},"PeriodicalIF":0.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply To: Comments on \"Age-Associated Differences in Optic Disc Findings of Leber's Hereditary Optic Neuropathy\".","authors":"Yasuyuki Takai, Akiko Yamagami, Mayumi Iwasa, Kenji Inoue, Ryoma Yasumoto, Hitoshi Ishikawa, Masato Wakakura","doi":"10.1080/01658107.2026.2642123","DOIUrl":"10.1080/01658107.2026.2642123","url":null,"abstract":"","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 3","pages":"294-295"},"PeriodicalIF":0.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Poor Visual Outcomes Among Males with Idiopathic Intracranial Hypertension (IIH).","authors":"Jacqueline K Shaia, Jeffrey Chu, Taseen Alam, Ilene Trinh, Jenna Rock, Rishi P Singh, Katherine E Talcott, Devon A Cohen","doi":"10.1080/01658107.2026.2628245","DOIUrl":"10.1080/01658107.2026.2628245","url":null,"abstract":"<p><p>Although idiopathic intracranial hypertension (IIH) mainly impacts women of a reproductive age, approximately 10% of IIH patients are males. The purpose of this study was to evaluate male IIH with the aim of identifying risk factors for poor visual outcomes. Patients who met the revised Dandy Criteria and received an ICD code of IIH or papilledema at a single tertiary institution between June 2012 and September 2023 were included in this study. Demographics, treatment, and outcomes data were collected, and patients were stratified based on final visual outcomes. Statistical analyses including risk ratio (RR) calculations utilized a <i>p</i> value of <0.05. Male IIH patients composed 11.2% (<i>n</i> = 84) of patients and post-pubertal men had a mean age of 29.37 (SD 13.28). The majority of the population was white at 73% with 5.5% of patients presenting with fulminant IIH. When compared to female IIH patients, 7.9% of females had a poor visual outcome compared to 12.9% of post-pubertal males. Distinct risk factors for post-pubertal male poor visual outcomes include current/former smoker, history of diabetes, and hypertension (<i>p</i> < .05). Although men continue to comprise a small proportion of IIH patients, they may be more likely to have poor visual outcomes than female IIH patients. Prognostic indicators for poor visual outcomes among males may include having poor baseline vision, being a current or former smoker, and having diabetes or hypertension history. Multi-institutional and longitudinal research studies are needed to further explore potential risk factors for poor visual outcomes.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"355-362"},"PeriodicalIF":0.6,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Therapy for Leber Hereditary Optic Neuropathy (LHON): A Systematic Review and Meta-Analysis.","authors":"Lama Nasser Alghamdi, Ali Saleh Alsudais, Salma Hamdan Almarwani, Rose Abdullah Alraddadi, Abdulrahman Hamid Alsamadani, Abdulrahman Ahmed Alnamlah, Saif Kamal Aljehani, Yousof Fahad Allarakia, Amer M Alghamdi, Daniah Alshowaeir","doi":"10.1080/01658107.2026.2624440","DOIUrl":"10.1080/01658107.2026.2624440","url":null,"abstract":"<p><strong>Background: </strong>LHON is a rare mitochondrial disease causing bilateral vision loss, most commonly due to the m.11778G>A mutation. rAAV2/2-ND4 gene therapy is a potential disease-modifying treatment.</p><p><strong>Methods: </strong>Systematic review and meta-analysis of three RCTs (RESCUE, REVERSE, REFLECT) including 175 patients.</p><p><strong>Results: </strong>Gene therapy significantly improved best-corrected visual acuity but did not significantly increase responder rates. Adverse events were mostly mild ocular inflammation, with no treatment-related mortality.</p><p><strong>Conclusions: </strong>rAAV2/2-ND4 is a moderately effective and safe treatment for LHON, though long-term outcomes and predictors of response remain unclear.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 3","pages":"215-221"},"PeriodicalIF":0.