Presentation
Up to 4-10% of patients with untreated syphilis may develop NS. [1] These days NS rarely presents in its classical forms, tabes dorsalis or general paresis, and often presents with atypical features. [2] The clinical and laboratory features of NS have [annalsofian.org]
An abnormal fundus examination on initial presentation is a significant predictor of visual impairment at 3 months after presentation. [omicsonline.org]
Two cases of the disease with other central nervous system involvement are presented and briefly discussed as to nosology and relationship to the heredofamilial group of diseases. [link.springer.com]
Less than five percent of patients only present with sole ocular involvement at diagnosis. [japi.org]
Strabismus and latent nystagmus are often present. Up slanting palpebral fissures and epicanthal folds have been noted. Visual acuity levels have not been reported. [disorders.eyes.arizona.edu]
Entire Body System
- Asymptomatic
After the secondary stage, there is a dormant (asymptomatic) stage, known as Latent Syphilis which may last for many years (even decades). All infections do not progress to the final (tertiary) stage. [dovemed.com]
Posterior segment abnormalities range from relatively common, asymptomatic microvascular changes, including cotton-wool spots and intraretinal haemorrhages, to rare vision-threatening retinal arterial or venous occlusions.1 Optic neuritis and papilloedema [japi.org]
Although NS has been divided five major categories, that is, asymptomatic, meningeal, meningovascular, parenchymatous, and gummatous, these entities represent a continuum and frequently overlap. [3] Overlap between different forms of NS is largely restricted [annalsofian.org]
16 ] Skeletalradiographs reveal a generalized increase in bone density and clubbing of metaphyses Alternating bands of lucent and dense bands produce a sandwich appearance to vertebral bodies. [17 ] Up to half of individuals with the benign form are asymptomatic [djo.org.in]
Subjective MR Imaging Appearances Abnormal signal intensity was demonstrated in all clinically affected optic nerves and was not seen in any asymptomatic nerve on the XETA FLAIR sequence as judged by both reviewers. [ajnr.org]
Gastrointestinal
- Failure to Thrive
This case was diagnosed as malignant variety of osteopetrosis with failure to thrive with primary optic atrophy. The patient was admitted and treated symptomatically while monitoring vitals. [djo.org.in]
Clinical presentations include hypopituitarism, the commonest being growth hormone deficiency presenting as short stature, failure to thrive, hypoglycemia, developmental delay, and visual impairment. [14] It usually occurs sporadically; however, a number [ijri.org]
Cardiovascular
- Hypotension
This can occur in patients who are predisposed to AAION and NAION as described above as well as those who had cardiac and spine surgery or serious episodes of hypotension. [en.wikipedia.org]
Eyes
- Eye Pain
Diplopia and facial pain suggest multiple cranial neuropathies due to inflammatory or neoplastic lesions behind the eye. [patient.info]
EYES - PAIN - nerves, optic cedr. clem. pip-m. sarr. EYES - PAIN - pressing - nerves, optic clem. EYES - PAIN - sore, bruised - nerves, optic sarr. EYES - PARALYSIS - nerves - optic nerve, amaurosis - brights disease, in APIS ARS. CANN-I. colch. [homeopathyworldcommunity.ning.com]
Symptoms of optic neuritis in the affected eye include pain on eye movement, sudden loss of vision, and decrease in color vision (especially reds). [en.wikipedia.org]
It may be associated with eye pain worsened by eye movement. It is more common in young to middle-aged women. Some patients with optic neuritis may develop multiple sclerosis later on in life. Leber's hereditary optic neuropathy. [medical-dictionary.thefreedictionary.com]
- Central Scotoma
scotoma OS Orthophoric Minimal amplitude horizontal pendular 10 CF 5′ CF 5′ 0 0 Diffuse optic atrophy OU Central scotomas OU Orthophoric None 11 20/200 20/100 Small discs with diffuse optic atrophy OU Unable OU Modest XT Moderate amplitude horizontal [iovs.arvojournals.org]
SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS. [journal.opted.org]
(Case 6) 1 remember an experience in my early days of practice at an age when youth is synonymous with rashness, of having seen a case of optic neuritis with a central scotoma first in one eye then in the other. [ijo.in]
