RESUMEN
Cotton-wool spots are the clinical manifestation of focal infarcts of the retinal nerve fiber layer. They rarely cause significant visual field loss. A large idiopathic cotton-wool spot in a 34-year-old healthy woman caused a nerve fiber bundle visual field defect and an afferent pupillary defect that remained after the cotton-wool spot had disappeared and the retina and optic nerve appeared normal.
Asunto(s)
Fibras Nerviosas/patología , Enfermedades de la Retina/complicaciones , Células Ganglionares de la Retina/patología , Trastornos de la Visión/etiología , Campos Visuales , Adulto , Femenino , Humanos , Agudeza VisualRESUMEN
Edge-light pupil cycle time is a quantitative measure of pupil reaction to light, dependent on the functioning of the afferent arm of the pupillary reflex arc. It has been used as an objective assessment of optic nerve function in various neuroophthalmic diseases. In this study, pupil cycle times were determined on 60 eyes of 30 normal subjects, and a mean value of 814 ms with an upper limit of normal at 935 ms was established. The average difference between the two eyes was 34 ms, and the upper limit of normal was 79 ms. Pupil cycle times were then performed on ten eyes with optic atrophy, and all ten (100%) had abnormal values. Nine patients with multiple sclerosis were tested and abnormal cycle times were found in 15 of 18 eyes (83%). Five additional patients with questionable diagnoses were tested, and all but one had abnormal pupil cycle times. A discussion of pupil reactions in optic nerve disease is presented, and the value of edge-light pupil cycle time as a quantitative measure of nerve function is assessed.
Asunto(s)
Esclerosis Múltiple/diagnóstico , Atrofia Óptica/diagnóstico , Enfermedades del Nervio Óptico/diagnóstico , Pupila , Adulto , Anciano , Niño , Humanos , Persona de Mediana Edad , Factores de TiempoRESUMEN
Fifty patients with pituitary adenomas were evaluated preoperatively by an ophthalmologist; of these, 68% had visual field defects, the most common (25%) a superior bitemporal depression and 16%, bitemporal hemianopsia. Almost 60% of patients with field defects had visual complaints; 38% had visual acuity in one eye of 20/60 or less. Patients with larger, nonsecreting tumors had more visual defects than patients with secreting pituitary adenomas.
Asunto(s)
Adenoma/complicaciones , Neoplasias Hipofisarias/complicaciones , Trastornos de la Visión/etiología , Adenoma/diagnóstico por imagen , Adenoma/metabolismo , Adenoma Acidófilo/complicaciones , Adenoma Cromófobo/complicaciones , Hormona Adrenocorticotrópica/sangre , Adulto , Factores de Edad , Anciano , Femenino , Hormona del Crecimiento/sangre , Hemianopsia/etiología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Hipofisarias/diagnóstico por imagen , Neoplasias Hipofisarias/metabolismo , Prolactina/sangre , Tomografía Computarizada por Rayos X , Agudeza Visual , Campos VisualesRESUMEN
Three cases of filamentary keratitis were associated with brain-stem injuries. Severe stromal neovascularization developed in two cases. There was corneal sensation in the involved eyes. The first case resolved spontaneously over a 20-month period after stromal neovascularization. Two patients responded rapidly to treatment with soft contact lenses. The vascularization resolved in both cases, but much sooner in the eyes treated with the soft contact lenses.