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1 Enophthalmos from breast cancer metastasis to the orbitRight painful ophthalmoplegia with right enophthalmos secondary to breast cancer metastasis to the right orbit.Valerie Biousse, MD; Emory Eye Center, Atlanta, Georgia
2 Vertical Diplopia secondary to Skew Deviation with Ocular Tilt Reaction with Multiple Posterior Fossa MetastasesThis is a case of multiple brain metastases in the posterior fossa resulting in a skew deviation. Figure 1 : Photograph of the patient demonstrating a spontaneous right head tilt. The patient's head is tilted toward his right shoulder to suppress his diplopia Figure 2 : Ocular movements : There is a...Rabih Hage, MD, Emory Eye Center; Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia, Jason Peragallo, MD, Emory Eye Center
3 Large Sellar and Suprasellar Mass (Pituitary Macroadenoma) with Left Third Nerve Palsy and Left Optic Tract CompressionA case of a large sellar and suprasellar pituitary macroadenoma with an associated left third nerve palsy and left optic tract compression. Images from an MRI of the brain with contrast illustrate the imaging characteristics and extent of the tumor. Figure 1 : Humphrey Visual Fields (24-2 SITA-Fast)...Devin D. Mackay, MD, Emory Eye Center; Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia
4 Large right hypophyseal aneurysm causing a junctional scotomaRight, multi-lobulated superior hypophyseal artery aneurysm measuring 1.6 x 1.2 x 2.2 cm with 6 mm neck causing a right junctional scotoma . Images from a brain CT with contrast, a brain CT angiography with contrast, cerebral angiogram, Humphrey visual fields and ocular fundus photographs are includ...Laurel N. Vuong, MD, Emory Eye Center, Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia
5 Optical coherence tomography of the retinal nerve fiber layerA normal optical coherence tomography (OCT) of the macula is shown highlighting the position of a single retinal ganglion cell and its axon in the retinal nerve fiber layer (Figure 1). The topographical relationship of retinal ganglion cells in the retina to the visual field and position in the ante...Jonathan A. Micieli, MD Department of Ophthalmology, Emory University School of Medicine Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
6 Vitreopapillary tractionA 64-year-old woman was referred for bilateral optic disc edema. Examination of her optic nerves showed indistinct margins at the nasal aspect of both eyes (Figure 1). Humphrey 24-2 SITA-Fast visual fields showed non-specific depressed points in both eyes (Figure 2). Optical coherence tomography (...Jonathan A. Micieli, MD Department of Ophthalmology, Emory University School of Medicine Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
7 Ganglion cell layer analysis by optical coherence tomography (OCT)A normal optical coherence tomography (OCT) of the macula is shown (Figure 1) and the various layers of the retina are labelled (Figure 2). The cell bodies of retinal ganglion cells (RGC) are located in the ganglion cell layer (GCL) of the retina and mostly synapse in the lateral geniculate nucleus ...Jonathan A. Micieli, MD, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
8 Incipient non-arteritic anterior ischemic optic neuropathy (NAION) evolving to symptomatic NAIONA 54-year old woman with hypertension was seen in neuro-ophthalmology consultation for asymptomatic left optic disc edema. She had a small, crowded optic disc in the right eye known as a "disc-at-risk" (Figure 1). Her visual function including 24-2 SITA-Fast Humphrey visual fields were normal in bot...Jonathan A. Micieli, MD, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
9 Optic nerve sheath meningiomaThis is a case of an optic nerve sheath meningioma (ONSM) in a 56-year-old woman who presented with gradual, painless vision loss in her left eye. Optic disc photos at presentation showed temporal pallor of the left optic nerve (Figure 1) and Cirrus optical coherence tomography (OCT) of the retinal ...Jonathan A. Micieli, MD, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
10 Right lateral mediullary syndrome (Wallenberg syndrome) with lateropulsion and ocular tilt reactionA 55-year old man presented with acute onset right-sided facial numbness, left-sided body numbness, vertigo, right ptosis, and binocular vertical diplopia. External examination showed right ptosis and miosis indicating a right Horner syndrome (Figure 1). He had gaze-evoked nystagmus only on right g...Jonathan A. Micieli, MD, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
11 Incipient non-arteritic anterior ischemic optic neuropathy (NAION)A 61-year old white man with hypertension, diabetes, and dyslipidema was seen in neuro-ophthalmology consultation for asymptomatic right optic disc edema. He had a small, crowded optic disc in the left eye known as a "disc-at-risk" (Figure 1). He had normal visual function including normal 24-2 SITA...Jonathan A. Micieli, MD, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
12 Typical idiopathic optic neuritisThis is a case of a typical optic neuritis in a 41-year-old woman presenting with vision loss and pain with eye movements in the right eye. Optic disc photos at presentation showed subtle hyperemia in the right eye (Figure 1) and optical coherence tomography (OCT) of the retinal nerve fiber layer (R...Jonathan A. Micieli, MD Department of Ophthalmology, Emory University School of Medicine Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
