Smoke Gets in Your Eyes (Slides)

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Identifier walsh_2020_s3_c2-slides
Title Smoke Gets in Your Eyes (Slides)
Creator Tatiana Bakaeva; John Gittinger, Jr
Affiliation (TB) Lifespan Physician Group, The Warren Alpert Medical School at Brown University, Providence, Rhode Island; (JG) Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
Subject Optic Neuropathy, Disc Edema, Paraneoplastic Syndromes
History A 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She was admitted to the hospital where she had a brain MRI that was interpreted as normal. Lumbar puncture showed elevated CSF white cells and protein. CSF cultures were negative. She was diagnosed with viral meningitis and treated supportively with subjective improvement of vision. Over the next three months she developed progressive bilateral vision loss and severe ataxia to the point that she was not able to ambulate without a walker. On presentation to our neuro-ophthalmology clinic, her best corrected visual acuities were 20/60-2 OD and 3/200 OS, she missed 6.5 Richmond color plates OD and was unable to see the control plate OS. She had a left relative afferent pupillary defect. Her extraocular motility was full, and she had downbeat nystagmus. The external and anterior segment exams were normal. On funduscopic exam, she had bilateral moderate optic disc edema. Automated perimetry showed an inferonasal defect OD and generalized depression OS. The rest of her neurological exam was notable for dysmetria with left heel-to-shin probe and severe swaying in all directions when standing. She was unable to take any steps due to imbalance.
Disease/Diagnosis CRMP-5 paraneoplastic syndrome with bilateral optic neuropathy and cerebellar syndrome
Date 2020-03
References 1. Antoine JC et al. J Neurol Sci: Jul 1993, Vol. 117(1-2): 215-23. 2. Cross SA et al. Ann Neurol. 2003 Jul; 54(1): 38-50
Language eng
Format application/pdf
Format Creation Microsoft PowerPoint
Type Text
Source 2020 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NANOS Annual Meeting Frank B. Walsh Sessions; 2020
Collection Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2020. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6x97pj3
Setname ehsl_novel_fbw
ID 1551208
Reference URL https://collections.lib.utah.edu/ark:/87278/s6x97pj3
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