No abstract available.
Diagnosis* ; Optic Neuritis*

We performed full field pattern reversal VEP using UTAS-E 2000, in 87 eyes of the 70 patients with amblyopia(14 eyes) and optic nerve diseases; optic neuritis(21 eyes), optic nerve atrophy(23 eyes), toxic optic neuropathy(15 eyes) and optic nerve injury(14 eyes) from December 1993 to July 1994. This study was carried out to evaluate the relationship of the visual acuity with P1 amplitude, P1 latency, and to compare the latency of P1, and P1-N2 amplitude to each disease group and the normal groups. There was no correlation between the visual acuity and P1 latency, but significant correlation between the visual acuity and P1 amplitude(p<0.01). In the P1 implicit time, optic neuritis, optic nerve atrophy and toxic optic neuropathy patients presented marked delay and amblyopia patients presented moderate delay, but there was no other significant difference in each disease group. Over 50% of each disease group except amblyopia presented P1 destruction. Therefore, the authers concluded that P1 amplitude might not be good parameter in diagnosis of the optic nerve disease because of its variability to the visual acuity, but P1 latency and P1 destruction could be good parameter.
Amblyopia* ; Atrophy ; Diagnosis ; Humans ; Optic Nerve Diseases* ; Optic Nerve Injuries ; Optic Nerve* ; Optic Neuritis ; Visual Acuity

In order to investigate causative mechanisms of optic neuropathy, retrospective clinical studies including ophthalmologic examination, imaging study, and molecular biologic analyses were performed on 322 patients with optic neuropathy. The causes include hereditary optic neuropathy(71 patients, 22.1%), optic neuritis(66 patients, 20.5%), traumatic optic neuropathy(40 patients, 12.5%), ischemic optic neuropathy(35 patients, 10.9%), compressive optic neuropathy(31 patients, 9.6%), toxic optic neuropathy(23 patients, 7.1%), etc. In 29 patients of bilateral optic atrophy and 18 patients of unilateral optic atrophy, the causative mechanism was not clear. In conclusion, hereditary optic neuropathy was the most common causative mechanism of optic neuropathy in this study. The importance of meticulous history taking and molecular biologic test should be stressed in differential diagnosis of optic neuropathy.
Diagnosis, Differential ; Humans ; Optic Atrophy ; Optic Nerve Diseases* ; Optic Nerve Injuries ; Optic Neuritis ; Retrospective Studies

In order to investigate causative mechanisms of optic neuropathy, retrospective clinical studies including ophthalmologic examination, imaging study, and molecular biologic analyses were performed on 322 patients with optic neuropathy. The causes include hereditary optic neuropathy(71 patients, 22.1%), optic neuritis(66 patients, 20.5%), traumatic optic neuropathy(40 patients, 12.5%), ischemic optic neuropathy(35 patients, 10.9%), compressive optic neuropathy(31 patients, 9.6%), toxic optic neuropathy(23 patients, 7.1%), etc. In 29 patients of bilateral optic atrophy and 18 patients of unilateral optic atrophy, the causative mechanism was not clear. In conclusion, hereditary optic neuropathy was the most common causative mechanism of optic neuropathy in this study. The importance of meticulous history taking and molecular biologic test should be stressed in differential diagnosis of optic neuropathy.
Diagnosis, Differential ; Humans ; Optic Atrophy ; Optic Nerve Diseases* ; Optic Nerve Injuries ; Optic Neuritis ; Retrospective Studies

Leber's hereditary optic neuropathy is caused by a single nucleotide change in the mitochondrial deoxynucleic acid(mtDNA). We identified a single guanine to adenine transition mutation in the mitochondrial DNA at nucleotide position 11778(Wallace mutation)in a 13 year old boy. To our knowldge, this is the first report confirming mtDNA mutation in Korea. This would be very helpful for the correct diagnosis of optic neuritis, optic neuropathy and optic atrophy of unknown etiology as well as for genetic counselling in the future.
Adenine ; Adolescent ; Diagnosis ; DNA, Mitochondrial ; Guanine ; Humans ; Korea ; Male ; Optic Atrophy ; Optic Atrophy, Hereditary, Leber* ; Optic Nerve Diseases ; Optic Neuritis

