MyMedR

Fulltext Bilateral optic neuritis with maculopathy: A rare manifestation of dengue fever

Boo YL, Lim SY, Chin PW, Hoo FK

Malays Fam Physician, 2017;12(1):32-34.

Dengue fever is a common mosquito-borne disease, which is endemic in tropical and subtropical countries. Bilateral optic neuropathy is a relatively unusual dengue-related ocular complication. Here, we present a case of bilateral optic neuritis with maculopathy complicating dengue infection.

Matched MeSH terms: Optic Nerve Diseases

Fulltext Glaucomatous neurodegeneration: an eye on tumor necrosis factor-alpha

Agarwal R, Agarwal P

Indian J Ophthalmol, 2012 Jul;60(4):255-61.

PMID: 22824592 DOI: 10.4103/0301-4738.98700

Glaucoma, a neurodegenerative disease, is currently being treated by modulation of one of its primary risk factors, the elevated intraocular pressure. Newer therapies that can provide direct neuroprotection to retinal ganglion cells are being extensively investigated. Tumor necrosis factor-α, a cytokine, has been recognized to play an important role in pro and antiapoptotic cellular events. In this paper we review the relevant literature to understand (1) The association of increased expression of tumor necrosis factor-α with glaucomatous neurodegeneraion, (2) Modulation of tumor necrosis factor-α expression by exposure to various risk factors of glaucoma, (3) Downstream cellular signaling mechanisms following interaction of tumor necrosis factor-α with its receptors and (4) Role of tumor necrosis factor-α as a possible target for therapeutic intervention in glaucoma. Literature was reviewed using PubMed search engine with relevant key words and a total of 82 English language papers published from 1990 to 2010 are included in this review.

Matched MeSH terms: Optic Nerve Diseases/etiology*; Optic Nerve Diseases/metabolism; Optic Nerve Diseases/pathology

Combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without detectable systemic infection

Ooi YL, Tai LY, Subrayan V, Tajunisah I

Ocul Immunol Inflamm, 2011 Oct;19(5):370-2.

PMID: 21834697 DOI: 10.3109/09273948.2011.594203

To report a rare case of combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without systemic infection.

Matched MeSH terms: Optic Nerve Diseases/diagnosis*; Optic Nerve Diseases/drug therapy; Optic Nerve Diseases/microbiology

Meningioma Mimicking Fibrous Dysplasia

Kamaluddin NA, Samsudin AHZ, Wan Hitam WH, Ibrahim M

Cureus, 2019 Sep 27;11(9):e5782.

PMID: 31723541 DOI: 10.7759/cureus.5782

Despite being among the common primary intracranial tumors, intraosseous craniofacial meningioma is the least common subtype of meningioma accounting for only 1-2% of intracranial meningiomas. Interestingly, it can display clinical and radiologic features that can be confused for fibrous dysplasia. Scan imaging and biopsy are crucial for the diagnosis as well as for further proper treatment. We report a case of unilateral eye proptosis and optic neuropathy which was initially thought for fibrous dysplasia. Later the histopathology revealed meningioma grade 1. As the clinical presentations are almost undifferentiated, diagnosis and further prompt treatment are challenging.

Matched MeSH terms: Optic Nerve Diseases

MRI of optic tract lesions: review and correlation with visual field defects

Fadzli F, Ramli N, Ramli NM

Clin Radiol, 2013 Oct;68(10):e538-51.

PMID: 23932674 DOI: 10.1016/j.crad.2013.05.104

Visual field defects are a conglomerate of patterns of visual impairment derived from diseases affecting the optic nerve as it extends from the globe to the visual cortex. They are complex signs requiring perimetry or visual confrontation for delineation and are associated with diverse aetiologies. This review considers the chiasmatic and post-chiasmatic causes of visual disturbances, with an emphasis on magnetic resonance imaging (MRI) techniques. Newer MRI sequences are considered, such as diffusion-tensor imaging. MRI images are correlated with perimetric findings in order to demonstrate localization of lesions in the visual pathway. This may serve as a valuable reference tool to clinicians and radiologists in the early diagnostic process of differentiating causes of various visual field defects in daily practice.

