Radiologically isolated aquaporin-4 antibody neuromyelitis optica spectrum disorder

Aquaporin-4 antibody (AQP4-Ab) Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare neuroinflammatory syndrome presenting predominantly with optic neuritis and transverse myelitis. We report a case of radiologically isolated longitudinally extensive optic neuritis in an asymptomatic 12-year-old female with positive serum AQP4-Ab, with resolution of imaging changes after immune therapy. By contrast to patients with radiologically isolated syndrome, of which some will never convert to multiple sclerosis, the pathogenicity of AQP4-Ab in the context of sub-clinical disease, supported treatment in our patient. Given the severe morbidity in AQP4-Ab NMOSD, prognostic biomarkers for disease severity are required to guide optimal therapy for patients

Familial Pseudotumor Cerebri - Case Series

Pseudotumor cerebri (PTC) is a disorder of unknown etiology. Few reports have described its occurrence amongst families

Comparison of Ishihara Booklet with Color Vision Smartphone Applications

Evaluation of color vision, an important component of visual function, is commonly performed using the pseudoisochromatic Ishihara plates. During the recent decade Color vision tests applications became widely available and are widely used even though they have not yet been validated in the literature. The aim of this study was to compare the standard Ishihara booklet with color-vision-testing smartphone applications

Traumatic Optic Neuropathy

Traumatic optic neuropathy (TON) is a specific neurological sequence of traumatic brain injury (TBI). It has a different mechanism than other most neurologic complications of head trauma and its consequences can be devastating. The damage can be from direct penetrating trauma or bone fracture injuring the optic nerve directly or secondary to indirect blunt trauma (usually causing traction). The diagnosis of TON is based on the clinical history and examination findings indicative of optic neuropathy, especially the presence of defective pupillary light response. TON can cause only mild vision loss but, in some cases, severe vision loss is present. Imaging findings can support the diagnosis, and provide information on the mechanism as well as treatment options. The treatment options include observation alone, systemic steroids, erythropoietin, surgical decompression of the optic canal, or combination. The evidence base for these various treatment options is controversial and each treatment has its side effects and risks. Poor prognostic factors include poor visual acuity at presentation, loss of consciousness, no improvement in vision in the first 48 hours, and evidence of optic canal fractures on neuroimaging

Autoimmune Optic Neuropathy, Case Series (.pdf)

Auto-immune optic neuropathy represents a heterogeneous group of conditions, some with recognized systemic autoimmune disease and various autoimmune markers in serologic testing including NMO Abs. Others may present with recurrent visual loss and steroids dependency, but lack any evidence of other systemic inflammatory disease. The aim of this study is to characterize the clinical course of patients with recurrent and/or progressive autoimmune optic neuropathy

Why is He Losing His Sight

"Retinitis pigmentosa has a wide spectrum of clinical and retinal presentation and can lead to progressive visual field loss. Papilledema can also lead to visual field defects and decreased vision. We describe here an unusual case of combined optic neuropathy and retinal degeneration leading to vision loss.

Real-World Translation of Artificial Intelligence in Neuro-Ophthalmology: The Challenges of Making an Artificial Intelligence System Applicable to Clinical Practice

1. Lin D, Xiong J, Liu C, Zhao L, Li Z, Yu S, Wu X, Ge Z, Hu X, Wang B, Fu M, Zhao X, Wang X, Zhu Y, Chen C, Li T, Li Y, Wei W, Zhao M, Li J, Xu F, Ding L, Tan G, Xiang Y, Hu Y, Zhang P, Han Y, li J, Wei L, Zhu P, Liu Y, Chen W, Ting D, Wong T, Chen Y, Lin H. Application of Comprehensive Artificial intelligence Retinal Expert (CARE) system: a national real-world evidence study. Lancet Digit Health. 2021;3:e486-e495. 2. Xie Y, Nguyen Q, Bellemo V, Yip M, Lee M, Hamzah H, Lim G, Hsu W, Lee ML, Wang JJ, Cheng CY, Finkelstein EA, Lamoureux EL, Tan GSW, Wong T. Cost-Effectiveness analysis of an artificial intelligence-assisted deep learning system implemented in the national tele-medicine diabetic retinopathy screening in Singapore. Invest Ophthalmol Vis Sci. 2019;60:5471. 3. Gulshan V, Peng L, Coram M, Stumpe MC, Wu D, Narayanaswamy A, Venugopalan S, Widner K, Madams T, Cuadros J, Kim R, Raman R, Nelson PC, Mega JL, Webster DR. Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus Photographs. JAMA. 2016;316:2402-2410. 4. van der Heijden AA, Abramoff MD, Verbraak F, van Hecke M, Liem A, Nijpels G. Validation of automated screening for referable diabetic retinopathy with the IDx-DR device in the Hoorn Diabetes Care System. Acta Ophthalmol. 2018;96:63-68. 5. Milea D, Najjar RP, Jiang Z, Ting D, Vasseneix C, Xu X, Aghsaei Fard M, Fonseca P, Vanikieti K, Lagrèze WA, La Morgia C, Cheung CY, Hamann S, Chiquet C, Sanda N, Yang H, Mejico LJ, Rougier MB, Kho R, Tran THC, Singhal S, Gohier P, Vignal-Clermont C, Cheng Cy, Jonas JB, Yu-Wai-Man P, Fraser CL, Chen JJ, Ambika S, Miller NR, Liu Y, Newman NJ, Wong TY, Biousse V. Artificial intelligence to detect papilledema from ocular fundus Photographs. New Engl J Med. 2020;382:1687-1695