Review of Vitreopapillary Traction Syndrome.

Vitreopapillary traction (VPT) syndrome is a potentially visually significant disorder of the vitreopapillary interface characterised by an incomplete posterior vitreous detachment with the persistently adherent vitreous exerting tractional pull on the optic disc and resulting in morphologic alterations and a consequent decline of visual function. It is most commonly unilateral but bilateral reports have also been described. The cause of the condition may be unknown or idiopathic, although the histology of traction shows proliferation of fibrous astrocytes, myofibroblasts, fibrocytes, and retinal pigment epithelial cells.

Spectral-Domain Optical Coherence Tomography of the Vitreopapillary Interface in Acute Nonarteritic Anterior Ischemic Optic Neuropathy.

Purpose: To use spectral-domain optical coherence tomography (SD-OCT) to assess whether epipapillary vitreous traction from evolving posterior vitreous detachment (PVD) is mechanistically involved in the pathogenesis of nonarteritic anterior ischemic optic neuropathy (NAION).

Design: Retrospective cohort study.

Methods: Setting: Single academic center.

Fourth down and five.

Binocular diplopia and right hemifacial numbness developed in a 52-year-old woman after resection of a right temporal lobe glioblastoma. Based on the Parks-Bielschowsky 3-step test, she was diagnosed with a right cranial nerve (CN) IV palsy in addition to right CN V dysfunction. Iatrogenic diplopia may result from temporal lobe surgery due to the intimate relationship of CN IV and CN III to the mesial temporal lobe.

A sticky situation.

An 81-year-old man with bilateral progressively blurry vision and optic disc swelling was referred for evaluation. Examination and ancillary testing confirmed a diagnosis of bilateral vitreopapillary traction accompanied by unilateral tractional retinoschisis in the right eye. Pars plana vitrectomy was performed to release the traction in both the eyes.

Bruch's membrane opening on optical coherence tomography in pediatric papilledema and pseudopapilledema.

Purpose: To determine whether the diameter of Bruch's membrane opening (BMO) can distinguish mild papilledema from pseudopapilledema using optical coherence tomography (OCT).

Methods: The medical records of pediatric patients with pseudopapilledma due to optic nerve head (ONH) drusen, patients with papilledema, and normal control subjects were retrospectively reviewed. All eyes underwent OCT imaging of the BMO and retinal nerve fiber layer (RNFL).

Characterizing retinal structure injury in African-Americans with multiple sclerosis.

To examine retinal structure injury in African-Americans (AA) with Multiple Sclerosis (MS) compared to Caucasians (CA) with MS, we used spectral domain optical-coherence tomography (OCT) in this cross sectional study. The peripapillary retinal nerve fiber layer (pRNFL) and macular volume of 234 MS patients (149 CA; 85 AA) and 74 healthy controls (60 CA; 17 AA) were measured. Intra-retinal segmentation was performed to obtain retinal nerve fiber (RNFL), ganglion cell (GCL), inner plexiform (IPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), retinal pigment epithelium (RPE), and photoreceptor (PR) layer volumes.

Irreversible Loss of Vision in a Child due to Occipital Infarction after Gastroenteritis.

A 2½-year-old girl developed a bilateral occipital infarct following severe gastroenteritis with bilateral vision of light perception. Evaluations for sickle cell anemia, hemolytic anemia and coagulopathies were negative. Cortical blindness is an uncommon but dramatic complication of gastroenteritis, hence the need of prompt hydration and other supportive measures to avoid irreversible visual loss or mental sequela.

Diagnostic Algorithm for Patients With Suspected Giant Cell Arteritis.

Background: To identify clinical and laboratory factors contributing to the diagnosis of giant cell arteritis (GCA) and develop a diagnostic algorithm for the evaluation of GCA.

Methods: Retrospective review of 213 consecutive cases of temporal artery biopsy (TAB) seen at a single academic center over a 10-year period (2000-2009). Pathologic specimens were re-reviewed and agreement between the original and second readings was assessed.

Thyroid eye disease: therapy in the active phase.

Background: The management of active thyroid eye disease (TED) can be a challenging therapeutic dilemma. The pathogenic complexity, disease heterogeneity, clinical unpredictability, and ocular morbidity associated with TED necessitate a team approach.

Evidence Acquisition: A literature search ending on December 31, 2013, was performed using PubMed (http://www.

"My eyes are turned outside".

A 78-year-old white woman noted progressively worsening headache, fluctuating decreased vision, dizziness, and binocular horizontal and vertical diplopia of two months duration. She had a 40 prism diopter exotropia and bilateral ophthalmoplegia. An initial temporal artery biopsy (TAB) was negative for findings of giant cell arteritis (GCA).

I'm stuffed; visual loss after trans-sphenoidal adenomectomy.

A 61-year-old woman developed bilateral decreased vision within 30 hours of uncomplicated trans-sphenoidal pituitary adenoma resection. Postoperative computed tomography of the brain was consistent with overpacking of the sella turcica with a fat graft. The patient was urgently taken back to the operating room for fat graft reduction and her vision improved.

Fingolimod therapy and macular hemorrhage.

A 54-year-old woman with relapsing-remitting multiple sclerosis (MS) developed visual loss in her left eye due to a macular hemorrhage 11 months after starting fingolimod. Visual acuity was 20/80 in the left eye, with a dense retinal hemorrhage involving the fovea with adjacent hard exudate and macular thickening confirmed by spectral domain optical coherence tomography. Three months after stopping fingolimod, vision in the left eye improved to 20/30 with resolution of the macular hemorrhage and exudates.

Complications of vision loss and ophthalmoplegia during endoscopic sinus surgery.

Objective: To describe two rare cases of concurrent vision loss and external ophthalmoplegia following powered endoscopic sinus surgery (ESS).

Design: Observational case report.

Results: The records of two patients who underwent powered ESS and developed multiple concurrent ophthalmic complications were retrospectively reviewed for clinical history, neuro-ophthalmologic examination, and imaging findings.

Fingolimod-associated macular edema: incidence, detection, and management.

Fingolimod (FTY-720), a sphingosine-1-phosphate receptor modulator, is the first US Food and Drug Administration (FDA)-approved oral agent for the treatment of relapsing forms of multiple sclerosis (MS). Two recent phase III clinical studies (TRANSFORMS [Trial Assessing Injectable Interferon vs FTY720 Oral in RRMS] and FREEDOMS [FTY720 Research Evaluating Effects of Daily Oral Therapy in MS]) demonstrated a significant reduction in the annualized relapse rate in patients with relapsing-remitting MS, compared to once weekly interferon β-1a and placebo. Macular edema was a prominent adverse event reported in these and prior studies of fingolimod.

Clinical characteristics in 53 patients with cat scratch optic neuropathy.

Objective: To describe the clinical manifestations and to identify risk factors associated with visual outcome in a large cohort of patients with cat scratch optic neuropathy (CSON).

Design: Multicenter, retrospective chart review.

Participants: Fifty-three patients (62 eyes) with serologically positive CSON from 5 academic neuro-ophthalmology services evaluated over an 11-year period.