Neurologic
- Seizure
Many children with BOA may have other neurological problems such as seizures, developmental delays or motor problems. [secure.ssa.gov]
Seizures, problems with motor function and developmental delays are commonly seen in more severe cases. There is no cure for BOA and early treatment focuses primarily on addressing symptoms. [disabilitybenefitscenter.org]
Many children with ONA have additional neurologic problems, such as seizures, developmental delays or motor problems, and Cortical Visual Impairment (CVI). [tsbvi.edu]
[…] has been divided five major categories, that is, asymptomatic, meningeal, meningovascular, parenchymatous, and gummatous, these entities represent a continuum and frequently overlap. [3] Overlap between different forms of NS is largely restricted to seizure [annalsofian.org]
Infections, especially pneumonia and septicaemia, are a common cause of death. [7 ] Neurologic problems, such as hydrocephalus, facial paresis, seizures, and mental retardation, are also common. [5, 8 ] Dental problems are also common. [djo.org.in]
Workup
Our case report highlights the fact to incorporate serum and CSF VDRL screening in workup of noncompressive myelopathy. [annalsofian.org]
Visual Field Test
- Central Scotoma
scotoma OS Orthophoric Minimal amplitude horizontal pendular 10 CF 5′ CF 5′ 0 0 Diffuse optic atrophy OU Central scotomas OU Orthophoric None 11 20/200 20/100 Small discs with diffuse optic atrophy OU Unable OU Modest XT Moderate amplitude horizontal [iovs.arvojournals.org]
SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS. [journal.opted.org]
(Case 6) 1 remember an experience in my early days of practice at an age when youth is synonymous with rashness, of having seen a case of optic neuritis with a central scotoma first in one eye then in the other. [ijo.in]
Other Pathologies
- Gliosis
A small degree of gliosis is usually present and primarily represents a proliferation of astrocytes. This gliosis is not as severe as in inflammations of the optic nerve. [test.aneskey.com]
General Pathology In optic nerve atrophy there is loss of axons and shrinkage of myelin leading to gliosis and widening of the optic cup. Primary prevention Optic atrophy is the end stage of a process causing damage to the optic nerve. [eyewiki.aao.org]
Fundus examination (Figure 2a, 2b) revealed chalky white optic discs with well defined margins without any gliosis or disc edema bilaterally. [djo.org.in]
Histopathologic changes in optic atrophy Shrinkage or loss of both myelin and axis cylinders Gliosis Deepening of the physiologic cup with barring of the lamina cribrosa Widening of the subarachnoid space with redundant dura Widening of the pial septa [thehealthscience.com]
Histopathologic changes noted in optic atrophy include the following: Shrinkage or loss of both myelin and axis cylinders Gliosis Deepening of the physiologic cup with barring of the lamina cribrosa Widening of the subarachnoid space with redundant dura [emedicine.medscape.com]
Treatment
Treatment Guidelines There is no local (retinal) treatment for primary optic atrophy so no referral to a retinal specialist is warranted. The key to proper treatment is determining the etiology of the optic atrophy. [decisionmakerplus.net]
One of the reasons for pessimism is that there is too often an excessive delay in starting treatment and that, as a result, optic atrophy may progress to blindness before adequate treatment is instituted. [nejm.org]
Treatment depends on which disorder that you have. With some optic nerve disorders, you may get your vision back. With others, there is no treatment, or treatment may only prevent further vision loss. [icdlist.com]
Until recently, there was no treatment indicated for LHON. [santhera.com]
However, after established optic neuropathy and visual loss there is little chance, if any, for visual recovery and no definitive treatment exist for treatment in these cases. [clinicaltrials.gov]
Prognosis
Atrophic (BR)- atrophic pallor, edema, attenuated vessels, no hemes, opacified NFL - profoundly reduced VAs, color vision, VF defects, + APD Prognosis and Management of Papilledema 1. Brain scan - rule out SOL 2. [studyblue.com]
