Chiasmal Syndromes

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Identifier 91_64
Title Chiasmal Syndromes
Creator Larry P. Frohman, MD
Affiliation UMDNJ-New Jersey Medical School
Contributing Institution AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology Society
Subject Toxoplasmosis
Description This 39-year-old HIV-positive man presented in 1982 with 1 month of bilateral vision loss. His prior evaluation had included 2 CT scans, which suggested a fullness to the chiasm, and a spinal tap that showed 6 monocytes, 14 red cells, a protein of 81 mg/dl, and a glucose of 56 mg/dl, with a negative VDRL and India ink preparation. His acuity at neuro-ophthalmologic assessment was 20/40 OD and NLP OS . He had an absolute temporal field defect OD. and NLP OS. There were no retinal lesions, but he had marked pallor to both disks. Metrizamide cisternography showed intrinsic expansion of the anterolateral chiasm. A subsequent lumbar puncture showed a positive cryptococcal antigen and a protein elevated to 185 mg/dl, with 15 white cells. The toxoplasmosis titers were negative. A subsequent CT scan showed numerous enhancing lesions, and therapy with pyrimethamine, amphotericin B, clindamycin, and flucytosine was ineffective, with blindness developing OD. The man expired 1 month later. Autopsy demonstrated findings that included toxoplasmosis of the chiasm.
Date 1999
Date Digital 2004
Language eng
Format image/jpeg
Type Image
Source AAO/NANOS Clinical neuro-ophthalmology : image collection for ophthalmic practitioners. American Academy of Ophthalmology [electronic resource], [San Francisco, Calif.] : AAO, c1999.
Relation is Part of Case 109
Collection Neuro-Ophthalmology Virtual Education Library: AAO-NANOS Neuro-Ophthalmology Clinical Collection: https://NOVEL.utah.edu/AAO
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 1999. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6n32whp
Setname ehsl_novel_aao_nanos
ID 176985
Reference URL https://collections.lib.utah.edu/ark:/87278/s6n32whp
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