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1 Best's Vittelform MaculopathyGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineThis 14 year old presented with decreased vision, headaches and central scotomas. She was found to have bilateral papilledema related to IIH and also Best's vitilliform maculopathy. The maculas are commonly described as having a "fried egg" sunny side up appearance.
2 Acute Retinal Necrosis (ARN)Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineAcute Retinal Necrosis causes inflammation and subsequent retinal detachment. This powerpoint provides images depicting ARN.
3 Retinitis PigmentosaGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineRetinitis pigmentosa is a retinal/choroidal degeneration caused by various genetic defects. The term retinitis pigmentosa is really a misnomer since it is not inflammation (retinitis) and it is not a disease of the pigmentary system (pigmentosa).
4 Stargardt's DiseaseGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineStargardt's disease is an inherited maculopathy which frequently presents with a loss of central vision.
5 BirdshotGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineBirdshot Retinochoroidopathy is a posterior uveitis seen in women 30-60 years of age who present with floaters, changes in color vision, and difficulty with night vision.
6 HistoplasmosisGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineHistoplasmosis, a fungus, can present acutely as a systemic condition. This image shows signs of Histoplasmosis.
7 Acute Multifocal Pigment Epithelium Epitheliopathy (AMPEE)Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineImages providing example of Acute Multifocal Pigment Epithelium Epitheliopathy (AMPEE)
8 Congenital and Secondary SyphilisGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineImages showing evideince of Congenital and Secondary Syphilis
9 Multifocal ChoroiditisGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineMulti-focal choroiditis is usually a bilateral choroidopathy seen more frequently in women associated with punched out appearing lesions occasionally with pigment around the edges. Image provides example.
10 What is White? Normal white structuresGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineThe only inherently "white" element in the normal eye is the sclera.
11 Serpiginous ChoroidopathyGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineSerpiginous choroidopathy (also known as Geographic choroidopathy) usually affects the choroid, the choriocapillaris and the retinal pigment epithelium in both eyes.
12 Vogt Koyanagi-Harada (VKH) SyndromeGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineVogt-Koyanagi disease causes bilateral uveitis, along with alopecia, vitiligo, and hearing loss.
13 Pars PlanitisGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicinePars planitis is an inflammatory condition seen in children and young adults. It is associated with inflammation of the pars plana--at the far periphery of the retina.
14 Skew Deviation and the Ocular Tilt ResponseDavid Newman-Toker, MD, PhD, Associate Professor, Departments of Neurology, Ophthalmology, & Otolaryngology, The Johns Hopkins University School of MedicineThe objectives of this presentation are to provide an understanding of the current use of the terms "ocular tilt reaction" and "skew deviation," to create some familiarity with the anatomic and physiologic substrate of ocular tilt and skew, and to demonstrate how to distinguish between skew and isol...
15 Aberrant Regeneration of Third NerveGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of Medicine48 year old woman S/P rupture and repair of right sided posterior communicating artery aneurysm Video shows residual partial right third nerve palsy, with aberrant regeneration, causing a pseudo Von Graefe's sign (elevation of the right upper eyelid with attempted infraduction of the right eye) Se...
16 Papilledema and Resolution (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can be seen with chronic optic disc edema. This image shows the chronic papilledema at presentation, with associated refractile hyaline bodies at the disc periphery in both eyes.
17 Periphlebitis in Optic Neuritis (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 35-year-old otherwise-healthy woman developed typical optic neuritis OD with excellent recovery. She had no clinical evidence of multiple sclerosis at that time. She presented in August of 1991, at which time perivenous sheathing was seen in the retinal periphery OU. A limited workup was negati...
18 Tadpole Pupil (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
19 Chiasmal Herniation (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis woman was 61 years old when she underwent initial neuro-ophthalmologic evaluation. Twenty-three years earlier, she had undergone removal of a pituitary adenoma followed by radiation therapy. At that time, she had noted a preoperative visual field defect that improved somewhat after the surgery....
20 Moyamoya Disease (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...
21 Paraneoplastic Disease (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 46-year-old woman noted progressive bilateral visual loss over a 10-month period. She had a malignant melanoma removed from her right thigh 2 years ago and excisional biopsy of an inguinal node metastasis 8 months ago. She also complained of poor night vision and rare intermittent ""sparkles"" ...
22 Radiation Retinopathies (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyRadiation retinopathy may mimic diabetic or hypertensive optic neuropathy. A history of irradiation to the eye, orbit, or head is mandatory. Radiation retinopathy usually occurs many months after radiation therapy.
23 Leber's Optic Neuropathy (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietySeveral Primary Mutations result in Leber's hereditary optic neuropathy, including mitochondrial deletions at positions 11778, 3460, and 14484. Although the 11778 is the most common mutation, the 11484 has the best prognosis for spontaneous recovery. This case exhibits the 3460 mutation.
24 Multiple Myeloma (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 48-year-old female was seen in May 1996 with a history of 2 months of diplopia from a right abducens palsy. This was due to the recurrence of myeloma that had initially been diagnosed and treated with radiation and chemotherapy 9 years before and required further therapy, including bone marrow ...
25 Histiocytosis (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This image demonstrates the optic nerve infiltration. He was treated with ra...
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