Developing a Quality Assurance Framework for Neuro-Ophthalmology Using a Multisite Data Registry.

Background: Quality assurance (QA) in neuro-ophthalmology (NOPH) is often lacking. We aimed to assess the quality of referral assessment and time to consult for common neuro-ophthalmological conditions by implementing a quality-assurance registry, NODE (Neuro-ophthalmology Database), in a tertiary neuro-ophthalmology clinic. Australian standardized triage categories, namely, P1 (consult ≤30 days), P2 (consult ≤30-60 days), and P3 (consult ≤60-90 days), were developed and validated for neuro-ophthalmological conditions.

Superior oblique enlargement in thyroid eye disease.

Purpose: To determine the extent of superior oblique enlargement in thyroid eye disease (TED) by comparing the cross-sectional superior oblique areas of TED patients with those of unaffected control subjects.

Methods: The medical records of TED patients treated for strabismus from January 2005 to January 2016 were reviewed retrospectively for demographic and surgical data. The cross-sectional superior oblique area was compared to age-matched controls on high-resolution orbital computed tomography (CT) using a standardized protocol.

Remember the retina: retinal disorders presenting to neurologists.

General neurologists and stroke specialists are regularly referred cases of visual disturbance by general practitioners, emergency doctors and even ophthalmologists. Particularly when the referral comes from ophthalmologists, our assessment tends to focus on the optic nerve; however, retinal conditions may mimic optic neuropathy and are easily missed. Their diagnosis requires specific investigations that are rarely available in a neurology clinic.

Treatment of persistent and recurrent acromegaly.

Acromegaly is a chronic insidious disease characterised by growth hormone (GH) hypersecretion, typically from a pituitary adenoma. Effective treatment of acromegaly is vital because it is associated with a mortality rate more than twice that of the general population, an increased prevalence of colonic malignancy and many significant co-morbidities. Transsphenoidal adenoma resection is still the best first-line treatment for acromegaly but persistence (43%) or recurrence (2% to 3%) of GH hypersecretion after surgery remains a problem.

Management of recurrent Cushing's disease.

The management of patients with Cushing's disease remains a major challenge. The remission rate for initial transsphenoidal surgery is reported as 69-94% while the recurrence rate following initially successful transsphenoidal surgery is 2-27%. Treatment options for Cushing's disease after failed initial therapy or recurrence include repeat transsphenoidal surgery, radiotherapy, medical therapy and bilateral adrenalectomy.

Correlation between muscle atrophy on MRI and manual strength testing in hereditary neuropathies.

MRI shows areas where muscle has been replaced by fat, a process which occurs in neuropathies. The purpose of this study was to investigate the usefulness of MRI in assessing disease severity in Charcot-Marie-Tooth (CMT) and hereditary motor neuropathy (HMN) compared to manual muscle testing (MMT). MRI and MMT correlated well (Spearman's rank correlation coefficient 0.