| Identifier |
walsh_2014_s2_c2 |
| Title |
Its Not the Tumor |
| Creator |
Courtney E. Francis |
| Subject |
Vision Loss; Leber Hereditary Optic Neuropathy; Radiation Therapy |
| History |
A 58 year old woman with a history of metastatic parotid adenocarcinoma presented with bilateral vision loss over 2 months. She had undergone surgical resection of the tumor followed by fractionated external beam radiation with a total of 66.6 Gy 18 months prior to presentation. She was recently found to have metastatic disease involving V3 and Meckel's cave on the left. On initial exam, her vision was 20/125 right eye, 20/50 left eye, without APD. She had reduced color vision in both eyes (2.5/14 right eye, 3/14 left eye). She had a left facial droop secondary to her parotid resection with resulting mild exposure keratopathy in the left eye. Posterior segment exam was unremarkable. Perimetry was normal in the left eye and showed superior/central depression in the right eye. The day following initial evaluation she underwent stereotactic radiosurgery to her left middle cranial fossa lesion, with a total dose of 2.12 Gy to the left optic nerve. Her vision loss progressed to counting fingers in the right eye and 20/200 in the left eye over the following month and at last follow-up was 8/200 right eye and 4/200 left eye. |
| Disease/Diagnosis |
Leber Hereditary Optic Neuropathy (11778 mutation) |
| Presenting Symptom |
A 58 year old woman with a history of metastatic parotid adenocarcinoma presented with bilateral vision loss over 2 months. |
| Date |
2014-03 |
| References |
1. Sadun AA, Carelli V, Salomao SR, Berezovsky A, Quiros PA, et al. Extensive investigation of a large Brazilian pedigree of 11778/haplogroup J Leber hereditary optic neuropathy. Am J Ophthalmol 136; 231-8, 2003. 2. Carelli V, Franceschini F, Venturi S, Barboni P, Savini G, et al. Grand Rounds: Could occupational exposure to n-hexane and other solvents precipitate visual failure in Leber hereditary optic neuropathy? Environ Health Perspect 115; 113-5, 2007. 3. Tsao K, Aitken PA, Johns DR. Smoking as an aetiological factor in a pedigree with Leber's hereditary optic neuropathy. Br J Ophthalmol 83; 577-81, 1999. 4. Sanchez RN, Smith AJ, Carelli V, Sadun AA, Keltner JL. Leber hereditary optic neuropathy possibly triggered by exposure to tire fire. J Neuro-Ophthalmol 26; 268-72, 2006. |
| Language |
eng |
| Format |
application/pdf |
| Type |
Image |
| Source |
46th Annual Frank Walsh Society Meeting |
| Relation is Part of |
Case presented at the NANOS 2014 Walsh Session, March 2 |
| Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-6255 |
| Rights Management |
Copyright 2014. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6ng7n7w |
| Setname |
ehsl_novel_fbw |
| ID |
179208 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6ng7n7w |
