NOVEL - Emory Eye Center
 
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1 "Checkboard" Visual Field Loss Due to Bilateral Homonymous HemianopsiasA 70-year-old man with vascular risk factors was seen for assessment of sudden visual field loss in both eyes. His examination showed: visual acuity: 20/20 OD and 20/25 OS; pupils: equal with no relative afferent pupillary defect; color vision: 14/14 plates correct OU; anterior segment exam: normal ...Rahul A. Sharma, MD, MPH, Neuro-ophthalmology Fellow, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD, Cyrus H. Stoner Professor of Ophthalmology, Professor of Ophthalmology and Neurology, Departments of Ophthalmology and Neurology, Emory University School of M...
2 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, MD Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
3 Anatomy of the Orbits on CT and MRIMRI and CT imaging of the orbit.Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
4 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
5 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
6 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, Neuro-ophthalmology Fellow; Department of Ophthalmology; Valérie Biousse, MD, Reunette Harris Professor of Ophthalmology, Professor of Ophthalmology and Neurology; Emory University School of Medicine, Atlanta, GA
7 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
8 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, Medical Student, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD, Cyrus H. Stoner Professor of Ophthalmology, Professor of Ophthalmology and Neurology, Departments of Ophthalmology and Neurology, Emory University School of Medicine
9 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
10 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
11 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
12 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
13 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
14 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, Neuro-ophthalmology Fellow; Andre Aung, MD, Neuro-ophthalmology Fellow; Department of Ophthalmology; Valérie Biousse, MD, Reunette Harris Professor of Ophthalmology, Professor of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta, GA
15 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, Neuro-ophthalmology Fellow, Corrina Azarcon, MD, Ocular Oncology and Pathology Fellow, Wael A. Alsakran, MD, Neuro-ophthalmology Fellow, Valérie Biousse, MD, Reunette Harris Professor of Ophthalmology, Professor of Ophthalmology and Neurology, Department of Ophthalmology, Emory Univ...
16 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, Neuro-ophthalmology Fellow, Department of Ophthalmology, Emory University School of Medicine; Jason H. Peragallo, MD, Associate Professor of Ophthalmology, Departments of Ophthalmology and Neurology, Emory University School of Medicine; Valérie Biousse, MD, Cyrus H. Stoner...
17 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, MD, Emory Eye Center Atlanta, Georgia; Valérie Biousse, MD, Departments of Ophthalmology and Neurology, Emory University School of Medicine
18 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
19 Compressive Optic Neuropathy from Cavernous HemangiomaA 42-year-old man was seen for assessment of progressive blurring of vision in his left eye (OS) over several weeks. His examination showed a left optic neuropathy: visual acuity: 20/20 OD and 20/20-2 OS; pupils: 1+ left relative afferent pupillary defect; color vision: 14/14 plates correct OU. Ther...Rahul A. Sharma, MD, MPH, Neuro-ophthalmology Fellow, Department of Ophthalmology, Emory University School of Medicine; Aaron M. Yeung, MD, Ocular pathology fellow, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD, Cyrus H. Stoner Professor of Ophthalmology, Pro...
20 Cotton Wool Spots in Giant Cell ArteritisThis is a case of cotton wool spots in a patient with temporal artery-biopsy proven temporal arteritis.; ; A 66-year-old woman presents with isolated painless vision loss related to a left optic neuropathy in her left eye. She denies systemic symptoms to suggest giant cell arteritis.; Her examinatio...Rahul A. Sharma, MD, MPH, Neuro-ophthalmology Fellow, Department of Ophthalmology, Emory University School of Medicine; Valérie Biousse, MD, Cyrus H. Stoner Professor of Ophthalmology, Professor of Ophthalmology and Neurology, Departments of Ophthalmology and Neurology, Emory University School of M...
21 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, Neuro-ophthalmology Fellow, Department of Ophthalmology; Valérie Biousse, MD, Reunette Harris Professor of Ophthalmology, Professor of Ophthalmology and Neurology; Ling Chen Chien, MD, Neuro-radiology Fellow,Department of Radiology; Emory University School of Medicine, Atlanta, ...
22 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
23 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
24 Fourth 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, Atlanta, GA
25 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
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