Nerve fibre organisation in the human optic nerve and chiasm: what do we really know?

A recent anatomical study of the human optic chiasm cast doubt on the widespread assumption that nerve fibres travelling in the human optic nerve and chiasm are arranged retinotopically. Accordingly, a scoping literature review was performed to determine what is known about the nerve fibre arrangement in these structures. Meta-analysis suggested that the average number of fibres in each optic nerve was 1.

Reduced Cone Density Is Associated with Multiple Sclerosis.

Purpose: Multiple sclerosis (MS) is an inflammatory neurodegenerative disease of the central nervous system. Recent evidence suggests that degeneration of the inner layers of the retina occurs in MS. This study aimed to examine whether there are outer retinal changes in patients living with MS.

A Two-Stage Laser-Induced Mouse Model of Subretinal Fibrosis Secondary to Choroidal Neovascularization.

Purpose: To develop a model that can recapitulate key features of macular fibrosis in neovascular age-related macular degeneration (nAMD).

Methods: Adult C57BL/6J mice received three laser burns/eye to induce choroidal neovascularization (CNV). Seven days later, a second laser burn was directed to each of the neovascular lesions.

Finite element modeling of optic chiasmal compression.

Background: The precise mechanism of bitemporal hemianopia is still not clear. Our study investigated the mechanism of bitemporal hemianopia by studying the biomechanics of chiasmal compression caused by a pituitary tumor growing below the optic chiasm.

Methods: Chiasmal compression and nerve fiber interaction in the chiasm were simulated numerically using finite element modeling software.

Multi-scale analysis of optic chiasmal compression by finite element modelling.

The precise mechanism of bitemporal hemianopia (a type of partial visual field defect) is still not clear. Previous work has investigated this problem by studying the biomechanics of chiasmal compression caused by a pituitary tumour growing up from below the optic chiasm. A multi-scale analysis was performed using finite element models to examine both the macro-scale behaviour of the chiasm and the micro-scale interactions of the nerve fibres within it using representative volume elements.

Interventions for idiopathic intracranial hypertension.

Background: Idiopathic intracranial hypertension occurs throughout the world with an estimated incidence of one to three per 100,000 population per year. It occurs most commonly in obese young women but the cause is unknown. It presents a significant threat to sight and is associated with severe morbidity, in the form of headaches in most cases.

A mechanical theory to account for bitemporal hemianopia from chiasmal compression.

The association between bitemporal hemianopia and chiasmal compression is well recognized. The majority of chiasmal syndromes are caused by extrinsic compression from pituitary tumors, suprasellar meningiomas, craniopharyngiomas, and aneurysms. However, it is not clear why compressive lesions of the chiasm show a predilection for damage to nasal fibers with bitemporal hemianopia.

Delayed diagnosis of HIV infection in ophthalmic practice.

The introduction of potent antiretroviral drug combinations has transformed human immunodeficiency virus/acquired immunodeficiency disease syndrome (HIV/AIDS) from an intractable and rapidly fatal disease to a chronic manageable illness with prolonged life survival for many patients. This paper discusses the ophthalmic and medical histories of two young female patients who presented with 'atypical' optic neuropathy and toxoplasma gondii retinochoroiditis and were later found to be HIV infected. We discuss the need for increased vigilance in the ophthalmic community for suspecting HIV infection to allow optimal management of the ophthalmic and systemic manifestations of the disease spectrum associated with HIV/AIDS.

Interventions for idiopathic intracranial hypertension.

Background: Idiopathic intracranial hypertension (IIH) occurs throughout the world with an estimated incidence of one to three per 100,000 population per year. It occurs most commonly in obese young women, but the cause is unknown. It presents a significant threat to sight and is associated with severe morbidity in the form of headaches in the majority of cases.

Bilateral panuveitis: a possible association with Kikuchi-Fujimoto disease.

Purpose: To report a case of necrotizing lymphadenitis caused by Kikuchi-Fujimoto disease, which developed bilateral panuveitis.

Methods: A 16-year-old Chinese female with histologically proven Kikuchi-Fujimoto disease developed bilateral panuveitis 2 years after the onset of lymphadenopathy.

Results: Bilateral panuveitis was successfully treated with topical steroid.

Creutzfeldt-Jakob disease and the eye. I. Background and patient management.

This article attempts to summarise our current understanding of TSEs as they affect man. Specific aspects relevant to ophthalmological practice, in particular the management of patients in day-to-day clinical practice and with respect to corneal transplantation, have been discussed. In the companion article we discuss the specific ophthalmic and neuro-ophthalmic features of these diseases.

Papilloedema, a complication of progressive diaphyseal dysplasia: a series of three case reports.

Background/aims: Progressive diaphyseal dysplasia (PDD) is a rare, autosomal dominant, osteosclerotic dysplasia affecting both endochondrally and intramembranously derived bones. Severely affected patients can develop progressive stenosis of the optic canals and compressive optic neuropathy. Although raised intracranial pressure (ICP) has been described in patients with PDD in whom visual loss has occurred, the elevation of ICP in those patients has been thought to be either non-contributory or only partially responsible for the accompanying visual loss.

Is a rising caesarean section rate inevitable?

Objective: To determine the indications for singleton caesarean sections in Scotland in 1994.

Design: Prospective survey of singleton caesarean sections using information provided by clinicians entering data onto a computer in labour wards.

Setting: Twenty-three consultant-led obstetric units in Scotland.

The neonatal consequences and neonatal cost of reducing the number of embryos transferred following IVF.

This clinical audit project examined the effects of change of policy between 1990 and 1993 transferring an average two (maximum three for particular cases) embryos to women undergoing IVF in the West of Scotland programme. All women who achieved clinical pregnancy in 1990 (92 women) and 1993 (93 women) as a result of the IVF programme were included in the study. The hospital records of women via the programme were analysed.

Comparison of the efficacy of diclofenac and betamethasone following strabismus surgery.

Aims: To compare the relative antiinflammatory potency and safety of topical diclofenac-gentamicin with betamethasone-neomycin following strabismus surgery.

Methods: A single centre, single observer, prospective, randomised, and double masked clinical trial of 25 children undergoing bilateral symmetrical horizontal strabismus surgery was carried out. One eye received diclofenac-gentamicin and the contralateral eye received betamethasone-neomycin; both treatments were instilled four times a day for 4 weeks postoperatively.

Randomised, controlled trial of efficacy of midwife-managed care.

Background: Midwife-managed programmes of care are being widely implemented although there has been little investigation of their efficacy. We have compared midwife-managed care with shared care (ie, care divided among midwives, hospital doctors, and general practitioners) in terms of clinical efficacy and women's satisfaction.

Methods: We carried out a randomised controlled trial of 1299 pregnant women who had no adverse characteristics at booking (consent rate 81.

Should obstetricians see women with normal pregnancies? A multicentre randomised controlled trial of routine antenatal care by general practitioners and midwives compared with shared care led by obstetricians.

Objective: To compare routine antenatal care provided by general practitioners and midwives with obstetrician led shared care.

Design: Multicentre randomised controlled trial.

Setting: 51 general practices linked to nine Scottish maternity hospitals.