Asunto(s)
COVID-19/complicaciones , Infecciones Virales del Ojo/etiología , Enfermedades del Nervio Óptico/etiología , Enfermedades de la Retina/etiología , SARS-CoV-2/inmunología , Escotoma/etiología , Tomografía de Coherencia Óptica , Enfermedad Aguda , Adulto , COVID-19/diagnóstico , COVID-19/virología , Prueba Serológica para COVID-19 , Infecciones Virales del Ojo/diagnóstico por imagen , Infecciones Virales del Ojo/virología , Femenino , Humanos , Masculino , Enfermedades del Nervio Óptico/diagnóstico por imagen , Enfermedades del Nervio Óptico/virología , Embarazo , Enfermedades de la Retina/diagnóstico por imagen , Enfermedades de la Retina/virología , Escotoma/diagnóstico por imagen , Escotoma/virologíaAsunto(s)
Retina/patología , Tomografía de Coherencia Óptica/métodos , Vidarabina/análogos & derivados , Baja Visión/inducido químicamente , Agudeza Visual , Campos Visuales , Antineoplásicos/efectos adversos , Estudios de Seguimiento , Neoplasias Hematológicas/tratamiento farmacológico , Humanos , Pronóstico , Retina/efectos de los fármacos , Vidarabina/efectos adversos , Baja Visión/diagnóstico , Baja Visión/fisiopatología , Pruebas del Campo VisualRESUMEN
General neurologists and stroke specialists are regularly referred cases of visual disturbance by general practitioners, emergency doctors and even ophthalmologists. Particularly when the referral comes from ophthalmologists, our assessment tends to focus on the optic nerve; however, retinal conditions may mimic optic neuropathy and are easily missed. Their diagnosis requires specific investigations that are rarely available in a neurology clinic. This article focuses on how a general neurologist can identify retinal problems from the clinical assessment and how to proceed with initial investigations. The following cases were all referred to a consultant neurologist (GTP) from ophthalmology services as optic neuropathies or other neurological disorders. Part A of the summary describes the presentation and findings in the neurology clinic; part B describes the subsequent specialist assessment in the neuro-ophthalmology/eye clinic.
Asunto(s)
Enfermedades de la Retina/diagnóstico , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neurólogos , Neurología , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades de la Retina/complicaciones , Trastornos de la Visión/etiologíaRESUMEN
A brainstem lesion of any type that involves the medial longitudinal fasciculus (MLF) can cause internuclear ophthalmoplegia (INO). This primarily affects conjugate horizontal gaze and classically manifests as impaired adduction ipsilateral to the lesion and abduction nystagmus contralateral to the lesion. Here, we describe the anatomy of the MLF and review the clinical features of INO. We also describe conjugate horizontal gaze palsy and some of the 'INO-plus' syndromes.
Asunto(s)
Infartos del Tronco Encefálico/complicaciones , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/etiología , Vías Aferentes/patología , Vías Aferentes/fisiopatología , Infartos del Tronco Encefálico/diagnóstico por imagen , Movimientos Oculares , Femenino , Lateralidad Funcional , Humanos , Imagen por Resonancia Magnética , Masculino , Nistagmo Patológico/etiologíaRESUMEN
This report is of two cases of asymmetrical papilloedema in patients with asymmetrical intraocular pressures (IOPs). The first patient presented with headaches, transient visual obscurations (TVOs), and elevated IOPs, and was found to have increased intracranial pressure caused by a torcula meningioma. He developed papilloedema after his IOPs were pharmacologically lowered; the papilloedema resolved after the IOP became elevated again after stopping his glaucoma drops, and then again returned as the IOP reduced when the drops were restarted. The second patient with a history of Sturge-Weber syndrome requiring previous left trabeculectomy, presented with left-sided TVOs, photopsia, and pulsatile tinnitus caused by idiopathic intracranial hypertension. Asymmetrical papilloedema was observed, worse in the eye with the lower IOP following trabeculectomy. These cases suggest that asymmetric IOP may be one factor that can influence the development of asymmetric papilloedema. Ophthalmologists finding disc swelling at low normal pressures should ask about symptoms of raised ICP, and neuro-ophthalmologists confronted with asymmetrical disc swelling should routinely measure IOP.