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1 Anatomy of the Ocular FundusA review of normal features of the ocular fundus. Fundus photography using various techniques illustrate anatomic features of the ocular fundus. - Figure 1 : A) Color fundus photograph of the left optic disc and peripapillary retina showing a normal optic disc, retinal arteries, retinal veins, and...Devin D. Mackay, M.D. Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
2 Anatomy of the orbits on CT and MRIMRI and CT imaging of the orbitValérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
3 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
4 Anterior and Posterior ScleritisA case of anterior and posterior scleritis secondary to idiopathic orbital inflammation, also known as orbital pseudotumor. Various imaging modalities are included to demonstrate optic disc edema, macular edema, and fluid in tenon's capsule which may be seen in posterior scleritis. Figure 1 : Exter...Joshua Levinson, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
5 Bilateral lens subluxation in Marfan syndromeThis is a case of known Marfan syndrome with bilateral progressive visual loss. The ocular examination showed bilateral lens dislocation. Figure 1a: Typical superonasal lens subluxation in both eyes Figure 1b: The arrows show the inferior edges of the lenses Figure 2: Optical section of the lenses u...Rabih Hage, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
6 Cavernous sinus meningioma extending into the orbital apexSeptic left cavernous sinus and superior ophthalmic vein thrombosis, secondary to left maxillary tooth abscess. MRI characteristics Figure 1 : MRI Orbits (Coronal T2 with fat suppression) : Left periorbital edema (increased T2 signal, yellow arrows) extends inferiorly along the premalar tissues to t...Supharat Jariyakosol, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
7 Central retinal artery occlusion with cilioretinal artery sparingCentral retinal artery occlusion with sparing of the cilioretinal artery Figure 1 : Fundus photographs show retinal whitening in the right eye, with sparing of the perfused retina in the distribution of the cilioretinal artery (arrows); the left eye has a normal funduscopic appearance. Figure 2 : Mo...Supharat Jariyakosol, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
8 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
9 Cerebral venous sinus thrombosis with papilledemaA case of superior sagittal sinus, right transverse sinus and right sigmoid sinus thrombosis, presenting with increased intracranial pressure (headaches, bilateral sixth palsy and papilledema). Figure 1 : Disc photos of the right and left eyes demonstrating bilateral disc edema. Figure 2 : Non-contr...Supharat Jariyakosol, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
10 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
11 Coexisting Thyroid Eye Disease and Myasthenia GravisA case of coexisting thyroid orbitopathy and myasthenia gravis. External photographs of the eyes and eyelids, as well as images from an MRI of the orbits, are included. Figure 1 : External photograph of eyes showing right lid retraction and left upper lid ptosis. Figure 2 : External photograph of ...Devin D. Mackay, M.D. Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
12 Colloid cyst HydrocephalusThis is a case of colloid cyst of the third ventricle complicated by severe hydrocephalus, raised intracranial pressure and papilledema. Figure 1: Fundus photographs demonstrating bilateral optic nerve head edema Figure 2a and 2b: T1-weighted axial brain MRI without contrast: Dilation of both later...Rabih Hage, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
13 Direct carotid-cavernous sinus fistulaA 40-year-old man presented with decreased vision and redness in his left eye. He had a significant trauma to the left side of his face about one year ago, but did not seek medical attention. External examination showed significant proptosis of the left eye (Figure 1) and conjunctival injection and ...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
14 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
15 Fundus AutofluorescenceThe retinal pigment epithelium (RPE) has many important functions including phagocytosis of the photoreceptor outer segments. The metabolism of the photoreceptor outer segments leads to the formation of lipofuscin. Disease states and potentially increased oxidative damage can lead to the buildup of ...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
16 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
17 Geniculate Nucleus Metastasis with Homonymous SectoranopiaThis is a case of multiple brain metastases in the setting of bladder cancer complicated with right homonymous horizontal sectoranopia. Figure 1: Pet-scan showing liver (yellow arrows) and kidneys (red arrow) metastases Figure 2: Goldmann Visual Fields: Right homonymous horizontal sectoranopia Figu...Rabih Hage, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
18 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
19 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
20 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
21 Iris transilluminationSingle case of iris transillumination in a patient with albinism. Figure 1 : Anterior segment photograph demonstrating reddish hue to iris in albinism Figure 2 : Slit lamp photograph with retroillumination demonstrating iris transillumination Figure 3 : Slit lamp photograph with retroillumination...Jason Peragallo, MD, Emory Eye Center; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
22 IVth Nerve SchwannomaThis is a case of IVth cranial nerve schwannoma, showing an enhancement in the subarachnoid space consistent with the clinical presentation. Figure 1a : T1-weighted axial brain MRI Figure 1b : T1-weighted axial brain MRI : magnification of the brainstem Figure 1c : T1-weighted axial brain MRI : cr...Rabih Hage, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
23 Junctional scotoma from a sellar massThis is a case of a 55-year-old woman presenting with gradual painless vision loss in both eyes. Although visual acuity was 20/20 in both eyes, there was a left relative afferent pupillary defect and diffuse pallor of both optic nerves (Figure 1). Visual fields (24-2 SITA-Fast) showed a temporal def...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
24 Large Frontal Meningioma with Mass Effect and Increased Intracranial PressureThis is a case of frontal meningioma presenting with raised intracranial pressure and bilateral papilledema responsible for visual loss. Figure 1: Goldmann visual field of the left eye. In the right eye, there was no response to the V4e. The visual field is severely constricted in the left eye. Fig...Rabih Hage, MD, Emory Eye Center Atlanta Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
25 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
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