Matched MeSH terms: Optic Nerve Diseases/diagnosis*; Optic Nerve Diseases/pathology

Fulltext Optic nerve involvement as a first manifestation of acute lymphoblastic leukaemia after remission

Peyman M, Hieng TL, Subrayan V

BMJ Case Rep, 2011;2011.

PMID: 22698906 DOI: 10.1136/bcr.11.2010.3517

Matched MeSH terms: Optic Nerve Diseases/etiology*; Optic Nerve Diseases/pathology

Optic nerve involvement in nasopharyngeal carcinoma

Prasad U, Doraisamy S

Eur J Surg Oncol, 1991 Oct;17(5):536-40.

PMID: 1936303

Five rare cases of nasopharyngeal carcinoma with optic nerve involvement are reported. Computerised Tomographic Scan (CT Scan) studies were performed in four of them. Evidence of intracranial spread of the tumour, from the roof of the fossa of Rosenmuller to the apex of the orbit through the cavernous sinus, was noted in three patients. In one of them there was extracranial extension of the tumour, to the orbit through the posterior ethmoid.

Matched MeSH terms: Optic Nerve Diseases/pathology*; Optic Nerve Diseases/radiography

Fulltext Severe diabetic papillopathy mimicking non-arteritic anterior ischemic optic neuropathy (NAION) in a young patient

Mallika PS, Salowi MA, Thanaraj A, Chong MS, Tan AK, Chua CN

Med J Malaysia, 2012 Apr;67(2):228-30.

PMID: 22822654 MyJurnal

With the pathophysiology not clearly understood and fewer than 130 cases having been reported in the literature, diabetic papillopathy presents a special challenge to the ophthalmologist. We report a case of a young patient with more than 12 years of type 1 diabetes mellitus (T1DM) on insulin with poor compliance to treatment who presented with sudden bilateral loss of vision. Ocular examination, fluorescence angiography (FA) and systemic signs were conclusive of diabetic papillopathy. His fasting blood sugar level was high and serum glycosylated haemoglobin (HbA1c) indicated a long term fluctuating blood glucose control. His vision initially improved with treatment, but later deteriorated with tight glycemic control.

Matched MeSH terms: Optic Nerve Diseases/diagnosis*; Optic Nerve Diseases/pathology

Fulltext Recent advance s in pathophysiology and pharmacotherapy of glaucoma

Agarwal R

Medical Health Reviews, 2009;2009(1):75-93.

MyJurnal

Glaucoma, recognized as optic neuropathy is the second largest cause of blindness worldwide. The disease is characterized by progressive loss of retinal ganglion cells and visual field defects. The pathophysiological factors involved in the onset and progression of glaucoma are not fully understood. However, it is now well accepted that elevated intraocular pressure is not the only causative factor. The pathophysiology of glaucoma involves multiple factors that interact in a highly complex manner to favor development of glaucomatous optic neuropathy. As the knowledge of molecular mechanisms involved is expanding, more and more therapeutic targets are being recognized for the development of safe and effective pharmacotherapy of glaucoma. Although at present the intraocular pressure lowering drugs are still the first line of treatment, the prospect of introducing neuroprotective therapies that can directly protect and perhaps stimulate regeneration of dying and dead retinal ganglion cells, shows considerable promise. This review presents recent developments in the pathophysiology and pharmacotherapy of glaucoma.

Matched MeSH terms: Optic Nerve Diseases

Optic disc swelling in acromicric and geleophysic dysplasia

Moey LH, Flaherty M, Zankl A

Am J Med Genet A, 2019 09;179(9):1898-1901.

