Ординатура / Офтальмология / Английские материалы / Neuro-Ophthalmology_Kidd, Newman, Biousse_2008

Dermolipomas, from dermis, 74–75 Desquamated epithelium, accumulation of,

73–74 Deviations

concomitant, 37 inconcomitant, 37

Devic’s syndrome, 153–154, 172, 174f, 176–177, 177–178

diagnostic criteria for, 175t Diabetes insipidus, presence of, 240 Diabetes mellitus

bilateral Horner’s syndrome in, 272

as manifestations of systemic disorders, 2 symptoms and signs of, 201

Diabetic papillopathy, 131f

DIDMOAD, (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness), 201

Dilation lag, 32

Dilator muscle, by sympathetic neurones, 265 Diplopia

as binocular, 34 causes of, 64–65 crossed, 35–36 monocular, 34

Disc abnormalities, for papilledema, 283–284 Disc, at risk, 114–117, 117f

Disc drusen, 287f

Disc edema, 57, 280–281 diffuse/segmental, 113–114

in setting intracranial pressure, 97f Disc pallor, 138

temporal, 140f Disc swelling, 161

asymptomatic, 130 causes of, 288

diabetes mellitus develop, 130 generic, 281

mechanism of, 130 mild, 140f

DNA, extranuclear, source of, 195–196 DOA. See Dominant optic atrophy Doll’s eye, 39

Doll’s head, 16–17, 41

Dominant optic atrophy (DOA), 196f autosomal, 199

with Kidd blood group antigen, 200–201 phenotypic variant of, 199–200

Dorello’s canal, 321

beneath petroclinoid ligament, 16–17 Dorsal midbrain syndrome, 323 Downbeat nystagmus, 326

effective treatments for, 326

Drug chemotherapy, with or without orbital radiotherapy, 89–90

Drugs, on iris color, 269

Drug toxicity, as manifestations of systemic disorders, 2

Drusen, computed tomography scan of, 287f

Duction testing, forced, 37f Dural biopsy, of dura, 170f Dural shunts, 79–80

Dural venous thrombosis, 302 Dyschromatopsia

acquired, 26

with funduscopic abnormality, 26 with optic nerve lesions, 26

Dysmetropsia, 345–346

E

Edinger-Westphal nucleus, 19–20, 268–269, 336 contralateral, 265–267

Edrophonium chloride test, 317 Edrophonium test method, for diagnosis in

myasthenia gravis, 318f Electrophysiology, 56 Electroretinogram (ERG), 50–51 ENA. See Extractable nuclear antigens Endocrine disease, 307

Endothelial cell, with pericytes, 214 Enophthalmos and hypoglobus, 65f Epidermoids and dermoids, 252

Episcleral vasculature, dilated, of low-flow dural shunt, 69f

Episcleral vessels, 68 Epithelial cysts, 73

ERG. See Electroretinogram

Erythrocyte sedimentation rate (ESR), 124–126, 141

Esodeviation, 35f, 36f Esotropia, amount of, 321

ESR. See Erythrocyte sedimentation rate Ethambutol, toxic to optic nerve, 198 Ethmoid air cells, anterior, 164

Ethmoidal mucocele, displacement of left globe, 76f

Ethmoid and sphenoid sinus, mucoceles of, 164f Exophthalmos, 60–63

Extractable nuclear antigens (ENA), 179 Eye charts, for maximal contrast, 26 Eye deviation, conjugate lateral, 40 Eyelid

elevator muscle, 12–13 examination of, 32–33 function, defined, 32f

meibomian gland carcinomas of, 92–93 retraction

causes of, 32–33

from dorsal midbrain compression, 33f upper, 68f

swelling, 68 tenderness of, 66f

Eye movements

abnormality in coma, 40–41 disorders, 312

functional class of, 314–315 initiation of conjugate, 18

Eye movements—Cont’d muscles responsible for, 11 restriction of, 81f summary of, 17f

vergence, 314–315 vestibular, 314–315

Eyes

conjugate movement of, 18 dysconjugate, 40–41

effect of removal of fixation on, 314 esotropia, 35

exotropia, 35 hypertropia, 35 inability to move, 37

symptoms and signs of, 83–84 test for horizontal deviation of, 35f

testing for vertical separation of, 36f

F

Face recognition, 341–342

Facial colliculus syndrome, 16–17 Farnsworth D-15 panel test, 25–26 Farnsworth-Munsell 100 hue test, 25–26 Fatigueable ptosis, 34

