PURPOSE: The authors hereby describe a case of Wernicke-Korsakoff syndrome with accompanying ocular findings that is caused by hyperernesis gravidarum. METHODS: We experienced a 27-year-old female at 12 weeks of pregnancy, who visited our clinic because of weight loss, gait disturbance, decreased mentality and dizziness after prolonged vomiting for 2 months. Neurological examination demonstrated ataxia of gait and loss of orientation. Ophthalmologic examination showed decreased visual acuity, upbeat nystagmus, diplopia and retinal hemorrhage. RESULTS: We report a relatively rare case of Wernicke-Korsakoff syndrome with ophthalmic symptoms induced by hyperemesis gravidarum. CONCLUSIONS: If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.
Vision Disorders/*etiology ; *Pregnancy Complications ; Pregnancy ; Korsakoff Syndrome/*etiology/*physiopathology ; *Hyperemesis Gravidarum ; Humans ; Female ; Eye Diseases/*etiology ; Adult

Visual loss and field defects commonly occur after acute blood loss. We present a case of bilateral permanent visual field defect in a 30-year-old man after a massive hemorrhage caused by large vessel injury during a right nephrectomy. His postoperative visual acuity decreased significantly, and his visual field showed peripheral constriction and inferior altitudinal field defect in both eyes. A year and a half after the operation, visual acuity recovered to the preoperative level, but the field did not show improvement. We advance that this is a possible result of extensive injury to the occipital area, excluding the corresponding area of the macula.
Acute Disease ; Adult ; Blindness/*etiology ; Blood Loss, Surgical/*physiopathology ; Cerebral Infarction/complications/*etiology ; Humans ; Male ; Nephrectomy ; Occipital Lobe/pathology ; Vena Cava, Inferior/injuries ; Vision Disorders/*etiology ; *Visual Fields

Dengue fever is a viral disease that is transmitted by mosquitoes and affects humans. In rare cases, dengue fever can cause visual impairment, which usually occurs within 1 month after contracting dengue fever and ranges from mild blurring of vision to severe blindness. Visual impairment due to dengue fever can be detected through angiography, retinography, optical coherence tomography (OCT) imaging, electroretinography, event electroencephalography (visually evoked potentials), and visual field analysis. The purpose of this study is to report changes in the eye captured using fluorescein angiography, indocyanine green, and OCT in 3 cases of dengue fever visual impairment associated with consistent visual symptoms and similar retinochoroidopathic changes. The OCT results of the three patients with dengue fever showed thinning of the outer retinal layer and disruption of the inner segment/outer segment (IS/OS) junction. While thinning of the retina outer layer is an irreversible process, disruption of IS/OS junction is reported to be reversible. Follow-up examination of individuals with dengue fever and associated visual impairment should involve the use of OCT to evaluate visual acuity and visual field changes in patients with acute choroidal ischemia.
Adult ; Dengue/*complications/diagnosis/physiopathology ; Electroretinography ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Tomography, Optical Coherence/*methods ; Vision Disorders/*diagnosis/etiology/physiopathology ; *Visual Acuity ; *Visual Fields

Dengue fever is a viral disease that is transmitted by mosquitoes and affects humans. In rare cases, dengue fever can cause visual impairment, which usually occurs within 1 month after contracting dengue fever and ranges from mild blurring of vision to severe blindness. Visual impairment due to dengue fever can be detected through angiography, retinography, optical coherence tomography (OCT) imaging, electroretinography, event electroencephalography (visually evoked potentials), and visual field analysis. The purpose of this study is to report changes in the eye captured using fluorescein angiography, indocyanine green, and OCT in 3 cases of dengue fever visual impairment associated with consistent visual symptoms and similar retinochoroidopathic changes. The OCT results of the three patients with dengue fever showed thinning of the outer retinal layer and disruption of the inner segment/outer segment (IS/OS) junction. While thinning of the retina outer layer is an irreversible process, disruption of IS/OS junction is reported to be reversible. Follow-up examination of individuals with dengue fever and associated visual impairment should involve the use of OCT to evaluate visual acuity and visual field changes in patients with acute choroidal ischemia.
Adult ; Dengue/*complications/diagnosis/physiopathology ; Electroretinography ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Tomography, Optical Coherence/*methods ; Vision Disorders/*diagnosis/etiology/physiopathology ; *Visual Acuity ; *Visual Fields

OBJECTIVETo understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing.

METHODSFrom a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery.

RESULTSAt the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery.

CONCLUSIONSThe data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery.

