RESUMO
BACKGROUND: To evaluate the relative frequencies of arteritic and nonarteritic anterior ischemic optic neuropathy (AION) in an Arab population and to compare and contrast these findings with known epidemiological data from Caucasian populations. METHODS: A retrospective review of the medical records of all patients diagnosed with AION at the King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia, between 1997 and 2012. RESULTS: Of 171 patients with AION, 4 had biopsy-proven giant-cell arteritis (GCA). The relative frequencies of arteritic anterior ischemic optic neuropathy (AAION) and nonarteritic anterior ischemic optic neuropathy (NAION) in this Arab cohort were 2.3% and 97.7%, respectively. CONCLUSIONS: The relative frequencies of arteritic anterior ischemic optic neuropathy and nonarteritic anterior ischemic optic neuropathy differ between Arab and North American clinic-based populations, with giant-cell arteritis-related ischemia being much less frequent in Saudi Arabia.
Assuntos
Arterite de Células Gigantes/complicações , Disco Óptico/patologia , Neuropatia Óptica Isquêmica/epidemiologia , Artérias Temporais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neuropatia Óptica Isquêmica/diagnóstico , Neuropatia Óptica Isquêmica/etiologia , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto JovemAssuntos
Disco Óptico/diagnóstico por imagem , Nervo Óptico/patologia , Neuropatia Óptica Isquêmica/complicações , Papiledema/etiologia , Encéfalo/patologia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Neuropatia Óptica Isquêmica/diagnóstico , Papiledema/diagnóstico , Fatores de RiscoRESUMO
In this report, we describe a patient with a medial wall orbital fracture, who presented with vasovagal-like symptoms secondary to an oculocardiac reflex. This case is unusual because the patient had no other clinical evidence of muscle entrapment. A 15-year-old male presented with daily 5-10 min episodes of dizziness, light headedness, and nausea consistent with a vasovagal reaction. On examination, the patient had full extra ocular motility and was orthotropic in all fields of gaze. On computed tomography a comminuted medial orbital wall fracture was identified. The adjacent medial rectus muscle was in normal position, but was "rounded" relative to the contralateral side. The patient underwent fracture repair with immediate resolution of all symptoms. Symptoms related to a vasovagal response may occur with orbital fractures despite normal extra ocular motility. Presumably this relates to tension or pulling on an extra ocular muscle, which is not to a degree that alteration in function is appreciable clinically.