Time is vision in recurrent optic neuritis

In optic neuritis (ON) inflammation precedes onset of demyelination and axonal loss. The anti-inflammatory properties of corticosteroids may be most effective in the early inflammatory phase, but rapid patient recruitment remains a logistic challenge. The aim of the study was to review the effect of time to initiation of treatment on visual outcome in recurrent ON. A retrospective case note review of patients known to our centre with recurrent ON. The primary clinical outcome was change of best corrected high contrast visual acuity (BCVA). The secondary outcome was the change of optical coherence tomography (OCT) thickness of the peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell layer (mGCL) from baseline and after a minimum of 3months following the episode of recurrent ON. Of 269 patients with a previous episode of ON, 54 experienced recurrent ON. In total 40 OCT documented episodes of relapsing ON were captured in 19 patients. Treatment within <2days led to better recovery of the BCVA (+0.02) and mGCL (-2.4µm) if compared to delayed treatment (BCVA -0.2, p=0.036, mGCL -25.6µm, p=0.019) or no corticosteroids treatment (BCVA -0.2, p=0.045, GCL -5.0µm, p=0.836). These data suggest a beneficial effect of hyperacute corticosteroid treatment. A pragmatic approach for a prospective treatment trial should consider patients with recurrent ON for logistic reasons

La Charente

09 octobre 19081908/10/09 (A37,N9084)-1908/10/09.Appartient à l’ensemble documentaire : PoitouCh

Dacryocystography after paranasal sinus surgery

The influence of nasolacrimal duct dissection and irradiation of the lacrimal system on lacrimal drainage were assessed. Findings at dacryocystography, in correlation with the results of dye tests and symptoms, are presented. Lacrimal drainage obstruction was demonstrated in one of 10 patients after paranasal sinus surgery not followed by irradiation and in four of 10 patients in which surgery was followed by irradiatio

Dacryocystography after paranasal sinus surgery

The influence of nasolacrimal duct dissection and irradiation of the lacrimal system on lacrimal drainage were assessed. Findings at dacryocystography, in correlation with the results of dye tests and symptoms, are presented. Lacrimal drainage obstruction was demonstrated in one of 10 patients after paranasal sinus surgery not followed by irradiation and in four of 10 patients in which surgery was followed by irradiation.</p

Progression of Anterograde Trans-Synaptic Degeneration in the Human Retina Is Modulated by Axonal Convergence and Divergence

In the visual pathway of patients with multiple sclerosis (MS), the inner nuclear layer (INL) of the retina is a tight barrier for retrograde trans-synaptic degeneration. In this observational, retrospective cross-sectional study, segmented macular spectral domain optical coherence tomography (OCT) volume scans were reviewed to investigate if this observation also holds true for anterograde trans-synaptic degeneration. Significant thinning was found in all retinal layers in patients with outer retinal diseases compared with the healthy controls, while there was no significant attenuation of the outer retina in patients with MS. In contrast to the tight barrier function observed with retrograde trans-synaptic degeneration, the INL appears to be more permissive for the propagation of anterograde trans-synaptic degeneration. We speculate that this may be due to the size of the area affected and be explained by convergence and divergence of axons within the retinal layers. These findings are likely relevant to future restorative stem cell treatment of the outer retinal layers, as time may matter