{"title":"Symptomatic Treatment of Neuro-ophthalmic Visual Disturbances.","authors":"Sachin Kedar","doi":"10.1212/CON.0000000000001562","DOIUrl":"https://doi.org/10.1212/CON.0000000000001562","url":null,"abstract":"<p><strong>Objective: </strong>Neuro-ophthalmic deficits can significantly impair quality of life. This article reviews neuro-ophthalmic symptoms and their impact on activities of daily living and discusses therapies that can improve quality of life.</p><p><strong>Latest developments: </strong>Loss of central vision, peripheral visual field deficits, and diplopia can result in loss of driving privileges, restricted ambulation, impaired reading, and poor social interaction. Poor vision is associated with worse cognition and mental health deterioration in older patients, which can be reversed by ophthalmic interventions such as cataract surgery. Ophthalmic conditions such as dry eye syndrome and convergence insufficiency are common in patients with neurologic diseases such as Parkinson disease and can affect daily activities such as reading and watching television. Low-vision occupational therapy can improve quality of life by helping patients adjust to visual disturbances from neuro-ophthalmic disorders. Vision-related quality of life is an important outcome measure in studies of neuro-ophthalmic diseases. It is most frequently measured using the National Eye Institute Visual Function Questionnaire.</p><p><strong>Essential points: </strong>Neurologists should screen vision, visual symptoms, and vision-related quality of life when managing patients with neurologic diseases. Patients must be encouraged to consult an eye care provider to manage common ophthalmic conditions such as refractive error, dry eyes, and cataracts. Neurologists should partner with low-vision occupational therapy services to improve vision, cognition, mental health, and quality of life in patients with these conditions.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"566-582"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postreading Self-Assessment and CME Test.","authors":"Douglas J Gelb, Adam Kelly","doi":"10.1212/CON.0000000000001547","DOIUrl":"https://doi.org/10.1212/CON.0000000000001547","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"603-614"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Key Points for Issue.","authors":"","doi":"10.1212/01.cont.0001110764.63401.62","DOIUrl":"https://doi.org/10.1212/01.cont.0001110764.63401.62","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Papilledema.","authors":"Susan P Mollan","doi":"10.1212/CON.0000000000001556","DOIUrl":"https://doi.org/10.1212/CON.0000000000001556","url":null,"abstract":"<p><strong>Objective: </strong>This article describes the recognition, investigation, and management of papilledema.</p><p><strong>Latest developments: </strong>Papilledema describes optic disc swelling (usually bilateral) arising from raised intracranial pressure. Due to the serious nature of papilledema, there is a fear of underdiagnosis and hence one of the major stumbling points is the correct identification of papilledema. While there has been a stepwise increase in the incidence and prevalence of idiopathic intracranial hypertension due to the worldwide epidemic of people living with obesity, secondary causes such as cerebral venous sinus thrombosis, intracranial masses, and infections must not be missed. Our ability to image the optic nerve has been greatly enhanced by the directed use of optical coherence tomography, with recent studies observing novel imaging findings that can help distinguish pseudopapilledema from papilledema. The structured investigation of papilledema is now routine and research into the management of CSF disorders is finding new avenues for targeted treatments.</p><p><strong>Essential points: </strong>Confirmation of papilledema typically requires a thorough ocular examination including visual field testing. Ocular imaging such as color fundus photographs and optical coherence tomography are useful. Joint care between ophthalmologists and neurologists is key to treating the underlying condition and managing any visual dysfunction and headache.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"436-462"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ocular Imaging and Electrophysiology.","authors":"Robert M Mallery","doi":"10.1212/CON.0000000000001543","DOIUrl":"https://doi.org/10.1212/CON.0000000000001543","url":null,"abstract":"<p><strong>Objective: </strong>This article describes how ocular imaging techniques and electrophysiology studies aid in the localization, diagnosis, and management of disorders affecting vision.