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Optic Nerve Infarction


Presentation

  • Patients present with nonspecific complaints such as headache, low-grade fever, facial swelling, sinusitis, and ocular symptoms.[meajo.org]
  • A 39-year-old man presented with headache, weight loss, bilateral subdural hematomas, pansinusitis, and visual loss. The neuro-ophthalmologic examination disclosed deep choroidal lesions and bilateral optic disc edema.[ncbi.nlm.nih.gov]
  • After reviewing the literature, this is the first case described of Sneddon's syndrome presenting with optic nerve infarction. Read this article (multiple options) Comments Related Papers[readbyqxmd.com]
  • Presents a more streamlined format to the printed text to help you focus on the clinically actionable information you need everyday.[books.google.com]
  • A 33-year-old man presented to the emergency room after a massive object fell onto his head and neck. An acute epidural hematoma on the left side was identified and evacuated.[nejm.org]
Burning Pain
  • He was well until a month earlier, when he had vomiting, burning, pain in the epigastrium followed by malaena.[ijo.in]
Fishing
  • Lisinopril vs Combivent respimat Lisinopril vs Coq10 Lisinopril vs Coreg Lisinopril vs Crestor Lisinopril vs Digoxin Lisinopril vs Enalapril maleate and hydrochlorothiazide Lisinopril vs Endep Lisinopril vs Esidrix Lisinopril vs Fenofibrate Lisinopril vs Fish[ehealthme.com]
Constipation
  • […] blood pressure. ( latest outcomes from Lisinopril 228,281 users ) Optic nerve infarction Optic nerve infarction (optic nerve fibre damage) has been reported by people with high blood pressure, high blood cholesterol, hepatitis c, erection problems, constipation[ehealthme.com]
Leg Pain
Osteoporosis
  • : 1 person, 9.09% Colon Cancer: 1 person, 9.09% Depression: 1 person, 9.09% Diuretic Therapy: 1 person, 9.09% Gastroesophageal Reflux Disease (a condition in which stomach contents leak backward from the stomach into the oesophagus): 1 person, 9.09% Osteoporosis[ehealthme.com]
Ptosis
  • When abnormal ptosis and ophthalmoplegia are observed after a patient awakens, an ophthalmologist should be consulted as soon as possible.[journals.lww.com]
  • There is a protective ptosis. The fracture in the floor of the orbit incarcerates the inferior oblique muscle causing inability to move the eyeball upward. Involvement of the inferior division of the oculomotor nerve results in a dilated pupil.[thamburaj.com]
  • […] confusion later, diplopia, got worse, ct scan normal; more ataxic, unsteady, areflexic, bilateral 6th and left 3rd, then lost vision in left eye lymphoma Case c (Congress 2014) 2000 dob, 3rd nerve palsy epsodes of headache, migraine like next day complete ptosis[goodhopeeyeclinic.org.uk]
Unilateral Blindness
  • Unilateral blindness occurring during anesthesia for neurosurgical operations. AMA Arch Ophthalmol 1954;52:819–30.[journals.lww.com]
  • . · Unilateral blindness due to optic nerve injury is often missed on a quick clinical examination in the emergency room. However, careful neurological testing will reveal the visual loss.[thamburaj.com]
Halo Vision
  • Vision (rainbow vision): 3 people, 27.27% Optic Neuropathy (optic nerve damage): 3 people, 27.27% Nausea (feeling of having an urge to vomit): 3 people, 27.27% Drowsiness: 3 people, 27.27% Drug Intolerance (drug sensitivity): 3 people, 27.27% Headache[ehealthme.com]

Workup

  • The causes and mechanisms of ischemic optic neuropathies are different, and the workup of a patient with an ischemic optic neuropathy is not the same as that for patients with retinal or cerebral infarction.” 1 Reference: 1.[neuro-ophthalmology.stanford.edu]
  • Clinical testing This young patient underwent a workup including optical coherence tomography (OCT), B-scan ultrasonography and fundus photography.[healio.com]
  • As the patient’s pre-corticosteroid workup was positive for latent tuberculosis, prophylactic isoniazid was prescribed in addition to the multiple medications, which the patient was already taking for her other medical conditions.[smj.org.sg]

Treatment

  • Helps you make optimal use of the newest drug therapies, including Anti-VEGF treatment for wet ARMD and bevacizumab treatment for complications of diabetes.[books.google.com]
  • OUTCOMES: Twenty days after the treatment, the motion of the left extraocular muscles was significantly improved. However, recovery from the left visual loss did not occur until 4 months after the operation.[ncbi.nlm.nih.gov]
  • A retrospective analysis of clinical features and treatment outcomes. Indian J Ophthalmol 2003;51:231-6. [ PUBMED ] 5. Mathur S, Karimi A, Mafee MF.[meajo.org]