PMID: 31228225 DOI: 10.1002/ajmg.a.61268

Matched MeSH terms: Optic Nerve Diseases/drug therapy*; Optic Nerve Diseases/genetics; Optic Nerve Diseases/pathology

Fulltext Endoscopic orbital decompression for optic neuropathy in thyroid ophthalmopathy

Tang IP, Prepageran N, Subrayan V, Tajunisah I

Med J Malaysia, 2008 Oct;63(4):337-8.

PMID: 19385499 MyJurnal

Optic neuropathy, an uncommon manifestation occurs in 5% of patients with Graves' ophthalmopathy. Its outcome is good if early and proper treatment given. We reported a 49 years old male patient of Graves' disease with bilateral optic neuropathy. He underwent bilateral transnasal endoscopic orbital decompression with marked improvement of visual acuity bilaterally. The preoperative visual acuity was 6/36 in his right eye and 6/60 in his left eye. Two days after operation, his visual acuity was 6/12 in his right eye and 6/24 in his left eye. Transnasal endoscopic orbital decompression is a choice of treatment in optic neuropathy in thyroid ophthalmopathy after trial of corticosteroids.

Matched MeSH terms: Optic Nerve Diseases/surgery*

Colloid cyst of third ventricle mimicking normal tension glaucoma

Patel DK, Ali NA, Iqbal T, Subrayan V

Ann Ophthalmol (Skokie), 2008;40(3-4):177-9.

PMID: 19230359

Colloid cysts are rare intracranial tumors most commonly found in the third ventricle. We present a case of colloid cyst of the third ventricle that manifested as bilateral advance optic disc cupping, superior hemifield defects in the visual fields and normal intraocular pressure.

Matched MeSH terms: Optic Nerve Diseases/diagnosis*

Glaucoma severity affects diffusion tensor imaging (DTI) parameters of the optic nerve and optic radiation

Sidek S, Ramli N, Rahmat K, Ramli NM, Abdulrahman F, Tan LK

Eur J Radiol, 2014 Aug;83(8):1437-41.

PMID: 24908588 DOI: 10.1016/j.ejrad.2014.05.014

To evaluate whether MR diffusion tensor imaging (DTI) of the optic nerve and optic radiation in glaucoma patients provides parameters to discriminate between mild and severe glaucoma and to determine whether DTI derived indices correlate with retinal nerve fibre layer (RNFL) thickness.

Matched MeSH terms: Optic Nerve Diseases/pathology*

Determinants of the optic cup to disc ratio in an Asian population: the Singapore Malay Eye Study (SiMES)

Amerasinghe N, Wong TY, Wong WL, Mitchell P, Shen SY, Loon SC, et al.

Arch. Ophthalmol., 2008 Aug;126(8):1101-8.

PMID: 18695105 DOI: 10.1001/archopht.126.8.1101

To describe the distribution and determinants of the optic cup to disc ratio (CDR) in Malay adults in Singapore.

Matched MeSH terms: Optic Nerve Diseases/ethnology; Optic Nerve Diseases/genetics*

Difference in glaucoma progression between the first and second eye after consecutive bilateral glaucoma surgery in patients with bilateral uveitic glaucoma

Din NM, Talat L, Isa H, Tomkins-Netzer O, Barton K, Lightman S

Graefes Arch Clin Exp Ophthalmol, 2016 Dec;254(12):2439-2448.

PMID: 27495303

PURPOSE: To determine whether the second eyes (SE) of patients with bilateral uveitic glaucoma undergoing filtration surgery have more glaucomatous progression in terms of visual acuity, visual field (VF) and optic nerve changes compared to the first eyes (FE).

METHODS: This retrospective study analysed data of 60 eyes from 30 patients with bilateral uveitic glaucoma who had undergone glaucoma surgery in both eyes on separate occasions. Humphrey VF progression was assessed using the Progressor software.

