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Biomedical subjects

Rod Foroozan

Publications and source records attributed to Rod Foroozan.

52 records · Page 3Linked to original sources
PubMed2002

Nonarteritic anterior ischemic optic neuropathy.

Nonarteritic anterior ischemic optic neuropathy refers to an idiopathic ischemic process of the anterior portion of the optic nerve. The typical presentation is sudden and painless visual loss with examination features of an optic neuropathy. Among the various associated risk factors are optic disc morphology, advanced age, systemic arterial hypertension, diabetes mellitus, and nocturnal hypotension. Currently, there is no proven effective long-term treatment for this disorder.

Decompression, Surgical↗
PubMed2002

Is normal tension glaucoma actually an unrecognized hereditary optic neuropathy? New evidence from genetic analysis.

Normal tension glaucoma and dominant optic atrophy share many overlapping clinical features, and differentiating between these two diseases is often difficult. The gene responsible for dominant optic atrophy is the OPA1 gene located on chromosome 3. This gene encodes for a protein product that is involved in mitochondrial metabolic function. Recent genetic linkage analysis of patients with normal tension glaucoma has shown an association with polymorphisms of the OPA1 gene. This association suggests that normal tension glaucoma may actually be a hereditary optic neuropathy with a pathophysiology based in mitochondrial dysfunction.

Disease Progression↗
PubMed2002

Acute demyelinating optic neuritis.

Acute demyelinating optic neuritis associated with multiple sclerosis (MS) is the most common cause of inflammation of the optic nerve. The Optic Neuritis Treatment Trial (ONTT) has provided important clinical data on the use of corticosteroids, and demonstrated that patients with characteristic inflammatory lesions within the brain on magnetic resonance imaging had a greater chance of developing clinically definite MS (CDMS). The current approach to patients with optic neuritis has been modified by the results of the Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study (CHAMPS). Patients with an initial clinical episode of demyelination (optic neuritis, incomplete transverse myelitis, or brain-stem/cerebellar syndrome) and at least two characteristic demyelinating lesions within the brain were randomized to receive interferon beta-1a or placebo after initial treatment with intravenous corticosteroids. At the 3-year point patients treated with interferon beta-1a showed a 50% less risk of CDMS. The results of this study have set the standard for patients with a first bout of demyelinating optic neuritis.

Acute Disease↗
PubMedDate not supplied

Superior segmental optic nerve hypoplasia and diabetes mellitus.

PURPOSE: The aim of this study was to describe the ocular findings of an 8-year-old girl with bilateral superior segmental optic nerve hypoplasia (SSONH) whose mother had a history of Type 1 diabetes mellitus and to review the prior literature concerning this association. METHODS: Neuroophthalmic examination, including funduscopy, visual fields, optical coherence tomography, and magnetic resonance imaging (MRI) of the brain and orbits, were used. RESULTS: Bilateral inferior visual field defects prompted initial neuroophthalmic evaluation. Funduscopy revealed bilateral SSONH, worse on the right. MRI of the brain and orbits revealed hypoplastic optic nerves and a small optic chiasm. CONCLUSIONS: Although the association between SSONH and maternal diabetes mellitus is a well-documented entity, prior reports have been solely in the neuroophthalmic literature. The optic discs in patients with SSONH have a characteristic appearance, which may obviate the need for additional evaluation of the visual field defects. The MRI findings of hypoplastic optic nerves and a small optic chiasm have previously not been reported. This patient underscores the importance of recognizing the association between SSONH and maternal diabetes mellitus.

Brain↗
PubMedDate not supplied

Unexplained visual loss.

Dominant optic atrophy is the most common heredodegenerative optic neuropathy. Typically, patients present with slowly progressive, bilaterally decreased central visual acuity. Subtle central or cecocentral visual field defect and normal peripheral isopters are demonstrated with perimetry. A defect in blue-yellow discrimination (tritan error axis) is the most common type of dyschromatopsia, however protan and deutan axes may be superimposed. A characteristic optic disk appearance includes temporal disk pallor with excavation. An autosomal dominant inheritance pattern can often be elicited from the family history.

Adult↗
PubMedDate not supplied

Transsphenoidal diplopia.

