The Walsh Society Annual Meeting Archives: Proceedings of the annual meeting of the Walsh Society, which is now part of the North American Neuro-Ophthalmology Association (NANOS) Annual Meeting. Contains records from the first meeting in 1969, through the present.
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| Title | Creator | History | ||
|---|---|---|---|---|
| 1 |
 | Orbitally Vexed | Blake Colman; Rogan Fraser; Evelyn Perry; Prashanth Ramachandran; Shivanand Sheth; Neil Shuey; Subahari Raviskanthan | Genetic testing had revealed a Mel41Val missense mutation in a gene located in the UBA1 gene on the X- chromosome, in keeping with a diagnosis of VEXAS syndrome. Pulsed intravenous methylprednisolone resulted in rapid improvement of symptoms with only mild abduction restriction, temporal conjunctiva... |
| 2 |
 | The Path of Least Resistance: Over the Nose, Into the Orbit, and Around the Globe | Sahar Noorani; Ali Tejani; Mingyi Chen; Melanie Truong-Le | To determine a definitive diagnosis, biopsy of the left lateral rectus muscle was planned. Given the improvement seen on imaging and to optimize biopsy yield, the patient was weaned off steroids. However, he deteriorated almost immediately after cessation of steroids and developed worsening diplopia... |
| 3 |
 | Losing Vision, Losing Sleep | Bart Chwalisz; Aditi Varma-Doyle; Jenny Linnoila | CSF indirect immunofluorescence assay was positive for IgLON5 (Immunoglobulin-like cell adhesion molecule-5) antibodies at 1:8 titer, confirmed by cell-based assay. After completion of a subsequent steroid taper, given symptomatic progression, the patient's treatment regimen was escalated to monthly... |
| 4 |
 | Headache and Visual Deficits: Ironing Out the Details | Amalie Chen; Leigh Rettenmaier; Andres Santos; Mariel Kozberg; Sashank Prasad | MRI brain with gadolinium contrast revealed diffuse leptomeningeal enhancement, most prominently in the bilateral temporal parieto-occipital and left frontal sulci (Fig.1), with associated T2/FLAIR sulcal hyperintensity (Fig.2). T2-weighted images showed enlarged perivascular spaces (i.e. Virchow-Ro... |
| 5 |
 | Atypical Case of Optic Nerve Head Edema: Painful, Enhancing and Treacherous | Samir Touma; Katie Luneau; Jacinthe Rouleau | A cerebral MRI was done showing impressive enhancement of the intraorbital portion of the right optic nerve sheath with diffuse swelling of the optic nerve suggestive of optic neuritis. There was no extension to the optic chiasm and no infiltrative or demyelinating lesion. A retinal angiography reve... |
| 6 |
 | MY-OH-MY Just a Drop will Do | Mark Aurel Nagy; John Gonzales; Thuy Doan; Jay Stewart; Annemieke Vanzante; Nailyn Rasool | The patient initially presented with progressive intraocular inflammation and uveitic glaucoma. He reported headaches, weight loss, depression and changes in his libido. Upon examination, the patient's mental status was altered, being somnolent, slow to answer questions, with continuous hiccups and ... |
| 7 |
 | It Can't Be Me, But … Maybe it's Both of Us? | George Park; Steven Galetta; Laura Balcer; Janet Rucker; Leah Geiser Roberts; Arline Faustin; Nithisha Prasad; Ariane Lewis; Timothy Shepherd; Mark Finkelstein; Scott Grossman | The patient presented with progressive positional headaches, likely related to presumed increased intracranial pressure, along with a left 6th nerve palsy. The process was likely related to local inflammation/compression with initial imaging showing a left petroclival lesion with extension into the ... |
| 8 |
 | Devine Intervention | Letitia Pirau; Wayne Cornblath; Lindsey De Lott; Sangeeta Khanna; Tatiana Deveney | A 30 yo woman presented to the comprehensive ophthalmology clinic with bilateral decreased vision. She had no prior ocular history. Her medical history was notable for breast cancer (diagnosed 1 year prior), treated with radiation, chemotherapy, lumpectomy, and pembrolizumab (completed 8/9 planned i... |
| 9 |
 | Double Double, Toil and Trouble | Kevin Yan; Adeniyi Fisayo; Joachim Bähring; Declan McGuone | The patient's symptoms are all related to her multiple intracranial lesions, with the left cavernous sinus lesion being the most symptomatic and resulting double vision and jaw numbness. The lower motor neuron pattern left facial weakness is likely attributable to posterior extension of the lesion a... |
| 10 |
 | Go Back to the House, MD | Marc Bouffard | CSF examination revealed 0 WBC, 1 RBC, protein 78, and a glucose of 96. MRI brain revealed FLAIR hyperintensities in the brainstem, basal ganglia, and subcortical white matter without abnormal post-contrast enhancement or diffusion restriction. The history was revisited with a painstaking "yes/no" i... |
| 11 |
 | How to Get the Red Out | Raghu Mudumbai; Courtney Francis; Eugene May | Prior testing included C3, C4 normal, RF neg, ANA neg, MPO/PR3/ANCA neg HLA b27 neg, CCP neg, Hsv1 igG positive, Hga1c 6.3, ACE normal, HIV negative. An angiogram to evaluate for C-C fistula which was negative. MRI of the Orbits indicated Nodular enhancement along the left optic nerve with repeat im... |
| 12 |
 | A White Matter Riddle Encased in Mystery, Coiled Inside an Enigma | Nathan Tagg; Elizabeth Rooks; Vanessa Smith; Thomas Cummings | A 59-year-old woman was admitted for evaluation of progressive paranoia and was treated for bipolar disorder. An MRI during evaluation revealed a 10 x 7 x 7 mm right MCA aneurysm. She underwent stent-assisted coil embolization nine months later without immediate complications. Four months post-proce... |