PURPOSE: To compare the usefulness of combined fat- and fluid-suppressed selective partial inversion recovery-fluid attenuated inversion recovery(SPIR-FLAIR) images in the detection of high signal intensity of the optic nerve in optic neuritis with that of fat-suppressed selective partial inversion recovery(SPIR) or short inversion time inversion recovery(STIR) images. MATERIALS AND METHODS: Two radiologists independently analyzed randomly mixed MR images of 16 lesions in 14 patients (M:F=7:7; mean age, 40years) in whom optic neuritis had been clinically diagnosed. All subjects underwent both SPIR-FLAIR and fat-suppressed SPIR or STIR imaging, in a blind fashion. In order to evaluate the optic nerve, coronal images perpendicular to its long axis were obtained. The detection rate of high signal intensity of the optic nerve, the radiologists' preferred imaging sequences, and intersubject consistency of detection were evaluated. 'High signal intensity' was defined as the subjective visual evaluation of increased signal intensity compared with that of the contralateral optic nerve or that of white matter. RESULTS: The mean detection rate of high signal intensity of the optic nerve was 90% for combined fat- and fluid-suppressed SPIR-FLAIR images, and 59% for fat-suppressed SPIR or STIR images. In all cases in which the signal intensity observed on SPIR-FLAIR images was normal, that on fat-suppressed SPIR or STIR images was also normal. The radiologists preferred the contrast properties of SPIR-FLAIR to those of fat-suppressed SPIR or STIR images. CONCLUSION: In the diagnosis of optic neuritis using MRI, combined fat- and fluid-suppressed SPIR-FLAIR images were more useful for the detection of high signal intensity of the optic nerve than fat-suppressed SPIR or STIR images. For the evaluation of optic neuritis, combined fat- and fluid-suppressed SPIR-FLAIR imaging is superior to fat-suppressed SPIR or STIR imaging.
Axis, Cervical Vertebra ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Optic Nerve ; Optic Neuritis*

Hepatitis B ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Neurosyphilis ; complications ; diagnosis ; Optic Neuritis ; complications ; diagnosis

PURPOSE: To report a case of optic neuritis difficult to differentiate from ischemic optic neuropathy and optic nerve glioma. CASE SUMMARY: A 63-year-old male visited our clinic because of a sudden painless decrease in visual acuity in his right eye. He had a relative afferent pupillary defect and inferior altitudinal scotoma with disc pallor in his right eye. Ischemic optic neuropathy was suspected based on these clinical observations. However, a focal enhancing lesion was found in the intracranial portion of the right optic nerve on gadolinium-enhanced T1-weighted MRI. The radiologist's report revealed right intracranial optic glioma. Optic neurectomy was planned in accordance with the suspicion for optic glioma. However, a systemic mega-dose methylprednisolone therapy which is relatively less invasive was performed first based on the decision that optic neuritis should be distinguished from optic nerve glioma. The patient was hospitalized and 1 gram of methylprednisolone was injected intravenously daily for 3 days. The patient's visual acuity in the right eye improved from 0.1 before treatment to 0.3 after treatment. MRI scans at 8 months after steroid treatment showed disappearance of the previously enhanced lesion suspicious for optic glioma with developed atrophic change. The patient was finally diagnosed with optic neuritis based on these results. CONCLUSIONS: Careful differential diagnoses and therapeutic approaches to possible diseases are necessary because optic neuritis can manifest as a variety of clinical entities and imaging findings.
Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Methylprednisolone ; Middle Aged ; Optic Nerve ; Optic Nerve Glioma* ; Optic Neuritis* ; Optic Neuropathy, Ischemic* ; Pallor ; Pupil Disorders ; Scotoma ; Visual Acuity

Optic neuritis refers to any inflammatory disorder of optic nerves, but it usually denotes an acute or subacute disease of optic nerves attributed to inflammation associated with demyelination. The diagnosis of optic neuritis is usually made on a clinical ground. The condition usually presents as a painful subacute unilateral loss of vision, which progresses over a few days to 2 weeks. The pain varies in severity, although it typically does not interfere with sleep. We report 2 cases of atypical optic neuritis rapidly recovered by the administration of high doses of steroid that presented with severe eyeball pain accompanied by vague visual loss and painlessly insidious onset of visual loss respectively, with normal findings in fundoscopic examinations, visual evoked potentials and orbital MRIs.
Child ; Demyelinating Diseases ; Diagnosis ; Evoked Potentials, Visual ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Optic Nerve ; Optic Neuritis* ; Orbit

PURPOSE: To describe the clinical manifestations and magnetic resonance imaging (MRI) characteristics of idiopathic optic perineuritis patients in Korea. METHODS: A retrospective chart review of 5 patients (6 eyes) with idiopathic optic perineuritis and 7 patients (7 eyes) with optic neuritis was performed. RESULTS: The mean age of the 5 patients with idiopathic optic perineuritis was 59 years, and the mean age of the 7 patients with optic neuritis was 31.1 years. A relative afferent papillary defect (RAPD) was present in 4 eyes with idiopathic optic perineuritis, and in all 7 eyes with optic neuritis. All six eyes with idiopathic optic perineuritis showed relatively severe optic disc swelling, and 6 eyes with optic neuritis showed mild optic disc swelling. MRI demonstrated optic nerve sheath enhancement in all patients with idiopathic optic perineuritis and optic nerve enhancement in six patients with optic neuritis. CONCLUSIONS: On MRI, compared with optic neuritis, idiopathic optic perineuritis had a higher onset age, relatively severe optic disc swelling, and optic nerve sheath enhancement. Because idiopathic optic perineuritis is known to have different treatment strategies and prognosis compared with optic neuritis, differential diagnosis is crucial. The clinical manifestations and MRI characteristics of idiopathic optic perineuritis in the present study will help in the diagnosis of Korean patients.
Age of Onset ; Diagnosis, Differential ; Eye ; Humans ; Korea ; Magnetic Resonance Imaging ; Optic Nerve ; Optic Neuritis ; Prognosis ; Retrospective Studies