Fatigue waves, 268–269

Fat, proptosis and patchy infiltration of, 92f Fat-saturated fast spin echo, 142

FBC chemistry screening, blood test for, 141 FEF. See Frontal eye fields

Fibers

destined for iris dilator muscle, 265 form optic nerve, 51

Fibroblast activation and GAG deposition, 83–84

Field testing, 241

Fine needle aspiration, to establish diagnosis, 226

Fixation, with normal ocular alignment, 313f

Florid enhancement, in infected mucocele, 254f

Fluorescein angiography, 56, 126–127, 161–162, 172

FMRI. See Functional MRI Follicle-stimulating hormone (FSH), 239 Formal perimetry, 30

Fossa trigeminal Schwannoma with double vision, 252f

Fourth nerve, 15–16

Fourth nerve palsy, 16, 319–320 lesions of, 15–16

photograph of, 16f

Fovea, preservation of cherry red spot at, 52f

Friedreich’s ataxia, 201–202 Frontal eye fields (FEF), 323

FSH. See Follicle-stimulating hormone Full-field achromatopsia, 348

Functional MRI (fMRI), 335 Fundus

photograph of normal left, 3f schematic diagram of normal left, 3f

Fungal disorders, 161 Fusiform face area, 333

G

Gadolinium, showing Arnold-Chiari type I malformation, 327f

GAG deposition, 83–84 accumulation of, 83–84

Gamma aminobutyric acid (GABA)-ergic neural transmission, 325

Gamma knife, 245

Ganglioglioma, of optic nerve, 213f Ganglion cells, 2–3, 51

axons of, 51 damage to, 51 involvement of, 198

near mandible, 20–22

Ganglion cell tumors, within optic nerve, 211–212

Gaze deviation, 323 Gaze-evoked nystagmus, 327 Gaze palsy, 16–17

Gene therapy, form of, 203 Genetic analysis, 198

Geniculocalcarine fibers, for calcarine cortex form, 9

Germinoma, 251

GH-secreting tumors, 243–244, 244–245

Giant cell arteritis, 102, 121–124, 126, 128, 154, 183

artery biopsy showing, 183f diagnosis of, 126–127

ophthalmologic manifestations of, 124t Glasgow coma scale, 40

Glial tumors, of optic nerves, 250 Glioma, surgical excision of, 210 Globe displacement, 65f, 66

Goldmann kinetic perimeter, on damaged eye, 241

Goldmann perimetry, 287–288

to test for visual field defects in neuroophthalmic patients, 30

Goldmann visual field, showing relative central scotomas, 55f

Granular cell tumor, 255, 255f Granulomatous angiitis, 182 Granulomatous inflammation, 170–171 Granulomatous tissue, 166

Graves’ disease, 83–84

Graves’ thyrotoxicosis, treatment of, 86 Growth disorders, 303

example of, 303 Gruber’s ligament, 16–17

Guillain-Barre´ syndrome, 322

H

Hair follicles, cutaneous sinus containing, 74f Hairy dermolipoma, overlying lateral sclera, 75f Hallucinations

complex, 347 release, 347 visual, 347

Hand Rittler Round plates, 348 Hardy-Rand-Rittler (HRR) color plates series,

25–26, 25f, 137 Harlequin syndrome, 271–272 Headache

categorize of, 242

cause of, in hydrocephalus, 298 with high pressure, 285

with idiopathic intracranial hypertension, diagnostic criteria for, 297t

relief, extent of, 297 symptom of papilledema, 285

Head turning, 41

Hearing loss, severe and congenital, 199–200 Heidenhain variant, of Creutzfeldt-Jacob disease,

336

Hemangioblastomas, composed of, 214 Hemangiopericytoma, 72

as symptomatic, 224

type of angioblastic meningioma, 223–224 Hemianopsia defects, 5f

Hemiparesis, 11 Hemorrhage

drainage of, 77–78

and hydrocephalus, 323 Hepatitis B, 172

Hereditary optic neuropathy classification of, 191

dominant optic atrophy, 199–201 hereditary diseases, 201–203 Leber’s, 192–198

with mitochondrial dysfunction, 196f therapeutic implications, 203

Hering’s law, on neural innervation to eyelids, 316 Hess charting, 67

High-dose steroids, 253

Higher visual disorder, 348–349 High-flow fistula, 68

High-pressure arteriovenous communications, of intraconal circulation, 79–80

High-pressure headaches bilateral, 297 unilateral, 297

High-resolution imaging techniques, 335 Hodgkin’s disease, and non-Hodgkin’s

lymphoma (NHL), 72, 228 Holmes-Adie syndrome

clinical diagnosis of, 275–276 irregular pupil shape in, 274f signs in, 275–276

Homonymous defects, 5f Homonymous hemianopia, 349–350

Horner’s syndrome, 16, 32, 120, 269 bilateral, 272

causes of, 272 evaluating, 269 left-sided, 271f preganglionic, 272 signs of, 20–22, 272

