Diagnostic dilemma: Leber's hereditary optic neuropathy in a 70-year-Old woman.

Purpose: Reports of atypical cases have increased awareness that Leber's hereditary optic neuropathy (LHON) is not solely a disease of young men. Here, we present a case of a 70-year-old woman who presented with bilateral sequential loss of vision, and, after several diagnostic dilemmas, was ultimately found to have LHON.

Observations: Our patient presented with a one-month history of progressive central vision loss in the right eye.

Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia.

Background: Most patients with migraine report photophobia associated with headache; a subset report interictal photophobia. These patients are light sensitive even during headache-free periods. The objective of this case-control study was to assess the prevalence of symptoms of anxiety and depression in migraine patients with and without interictal photophobia.

Optic Nerve Fenestration in a Patient With the Syndrome of Acquired Hyperopia and Choroidal Folds.

We performed bilateral optic nerve sheath fenestrations on a patient with the syndrome of acquired hyperopia and choroidal folds. We are unaware of previous reports of this procedure being performed in this clinical setting. Despite the incomplete resolution of his posterior segment findings postoperatively, the results of the procedure, along with an understanding of the relevant anatomy, may help to shed light on the pathogenesis of this rare entity.

Thin-film optical notch filter spectacle coatings for the treatment of migraine and photophobia.

Previous evidence suggests optical treatments hold promise for treating migraine and photophobia. We designed an optical notch filter, centered at 480nm to reduce direct stimulation of intrinsically photosensitive retinal ganglion cells. We used thin-film technology to integrate the filter into spectacle lenses.

Blepharospasm in children and adolescents.

Purpose: Benign essential blepharospasm (BEB) generally is considered a disorder of adults; however, it rarely can present in childhood or adolescence. The main purpose of this study was to determine the prevalence of BEB in children and adolescents. Our research question was whether blepharospasm is seen in children or adolescents as well as in the adult population.

Chronic migraine is associated with reduced corneal nerve fiber density and symptoms of dry eye.

Background: We used in vivo corneal confocal microscopy to investigate structural differences in the sub-basal corneal nerve plexus in chronic migraine patients and a normal population. We used a validated questionnaire and tests of lacrimal function to determine the prevalence of dry eye in the same group of chronic migraine patients. Activation of the trigeminal system is involved in migraine.

Adalimumab and Non-Arteritic Anterior Ischaemic Optic Neuropathy: A Case Report.

Sequential anterior ischaemic optic neuropathy was observed in a patient treated with a tumour necrosis factor α (TNF) inhibitor, adalimumab, for ankylosing spondylitis. He developed decreased visual acuity in the right eye after 17 months of treatment. Findings showed right optic disc oedema with haemorrhages and visual field defect.

Optic neuropathy caused by Propionibacterium acnes pachymeningitis.

We describe a patient with vision loss from an optic neuropathy caused by Propionibacterium acnes pachymeningitis. The patient's optic neuropathy was stabilized with appropriate antibiotic therapy.

Cryopyrin-associated periodic syndromes and the eye.

Aim: To describe the ophthalmologic findings in two patients with Muckle-Wells Syndrome, a phenotype of the Cryopyrin Associated Periodic Syndromes (CAPS) spectrum. There is currently sparse ophthalmic literature regarding the ocular manifestations of CAPS. We hope to increase awareness of this spectrum of diseases and the importance of proper treatment amongst eye care professionals.

FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm.

Objective: The objective of these 2 studies was to assess the efficacy of FL-41-tinted lenses in the treatment of benign essential blepharospasm (BEB).

Design: A randomized crossover study and a randomized crossover case-control study.

Participants: The first study included 30 subjects with BEB.

A comparison of idiopathic intracranial hypertension with and without papilledema.

Objective: To compare clinical features, visual characteristics, and treatment of idiopathic intracranial hypertension patients with and without papilledema.

Background: Idiopathic intracranial hypertension does not often occur without papilledema. This study estimates the prevalence and compares the clinical characteristics of idiopathic intracranial hypertension patients with and without papilledema.

Giant cell arteritis and mortality.

Background: Giant cell arteritis (GCA) is a systemic vasculitis of elderly individuals associated with significant morbidity, including blindness, stroke, and myocardial infarction. Previous studies have investigated whether GCA is associated with increased mortality, with conflicting results. The objective of this study is to determine whether GCA, is associated with increased mortality.

A novel method for screening the multifocal electroretonogram in patients using hydroxychloroquine.

Purpose: To evaluate retinal function in patients on hydroxychloroquine using multifocal electroretinography.

Methods: A retrospective chart review was performed for 23 patients (46 eyes) on hydroxychloroquine therapy and referred for multifocal electroretinogram (mfERG) testing. Duration of treatment, daily hydroxychloroquine dose, visual acuity, fundus examination, color vision testing, Amsler grid testing, visual field examination, and fluorescein angiography results were obtained when available.

Retinol-binding protein and retinol analysis in cerebrospinal fluid and serum of patients with and without idiopathic intracranial hypertension.

Background: Several studies have implicated vitamin A-related compounds in the pathogenesis of idiopathic intracranial hypertension (IIH). The goal of this study was to compare cerebrospinal fluid (CSF) and serum concentrations of retinol and retinol-binding protein (RBP) in subjects with and without IIH.

Methods: CSF and serum samples were collected from 87 subjects.

Acute multifocal placoid pigment epitheliopathy associated with cavernous sinus thrombosis.

Acute multifocal placoid pigment epitheliopathy (AMPPE) has been associated with disease of the central nervous system. In this case report, we discuss a patient presenting with AMPPE in the setting of a new central nervous system association: cavernous sinus thrombosis.

Splenial corpus callosum lesion and hemifield visual color anomia associated with intracranial hypertension.

Lesions in the splenium of the corpus callosum are a rare complication of a variety of clinical conditions including ischemia, trauma, acute disseminated encephalomyelitis, infection, electrolyte imbalances, seizures, and antiepileptic drugs. This report describes a child presenting with hemifield visual color anomia, headache, and papilledema, who was found to have a midline splenial lesion on diffusion-weighted magnetic resonance imaging (MRI). Lumbar puncture revealed elevated intracranial pressure.

A family with X-linked optic atrophy linked to the OPA2 locus Xp11.4-Xp11.2.

Autosomal dominant optic atrophy (ADOA) is the most common inherited optic atrophy. Clinical features of ADOA include a slowly progressive bilateral loss of visual acuity, constriction of peripheral visual fields, central scotomas, and color vision abnormalities. Although ADOA is the most commonly inherited optic atrophy, autosomal recessive, X-linked, mitochondrial, and sporadic forms have also been reported.