Short-Term Clinical Observation of Acute Retinal Pigment Epitheliitis Using Spectral-Domain Optical Coherence Tomography

We investigated the case of a young man with blurred vision in his left eye. His visual acuity was slightly decreased, and ophthalmoscopy disclosed a gray-white lesion in the macula. He had no systemic or ocular history. On the visual field test, the threshold sensitivity was decreased in the corresponding region. Spectral domain optical coherence tomography (OCT) demonstrated a disruption in the photoreceptor inner and outer segment (IS/OS) junction and undulation of the retinal pigment epithelium (RPE) with backscattering. We re-examined the patient after two weeks and after three months without any treatment. Visual acuity and visual field results were gradually normalized, and OCT demonstrated the recovery of continuity in the photoreceptor IS/OS junction, as well as decreased RPE irregularity with minimal backscattering. We used spectral domain OCT instead of time domain OCT (OCT3) so that we could provide better image resolution of the acute retinal pigment epitheliitis (ARPE). Finally, we observed recovery of the functional and anatomical changes in the ARPE patient with a resolution of the condition within three months following the initial examination, using OCT and visual field tests

Neurologic Recovery According to Early Magnetic Resonance Imaging Findings in Traumatic Cervical Spinal Cord Injuries

The aim of this study was to determine the usefulness of early magnetic resonance imaging findings in predicting neurologic recovery at or below the injured level in traumatic cervical spinal cord injuries. Thirty patients with traumatic cervical spinal cord injuries were included. All of the patients received a magnetic resonance imaging and a neurologic examination in the emergency room, within 7 days of injury and at 6 months following the injury. To quantify neurologic recovery below the injured level, we modified clinical scales, particularly the motor ratio and the sensory ratio. We used the neurologic level to quantify recovery around the injured level. We assessed neurologic recovery according to MRI patterns and lesion extents. The pure hemorrhagic MRI pattern was not observed. In edematous and mixed types, the improvement of neurologic levels was not significantly different. The motor ratio and sensory ratio improved significantly more in edematous type patients than in mixed type patients. Based on MRI lesion extent, the improvement of neurologic levels was not significantly different, and motor ratio and sensory ratio improved significantly more in those with one or two segments involved than in those with more than two segments involved. In conclusion, early MRI pattern and lesion extent after traumatic cervical spinal cord injury may provide important information to help predict neurologic recovery, especially below the injured level

Local Relationship between Global-Flash Multifocal Electroretinogram Optic Nerve Head Components and Visual Field Defects in Patients with Glaucoma

properly cited. Purpose. To investigate the local relationship between quantified global-flash multifocal electroretinogram (mfERG) optic nerve head component (ONHC) and visual field defects in patients with glaucoma. Methods. Thirty-nine patients with glaucoma and 30 normal controls were enrolled. The ONHC amplitude was measured from the baseline to the peak of the second positive deflection of the induced component. The ONHC amplitude was normalized by dividing ONHC amplitude by the average of seven largest ONHC amplitudes. The ONHC amplitude ratio map and ONHC deficiency map were constructed. The local relationship between the ONHC measurements and visual field defects was evaluated by calculating the overlap between the ONHC deficiency maps and visual field defect plots. Results. The mean ONHC amplitude measurements of patients with glaucoma (6.01 ± 1.91 nV/deg 2 ) were significantly lower than those of the normal controls (10.29 ± 0.94 nV/deg 2 ) ( < 0.001). The average overlap between the ONHC deficiency map and visual field defect plot was 71.4%. The highest overlap (75.0%) was between the ONHC ratios less than 0.5 and the total deviations less than 5%. Conclusions. The ONHC amplitude was reduced in patients with glaucoma compared to that in normal controls. Loss of the ONHC amplitude from the global-flash mfERG showed a high local agreement with visual field defects in patients with glaucoma

Local Relationship between Global-Flash Multifocal Electroretinogram Optic Nerve Head Components and Visual Field Defects in Patients with Glaucoma

Purpose. To investigate the local relationship between quantified global-flash multifocal electroretinogram (mfERG) optic nerve head component (ONHC) and visual field defects in patients with glaucoma. Methods. Thirty-nine patients with glaucoma and 30 normal controls were enrolled. The ONHC amplitude was measured from the baseline to the peak of the second positive deflection of the induced component. The ONHC amplitude was normalized by dividing ONHC amplitude by the average of seven largest ONHC amplitudes. The ONHC amplitude ratio map and ONHC deficiency map were constructed. The local relationship between the ONHC measurements and visual field defects was evaluated by calculating the overlap between the ONHC deficiency maps and visual field defect plots. Results. The mean ONHC amplitude measurements of patients with glaucoma (6.01±1.91 nV/deg2) were significantly lower than those of the normal controls (10.29±0.94 nV/deg2) (P<0.001). The average overlap between the ONHC deficiency map and visual field defect plot was 71.4%. The highest overlap (75.0%) was between the ONHC ratios less than 0.5 and the total deviations less than 5%. Conclusions. The ONHC amplitude was reduced in patients with glaucoma compared to that in normal controls. Loss of the ONHC amplitude from the global-flash mfERG showed a high local agreement with visual field defects in patients with glaucoma

Computed Tomographic Angiogram of an Anterior Communicating Artery Aneurysm Causing Acute Retrobulbar Optic Neuropathy: A Case Report

Three-dimensional computed tomographic (3D-CT) angiography is a widespread imaging modality for intracranial vascular lesions. However, 3D-CT angiograms of an anterior communicating artery aneurysm associated with acute retrobulbar optic neuropathy have not been previously described. We present 3D-CT angiograms of an aneurysm of the anterior communicating artery that caused subarachnoid hemorrhage and vision loss in a 39-year old man. The 3D-CT angiograms were consistent with findings identified directly during surgery

Predictive Value of Pharyngeal Width at Rest (JOSCYL Width) for Aspiration in Elderly People

Objective To develop a new tool for aspiration risk prediction based on pharyngeal width at rest in older adults with symptoms of aspiration. Methods Lateral cervical spine roentgenograms were obtained from 33 older adult patients who complained of dysphagia and from 33 healthy, age-matched controls. Pharyngeal width at rest was measured at two points. We named the average of these two pharyngeal widths ‘JOSCYL Width’, calculated ‘JOSCYL Scale’, and compared these parameters between dysphagia and control groups. Correlations of individual JOSCYL Width and JOSCYL Scale, with Penetration Aspiration Scale (PAS) and Dysphagia Outcome and Severity Scale (DOSS) scores were analyzed for the dysphagia group. To determine optimal cutoff points for predicting aspiration, a receiver operating characteristic curve analysis was performed on JOSCYL Width and JOSCYL Scale. Results Both JOSCYL Width and JOSCYL Scale of the dysphagia group were larger than those of the control group (p<0.001). The correlation between JOSCYL Width and severity of dysphagia was significant for the dysphagia group (PAS p=0.007; DOSS p=0.012). The correlation between JOSCYL Scale and the severity of dysphagia was also significant for the dysphagia group (PAS p=0.009; DOSS p=0.011). Optimal cutoffs for JOSCYL Width and JOSCYL Scale for predicting aspiration were 20.0 mm and 5.9, respectively. Conclusion JOSCYL Width and JOSCYL Scale can be new indicators for predicting aspiration in older adults. They are both precise and easy to use