unilateral postganglionic, 271f HRR. See Hardy-Rand-Rittler Human brain

drawing of lateral surface of, 334f drawing of medial surfaces of, 338f

Humphrey static perimetry, 241 Humphrey visual field, 116f, 287–288 Huntington’s disease, 323–324, 346 Hydrocephalus, 169, 302–303

development of, 159 with shunts, 249

Hypercoagulable, with NAION, 120 Hyperemia, of optic nerve head, 194 Hyperglycemia/hypertension, control of,

86–87 Hyperopic disc, 285f

Hyperostotic sphenoidal type, 248 Hyperostotic sphenoid wing meningioma, 246f Hyperplasia, thyrotroph, 240f

Hypertension

and hypercoagulability, 53

as manifestations of systemic disorders, 2 systemic, treatment for, 295

Hypertrophic pachymeningitis, 321 Hypophysitis, 253–254 Hypotension, 100–101 Hypotensive retinopathy, 101f Hypothalamic lesions, 40

I

Ice pack test, 317

ICP. See Intracranial pressure Idiopathic, 81–82

Idiopathic hypertrophic pachymeningitis, complications of, 180

Idiopathic intracranial hypertension (IIH) associations with, 301t

and diplopia, 284

modified Dandy criteria for, 300t symptoms and signs of, 300

Idiopathic TMVL, in young individuals, 102 IIH. See Idiopathic intracranial hypertension Immunoglobulin G, elevated, 143 Implantation cysts, 73–74

INC. See Interstitial Nucleus of Cajal Inconcomitant deviations, 37 Incongruous defects, 5f

Inferior temporo-occipital cortex, lesions in, 342 Inflammatory diseases, of orbit, 80–82 Inflammatory disorders, 321

Inflammatory edema, STIR sequences on, 84–86

Optic nerve—Cont’d form optic chiasm, 7–8 frequency of, 228

funduscopic view of, 194f funduscopic view of right and left,

195f, 200f hemangioblastoma of, 214f hemangiopericytoma of, 225 infiltration of, 228, 229f invasive tumors of, 227 involvement of, 182 malignant glioma of, 211 medulloepithelioma of, 213f metastatic tumor to, 227 MRI scans of, 149, 168f, 227f

and optic chiasm, relationships of, 8 orbital portion of, 210

pathologic features of, 211 position of, 241

posterior segment of, 128 primary tumors of, 214

ganglioglioma, 211–212 hemangioblastoma, 214

malignant optic nerve glioma, 210–211 medulloepitheliomas, 212–214

optic nerve glioma, 207–210 summary, 231

and retina, 38

secondary tumors of, 206 lymphoreticular tumors, 228–231 metastatic and locally invasive tumors,

225–228

with transient visual obscurations, 96f tumors of, 73

vascularization of, 113f

Optic nerve dysfunction, causes of, 7 Optic nerve function, 70

Optic nerve glioma, 206, 207, 207f, 250 appearance of, 208f

common tumor of optic nerve, 206–207 diagnosis of, 208

enlarged optic canal, 208 gross appearance of, 209

macroscopic appearance of, 209f malignant, 212f

MRI of, 209f

natural history of, 209–210 and NF1, 207–208

as sporadic, 207

symptoms and signs with, 207 treatment for malignant, 211

Optic nerve head normal-appearing, 46f pale, 46f

swollen, 46f

Optic nerve head ischemia, 4–7 Optic nerve infiltration

appearance of, by lymphoma, 228–229 clinical patterns of, 229–231

Optic nerve medulloepithelioma, 213 composed of multilaminar columnar cells,

214 treatment of, 214

Optic nerve myelin, by oligodendrocytes, 223 Optic nerve sheath

enhancement of, 163f primary tumors of, 223–225

hemangiopericytoma, 223–225 meningioma, 215–223 Schwannoma, 223

tumor of, 215

Optic nerve sheath hemangiopericytoma computed tomography appearance of, 225f histopathology of, 224f

