A study was done to systematically characterize visual function in eyes with recovered optic neuritis. Thirty-five eyes from 27 patients, all of whom had recovered at least 20/30 Snellen acuity after ...resolution of the neuritis, were included. Minimum recovery period was 6 months. Abnormalities were found in color vision (57%), contrast sensitivity (72%), perimetry (26%), stereoacuity (80%), light brightness (89%), pupillary reaction (89%), and optic disc appearance (77%). Eighty-five percent of patients complained of at least some subjective disturbance in vision. Subjective visual complaints correlated better with deficits in contrast sensitivity than they did with the other measures. The results of the study indicate that deficits in visual function are common after resolution of optic neuritis.
Amblyopia in Children Aged 7 to 17 Years—Reply Scheiman, Mitchell M; Hertle, Richard W; Beck, Roy W ...
Archives of ophthalmology (1960),
11/2006, Letnik:
124, Številka:
11
Journal Article
The etiology of anterior ischemic optic neuropathy (AION), when not associated with giant cell arteritis, is usually unknown. Clinical, pathologic, and experimental studies have not determined a ...cause. The optic disc appearance in both the involved and normal fellow eye was studied in 51 patients with acute nonarteritic AION. The number of discs (both involved and fellow) without a physiologic cup was significantly greater than would be expected from normal population studies. The etiology of nonarteritic AION may be related to the anatomic configuration of the optic nerve.
BACKGROUND Participants enrolled in the Optic Neuritis Treatment Trial have been observed for more than a decade to assess the relationship between optic neuritis and the development of clinically ...definite multiple sclerosis. OBJECTIVE To assess neurologic disability 10 to 12 years after an initial episode of optic neuritis. DESIGN Longitudinal follow-up of a clinical trial. SETTING Fourteen Optic Neuritis Treatment Trial clinical centers performed standardized neurologic examinations, including an assessment of neurologic disability. PARTICIPANTS One hundred twenty-seven patients who had developed clinically definite multiple sclerosis. MAIN OUTCOME MEASURES Functional Systems Scale and Expanded Disability Status Scale. RESULTS The disability of most patients was mild, with 65% of patients having an Expanded Disability Status Scale score lower than 3.0. The degree of disability appeared to be unrelated to whether the baseline magnetic resonance imaging scan was lesion-free or showed lesions (P = .51). Among patients with baseline lesions, the degree of disability was unrelated to the number of lesions that were present on the scan (P = .14). Two patients died owing to severe multiple sclerosis, one of whom had no lesions revealed on the baseline scan. CONCLUSION Most patients who develop clinically definite multiple sclerosis following an initial episode of optic neuritis will have a relatively benign course for at least 10 years.Arch Neurol. 2004;61:1386-1389-->
Automated threshold static perimetry with the Humphrey field analyzer and kinetic and suprathreshold static perimetry with the Goldmann perimeter were performed on 171 eyes: 69 with glaucoma or ...ocular hypertension, 69 with "neurologic" disorders, and 33 normal. The two fields were similar or differed only slightly in 78% of eyes overall and in 88% when both fields appeared reliable. In general, defects were slightly more extensive using the Humphrey than the Goldmann perimeter. In 21% of the eyes with glaucoma or ocular hypertension, defects were found with the Humphrey perimeter that were not present with the Goldmann perimeter. Patient fixation was more difficult to maintain on the Humphrey than Goldmann perimeter. Poor fixation accounted for 9% of the automated fields being inadequate whereas only 2% of the manual fields were inadequate. The results indicate that the Humphrey Field Analyzer is capable of reliably detecting and quantitating visual field defects.
To assess the benefit of adding oral acyclovir to a regimen of topical prednisolone phosphate and trifluridine for the treatment of iridocyclitis caused by herpes simplex virus (HSV).
Patients with ...HSV iridocyclitis were enrolled in a multicenter controlled clinical trial supported by the National Eye Institute, Bethesda, Md, and randomly assigned to receive a 10-week course of either oral acyclovir, 400 mg, 5 times daily, or oral placebo in conjunction with regimens of topical trifluridine and a topical corticosteroid. Follow-up examinations were performed weekly during the 10-week treatment period, every 2 weeks for an additional 6 weeks, and at 26 weeks after enrollment in the trial. Treatment failure was defined as a persistence or worsening of ocular inflammation, withdrawal of medication because of toxicity, or a request by the patient to withdraw from the trial for any reason. The trial was stopped because of slow recruitment after only 50 of the originally planned 104 patients were enrolled in more than 4 years.
A treatment failure occurred in 11 (50%) of the 22 patients in the acyclovir-treated group and in 19 (68%) of the 28 patients in the placebo group. Compared with the placebo group, the adjusted rate ratio for a treatment failure in the acyclovir-treated group during the 10-week treatment period was 0.43 (90% confidence interval, 0.18-1.02; P = .06, 1-tailed) and during the 16-week follow-up period (10-week treatment period plus 6-week observation period) was 0.60 (90% confidence interval, 0.29-1.25; P = .13, 1-tailed in a proportional hazards model). The treatment effect seemed slightly greater when only the patients with a persistence or worsening of ocular HSV disease were considered as treatment failures (ie, excludes terminations because of toxic effects of the drug and patients who requested to withdraw from the trial). By life-table analysis, similar results were obtained; the possible benefit of acyclovir became apparent after the first 3 weeks of follow-up.
While the number of patients recruited in this trial was too small to achieve statistically conclusive results, the trend in the results suggests a benefit of oral acyclovir in the treatment of HSV iridocyclitis in patients receiving topical corticosteroids and trifluridine prophylaxis.
