Publications by authors named "Omer Bialer"

Article Synopsis
  • The study applied the 2022 international consensus criteria for optic neuritis (ICON) to 160 patients with acute optic neuritis to assess its effectiveness in classification.
  • About 50% of the patients were classified as definite optic neuritis, while 43% were not classified as having ON, mainly due to the absence of critical symptoms like relative afferent pupillary defect (RAPD) and dyschromatopsia.
  • The adjusted criteria led to a higher classification of 79% of patients as having optic neuritis, highlighting the importance of thorough examinations for accurate diagnosis.*
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Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder of the central nervous system. Optic neuritis (ON) is the most common clinical manifestation of MOGAD in adults. In 2023, new MOGAD diagnostic criteria were proposed, highlighting the importance of supplemental criteria when MOG-immunoglobulin G (IgG) titers are unavailable.

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Background: Patients with genetic optic atrophies must navigate all stages of life with their visual impairment, including the important milestone of family planning. Advances in genetic testing now allows physicians and affected families to consider medical help with the aim of preventing blindness through preconception, preimplantation, and perinatal methods.

Methods: This case series presents 4 patients with different genetic optic atrophies (Leber hereditary optic neuropathy [LHON], autosomal dominant optic atrophy, Wolfram syndrome, and papillorenal syndrome) who were followed by the Neuro-Ophthalmology Unit at a tertiary medical center between 2010 and 2023 and were of child-bearing age.

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Purpose: The evaluation and management of Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) lacks standardized guidelines. This study aimed to investigate the real-world practices of neuro-ophthalmologists in the evaluation and management of typical NAION cases.

Methods: A national survey, conducted between 2019 and 2021, involved all practicing neuro-ophthalmologists.

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Background And Objectives: Myelin oligodendrocyte glycoprotein antibody-associated disease optic neuritis (MOGAD-ON) and nonarteritic anterior ischemic optic neuropathy (NAION) can cause acute optic neuropathy in older adults but have different managements. We aimed to determine differentiating factors between MOGAD-ON and NAION and the frequency of serum MOG-IgG false positivity among patients with NAION.

Methods: In this international, multicenter, case-control study at tertiary neuro-ophthalmology centers, patients with MOGAD presenting with unilateral optic neuritis as their first attack at age 45 years or older and age-matched and sex-matched patients with NAION were included.

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Acute optic neuritis treatment lacks standardized protocols. The value of oral prednisone taper (OPT) following intravenous methylprednisolone (IVMP) on visual outcome parameters in optic neuritis (ON) has never been explored. In the present retrospective study, we investigated whether OPT after IVMP affects the structural and functional visual outcomes of inaugural clinically isolated syndrome (CIS)- or multiple sclerosis (MS)-ON.

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Article Synopsis
  • Optic neuritis (ON) often signals the onset of multiple sclerosis (MS) and other related disorders, with high-dose corticosteroids recommended for treatment but not adequately studied regarding timing and patient antibodies.
  • The Acute Optic Neuritis Network (ACON) aims to investigate how the timing of corticosteroid treatment affects visual outcomes 6 months post-ON onset by enrolling patients who present within 30 days of initial symptoms.
  • The study will collect extensive data on various ON subtypes and factors like visual acuity, imaging results, and patient-reported outcomes from 28 hospitals globally, targeting a recruitment of 200 patients across different ON classifications.
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Optic neuritis (ON) is a frequent presentation at onset of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). The pathophysiology underlying these diseases, especially MOGAD, is still being elucidated. While obesity has been reported to potentially be a risk factor for MS, this has not been explored in NMOSD or MOGAD.

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Article Synopsis
  • * In the first phase, neuro-ophthalmologists provided varying descriptions for visual field tests, averaging 7.5 unique descriptions per test, with some vague responses.
  • * Following the creation of a consensus statement, the second survey showed a notable reduction in unique descriptions to 5.9 per test and a significant increase in clarity and decisiveness in terminology.
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Aim: To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy (NAION) present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome.

Methods: This was a retrospective chart review. All patients with NAION seen during the acute stage from January 2012 to December 2018 were reviewed.

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Purpose: To evaluate the incidence of non-glaucomatous ocular disease in patients with asymmetric optic disc cupping.

Methods: A retrospective case series, including consecutive patients with cup-to-disc ratio (CDR) asymmetry greater than 0.2.

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Purpose: To evaluate the effect of methylphenidate on visual field testing in healthy adults with abnormal visual field results.

Methods: This prospective, randomized, controlled interventional clinical trial comprised all patients who had abnormal visual field test results and normal eye examination and ophthalmic history. Eligible patients were randomly assigned to either the study group or the control group.