Optic nerve sheath meningiomas (ONSM), 163, 215, 217, 247

in childhood, 216 diagnosis of, 216, 218–219

echographic evaluation of, 218–219 goals in management of, 221–223 majority of primary, 216

natural history of, 220–221 primary, 215, 219–220 radiotherapy for, 219, 220

with retinochoroidal collateral vessels, 216f secondary, 215

for small segment of optic nerve, 215 treatment option for, 221

Optic nerve sheath Schwannoma, 223 computed tomography, 224f histopathology, 224f

Optic neuritis, 135–137, 154, 179 acute, 140f

acute demyelinating, 141 bilateral, 140

causing disc swelling, 287 clinical features, signs, 140–141

abnormalities in fellow eye, 140–141 ophthalmoscopic abnormalities,

138–140

pupillary reactions, 138 visual acuity, 137–138 visual field, 138

clinical features, symptoms, 137 orbital pain and headache, 135–137 positive visual phenomena, 137 visual loss, 137

development of, 160 diagnosis, 143

blood investigation, 141 cerebrospinal fluid, 143

magnetic resonance imaging, 142–143 visual evoked potential, 141–142

disorder in females, 136t epidemiology, 135 history of, 135

in infectious disease, 153 introduction, 135

Optic neuritis—Cont’d

multiple sclerosis, relationship to, 148 cerebrospinal fluid data, 148 clinical data, 146–147

MRI data, 147 natural history of, 146

recurrent, 146

residual visual loss, 145–146 neuro-ophthalmologic condition, 134 and paraneoplastic antibody, 172 with reduction in central acuity, 137 subacute disorder, 135

subacute, visual disorder, 149 summary, 149

treatment, 148–149 and visual loss, 307

Optic Neuritis Treatment Trial, 26, 135, 148 Optic neuropathy, 57, 167–169, 181, 228

with adjacent inflammatory mass lesion, 169 bilateral, 56

and symmetric, 54 and synchronous, 173

categories of disease processes cause, 57t causes, 77–78

complicate meningitis, 160

consequence of intracranial hypertension, 161 consequence of ischemia, 154

consequence of retinal vasculitis, 176 in cryptococcal infections, 161

from demyelinating optic neuritis, 153 with Devic’s syndrome, 179–180 diagnosis of, 54

differentiate, 45

from direct toxic effect of HIV, 155–159 etiology of, 57

evidence of, 201–202 features of, 44, 45 inherited, 192t isolated, 176

in isolation, 154 in lupus, 178

of neurogenic visual loss, 45 occurrence of, 172

with orbital apex, 84–86 primary, 191

primary bilateral, 54 progressive or subacute, 165 recognizing, 45

spare visual acuity, 45 subacute, 154, 167–168

with transversemyelitis, 172–173 in tuberculosis, 160

unilateral, 167–168 unilateral and sequential, 173

Optic perineuritis, 163f

Optic radiations, anatomic separation of, 10 Optic tract lesions, 276–277

Optic tracts, fibers of, 8–9

Orbital apex, and cavernous sinus syndromes, 18

Orbital apex crowding, with optic neuropathy, 86f

Orbital apex syndrome, 81–82 Orbital capillary hemangioma, 76–77 Orbital cellulitis, 93f

Orbital disease

ancillary tests for, 70–73 assessment of, 70–73

diplopia, 64–65

globe, position of, 60–63 pain, 60

sensory disturbance, 65 visual loss, 63–64

choice for, 59

clinical examination for, 69–70 evidence of mass, 66–67

ocular balance and ductions, 67 periorbital signs, 68

signs of intraocular or systemic disease, 69–70

visual functions, 66 clinical history in, 65 common, 88–93 incidence of, 73 malignant, 91–93

principal and causes of, 61t Orbital fat excision, 87–88

Orbital fissure and orbital apex, lesions on superior, 18

Orbital infiltration, 92–93 Orbital malignancy

adult, 91–93

in children and young adults, 89–91

Orbital mass, right, revealed by episodes of acute complete visual loss, 97f

Orbital metastases, 92 Orbital osseous disease, 88

Orbital pseudotumor syndrome, 163, 315–316 Orbital radiotherapy, complications of, 89–90 Orbital tissues, 166

