PURPOSE: To investigate the clinical manifestations and diagnoses of optic disc swelling. METHODS: The medical records of 49 patients who experienced optic disc swelling between March 2008 and June 2009 were retrospectively reviewed. The characteristics of non-arteritic anterior ischemic optic neuropathy (NA-AION) and optic neuritis (ON), which showed optic disc swelling most commonly, were compared. RESULTS: NA-AION was the most common disorder (34.7%) that presented with optic disc swelling. ON was identified in 15 patients (30.6%). Seven out of 49 patients (14.3%) had intracranially associated diseases, such as papilledema and compressive optic neuropathy. Pseudopapilledema was noted in four patients (8.2%). Other diseases (e.g., papillophlebitis, neuroretinitis, and diabetic papillopathy) were seen in six patients (12.2%). Ocular pain was observed more commonly in patients with ON (p = 0.001). Patients with ON expected a better visual prognosis than patients with NA-AION (0.12 +/- 0.32 vs. 0.49 +/- 0.35, p = 0.001). CONCLUSIONS: NA-AION and ON should be considered in the differential diagnosis when patients with optic disc swelling present to the neuro-ophthalmology clinic. Detailed history taking and supportive examinations, such as visual field, color-vision and imaging tests, should also be performed as indicated. Regular follow-up of such exams is necessary for the differential diagnosis of these diseases.
Adult ; Female ; Humans ; Male ; Middle Aged ; Optic Nerve Diseases/complications/etiology ; Optic Neuritis/complications/physiopathology ; Optic Neuropathy, Ischemic/complications/physiopathology ; Papilledema/*etiology ; Retrospective Studies ; Visual Fields

OBJECTIVE: To investigate the clinical characters and therapeutic methods of orbital apex syndrome caused by sinus diseases. METHOD: Six cases of orbital apex syndrome originated from sinus diseases were retrospective analyzed in our hospital from August 2003 to February 2009. Different therapeutic methods were taken according to different causes of disease. RESULT: Four cases of sinus infection,one cases of sphenoethmoidal mucocele, one cases of sinus squamous cell carcinoma. The results of patients with orbital apex syndrome included cure and effectiveness in 2 cases respectively, death from myocardial infarction in one case, and one case is still following up. CONCLUSION Orbital apex syndrome originated from sinus diseases was rare, which was mainly caused by sinus infection. The key point is the correct etiology diagnosis in early phase. Treatment with endoscopic sinus surgery early is a good effective method for orbital apex syndrome caused by sinus diseases, in the same time with enough dosage of antibiotic and glucocorticoid therapy intravenously.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nose Diseases ; complications ; Optic Nerve Diseases ; etiology ; Orbital Diseases ; etiology ; Retrospective Studies ; Syndrome

Acupuncture Therapy ; Adolescent ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; Optic Nerve Diseases ; etiology ; therapy ; Retinal Degeneration ; etiology ; therapy

A 32-year-old man with blurred vision in the right eye and headache presented with anterior uveitis, an intraocular pressure (IOP) of 60 mmHg, an open angle, no visual field defects, and normal optic nerve. He had a history of five previous similar attacks. In each of the previous instances, his anterior uveitis and high IOP were controlled with antiglaucoma medications and topical steroids. However, at the fifth attack, his optic disc was pale and a superior paracentral visual field defect was shown. Brain magnetic resonance image studies were normal. This case represents that a recurrent Posner-Schlossman syndrome (PSS)-induced optic disc atrophy likely due to ocular ischemia caused by a recurrent, high IOP. Although PSS is a self-limiting syndrome, we should manage high IOP and prevent ischemia of the optic nerve head by treating with ocular antihypertensive medications.
Atrophy/diagnosis/etiology ; Diagnosis, Differential ; Glaucoma, Open-Angle/*complications/diagnosis/physiopathology ; Humans ; *Intraocular Pressure ; Male ; Optic Disk/*pathology ; Optic Nerve Diseases/diagnosis/*etiology/physiopathology ; Syndrome ; Young Adult