13 Toxic Retinopathy: Deferoxamine ToxicityNumber of Figures and legend for each: 6 figures Figure 1: Goldmann perimetry showing large cecocentral scotomas in both eyes Figure 2: Fundus photograph of the right eye demonstrating hypopigmentation of the peripapillary and perifoveal retinal pigment epithelium (RPE) with subfoveal yellow lesions...Will Pearce, MD, Emory Eye Center Atlanta, Georgia; Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia
14 Posterior Cerebral Artery Infarction from Vertebral Artery DissectionRight posterior cerebral artery ischemic infarction due to post traumatic (martial arts) left vertebral artery dissection with resulting right PCA occlusion. Left homonymous hemianopia due to right occipital lobe infarction and left hemisensory loss due to right thalamic infarction. Imaging of the a...Kristen Hudson, MD, Emory Eye Center Atlanta, Georgia; Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia
15 Nonfunctiong Pituitary Adenoma with Chiasmal CompressionThis is a case of large non-functioning pituitary adenoma with mass effect on the optic chiasm inducing loss of optic nerve fibers and subsequent visual field. Figure 1: Fundus photographs demonstrating bilateral temporal optic nerve head pallor Figure 2: Humphrey visual fields demonstrating a bitem...William Pearce, MD, Emory Eye Center Atlanta, Georgia; Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia
16 Radiologic Appearance of Unilateral Sphenoid Wing Hypoplasia in Neurofibromatosis Type IMRI features of greater wing sphenoid hypoplasia in the setting of neurofibromatosis type 1. - Figure 1 : Orbital MRI with contrast showing right greater sphenoid wing hypoplasia. The lack of bone tissue leads to herniation of the right temporal lobe into the orbit, pushing forward the orbital conte...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
17 Pulsatile proptosis from sphenoid wing hypoplasia in neurofibromatosis type 1Clinical and radiologic features of greater wing sphenoid hypoplasia in the setting of neurofibromatosis type 1. Figure 1 : slit lamp examination showing Lisch nodules; Figure 2 : orbit CT scan (1); Figure 3 : orbit CT scan (2) with annotations. For visual examples of this disorder, please see the...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
18 Ocular Hypoperfusion From Severe Internal Carotid Artery Stenosis68 year-old man complaining of mildly decreased vision OD with fluctuation of vision throughout the day. Fluorescein angiography shows delayed choroidal and retinal fillings, suggesting hypoperfusion of the right eye.Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
19 Osseous anatomy of the optic canalsAnatomic study of the optic canals using 3D reconstruction of CT scan images. Figure 1 : Orbital canal seen through the orbit Figure 2 : Optic canal seen from the intracranial side (1) Figure 3 : Optic canal seen from the intracranial side (2) Figure 4 : Optic canal : axial plane Figure 5 : Optic c...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
20 Rathke's Cleft Cyst Apoplexy with Junctional ScotomaMRI features of Rathke's cleft cyst apoplexy. - Figure 1 : Humphrey visual fields at initial presentation - Figure 2 : Brain MRI without contrast at initial presentation - Figure 3 : Brain MRI with contrast at initial presentation - Figure 4 : Postoperative Humphrey visual fieldsSamuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
21 Occipital Infarction with Incomplete Congruent Homonymous HemianopiaCT appearance of a remote occipital infarction. Congruent homonymous hemianopia.Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
22 Internal Carotid Artery / Posterior Communicating Artery Aneurysm with Third Nerve Palsy Shown on CT AngiogramInternal Carotid Artery / Posterior Communicating Artery Aneurysm with Third Nerve Palsy Shown on CT Angiogram ; anatomic description of vascular and bony findings on the CTA. - Figure 1 : 51 year-old man complaining of painful binocular diplopia. Orange arrows indicate the direction of gaze. In p...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
23 Cerebral Arterial VascularizationArteries of the neck and brain as seen on a CT Angiogram. Figure 1 : Overview. Figure 1A. Anterior view. Figure 1B. Lateral view. Figure 2 : Internal carotid artery. Segmentation. Figure 3 : Internal carotid artery and vertebral arteries. Extracranial part. Posterolateral view. Figure 4 : Internal c...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
24 Anatomy of the Trigeminal NerveMRI and CT scan imaging of the trigeminal nerve and its 3 divisions. Figure 1 : trigeminal nerve. Overview Figure 2 : trigeminal nuclei Figure 3 : trigeminal root. Cisternal segment. Figure 3A. FIESTA axial image through midpons. Figure 3B. T2 coronal image through prepontine cistern Figure 4 : trig...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
25 Cerebral Venous VascularizationMRV and CTV scan imaging of the brain veins. Figure 1 : Overview. MRV with contrast Figure 1A. Right postero-lateral view. Figure 1B. Sagittal view. Figure 2 : Dural sinuses. Superior endocranial view. CTV. Figure 3 : Dural sinuses. Sagittal endocranial view. CTV. Figure 4 : Dural sinuses. Right an...Samuel Bidot, MD, Emory Eye Center Atlanta, Georgia; Amit M. Saindane, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
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