</p><p><strong>Latest development: </strong>The retina and optic nerve are functionally and embryologically part of the central nervous system, and they are the exceptional parts of the brain that can be directly examined by the neurologist or ophthalmologist (through the fundus examination). Ocular imaging techniques including fundus photography, optical coherence tomography (OCT), retinal angiography, and orbital ultrasound allow more detailed assessments of the retina and optic nerve. In some settings, nonmydriatic fundus photography can provide more accurate assessments than direct ophthalmoscopy. OCT allows high-resolution imaging of retinal and optic nerve structures. Combined with automated segmentation algorithms to allow for the measurement of retinal nerve fiber layer and macular ganglion cell layer thicknesses, clinicians and investigators can determine how these layers are affected in optic neuropathies and some neurodegenerative disorders. Electrophysiologic studies provide complementary information to ocular imaging modalities. Electroretinography assesses the function primarily of photoreceptor rods and cones, whereas visual evoked potentials assess primarily optic nerve function.</p><p><strong>Essential points: </strong>Ocular imaging and electrophysiology techniques aid in diagnosing and managing neuro-ophthalmic disorders and are increasingly accessible to neurologists.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"356-380"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Eyes Have It.","authors":"Lyell K Jones","doi":"10.1212/cont.0000000000001588","DOIUrl":"https://doi.org/10.1212/cont.0000000000001588","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"326-327"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Supranuclear Disorders of Eye Movements.","authors":"Gregory P Van Stavern","doi":"10.1212/CON.0000000000001558","DOIUrl":"https://doi.org/10.1212/CON.0000000000001558","url":null,"abstract":"<p><strong>Objective: </strong>This article reviews the basic anatomy and pathophysiology of the supranuclear ocular motor pathways, emphasizing clinical correlations.</p><p><strong>Latest developments: </strong>More advanced neuroimaging, particularly functional MRI, has yielded insight into previously unclear mechanisms of eye movement control with potential clinical implications. A better understanding of the mechanisms of eye movement control has implications for translational research, resulting in improved and early diagnosis and better treatment options.</p><p><strong>Essential points: </strong>Dysfunction of the supranuclear ocular motor pathways typically causes highly localizable deficits. With relative ease of access to sophisticated neuroimaging, it is critical to better understand structure-function relationships and precisely localize pathology within the brain. Accurately localizing a lesion in the supranuclear ocular motor pathways might prevent delay in diagnosis and misdiagnosis, and in some cases allow for early recognition of neurodegenerative diseases.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"479-502"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Approach to Vision Loss.","authors":"Nancy J Newman, Valérie Biousse","doi":"10.1212/CON.0000000000001546","DOIUrl":"https://doi.org/10.1212/CON.0000000000001546","url":null,"abstract":"<p><strong>Objective: </strong>Diagnosing and differentiating among the many possible localizations and causes of vision loss is an essential skill for neurologists. This article outlines the examination of the eye and visual pathways and the differential diagnosis of pathophysiologic processes that can affect visual function.</p><p><strong>Latest developments: </strong>The eyes, optic nerves, and intracranial pathways of vision account for more than one-third of the volume of the human brain, and patients with vision loss are commonly seen by both eye care specialists and neurologists. A basic examination of the eye and visual pathways allows the neurologist to localize the abnormality causing the vision impairment and generate a differential diagnosis of the potential pathophysiologic processes that can cause a vision problem at that particular location. Neurologists should be aware of the many ocular causes of vision loss and recognize when a visual problem is not the result of an optic neuropathy or brain parenchymal lesion. The standard bedside examination of the visual system can be augmented using specialized ancillary testing of visual pathway structure and function, which is most often the purview of eye care specialists, although portable instruments such as small visual field machines and nonmydriatic ocular fundus imaging can be easily used in hospitals and neurology clinics.</p><p><strong>Essential points: </strong>The approach to vision loss should include a history and examination geared toward localization, followed by a differential diagnosis based on the likely location of the pathophysiologic process. Coordinated care between neurologists and eye care specialists is essential for patients with optic neuropathy or other lesions of the intracranial pathways.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"328-355"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SELF-ASSESSMENT AND CME.","authors":"","doi":"10.1212/CON.0000000000001549","DOIUrl":"https://doi.org/10.1212/CON.0000000000001549","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"601"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