A brain lesion located at the lateral side of the sella turcica can produce a junctional scotoma by compressing the ipsilateral optic nerve and the contralateral inferonasal nerve fiber. This study reports a female patient with a junctional scotoma caused by a cerebral aneurysm. At the initial visit, she complained of visual disturbance in both eyes and the right optic disc was atrophied. The visual field showed right blindness and left superotemporal quadrantopsia. A brain CT indicated an approximately 3 cm sized brain mass located superolateral to the sella turcica. The brain MRI showed the lesion to be more like an aneurysm than a pituitary adenoma. Therefore, 4 vessels angiography was done, and this lesion was confirmed to be a sellar variant of an aneurysm located at the right carotid siphon. Like a tumor of the optic chiasm, a cerebral aneurysm can cause visual disturbance and visual field defects. Therefore, an early differential diagnosis is important because the prognosis and treatment of an aneurysm differ.
Aged ; Cerebral Angiography ; Female ; Human ; Intracranial Aneurysm/*complications/radiography ; Magnetic Resonance Imaging ; Optic Nerve Diseases/diagnosis/*etiology ; Scotoma/diagnosis/*etiology ; Tomography, X-Ray Computed ; Visual Fields

PURPOSE: To document the clinical features of disc hemorrhage in patients with branch retinal vein occlusion (BRVO) and normal tension glaucoma (NTG), and to evaluate the relationship between BRVO and NTG with disc hemorrhages. METHODS: From July 2001 to May 2006, sixteen patients with both NTG and BRVO in different eyes were successively collected from outpatient population of Seoul National University Hospital in this observational case series. The frequency and location of disc hemorrhages, history of associated systemic diseases, and the order of the time of diagnosis between NTG and BRVO were studied. RESULTS: All patients had unilateral BRVO, and their mean age was 63.3+/-10.6 years. Disc hemorrhages were detected in eight patients (50%) during the mean follow-up of 26.8 months (range, 3-96 months). Six patients (75%) had disc hemorrhages in the non-BRVO eyes and two patients (25%) in BRVO eyes. Five hemorrhages (62.5%) were located at inferior-temporal quadrant of the optic disc. History of systemic hypertension was identified in 12 patients (75.0%). In 11 patients (68.8%), NTG was diagnosed at the same time as BRVO. CONCLUSIONS: A higher frequency of disc hemorrhages was identified in patients with both BRVO and NTG. Therefore, some cases of NTG, especially with disc hemorrhages, may share a common vascular pathophysiology with BRVO.
Adult ; Aged ; Eye Hemorrhage/*etiology/pathology/physiopathology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glaucoma, Open-Angle/*complications/pathology/physiopathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Optic Disk/*pathology ; Optic Nerve Diseases/*etiology/pathology/physiopathology ; Retinal Vein Occlusion/*complications/pathology ; Retrospective Studies ; Severity of Illness Index ; Visual Acuity

A 44-year-old woman with Castleman disease presented with acute visual loss in the left eye. A full ophthalmologic examination and imaging were performed. Visual acuity was 20/20 in the right eye and 20/100 in the left eye. Total dyschromatopsia, a relative afferent pupillary defect, and a cecocentral scotoma were observed in the left eye. Mild disc edema, without leaking during fluorescein angiography, was also observed. Magnetic resonance imaging revealed a small cystic epidermoid-like lesion in the right prepontine and suprasellar cistern. Her visual acuity did not improve and deteriorated to 20/200 in the left eye at 22 months after the initial visual loss. Optic neuropathy may rarely be associated with Castleman disease and suggests a poor prognosis.
Adult ; Diagnosis, Differential ; Disease Progression ; Female ; Fluorescein Angiography ; Fundus Oculi ; Giant Lymph Node Hyperplasia/*complications/diagnosis ; Humans ; Magnetic Resonance Imaging ; Optic Nerve Diseases/diagnosis/*etiology/physiopathology ; Tomography, Optical Coherence ; Visual Acuity ; Visual Field Tests ; Visual Fields

Three-dimensional computed tomographic (3D-CT) angiography is a widespread imaging modality for intracranial vascular lesions. However, 3D-CT angiograms of an anterior communicating artery aneurysm associated with acute retrobulbar optic neuropathy have not been previously described. We present 3D-CT angiograms of an aneurysm of the anterior communicating artery that caused subarachnoid hemorrhage and vision loss in a 39-year old man. The 3D-CT angiograms were consistent with findings identified directly during surgery.
Acute Disease ; Adult ; Cerebral Angiography/*methods ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; *Imaging, Three-Dimensional ; Intracranial Aneurysm/complications/*radiography ; Male ; Optic Nerve Diseases/etiology/*radiography ; Tomography, X-Ray Computed/*methods