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 Second Order Horner Syndrome Revealing Metastatic Squamous Cell Carcinoma (video)Horner 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
10 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
11 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
12 Interpreting Ocular Fundus Photographs: a brief guideBrief guide for interpreting ocular fundus photographs.Gabriele Berman, MD; Sachin Kedar, MD; Nancy J. Newman, MD; Valérie Biousse, MD
13 Vitreopapillary Traction Syndrome (VPT)Vitreopapillary traction (VPT) is characterized by abnormal vitreous adherence to the optic disc due to a fibrocellular membrane or incomplete posterior vitreous detachment (PVD). Traction on the optic disc can result in elevation of the disc, blurred margins, and rarely peripapillary hemorrhage. Pa...Kirstyn Taylor; Sachin Kedar, MD
14 Vitreomacular Traction Syndrome (VMTS)Vitreomacular traction (VMT) syndrome is characterized by an abnormal vitreous adherence to the macula due to incomplete posterior vitreous detachment (PVD). The resulting traction produces morphological changes of the macula. Patients may complain of decreased visual acuity, photopsia, micropsia, o...Kirstyn Taylor; Sachin Kedar, MD
15 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
16 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
17 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
18 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
19 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
20 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
21 Internuclear Ophthalmoplegia (INO)A 67-year-old man with a known history of heart failure and atrial fibrillation developed binocular horizontal diplopia in right gaze after cardiac catheterization. His examination showed normal afferent visual function, full ocular movement of the right eye, and slow adducting saccades in the left ...Wael A. Alsakran, MD; Valérie Biousse, MD
22 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
23 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
24 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
25 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
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