The Prevalence and Demographics of Atypical Optic Neuritis Subtypes in Alberta

Optic neuritis (ON) is a complex clinical syndrome often associated with central nervous system demyelination disorders. While ON may be sporadic in nature or encountered in the setting of multiple sclerosis (MS), the discovery of two biomarkers, myelin oligodendrocyte glycoprotein (MOG)-IgG and aquaporin-4-immunoglobulin G (AQP-IgG), has enabled clinicians to diagnose other subtypes. Herein, we evaluate the distribution and clinical presentation of various ON subtypes

Population-Based Evaluation of Total Protein in the Cerebrospinal Fluid

Cerebrospinal fluid protein (CSF) has a large range of normal, but this has not been defined in a large community-based population

External Validation of Predictive Models of Long-Term Visual Acuity in Acute Demyelinating Optic Neuritis

For patients with acute idiopathic/MS-associated optic neuritis (ON), the only predictor of long-term visual acuity (VA; 1 year) is baseline VA.1 Because prediction models were developed with Optic Neuritis Treatment Trial (ONTT) data,2 external validation is needed

Pseudo-Pseudotumor Cerebri?

A 23-year-old female to male transgender patient (BMI=30) on testosterone therapy presented to the urgent clinic with bilateral disc swelling and preserved optic disc function (Figure 1a-1b). He had a 5 day history of general malaise. Past medical history was pertinent for scoliosis surgery at age 14 in Brazil with an incidental discovery and subsequent resection of a pilocytic astrocytoma

Artificial Intelligence to Predict Optic Neuritis Subtypes from Ocular Fundus Photographs

Optic neuritis (ON) is a complex clinical syndrome that has diverse etiologies and treatments based on its subtypes. Notably, ON associated with MS has a good prognosis for visual recovery, whereas ON associated with other conditions including Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Glycoprotein IgG associated disorder (MOGAD) is often associated with less favourable outcomes. Distinguishing MS ON from other ON subtypes is critical to guiding appropriate management. Herein we introduce a deep learning artificial intelligence (AI) algorithm to predict ON subtype based on fundus photographs

A Sase of Intracranial Hypertension Secondary to Systemic Lupus Erythematosus

Systemic Lupus Erythematosus (SLE) has been reported to cause Intracranial hypertension (ICH)[1]. In rare cases, SLE can present with a clinical picture like Idiopathic Intracranial Hypertension (IIH). The clinical importance of ICH in the context of SLE is unclear due to its rarity and their uncertain association[2]. While several mechanisms have been proposed to explain this association, none have been found to be causa

Expect the Unexpected, When at a Diagnostic Crossroad!

A 44-year old man presents with subacute onset vision loss in the right moreso than the left eye for several months before seeking medical attention. His vision at initial presentation was CF OD and 20/40 OS. He had a right RAPD. Fundus examination showed marked optic atrophy with no recordable color vision in either eye. His baseline MRI scan showed some mild chiasmal thickening and enhancement of the right more than left optic nerves

Systematic Review of the Yield of Temporal Artery Biopsy for Suspected Giant Cell Arteritis

<p>Purpose: To determine the positive yield (utility rate) of temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA).</p> <p>Study Design: Systematic review (CRD42017078508) and meta-regression.</p> <p>Materials and Methods: All articles concerning TAB for suspected GCA with English language abstracts from 1998 to 2017 were retrieved. Articles were excluded if they exclusively reported positive TAB, or only cases of known GCA. Where available, the pre-specified predictors of age, sex, vision symptoms, jaw claudication, duration of steroid treatment prior to TAB, specimen length, bilateral TAB, and use of ultrasound/MRI (imaging) were recorded for meta-regression.</p> <p>Results: One hundred and thirteen articles met eligibility criteria. The <i>I</i>² was 92%, and with such high heterogeneity, meta-analysis is unsuitable. The median yield of TAB was 0.25 (95% confidence interval 0.21 to 0.27), with interquartile range 0.17 to 0.34. On univariate meta-regression age (coefficient 0.012, <i>p</i> = 0.025) was the only statistically significant patient factor associated with TAB yield.</p> <p>Conclusions: Systematic review revealed high heterogeneity in the yield of TAB. The median utility rate of 25% and its interquartile range provides a benchmark for decisions regarding the under/overutilization of TAB and aids in the evaluation of non-invasive alternatives for the investigation of GCA.</p