Orbital varices, distensible, 64f

Orbit and extraocular muscles, anatomy of, 11–12

Orbit and paranasal sinuses, structural lesions of, 73–76

OTR. See Ocular tilt reaction

P

Paget’s disease, 326 Pain

within affected eye, 135–137 as dull ache, 135–137 factors influencing, 60

in neck, 285–286 Palatal necrosis, 68 Palinopsia, 344–345

mechanism of, 345 types of, 344–345

PAN. See Periodic alternating nystagmus Pancoast’s syndrome, 272 Panhypopituitarism, with diabetes insipidus,

253

Papilledema, 41, 298–299, 302

with Addison’s disease and Cushing’s disease, 307

causes of, 289t, 291–294, 292t, 300 complications of, 296

with corticosteroids, 296 diagnosing, 288–290 evaluation for, 280 features of, 38

fluorescein angiogram in, 289f

natural history and visual complications of, 294–296

nonvisual symptoms of, 285–286 signs of, 286–288

symptoms of, 284–286 treatment of, 296–298 unusual forms of, 290 visual field testing in, 288f

Papilledema-associated headache, management of, 297

Papilledema-associated vision loss, prognostic factors for, 294

Papilledema Staging Scheme, by Lars Frise´n, 284t

Papilledema, with elevated pressures, 289–290 Papillitis, 280

Papillomacular bundle, 2–3

Paramedian pontine reticular formation (PPRF), 16–17, 323

and MLF, 324 Paraneoplastic retinopathy, 56

Paraneoplastic syndromes, 327–328 Parieto-occipital-temporal (POT) junction, 19 Parkinson’s disease, 323–324, 346

Pars planitis and intermediate uveitis, 138–140 PCA. See Posterior cerebral artery Pelizaeus-Merzbacher disease, 325 Pelli-Robson chart, 26

Penicillin, advent of, 277–278 Pericytes, endothelial cell with, 214

Periodic alternating nystagmus (PAN), 326–327 Periorbital inflammation, marked, 66f Peripheral field, ganglion cell axons from, 2–3 PET. See Positron emission tomography Petroclival meningiomas, sinus-involving, 246 Phosphenes or photopsias, 137 Photoreceptors, loss of, 56

Pineal gland cyst, 323 “ping-pong” gaze, 41

Pinhole device, on retina, 23–24, 23f

PION. See Posterior ischemic optic neuropathy Pituitary carcinomas, 245

Pituitary dysfunction, late, 220 Pituitary fossa, 252–253

chiasm, position of, 8

Pituitary function, investigations for, 240 Pituitary hormones, underproduction and

overproduction of, 239 Pituitary lesions, silent, 243–244 Pituitary sella, optic chiasm above, 8 Pituitary tumors, cause headache, 241

Planum meningioma and cerebral arteries, 246f Planum meningioma, vision in, 248 Platelet-fibrin emboli, 100f

POEMS syndrome, 302

Point mutations, mitochondrial genome showing, 197f

Polyarteritis nodosa (PAN), 182 Polygonal cells, 219

Positive syndromes, 346–347

Positron emission tomography (PET), 72, 335 Posterior cerebral artery (PCA), 335 Posterior ischemic optic neuropathy (PION),

128 AION and, 128 causes of, 128

diagnosis of, 128 Postganglionic fibers form, 265

POT. See Parieto-occipital-temporal Potassium channel blockers, 326 P-POHS. See Pseudo-presumed ocular

histoplasmosis syndrome

PPRF. See Paramedian pontine reticular formation

Preganglionic parasympathetic blockade, 273–274

Pressure symptoms, of mass lesion, 239 Pretectal lesions, 277

Pretectal neurons, 265–267 Primary LHON mutations, 196–197 Primary tumors, 321

contiguous spread of, 227 Prolactinoma

anterior pituitary hormone, 239 with entrapment mucoceles, 254f with prolactin, 244f

Proptosis, 60–63

after Valsalva maneuver, 64f apparent right, 63f

cause of unilateral and bilateral, 59 and optic disc swelling, 213 orbital signs, 216

Prosopagnosia, 341–342

Protein elevation and lymphocytosis, 154–155

Pseudo-isochromatic color plates, 25f Pseudopapilledema

cause of, 283–284 common cause of, 285f

differentiating papilledema from, 286t Pseudo-presumed ocular histoplasmosis

syndrome (P-POHS), 50–51 Pseudoptosis, with blepharospasm, 32–33 Pseudotumor syndrome, 81–82, 301