A 46-year-old man developed a pupil-involving incomplete third cranial nerve palsy after undergoing transsphenoidal resection of a pituitary macroadenoma. A CT scan 1 week later revealed postoperative changes, with no new mass lesion, hemorrhage, or orbital fracture. The third cranial nerve palsy spontaneously improved over the ensuing week. Postoperative ocular motor palsy is an uncommon complication of transsphenoidal pituitary surgery. Neuro-imaging should be performed to exclude the presence of a new compressive lesion.

Adenoma↗
PubMedDate not supplied

Perioperative posterior ischemic optic neuropathy: review of the literature.

Posterior ischemic optic neuropathy (PION) is an uncommon cause of perioperative visual loss. Perioperative PION has been most frequently reported after spinal surgery and radical neck dissection. The visual loss typically presents immediately after recovery from anesthesia, although it may be delayed by several days. Visual loss is often bilateral and profound with count fingers vision or worse. The examination findings are consistent with an optic neuropathy; however the funduscopic examination is initially normal. The cause is unknown, although patient-specific susceptibility to perioperative hemodynamic derangements is likely. No treatment has proven to be effective. The prognosis for visual recovery is generally poor.

Humans↗
PubMedDate not supplied

Diplopia after cataract surgery.

A 69-year-old man developed binocular, vertical diplopia after undergoing cataract extraction in both eyes. He had normal extraocular motility and a 2 prism diopter right hypertropia that was comitant but could not be relieved with overlying prisms. Funduscopy revealed an epiretinal membrane within the macula on the left more than the right. After his metamorphopsia worsened, and his visual acuity decreased to 20/40 in the left eye, he underwent pars plana vitrectomy with removal of the epiretinal membrane and his diplopia resolved. Macular pathology including epiretinal membranes and choroidal neovascular membranes may rarely cause binocular diplopia because of foveal displacement and rivalry between central and peripheral fusional mechanisms.

Aged↗
PubMedDate not supplied

Jumping Jack Flash.

A 38-year-old woman presented with blurred vision and "jumping" of the right eye for 7 months. Magnetic resonance imaging of the head was normal. Intermittent intorsion of the right eye was noted on examination, consistent with superior oblique myokymia. She was initially treated with carbamazepine but stopped after becoming light-headed. The diagnosis and treatment of superior oblique myokymia are discussed.

Adult↗
PubMedDate not supplied

Double vision worth a double take.

An 18-year-old girl presented with an acute acquired comitant esotropia. Investigation showed a brainstem glioma. Discussion of types of acute acquired comitant esotropia, differential diagnosis and neurologic work-up is given. Review of the literature involving acute acquired comitant esotropia is provided.

Acute Disease↗
PubMedDate not supplied

A sticky situation.

A 19-year-old woman presented with frontal headaches, papilledema, and binocular horizontal double vision due to a left VI nerve palsy. MRV demonstrated sagittal sinus and bilateral transverse sinus thrombosis. The clinical and neuro-radiologic signs resolved after anticoagulation.

Abducens Nerve Diseases↗
PubMedDate not supplied

Foggy visual field defect.

A 32-year-old female migraneur developed a right incongruous homonymous hemianopia after taking the antiepileptic agent, topiramate. The visual field defect partially resolved when the medication was discontinued. The differential diagnosis of the homonymous hemianopia is discussed.

Adult↗
PubMedDate not supplied

Recurrent acute lymphoblastic leukemia presenting in the lacrimal gland.

A 14-year-old girl with a history of acute lymphoblastic leukemia presented with periorbital swelling of the right eyelid associated with enlargement of the lacrimal gland and cervical lymphadenopathy. Radiographic imaging showed diffuse enlargement and enhancement of the right lacrimal gland. The patient underwent an incisional biopsy of the lacrimal gland that showed atypical lymphocytes consistent with recurrent acute lymphoblastic leukemia. The lacrimal gland is a rare extramedullary site for recurrence of this disease.

Adolescent↗
PubMedDate not supplied

Ocular complications of sigmoid sinus thrombosis from L-asparaginase.

This article presents a 9-year-old boy with acute lymphocytic leukemia who developed ocular complications after beginning treatment with L-asparaginase. Ocular motor examination revealed esotropia with a right abduction deficit, consistent with a sixth nerve palsy, and funduscopy revealed bilateral optic disc edema. Thrombosis of the right sigmoid sinus was noted on magnetic resonance imaging and magnetic resonance venography. Symptoms gradually resolved after discontinuing L-asparaginase and treatment with heparin.

Abducens Nerve↗