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Primary Optic Atrophy


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]
  • 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]
  • Initially, it seemed as though this patient had no chief complaint and simply presented to the office for a “routine” eye examination for the purpose of receiving new prescription eyeglasses.[decisionmakerplus.net]
  • It presents two divisions. Of these one lies freely open to the numberless vicissitudes and agencies of the environment. That is to say, it is co-extensive with the so-called external surface of the animal.[books.google.com]
Falling
  • Graefe, Albrecht von: Ein ungewöhnlicher Fall von hereditärer Amaurose. Arch. f. Ophth., 4:266, 1858. Google Scholar 2. Leber, Theodor: Über hereditäre u. congenital angelagte Sehenervenleiden. Arch. f. Ophth., 17:249, 1871. Google Scholar 3.[link.springer.com]
Ulcer
  • Rompalo et al ., [12] report that the only significant difference among HIV-infected and uninfected persons suffering from syphilis was an increase in median number of genital ulcers.[annalsofian.org]
  • Any contact with these ulcerative lesions result in a transmission of the condition There are 3 stages in the progression of Syphilis; Primary, Secondary, and Tertiary. The sooner the treatment is started, better is the outcome.[dovemed.com]
Stiffness of the Lower Limbs
  • He had stiffness of both lower limbs. There was no history of numbness, imbalance while walking, and pain or paresthesias in any limb.[annalsofian.org]
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]
Compulsive Behavior
  • Obsessive-compulsive behavior and autistic features have been reported in a single individual. Hypotonia may be present.[disorders.eyes.arizona.edu]
Excitement
  • Thus, the property of brightness and the property of odour belonging to an object of prey may then better excite in unison a reaction in the distant reagent, or excite more potently than would either property alone. ‏[books.google.com]
  • Thus, the property of brightness and the property of odour belonging to an object of prey may then better excite in unison a reaction in the distant reagent, or excite more potently than would either property alone. ‎[books.google.com]

Workup

  • Our case report highlights the fact to incorporate serum and CSF VDRL screening in workup of noncompressive myelopathy.[annalsofian.org]
Glycosuria
  • Clifford Allbutt in 1871 stated “atrophy of the optic discs … does undoubtedly occur in a sufficient number of cases of glycosuria to make the coexistence seem more than accidental.”[diabetes.diabetesjournals.org]
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]

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]
  • It was found that the prognosis for useful vision is in general favorable in this group of cases.[pediatrics.aappublications.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]
  • Prognosis The optic nerve is a part of the central rather than the peripheral nervous system as it is derived from the diencephalon during embryonic development.[patient.info]
  • […] bacteria) Excessive craving for drugs and alcohol, may lead to unsafe practices, such as ‘sex for drugs’ If you are frequently sexually active with multiple partners; then regular screening for sexually transmitted diseases is essential What is the Prognosis[dovemed.com]

Etiology

  • The key to proper treatment is determining the etiology of the optic atrophy. For example, early diagnosis and aggressive treatment can prevent further damage in patients with compressive and toxic neuropathies.[decisionmakerplus.net]
  • 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]
  • HTN -positive APD, reduced VAs, VF defects, color vision defects - treat etiology and monitor! Usually resolves over time with good outcome.[studyblue.com]

Epidemiology

  • EPIDEMIOLOGY AND CAUSES OF OPTIC ATROPHY IN GENERAL OUTPATIENT DEPARTMENT OF LUMBINI EYE INSTITUTE. Journal of Universal College of Medical Sciences, 3 (2), 26-29.[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]
  • Shiose Y, Kitazawa Y, Tsukahara S, Akamatsu T, Mizokami K, et al. (1991) Epidemiology of glaucoma in Japan–a nationwide glaucoma survey. Jpn J Ophthalmol 35: 133–155. View Article Google Scholar 36.[journals.plos.org]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • Youl et al 3 studied the pathophysiology of acute optic neuritis and the timing of gadolinium leakage.[ajnr.org]

Prevention

  • With others, there is no treatment, or treatment may only prevent further vision loss.[icdlist.com]
  • 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]
  • 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]
  • Página 310 - A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. ‎[books.google.es]
  • Therefore, the best defense for optic nerve atrophy is an early diagnosis because if the cause can be found and corrected, further damage can be prevented.[rawa.com.au]

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