NOVEL - Emory Eye Center
 
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1 Severe Bilateral Optic Disc Edema in Hypertensive RetinopathyHypertensive retinopathy occurs when acute or chronically high blood pressure damages the retina. Here, we present a patient with progressive blurring of vision and a blood pressure of 270/160. Fundoscopic examination revealed arteriovenous nicking, copper wiring, cotton wool spots, and flame-shaped...Nithya Shanmugam; Valerie Biousse
2 Pineal Gland Mass Causing Severe PapilledemaThe pineal gland is a neuroendocrine gland that resides in the epithalamus, at the root of the third ventricle. Due to its close proximity to the ventricles, masses in the pineal region can lead to obstruction of the flow of cerebrospinal fluid and subsequent raised intracranial pressure. Here, we p...Nithya Shanmugam; Valerie Biousse
3 Multimodal Imaging in Ocular SyphilisA 60 year-old-man with a 3-month history of painless blurred vision was found to have bilateral disc edema. Visual function was unremarkable OU except for enlargement of the blind spot OS. Brain and Orbits MRI showed mild enhancement at the left optic disc insertion and optic disc edema OS. Multimod...George Alencastro; Valerie Biousse; Étienne Bénard-Séguin
4 Macular Star in the Setting of NeuroretinitisNeuroretinitis is often inflammatory or infectious in nature. Here, we present a case of Bartonella neuroretinitis and a typical finding of a unilateral "macular star" on color fundus photographs and OCT. The macular star usually appears 1-2 weeks after infection, and is secondary to exudates accumu...Nithya Shanmugam; Valerie Biousse
5 Aortitis from Giant Cell ArteritisGiant cell arteritis is a life-threatening inflammatory large vessel vasculitis, commonly associated with jaw claudication, temporal headaches, vision changes, and elevated ESR & CRP. This case highlights an additional common presenting feature of GCA at diagnosis - aortitis - and emphasizes the imp...Nithya Shanmugam; Valerie Biousse
6 Choroidal Neovascular Membrane in Chronic PapilledemaA 21-year-old woman with papilledema from idiopathic intracranial hypertension developed a peripapillary choroidal neovascular membrane (PCNVM) complicating untreated chronic papilledema 10 years later.George Alencastro; Valerie Biousse
7 Choroidal Hypoperfusion Defect in Giant Cell ArteritisHere, we present a case of a 62 year-old male with vision loss in the right eye, headaches, and neck/shoulder/temporal pain, found to have choroidal hypoperfusion and diagnosed with giant cell arteritis (GCA). In combination with anterior ischemic optic neuropathy and cotton wool spots, choroidal hy...Nithya Shanmugam; Michael Dattilo; Valerie Biousse
8 Second Order Horner Syndrome Revealing Metastatic Squamous Cell CarcinomaHorner Syndrome is secondary to a lesion of the ipsilateral sympathetic pathway and is associated with ptosis, miosis, and anhidrosis. Here, we present a unique presentation of metastatic squamous cell carcinoma in a patient with a right-sided Horner Syndrome (second order). We also highlight the di...Nithya Shanmugam; Michael Dattilo; Valerie Biousse
9 Optic Nerve Head Granuloma from SarcoidosisWe present a case of optic neuropathy with optic nerve head granuloma as the presenting sign of neurosarcoidosis. Initial patient presentation was notable for a chronic cough and worsening of vision in the left eye. Subsequent imaging revealed multiple brain lesions and the presence of a subcarinal ...Nithya Shanmugam; Valerie Biousse
10 Right Occipital Arteriovenous Malformation presenting as a Migraineous Visual AuraMigraine with visual aura is a distinct entity from a migraineous visual aura. A migraine with visual aura is characterized by a visual aura that does not prefer either visual field and accompanies a headache. The mechanism of the visual aura is via cortical spreading depression. A migraineous visua...Nithya Shanmugam; Fernando Labella; Valerie Biousse
11 Artifact from Incomplete Orbital Fat Suppression on Magnetic Resonance ImagingOrbital fat has short relaxation times that results in a hyperintense appearance on T1-weighted magnetic resonance imaging (MRI). Fat suppressed T1 MRI sequences are needed to remove the fat signal and better visualize the orbital anatomy, including the optic nerve. Contrast can be used with fat sup...Matthew Boyko, MD; Valérie Biousse, MD
12 Choroidal Infarction in Giant Cell ArteritisAn 80-year-old Caucasian woman presented with a 10-day history of headaches, intermittent binocular diplopia, and jaw pain. Temporal artery biopsy confirmed a diagnosis of giant cell arteritis. Examination showed characteristic large area of choroidal ischemia that is well-known to be associated wit...Wael A. Alsakran, MD; Andre Aung, MD; Valérie Biousse, MD