| 13 |
 | Anchora Sella | Adeniyi Fisayo; Vanessa Veloso | On August 3, 2023, endoscopic endonasal resection of the sellar mass revealed a soft hemorrhagic mass within the sphenoid sinus, sellar and suprasellar spaces. Gross appearance of the mass was atypical for meningioma while frozen section revealed malignant, metastatic appearance. Final pathology rev... |
| 14 |
 | (Don't) Blame it on Rio | Avital Lily Okrent Smolar; Andre Aung; Fernando Labella Alvarez; Aliaksandr Aksionau; Stewart Neill; Sachin Kedar | A 43-year-old woman experienced blurred vision and pulsatile tinnitus after gaining 20 lbs. Six months later, optometric evaluation showed normal vision and bilateral optic nerve swelling. MRI brain with and without contrast was reportedly normal. One month later, she underwent a "Brazilian butt lif... |
| 15 |
 | A Nod to the Nodule | Natalie Brossard; Kirill Zaslavski; Laila Al-Shafai; David Munoz; Edward Margolin | A 67-year-old man presented to emergency department in March'21 with 6hours h/o fever, headache, confusion, right- sided weakness and urinary incontinence. He had h/o hypertension, rheumatoid arthritis, spinal stenosis and was taking etanercept/leflunomide/sulfasalazine. Non-contrasted CT showed lef... |
| 16 |
 | Frizzle Frazzled | Eric Gaier; Farrah Rajabi; Anne Fulton; Gyula Acsadi; David Waitzman | An otherwise healthy 12-year-old boy originally from Palestine was referred for refractory papilledema secondary to familial IIH. He has a history of fully accommodative esotropia with onset age 2-3. At age 9, elevated optic nerves prompted a neuro-ophthalmic referral. Best corrected visual acuities... |
| 17 |
 | X' Marks the Spot | Luis Andre Leal Ferman; Leslie Bruch; John Buatti; Jeremy Greenlee | This 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symp... |
| 18 |
 | Sometimes a Biopsy is Best | Kevin Chodnicki; Natalie Wolkow; Michael Yoon; Bart Chwalisz | A 30 -year-old pregnant woman without significant medical or ocular history presented with decreased right eye vision. In her 2nd trimester, she was diagnosed with Lyme disease with a bulls-eye rash and positive Lyme antibodies; she was treated with two weeks of amoxicillin. At 33 weeks pregnant she... |
| 19 |
 | A 4-Year Wait | Dmitry Balian; Sachin Kedar; Michaelyn Everhart; Aleh Bobr; Liudmila Muinov | A 64 year old male with past history of hypertension, arthritis and chronic headache developed transient tingling and numbness of his left face in February 2016 and was diagnosed to have 'trigeminal neuralgia'. Two months later, he presented to the ED with sudden onset of binocular tilted diplopia. ... |
| 20 |
 | Never Too Young or Too Old | Bart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael Levy | An 81-year-old woman with history of ocular myasthenia gravis presented with sequential bilateral vision loss. Six days before presentation, she discovered that vision of her left eye was reduced to light perception. She did not have any eye pain, pain with eye movement, headache, scalp tenderness, ... |
| 21 |
 | A Small Leak Will Sink a Great Ship | Konstantinos Douglas; Vivian Paraskevi Douglas; Cameron Sadegh; David Chow; Sigurros Davidsdottir; Ganesh Shankar; Bradley Buchbinder; Bart Chwalisz | A 68 -year-old right -handed man presented for evaluation of progressive and fluctuating polyopia, gait instability and cognitive changes of about 14 months. Prior medical history was notable for Crohn's disease in remission, atrial fibrillation, a single episode of aseptic meningitis 12 years prior... |
| 22 |
 | Orbiting a Diagnosis | Daniel Liebman; Daniel Lefebvre; Emily Tam; Marie Lithgow; Bart Chwalisz; Eric Gaier; Joseph Kane | A 75 -year-old male with a history of chronic/small lymphocytic leukemia (CLL/SLL) presented for one day of left retro-orbital headache, painful eye movements, eyelid swelling, and diplopia. One week prior, his WBC count was 39.9 K/uL with 86% lymphocytes. Three days prior to presentation, the patie... |
| 23 |
 | Oh My GAD!! Something Else? | Olwen Murphy; Kemar Green; John Probasco; Daniel Gold | A 43 -year-old man presented with oscillopsia, dizziness, binocular vertical diplopia, and gait difficulties. He reported a six-month history of abdominal pain, anorexia and 50-pound weight loss, and a 3-month history of mood and cognitive changes. Torsional nystagmus, a left 4th nerve palsy (NP), u... |
| 24 |
 | Gone but Not Forgotten | Jonathan Micieli; Adriana Krizova; Walter Montanera | A 52 -year-old healthy woman presented with a 1-week history of blurred vision and 'soreness' in her left eye. Neuro-ophthalmic examination revealed a visual acuity of 20/20 OD, 20/40 OS, left RAPD and left superior arcuate defect on Humphrey visual field testing. Dilated fundus examination demonstr... |
| 25 |
 | A Definite Maybe | Raghu Mudumbai; Alex Solomon | 73 yo man French-Canadian presented to our institution for another opinion for a long standing diagnosis of Oculopharyngeal Dystrophy given at an outside institution. 17 years ago, the patient developed unfluctuating double vision that progressed to include severe, unfluctuating ptosis and mild dysp... |