Aged ; Aging ; pathology ; Animals ; Cataract ; complications ; physiopathology ; Cataract Extraction ; utilization ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Urban Population ; Vision Disorders ; etiology ; physiopathology

To observe corrected visual acuity and contrast sensitivity (CS) in patients with hypertensive disorders complicating pregnancy accompanied by fundus changes.
 Methods: Ninety-eight patients with hypertensive disorders complicating pregnancy and 50 healthy pregnant women underwent eye examination, including corrected visual acuity and fundus examination, and CS. Differences in corrected visual acuity and contrast sensitivity between the 2 groups were analyzed with two independent samples t-test analysis, while correlation between vision and contrast sensitivity in patients was evaluated by using spearman correlation test. Difference in CS was compared between the early and advanced stage of fundus diseases.
 Results: Corrected visual acuity and contrast sensitivity in patient with hypertensive disorders complicating pregnancy were lower than that in the control group (P<0.01). Corrected visual acuity in patients was associated with contrast sensitivity at variously spatial frequencies (P<0.01), showing the most correlation in contrast sensitivity at 6 of spatial frequency (r=0.87). Compared with the early stage, the CS in the advanced patients with fundus diseases was decreased (P<0.01).
 Conclusion: The visual acuity and contrast sensitivity in patient with hypertensive disorders complicating pregnancy are reduced. The CS (6.0 c/d) has the largest correlation with corrected visual acuity. Comparing with the visual acuity, contrast sensitivity can be more comprehensive in evaluation of retinal function damage in patients with hypertensive disorders complicating pregnancy.
Adult ; Contrast Sensitivity ; physiology ; Female ; Fundus Oculi ; Humans ; Hypertension ; complications ; Pregnancy ; Pregnancy Complications ; Retinal Diseases ; complications ; etiology ; Vision Disorders ; etiology ; physiopathology ; Visual Acuity ; physiology

OBJECTIVE: To analyze the unilateral image of the traumatic optic nerve atrophy using optical coherence tomography (OCT) and to explore the relationship between the optic nerve atrophy and visual acuity or visual field. METHODS: Fifteen cases with traumatic optic nerve atrophy were studied. All cases were tested by routine opthalmological examination, visual evoked potentials (VEP) and optic disc examination with OCT. In cases with visual acuity more than 0.1 the visual field was tested. RESULTS: All cases had visual acuity and visual field defect at various levels and optic disc retinal nerve fiber layer (RNFL) atrophy. CONCLUSION The traumatic optic atrophy begins in the temporal area of optic disc. The nasal area's atrophy occurs at the last and is the mildest. The more serious is the optic nerve atrophy, the worse is the vision function impairment. OCT is a valuable technique for evaluating the optic nerve atrophy and has good correlation with the visual function.
Adolescent ; Adult ; Eye Injuries/complications* ; Female ; Humans ; Male ; Middle Aged ; Optic Atrophy/etiology* ; Tomography, Optical Coherence/methods* ; Vision Disorders/physiopathology* ; Visual Acuity ; Visual Fields ; Young Adult

To estimate the rate of visual field progression in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), we reviewed the medical records of POAG and PACG patients who had a minimum of 5-year longitudinal Goldmann visual field data. I4e and I2e isopters were quantified using grid systems. The rate of change was calculated from the slope of a linear fit to a series of average visual field scores. Twenty-three eyes of POAG patients and 25 of PACG patients were studied. The rate of visual field score change was -2.00 +/- 2.0% per year in the PACG group, and -0.81 +/- 1.0% per year inthe POAG group. In these two patient groups, who were on conventional treatment at two referral hospitals, better visual field on initial presentation yielded faster progression in the POAG group, while the higher average of highest intraocular pressure in each year during follow-up was related to faster progression in the PACG group.
Adult ; Aged ; Comparative Study ; Disease Progression ; Female ; Glaucoma, Angle-Closure/*physiopathology ; Glaucoma, Open-Angle/*physiopathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Perimetry/methods ; Retrospective Studies ; Vision Disorders/etiology/*physiopathology ; *Visual Fields

The intravenous administration of gadopentetate dimeglumine (GD) is relatively safe and rarely causes systemic toxicity in the course of routine imaging studies. However, the general safety of intrathecal GD has not been established. We report a very rare case of an overdose intrathecal GD injection presenting with neurotoxic manifestations, including a decreased level of consciousness, global aphasia, rigidity, and visual disturbance.
Adult ; Aphasia/etiology/pathology/physiopathology ; Brain/drug effects/pathology ; *Contrast Media/administration & dosage/toxicity ; *Gadolinium DTPA/administration & dosage/toxicity ; Humans ; *Injections, Spinal ; Male ; Muscle Rigidity/etiology/pathology/physiopathology ; *Neurotoxicity Syndromes/etiology/pathology/physiopathology ; Tomography, X-Ray Computed ; Vision Disorders/etiology/pathology

Giant cell arteritis (GCA) is a common systemic vasculitis with an unknown etiology. It mainly affects people older than 50 years of age and often presents with symptoms such as headache, jaw claudication, visual loss, polymyalgia rheumatica and increased erythrocyte sedimentation rate (ESR). Established blindness is irreversible if the steroid treatment is not administered within a few days. Here, we report a case of GCA in a patient with a normal ESR whose left eye perceived just light at the initiation of treatment. Immediately prior to the combined treatment with high dose oral steroids and cyclophosphamide, the ESR level had increased to 80 mm/h and the vision improved after the combined treatment four months later.
Administration, Oral ; Cyclophosphamide/administration & dosage/*therapeutic use ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Female ; Human ; Immunosuppressive Agents/therapeutic use ; Middle Aged ; Recovery of Function ; Steroids/administration & dosage/*therapeutic use ; Temporal Arteritis/*complications/*drug therapy ; Vision Disorders/*etiology/*physiopathology