RESULTS: The pre-operative IOP between the FE (43.1 ± 7.7 mmHg) and SE (40 ± 8.7 mmHg) was not statistically significant (p = 0.15). IOP reduction was greater in the FE (64 %) than SE (59.7 %) post-operatively, but the mean IOP at the final visit in the FE (12.3 ± 3.9 mmHg) and SE (14.5 ± 7 mmHg) was not statistically different (p = 0.2). There was no significant change in mean logMAR readings pre and post-operatively (0.45 ± 0.6 vs 0.37 ± 0.6, p = 0.4) or between the FE and SE. The number of SE with CDR > 0.7 increased by 23 % compared to the FE. From 23 available VFs, five SE (21.7 %) progressed at a median of five locations (range 1-11 points) with a mean local slope reduction of 1.74 ± 0.45 dB/year (range -2.39 to -1.26), whereas only one FE progressed. However, there was no significant difference between mean global rate of progression between the FE (-0.9 ± 1.6 dB/year) and SE (-0.76 ± 2.1 dB/year, p = 0.17) in the Humphrey VF.

CONCLUSION: In eyes with bilateral uveitic glaucoma requiring glaucoma surgery, the SEs had more progressed points on VF and glaucomatous disc progression compared to FEs at the final visit.

Matched MeSH terms: Optic Nerve Diseases/diagnosis; Optic Nerve Diseases/etiology

Fulltext Monsoon and primary acute angle closure in Malaysia

Ch'ng TW, Mosavi SA, Noor Azimah AA, Azlan NZ, Azhany Y, Liza-Sharmini AT

Med J Malaysia, 2013 Oct;68(5):410-4.

PMID: 24632871 MyJurnal

INTRODUCTION: Acute angle closure (AAC) without prompt treatment may lead to optic neuropathy. Environmental factor such as climate change may precipitate pupillary block, the possible mechanism of AAC.

OBJECTIVE: To determine the association of northeast monsoon and incidence of AAC in Malaysia.

MATERIALS AND METHODS: A retrospective study was conducted on AAC patients admitted to two main tertiary hospitals in Kelantan, Malaysia between January 2001 and December 2011. The cumulative number of rainy day, amount of rain, mean cloud cover and 24 hours mean humidity at the estimated day of attack were obtained from the Department of Meteorology, Malaysia.

RESULTS: A total 73 cases of AAC were admitted with mean duration of 4.1SD 2.0 days. More than half have previous history of possibility of AAC. There was higher incidence of AAC during the northeast monsoon (October to March). There was also significant correlation of number of rainy day (r=0.718, p<0.001), amount of rain (r=0.587, p<0.001), cloud cover (r=0.637, p<0.001), mean daily global radiation (r=- 0.596, P<0.001), 24 hours mean temperature (r=-0.298, p=0.015) and 24 hours mean humidity (r=0.508, p<0.001) with cumulative number of admission for AAC for 12 calendar months.

CONCLUSION: Higher incidence of AAC during northeast monsoon suggested the effect of climate as the potential risk factor. Prompt treatment to arrest pupillary block and reduction of the intraocular pressure is important to prevent potential glaucomatous damage. Public awareness of AAC and accessibility to treatment should be part of preparation to face the effect of northeast monsoon.

Matched MeSH terms: Optic Nerve Diseases

Fulltext Clinical presentation, severity and progression of primary angle closure in malay and chinese patients

Liza-Sharmini AT, Ng GF, Nor-Sharina Y, Khairil Anuar MI, Nik Azlan Z, Azhany Y

Med J Malaysia, 2014 Dec;69(6):245-51.

PMID: 25934953 MyJurnal

OBJECTIVE: To compare the clinical presentation, severity and progression of primary angle closure between Chinese and Malays residing in Malaysia.

METHODS: A comparative retrospective record review study was conducted involving one hundred (200 eyes) Malay and fifty eight (116 eyes) Chinese patients. They were selected from medical records of Hospital Universiti Sains Malaysia, Kelantan and Hospital Pulau Pinang, Penang, Malaysia. The selected patients were re-diagnosed based on the International Society of Geographical and Epidemiological classification. The clinical data on presentation including the presence of systemic diseases were documented. Progression of the disease was based on available reliable visual fields and optic disc changes of patients who have been on follow-up for at least five years.