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Serum Immune-Inflammation Index and Serum Inflammatory Response Index in Optic Neuritis.","authors":"Abdülcemal Gürpınar, Ahmet Özdemir, İnci Güngör, Sedat Şen","doi":"10.1080/01658107.2026.2627358","DOIUrl":"10.1080/01658107.2026.2627358","url":null,"abstract":"<p><p>To evaluate the associations and diagnostic performance of inflammatory markers derived from complete blood counts in patients with optic neuritis (ON) and central nervous system (CNS) demyelinating diseases. This retrospective cross-sectional study included 54 patients with ON, 43 patients with CNS demyelinating diseases without ON, and 50 age- and sex-matched healthy controls. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were compared across the groups. Univariate and multivariate logistic regression analyses were performed to assess associations with ON. Receiver operating characteristic (ROC) curves were used to determine diagnostic ability. NLR, PLR, MLR, SII, and SIRI were significantly higher in patients with ON than in controls (all <i>p</i> < .01). NLR achieved the highest area under the curve (AUC = 0.795; sensitivity 75.9%; specificity 72.0%), whereas SII provided the best sensitivity - specificity balance (AUC = 0.768; sensitivity 81.5%; specificity 76.0%). SIRI also demonstrated good discriminatory ability (AUC = 0.748; sensitivity 72.2%; specificity 60.0%). When comparing ON patients with the CNS demyelinating disease group, MLR and SIRI showed modest discrimination (AUC = 0.644 and 0.645, respectively). NLR, PLR, MLR, SII, and SIRI are accessible, inexpensive biomarkers that may support the diagnosis of ON and help identify patients with ON among those with CNS demyelinating diseases. SII provided the best sensitivity - specificity balance for discriminating ON from healthy controls, whereas SIRI may be particularly helpful in differentiating atypical from typical ON.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"344-354"},"PeriodicalIF":0.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation for Potential Inequities in Efficacy and Patient Outcomes Following Implementation of a STAT Outpatient Neuroimaging Pathway for Evaluation of Patients with Optic Disc Swelling.","authors":"Apurva Dev, Peng Huang, Florian H Guillot, Rohini Nadgir, Haris I Sair, Andrew R Carey, Michael G Carper, Amanda D Henderson","doi":"10.1080/01658107.2026.2620598","DOIUrl":"10.1080/01658107.2026.2620598","url":null,"abstract":"<p><strong>Introduction: </strong>Previously, our group piloted an outpatient STAT neuroimaging pathway for optic disc swelling patients, typically referred to the emergency department (ED) for urgent neuroimaging. The STAT pathway is an alternative facilitating urgent outpatient MRIs, avoiding significant ED wait times and costs without compromising clinical outcomes. This study assesses demographic and BMI-based inequities in STAT pathway efficacy and clinical outcomes.</p><p><strong>Methods: </strong>A retrospective chart review identified patients receiving STAT outpatient or ED-based neuroimaging for optic disc swelling between 2020 and 2024. Data were collected on demographics and clinical characteristics at presentation and latest follow-up and STAT MRI scheduling/completion. Univariate and bivariate analyses evaluated for demographic-based outcome differences among STAT patients and compared demographic characteristics of STAT and ED patients. Multivariate regressions examined predictors of changes in ophthalmologic measures over time.</p><p><strong>Results: </strong>We examined 50 STAT and 63 ED patients. Among STAT patients, females were relatively younger with higher BMIs, baseline VF MDs, and baseline RNFL thickness (<i>p</i> < .05 for all). Blacks were younger than whites (<i>p</i> < .01). There were no significant demographic or BMI-based differences in clinical outcomes or MRI scheduling/completion rates among STAT patients. Multivariate models revealed no significant predictors of changes in ophthalmologic measures over time for STAT patients. The STAT and ED cohorts had similar demographic profiles.</p><p><strong>Conclusions: </strong>Overall, there were no demographic variations in outcomes or MRI scheduling/completion rates or differences in the demographic composition between the STAT and ED cohorts. These findings support the STAT protocol as an equitable alternative to ED-based care for a subgroup of patients with optic disc swelling.