Prognosis

  • On hospital day 33, the poor prognosis was discussed with the patient's family, and she was transferred to the hospice care, where she ultimately died.[ajnr.org]
  • PROGNOSIS-  Only 4% eyes with visual loss improved  Early,adequate steroid therapy prevent visual loss in 96% 25.[slideshare.net]
  • Prognosis Depends on etiology.[clinicalgate.com]
  • Prognosis for visual recovery is poor, particularly for the ischaemic form. Diabetic papillopathy Presentation : Progressive monocular visual loss. Ocular findings : Modest decrease in VA (6/12 or better).[patient.info]
  • If recovery does not begin within a few days the prognosis is grave.[thamburaj.com]

Etiology

  • […] discusses the adjunctive role of visual evoked potential (VEP), multifocal VEP, electroretinogram (ERG), and mul- focal ERG in the diagnosis of more challenging visual problems, es- cially in distinguishing them from macular disorders and psychogenic etiologies[books.google.com]
  • Several reports described the important etiologies of postoperative ischemic optic neuropathy ( 3 - 8 ).[kjronline.org]
  • Prognosis Depends on etiology.[clinicalgate.com]
  • If visual loss is identified, urgent ophthalmologic evaluation can help to determine the etiology [Table 2].[annalsofian.org]
  • Etiology: In most cases it is thought that vascular disease plays the primary role. The cystic spaces are created by the loss of neuronal tissue that is more sensitive to ischemic injury than the surround supportive connective tissue.[missionforvisionusa.org]

Epidemiology

  • Epidemiology Usually occurs in obese 20–45-year-old females (2 : 1).[clinicalgate.com]
  • A 14-year epidemiological, clinical and prognostic study. Scott Med J. 1979 ; 24 : 111 - 7. 3. Cullen JF, Chan BM, Wong CF, Chew WC. Giant cell (temporal) arteritis in Singapore: an occult case and the rationale of treatment.[smj.org.sg]
  • EPIDEMIOLOGY AND PATHOGENESIS Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over 50 years of age, with an estimated annual incidence in the United States of 2.3–10.2 per 100,000 population[medtextfree.wordpress.com]
  • Reversible cerebral vasoconstriction syndrome, part 1: Epidemiology, pathogenesis, and clinical course. Am J Neuroradiol. 2015;36:1392–9. Available from: . View Article PubMed Google Scholar Johnson MW, Kincaid MC, Trobe JD.[jmedicalcasereports.biomedcentral.com]
Sex distribution
Age distribution

Pathophysiology

  • Abstract Objective: To investigate the pathophysiologic mechanism of optic nerve infarction in giant-cell arteritis (GCA).[neurology.org]
  • Pathophysiology The pathophysiology of NAION is controversial and no one mechanism had been definitively demonstrated.[eyewiki.aao.org]
  • No clinically effective treatments exist, largely because little is known about its pathophysiology, and there are few histopathological studies of the acute condition. [10] An exhaustive review article published in March 2009 described the latest information[en.wikipedia.org]
  • […] vitamin B1) deficiency and in pernicious anaemia (vitamin B12 malabsorption). 16 Deficiencies in folic acid and proteins with sulphur-containing amino acids and severe tobacco/alcohol abuse are also associated with toxic optic neuropathy. 17 The proposed pathophysiology[aop.org.uk]
  • That appears to be the pathophysiology of AION." A "disc at risk." A small, crowded optic nerve head is a risk factor for AION; if axons swell, they may compress neighboring axons, triggering a cascade. All images courtesy of Jacqueline M.S.[reviewofophthalmology.com]

Prevention

  • Features consistent discussions of clinical manifestations, diagnosis, prevention, treatment, and more that make reference quick and easy.[books.google.com]
  • The best way to prevent retinal vascular occlusion is to identify and treat the risk factors.[healthline.com]
  • PROGNOSIS-  Only 4% eyes with visual loss improved  Early,adequate steroid therapy prevent visual loss in 96% 25.[slideshare.net]
  • Supported in part by an unrestricted grant from Research to Prevent Blindness in New York. David S.[glaucomatoday.com]
  • "Treatment might prevent ION in the second eye; it also might prevent a heart attack or stroke five or 10 years down the road."[reviewofophthalmology.com]

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