RESUMO
Primary malignant gliomas of the optic nerve and chiasm are rare, and are usually rapidly fatal in adults. We report a 48-year-old woman with a glioblastoma multiforme arising from the optic chiasm. Following radiotherapy, our patient survived nearly 14 months, which is the longest survival reported in patients with this diagnosis. There have only been four other reports of glioblastoma multiforme arising from the optic chiasm as distinct from secondary involvement of the chiasm, in the last 40 years.
Assuntos
Glioblastoma/patologia , Quiasma Óptico/patologia , Neoplasias do Nervo Óptico/patologia , Feminino , Glioblastoma/terapia , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Quiasma Óptico/cirurgia , Neoplasias do Nervo Óptico/terapia , Radioterapia/métodosRESUMO
A 19-year-old girl presented with advanced unilateral chronic angle closure glaucoma and myopia with gross cupping and field loss in a previously hyperopic eye with a marked increase in corneal curvature. This emphasises that a marked myopic shift may be an important sign of glaucoma in a young patient.
Assuntos
Glaucoma de Ângulo Fechado/complicações , Miopia/etiologia , Adulto , Doença Crônica , Feminino , Glaucoma de Ângulo Fechado/diagnóstico , HumanosRESUMO
A 49-year-old woman developed severe unilateral visual loss following carotid artery ligation for a carotid-cavernous fistula. The pathophysiology was presumed to be an ophthalmic artery steal caused by the fistula. This was confirmed when visual acuity was restored by a subsequent ligation of the ophthalmic artery, despite 2 weeks of profound visual loss and ocular ischemia. Superficial cotton-wool spots and deep gray intraretinal lesions developed in the retina during the period of ocular ischemia. We postulate that the deep intraretinal lesions are clinical manifestations of a zone of retinal microvascular watershed ischemia, and that their presence may be an important diagnostic guide to the presence of reversible ocular ischemia.