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 3","pages":"248-254"},"PeriodicalIF":0.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Papillitis and Unilateral Central Serous Retinopathy Associated with Dabrafenib and Trametinib Use in Metastatic Cutaneous Melanoma.","authors":"Andrew Mihalache, Ryan S Huang, Kenneth T Eng, Rahul A Sharma, Edsel Ing, Arun N E Sundaram","doi":"10.1080/01658107.2025.2549896","DOIUrl":"10.1080/01658107.2025.2549896","url":null,"abstract":"<p><p>Targeted BRAF/MEK inhibitor therapies have improved survival outcomes for patients with BRAF V600-positive cutaneous melanoma. However, rare neuro-ophthalmic complications attributed to these therapies warrant heightened clinical vigilance. We describe a distinct case of bilateral optic disc oedema and unilateral central serous chorioretinopathy induced by dabrafenib and trametinib in a 79-year-old male undergoing treatment for metastatic cutaneous melanoma. Three months after starting BRAF/MEK inhibitor therapy, the patient developed progressive, painless central vision loss OD and transient blurry vision OS. Clinical examination excluded uveitis and conditions such as Vogt-Koyanagi Harada syndrome, while contrast-enhanced magnetic resonance imaging revealed no optic nerve or chiasm abnormalities. Following prompt discontinuation of dabrafenib and trametinib, along with the initiation of oral prednisone, the patient's visual acuity significantly improved over three weeks, accompanied by resolution of optic disc oedema. At two months of follow-up, visual acuity remained stable, with complete resolution of optic disc oedema and no symptom recurrence. This case emphasises the importance of early recognition, prompt drug discontinuation, and timely corticosteroid administration to optimise visual prognosis in this setting.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"393-396"},"PeriodicalIF":0.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal Neovascular Membrane Formation in Idiopathic Intracranial Hypertension: A Scoping Review.","authors":"Ben Smith","doi":"10.1080/01658107.2025.2608259","DOIUrl":"https://doi.org/10.1080/01658107.2025.2608259","url":null,"abstract":"<p><p>Choroidal neovascular membrane (CNVM) formation is an uncommon but vision-threatening complication of idiopathic intracranial hypertension (IIH). While papilledema and optic neuropathy are recognized sequelae of raised intracranial pressure (ICP), the relationship between CNVM and conventional markers of disease severity remains unclear. A literature search of PubMed, Embase, and Scopus was conducted to identify published cases of CNVM in IIH. Case-level data were extracted where available, including ICP, intraocular pressure (IOP) and Frisén papilledema grade. Quantitative and narrative synthesis were performed. Forty patients (43 eyes) were identified across 26 publications. Twenty-three patients contributed extractable case-level data. CNVM occurred across a wide range of ICP values (25-40 cmH₂O) and papilledema severity (Frisén grades 1-4), without evidence of a dose-response relationship. Nearly half of patients developed CNVM at ICP ≤ 30 cmH₂O, and over a quarter had only grade 1 papilledema. CNVM in IIH arises independently of extreme ICP or papilledema, suggesting local biomechanical, vascular, or inflammatory factors contribute. Clinicians should remain vigilant for CNVM even in apparently moderate disease. These findings highlight the need for modeling and prospective studies to define predictive mechanisms and improve surveillance strategies.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 2","pages":"118-124"},"PeriodicalIF":0.