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A 61-year-old man presented with acute painless optic neuropathy with resultant no light perception in his left eye. Neuro-ophthalmological examination, optical coherence tomography and fluorescein angiography did not reveal the etiology. Since the patient had a cardiac pacemaker, he underwent a CT scan with contrast of the brain and orbits, which was normal.

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Objective: To investigate whether visual disability which is known to accumulate by poor recovery from optic neuritis (ON) attacks can be lessened by early treatment, we investigated whether the time from symptom onset to high-dose IV methylprednisolone (IVMP) affected visual recovery.

Methods: A retrospective study was performed in a consecutive cohort of patients following their first aquaporin-4 (AQP4)-IgG or myelin oligodendrocyte glycoprotein (MOG)-IgG-ON. Best-corrected visual acuity (BCVA) in ON eyes at 3 months (BCVA3mo) was correlated with time to IVMP (days).

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Optic neuritis (ON) is a common clinical manifestation in myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease. Other clinical manifestations include acute demyelinating encephalomyelitis, transverse myelitis and neuromyelitis optica spectrum disorders. Uncommon presentations of MOG-positive disease have recently been reported.

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Background: Optic neuritis (ON) in patients with anti-myelin oligodendrocyte glycoprotein (MOG)-IgG antibodies has been associated with a better clinical outcome than anti-aquaporin 4 (AQP4)- IgG ON. Average retinal nerve fiber layer thickness (RNFL) correlates with visual outcome after ON.

Objectives: The aim of this study was to examine whether anti-MOG-IgG ON is associated with better average RNFL compared to anti-AQP4-IgG ON, and whether this corresponds with a better visual outcome.

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Article Synopsis
  • The study aimed to find the best combination of keratometry readings from the Pentacam device and IOL power formulas when patients' clinical history is not available.
  • It involved 18 patients who had cataract surgery after undergoing refractive surgery, using various combinations of EKR and IOL formulas.
  • The results indicated that the pair of 4.5-mm EKR with the Holladay II formula yielded the most accurate predictions for lens power, with a minimal deviation from expected values.
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Article Synopsis
  • An 88-year-old woman with a painful, blind left eye received a retrobulbar alcohol injection to alleviate discomfort.
  • Nine months later, she experienced discomfort around her left brow and forehead, with dysesthesia in the left V1 nerve distribution, but showed no signs of orbital inflammation during examination.
  • An MRI indicated abnormal signals and enophthalmos, suggesting that the effects of the retrobulbar injection may resemble orbital inflammatory disease, even though the lack of associated clinical symptoms can help distinguish between the two conditions.
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Objective: MRI abnormalities have been described in patients with increased intracranial pressure (ICP), including in those with idiopathic intracranial hypertension (IIH). Spontaneous CSF-filled outpouchings of the dura (meningoceles) and secondary CSF leaks can occur from elevated ICP in patients with IIH; however, few studies have evaluated these findings. Our objective was to evaluate the frequency of spontaneous intracranial meningoceles among IIH patients and determine their association with visual outcome.

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Heteronymous hemianopic defects may lead to the hemifield slide phenomenon. We report one case of binasal and two of bitemporal visual field defects causing hemifield slide. Both patients with bitemporal visual field defects underwent strabismus surgery.

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Article Synopsis
  • The study examined how peripapillary optical coherence tomography (OCT) can track optic nerve damage in children with craniopharyngioma, analyzing medical records from 20 pediatric patients treated from 1999 to 2011.
  • Key findings included a significant difference in retinal nerve fiber layer (RNFL) thickness between healthy eyes and those with optic neuropathy, with thinner RNFL correlating to poorer visual acuity and visual field loss.
  • The researchers concluded that OCT is a valuable tool for assessing optic nerve health in these patients and suggested further studies to explore its effectiveness in monitoring ongoing nerve damage over time.
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Introduction: Idiopathic intracranial hypertension (IIH) is increasingly recognized as a cause of spontaneous cerebrospinal fluid (CSF) leak in the otolarnygological and neurosurgical literature. The diagnosis of IIH in patients with spontaneous CSF leaks typically is made a few weeks after surgical repair of the leak when symptoms and signs of elevated intracranial pressure (ICP) appear.

Methods: Case reports and literature review.

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A 28-year-old African American woman developed periocular pain worsening with eye movement and decreased vision in her left eye. A diagnosis of left optic neuropathy was made based on the findings of decreased vision in the left eye, a left relative afferent pupillary defect, and mild optic disc hyperemia in the left eye (figure 1), with normal retinae and maculae bilaterally. Automated perimetry showed a small central scotoma in the left eye.

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One of the most important steps during Descemet stripping automated endothelial keratoplasty (DSAEK) is attaching the donor Descemet lenticule to the host's cornea. This is usually carried out by injecting air into the anterior chamber with a syringe and needle. We present an alternative technique using an air fluid exchange system connected to an anterior chamber maintainer used in 22 cases in our institute.

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