Spectrum of Magnetic Resonance Imaging Features in Unilateral Optic Tract Dysfunction

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Title Spectrum of Magnetic Resonance Imaging Features in Unilateral Optic Tract Dysfunction
Creator Kristopher M. Kowal, MD, Francisco F. Rivas Rodriguez, MD, Ashok Srinivasan, MD,Jonathan D. Trobe, MD
Affiliation Departments of Ophthalmology and Visual Sciences (KMK, JDT), Radiology (Neuroradiology) (FFRR, AS) and Neurology (JDT), Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan
Subject Adolescent; Adult; Brain Diseases; Brain Diseases; Female; Hemianopsia; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Optic Nerve Diseases; Optic Nerve Diseases; Optic Tract; Retrospective Studies; Young Adult
Abstract Variable pupillary responses have been described with carotid-cavernous sinus fistulas. These often are associated with a decrease in visual acuity and attributed to retinal ischemia. We propose a novel pathophysiologic mechanism for changes in pupillary reactivity involving anatomic changes secondary to choroidal effusion. To demonstrate proof-of-concept, we investigated 2 consecutive patients with carotid-cavernous sinus fistulas and pupillary disturbances using repeated refractions and anterior segment ultrasound biomicroscopy. Ultrasound biomicroscopy demonstrated choroidal thickening and ciliary body effusion with forward rotation of the lens-iris diaphragm altering refraction and mechanically limiting iris movements. Where there are acute elevations in orbital venous pressure causing ciliary body effusion, changes in visual acuity and pupillary abnormalities can be produced by mechanical effects.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2017-03
Type Text
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s6v169rg
Setname ehsl_novel_jno
Date Created 2018-07-25
Date Modified 2020-03-24
ID 1353372
Reference URL https://collections.lib.utah.edu/ark:/87278/s6v169rg
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