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripapillary Choroidal Neovascular Membrane (P-CNVM) in Idiopathic Intracranial Hypertension (IIH): Clinical Profile and Outcomes at a Neuro-Ophthalmic Care Centre.","authors":"Rohan Nalawade, Sampada Kulkarni, Amol Bansal, Brijesh Takkar, Virender Sachdeva","doi":"10.1080/01658107.2025.2594609","DOIUrl":"10.1080/01658107.2025.2594609","url":null,"abstract":"<p><p>To report the clinical profile and outcomes of Peripapillary choroidal neovascular membrane (p-CNVM) in patients with idiopathic intracranial hypertension (IIH): at a neuro-ophthalmic care centre. We retrospectively studied records of IIH patients who developed pCNVM seen at our institute from January 1, 2016 to January 1, 2023. Data was collected regarding demographics, body mass index (BMI), Cerebrospinal fluid (CSF) opening pressure, fundus photographs, fluorescein angiography FFA, indocyanine green angiography (ICGA), optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A), treatment given and outcomes. 7 patients (9 eyes, all women, median age: 30.5 years) met the study criteria. Median BMI was 34.2 kg/m2. Median CSF opening pressure was 33.0 cm H2O. Median time from papilledema diagnosis to CNVM formation was 6.5 (IQR: 4.5-12.25) months. All patients were treated with intravitreal anti-VEGF and acetazolamide. Best corrected Visual acuity (logMAR) worsened in the right eye slightly from, 0.50 (IQR: 0.15-0.90) logMAR at presentation to 0.90 (IQR: 0.57-1.00) LogMAR at final visit. The left eye showed minimal improvement in BCVA from 0.65 (IQR: 0.28-0.95) to 0.37 (IQR: 0.18-0.85) logMAR. One patient underwent shunt surgery, while another needed optic nerve sheath fenestration for IIH. CNVM either resolved completely or was resolving in all patients, while papilledema showed resolution in all patients except one. Peripapillary Type 2 CNVM is an infrequent but significant complication of IIH, Multimodal imaging-including OCT, FFA and ICGA helps in diagnosis and monitoring. We recommend continued that acetazolamide treatment along with concurrent anti-VEGF treatment helps in managing both IIH and pCNVM.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 3","pages":"239-247"},"PeriodicalIF":0.8,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Demographic Predictors of Optic Neuritis Subtype.","authors":"Noreen F Khan, Etienne Benard-Seguin, Derek Waldner, Abdullah Al-Ani, Lizbeth Gonzalez, Patrice M Hicks, Yue Pan, Fiona Costello, Lindsey B De Lott","doi":"10.1080/01658107.2025.2588667","DOIUrl":"10.1080/01658107.2025.2588667","url":null,"abstract":"<p><p>To determine which clinical features differentiate acute optic neuritis (ON) subtypes to support treatment decision-making in patients when the diagnostic work-up is incomplete or inconclusive. We performed a retrospective study at two academic centers. ON was classified as idiopathic/multiple sclerosis-associated (I/MS-ON; also known as \"typical\" ON) versus non-I/MS-ON (e.g. neuromyelitis optica; also known as \"atypical\" ON). Multiple linear regression models assessed the association between ON subtype and clinical features including: demographics, presence of optic disc edema, bilaterality (simultaneous ON involving both eyes), and baseline visual acuity (logMAR). Sensitivity analyses examined the impact of incomplete race/ethnicity data on subtype. Among 614 episodes (518 patients), most ON events (<i>n </i>= 440, 85%) were I/MS-ON. In univariate analyses, bilaterality (OR 6.67 [95%CI 3.7,11.11]), presence of optic disc edema (OR 2.22 [95%CI 1.32,3.70]), and age (OR 1.32 [95%CI 1.08,1.61] for each decade) were significantly associated with higher odds of having non-I/MS-ON compared to I/MS-ON. In multiple logistic regression modeling, each decade of life (OR 1.35 [95%CI 1.06,1.69]), bilaterality (OR 7.69 [95%CI 4.17,14.29]), and each point increase in baseline logMAR (OR 1.47 [95%CI 1.11,1.92]) were associated with increased odds of having non-I/MS-ON compared to I/MS-ON. In sensitivity analyses, age no longer significantly predicted ON subtype. When considering multiple clinical factors, bilateral simultaneous ON and worse baseline visual acuity were significantly associated with non-I/MS-ON. Older age may also be associated with non-I/MS-ON, but additional studies are needed. These observations may guide decision-making in patients with ON, in which diagnostic testing is incomplete or inconclusive.</p>","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 3","pages":"231-238"},"PeriodicalIF":0.6,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}