Prognosis is variable, with moderate to severe visual loss and nystagmus. Systemic abnormalities include spastic gait, ataxia and mental handicap. 23. [slideshare.net]
It was found that the prognosis for useful vision is in general favorable in this group of cases. [pediatrics.aappublications.org]
Unfortunately, a prompt diagnosis is of extreme importance, since the sooner an appropriate treatment is initiated, the better the prognosis and the less probability of permanent visual damage. [frontiersin.org]
Visual prognosis following optic neuropathy is generally poor. Renal biopsy provided a clue for the diagnosis in the absence of clinical findings other than ocular involvement in these patients. [japi.org]
Etiology
Optic nerve damage may be reversible, so early detection and treatment of the underlying etiology is critical. Correction of an underlying nutritional deficiency and discontin... [5minuteconsult.com]
In 27 % of the cases no cause could be found while in the rest of 73% cases definite etiological factor was present. [ijo.in]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiology and Pathophysiology Genetic etiologies usually involve defects in mitochondrial function. Exposure of retinal nerve cells to light normally results in the generation of free radical species. [unboundmedicine.com]
Etiologic classification Regardless of etiology, optic atrophy is associated with variable degrees of visual dysfunction, which may be detected by one or all of the optic nerve function tests (see Other Tests). [thehealthscience.com]
Epidemiology
EPIDEMIOLOGY AND CAUSES OF OPTIC ATROPHY IN GENERAL OUTPATIENT DEPARTMENT OF LUMBINI EYE INSTITUTE. [nepjol.info]
The epidemiology of Leber hereditary optic neuropathy in the northeast of England. Am J Hum Genet. 2003;72:333-9. Horvath R, Abicht A, Scoubridge EA, et al. [rarediseases.org]
Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. [frontiersin.org]
Epidemiology Frequency United StatesAccording to Tielsch et al, the prevalence of blindness attributable to optic atrophy was 0.8%. [3] According to Munoz et al, the prevalence of visual impairment and blindness attributable to optic atrophy was 0.04% [thehealthscience.com]
Epidemiology Acquired ONA is more common than hereditary and congenital ONA and tends to occur later in life: Glaucoma, ischemic optic neuropathy (older), optic neuritis (younger), compressive (any age), and toxic/nutritional are leading causes in adults [unboundmedicine.com]
Pathophysiology
Pathophysiology The optic nerve comprises approximately 1.2 million axons that originate at the ganglion cell layer of the retina. [thehealthscience.com]
Traumatic optic neuropathy The exact pathophysiology of traumatic optic neuropathy is poorly understood, although optic nerve avulsion and transection, optic nerve sheath hematoma, and optic nerve impingement from a penetrating foreign body or bony fragment [emedicine.medscape.com]
Pathophysiology There is a loss of axons and shrinkage of myelin, leading to widening of the optic cup. Presentation [ 1 ] This depends on the causative condition. Optic disc atrophy in isolation results in the following symptoms and signs. [patient.info]
Etiology and Pathophysiology Genetic etiologies usually involve defects in mitochondrial function. Exposure of retinal nerve cells to light normally results in the generation of free radical species. [unboundmedicine.com]
The pathophysiology of NAION is unknown, but it is related to poor circulation in the optic nerve head. [en.wikipedia.org]
Prevention
They have to be also aware of the preventive measures and precautions to be taken, which include: Avoidance of multiple sex partners Practice of safe sex (use of condoms that prevent entry of the syphilis bacteria) Excessive craving for drugs and alcohol [dovemed.com]
Primary prevention (removal of the process causing the damage) is the goal to prevent loss of axons and optic atrophy (neuropathy). [eyewiki.aao.org]
With others, there is no treatment, or treatment may only prevent further vision loss. [icdlist.com]
Página 310 - A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. [books.google.es]
For example, early diagnosis and aggressive treatment can prevent further damage in patients with compressive and toxic neuropathies. Intravenous steroids are helpful in some cases of optic neuritis or anterior ischemic optic neuropathy. [decisionmakerplus.net]