RESULTS: Malay patients presented at older age (61.4 years SD 8.4) compared to Chinese (60.6 years SD 8.3). There was significant higher baseline Intraocular Pressure (IOP) among Malays (34.7 SD 18.5mmHg) compared to Chinese (30.3 SD 16.7mmHg) (p=0.032). The Chinese patients presented with significantly better visual acuity (p<0.001) and less advanced cup to disc changes (p=0.001) compared to Malays. Malay patients progressed faster than the Chinese. Majority progressed within 1 year of diagnosis. Malays without laser peripheral iridotomy (LPI) have a 4 fold (95% CI 1.4, 10.9) risk of progression. Higher baseline IOP, more advanced visual field defect and absence of LPI was identified as significant predictors associated with progression.

CONCLUSION: The Malays presented with more advanced angle closure glaucoma as compared to the Chinese in Malaysia. Aggressive disease progression was observed in Malays with the onset of optic neuropathy. Effective public awareness and aggressive management is important to prevent blindness in the Malaysian population.

Matched MeSH terms: Optic Nerve Diseases

Fulltext Good Visual Outcome Following Corticosteroid Treatment for Compressive Optic Neuropathy Secondary to Sinonasal Carcinoma

Mohammad Razali A, Mohd Zain A, Bt Wan Abdul Halim WH, Md Din N

Cureus, 2020 Apr 18;12(4):e7732.

PMID: 32440379 DOI: 10.7759/cureus.7732

Most patients with sinonasal carcinoma present to the otorhinolaryngologist with nasal symptoms. It is however uncommon for them to present with acute visual loss at first presentation. We report a case of compressive optic neuropathy secondary to sinonasal carcinoma, which presented acutely with right eye blurring of vision upon waking up. Computed tomography (CT) of the brain and orbit with contrast showed a locally invasive nasopharyngeal mass extending into the right orbit and cranial fossa. Histopathological examination revealed squamous cell sinonasal carcinoma. Her visual acuity improved with a three-day course of pulsed intravenous methylprednisolone 1 g per day, followed by a gradual tapering dose of oral prednisolone (1 mg/kg/day).

Matched MeSH terms: Optic Nerve Diseases

Evaluation of peripapillary retinal nerve fiber layer thickness in myopic eyes by spectral-domain optical coherence tomography

Mohammad Salih PA

J Glaucoma, 2012 Jan;21(1):41-4.

PMID: 21173707 DOI: 10.1097/IJG.0b013e3181fc8053

To investigate the influence of myopia on peripapillary retinal nerve fiber layer (RNFL) thickness using Cirrus optical coherence tomography (OCT) in normal eyes.

Matched MeSH terms: Optic Nerve Diseases/diagnosis*

Fulltext Irreversible visual loss and optic nerve dysfunction associated with central retinal vein occlusion in Waldenstrom Macroglobulinemia

Fadilah SA, Muhaya M, Azlin I

Med J Malaysia, 2007 Oct;62(4):349-51.

PMID: 18551947 MyJurnal

Irreversible optic nerve dysfunction associated with central retinal vein occlusion (CRVO) is an unusual but important complication of Waldenstrom Macroglobulinemia (WM). Acute visual loss in CRVO is mainly due the severe macular oedema. However, ischaemic optic neuropathy needs to be considered in patients with CRVO when, (i) there is a relative afferent papillary defect and central scotoma, (ii) the visual acuity is not consistent with the retinal pathology, and (iii) the visual defects persisted despite resolution of macular oedema following treatment of the hyperviscosity state. The ischaemic type of CRVO is associated with a poor visual prognosis and the presenting visual acuity has a prognostic role. We report the first description of irreversible unilateral optic nerve damage associated with CRVO in a patient with WM.

Matched MeSH terms: Optic Nerve Diseases/complications*; Optic Nerve Diseases/therapy

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