Isolated optic nerve, chiasm, and tract involvement in Bing-Neel Syndrome.

Central nervous system infiltration of Waldenström's macroglobulinemia is referred to as Bing-Neel Syndrome. We describe 2 patients whose clinical presentation was due to isolated involvement of the anterior visual pathways. The mechanism of visual failure in Bing-Neel Syndrome may involve both infiltrative and autoimmune processes.

Lesions of the optic nerve.

As experts on the central nervous system, neurologists are expected to be familiar with the many conditions that can result in visual loss arising from lesions of the optic nerve. The optic nerves are unique central nervous system structures in terms of surrounding anatomy, size, location, and blood supply; therefore, they are uniquely vulnerable to every pathological process that can affect the central and peripheral nervous systems, including inflammation, ischemia, compression, infiltration, toxic or hereditary metabolic dysfunction, trauma, and mechanical damage. This chapter highlights the importance of being able to identify the historical and clinical features that will enable neurologists to narrow down the broad differential diagnosis of optic nerve lesions.

Nonarteritic anterior ischemic optic neuropathy.

Currently there is no generally accepted, well-proven treatment for nonarteritic anterior ischemic optic neuropathy (NAION). Most proposed treatments are empirical and include antithrombotics, vasodynamic agents, treatments aimed at reducing optic disc edema, and various neuroprotective strategies. Most potential treatments have been inadequately studied, prematurely embraced, or prematurely discarded.

Treatment of nonarteritic anterior ischemic optic neuropathy.

Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common clinical presentation of acute ischemic damage to the optic nerve. Most treatments proposed for NAION are empirical and include a wide range of agents presumed to act on thrombosis, on the blood vessels, or on the disk edema itself. Others are presumed to have a neuroprotective effect.

Risk factors for idiopathic intracranial hypertension in men: a case-control study.

Objective: To identify risk factors for idiopathic intracranial hypertension (IIH) in men.

Design: Case-control study. A 96-item telephone questionnaire, answered retrospectively, with cases recalling at the age of their diagnosis and controls recalling at the age of their corresponding case's diagnosis.

Management of optic neuritis and impact of clinical trials: an international survey.

Objective: 1) To evaluate the management of acute isolated optic neuritis (ON) by ophthalmologists and neurologists; 2) to evaluate the impact of clinical trials; 3) to compare these practices among 7 countries.

Methods: A survey on diagnosis and treatment of acute isolated ON was sent to 5,443 neurologists and 6,099 ophthalmologists in the southeast-USA, Canada, Australia/New Zealand, Denmark, France, and Thailand. USA data were compared to those of other countries.

Post-traumatic visual loss.

Visual loss following head trauma is common, and the diagnosis can be challenging for the neurologist called to perform an emergency room assessment. The approach to the patient with post-traumatic visual loss is complicated by a wide range of potential ocular and brain injuries with varying pathophysiology. In addition to direct injuries of the eye and orbit, traumatic optic neuropathies, carotid cavernous fistulas, and damage to the intracranial visual pathways are classic causes of visual loss after head trauma.

Management of optic neuritis in Canada: survey of ophthalmologists and neurologists.

Background: Acute isolated optic neuritis is often the first manifestation of multiple sclerosis (MS), and its management remains controversial. Over the past decade, with the advent of new disease-modifying agents, management of isolated optic neuritis has become more complicated.

Objectives: To evaluate the current practice patterns of Canadian ophthalmologists and neurologists in the management of acute optic neuritis, and to evaluate the impact of recently published randomized clinical trials.

Optic neuritis.

Optic neuritis is a common cause of visual loss in young patients. Visual function generally spontaneously improves over weeks, and 95% of patients return to visual acuity of at least 20/40 within 12 months. The initial magnetic resonance imaging (MRI) helps stratify the risk of multiple sclerosis in patients with acute isolated optic neuritis.

The natural history of optic neuritis.

Optic neuritis is a common cause of visual loss in young patients, typically presenting with painful monocular visual loss and decreased color vision. Visual function generally spontaneously improves over weeks, and 95% of patients return to visual acuity of at least 20/40 within 12 months. The initial magnetic resonance imaging (MRI) helps stratify the risk of multiple sclerosis (MS) in patients with acute isolated optic neuritis.