13 MRI Findings in Giant Cell ArteritisCase 1. An 80-year-old Caucasian woman presented with a 10-day history of headaches, intermittent binocular diplopia, and jaw pain. Temporal artery biopsy confirmed a diagnosis of giant cell arteritis. MRI with contrast showed enhancement of bilateral optic nerve sheaths in addition to enhancement o...Wael A. Alsakran, MD; Andre Aung, MD; Valérie Biousse, MD
14 Classic Pathology Findings in Giant Cell ArteritisAn 80-year-old Caucasian woman presented with a 10 day history of headaches, intermittent binocular diplopia, and jaw pain. Temporal artery biopsy confirmed a diagnosis of giant cell arteritis. Pathology findings were classic for giant cell arteritis with numerous inflammatory cells in the tunica me...Andre Aung, MD; Corrina Azarcon, MD; Wael A. Alsakran, MD; Valérie Biousse, MD
15 Optic Disc Edema and PseudoedemaA presentation covering how to approach optic disc edema, including clinical characteristics and the distinction of pseudoedema.Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
16 Dilated Episcleral Vessels from Carotid Cavernous Fistula51 year white woman with a 6 months history of chronic right eye redness, periorbital swelling and progressive proptosis. She was seen by multiple providers and treated for dry eye and conjunctivitis. Her examination showed normal visual acuity, color vision and pupils. There was an intraocular pres...Amani Alzayani, MD; Valérie Biousse, MD; Ling Chen Chien, MD
17 Giant Cell Arteritis: Temporal Artery Anatomy and HistologyGross anatomy and histology of the normal superficial temporal artery.; Histopathology of the superficial temporal artery involved by active and healed GCA; Summary of the main histopathologic findings in GCASamuel Bidot, MD; Valérie Biousse, MD
18 Bilateral Optic Disc Edema from Hypertensive RetinopathyA 29 year-old woman was assessed for 2 weeks of headaches and 4 days of blurred vision in both eyes. Her blood pressure was 225/135. Her examination showed: best-corrected visual acuity: 20/25 OD, 20/30 OS; pupils equal and reactive without relative afferent pupillary defect; intraocular pressures 1...Benjamin I. Meyer, MD; Valérie Biousse, MD
19 Clinical Features of NeuroretinitisA 13-year-old girl was seen for assessment of blurred vision and optic disc edema in her right eye. Her examination showed: best-corrected visual acuity of hand motion OD and 20/25 OS; pupils: no relative afferent pupil defect; color vision: 0/14 plates OD and 14/14 plates OS; humphrey visual fields...Rahul A. Sharma, MD, MPH; Jason H. Peragallo, MD; Valérie Biousse, MD
20 Optic Disc Pseudoedema Due to Leber Hereditary Optic NeuropathyA 23-year-old woman developed sequential painless central vision loss in both eyes (right eye 5 months ago and left eye 2 months ago). Her examination showed bilateral optic neuropathies: visual acuity: 20/300 eccentrically OU (no improvement with pinhole); pupils: equal and reactive with no relativ...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
21 Retrograde Trans-Synaptic Degeneration from a Longstanding Occipital Lobe TumorThis is an illustrated guide that (1) discusses the localization of paracentral homonymous hemianopic scotomatous visual field defects and (2) discusses the concept of trans-synaptic retrograde degeneration. A 43-year-old woman was assessed for longstanding blurred vision in both eyes. Her examinati...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
22 Checkboard Visual Field Loss Due to Bilateral Homonymous HemianopsiasA 70-year-old man with vascular risk factors was seen for assessment of sudden visual field loss in both eyes. His examination showed: visual acuity: 20/20 OD and 20/25 OS; pupils: equal with no relative afferent pupillary defect; color vision: 14/14 plates correct OU; anterior segment exam: normal ...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
23 Compressive Optic Neuropathy from Cavernous HemangiomaA 42-year-old man was seen for assessment of progressive blurring of vision in his left eye (OS) over several weeks. His examination showed a left optic neuropathy: visual acuity: 20/20 OD and 20/20-2 OS; pupils: 1+ left relative afferent pupillary defect; color vision: 14/14 plates correct OU. Ther...Rahul A. Sharma, MD, MPH; Aaron M. Yeung, MD; Valérie Biousse, MD
24 Myelin Oligodendrocyte Glycoprotein (MOG) - Antibody Optic NeuritisThis is an illustrated guide to the clinical diagnosis of myelin oligodendrocyte glycoprotein (MOG)-antibody optic neuritis. Myelin oligodendrocyte glycoprotein (MOG) is a glycoprotein on the surface of myelin and is found exclusively in the central nervous system (CNS). MOG likely mediates a comple...Bryce Buchowicz, MD; Valérie Biousse, MD
25 NeurosarcoidosisThis is an illustrated guide to the clinical diagnosis of neurosarcoidosis. Sarcoidosis is a chronic systemic inflammatory disorder characterized by non-caseating granulomas. It can affect multiple organ systems including the lungs, skin, orbit, and brain. When there is central nervous system (CNS) ...Bryce Buchowicz, MD; Valérie Biousse, MD
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