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1 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
2 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
3 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; Valérie Biousse, MD
4 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; Valérie Biousse, MD
5 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
6 Optic Disc MelanocytomaA 26-year-old woman was seen for assessment of an asymptomatic optic nerve abnormality in her left eye. Her examination showed normal afferent visual function: visual acuity: 20/30 OD and 20/25 OS; PH 20/20 OU; pupils: no relative afferent pupil defect; color vision: 14/14 plates correct OU. Humphre...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
7 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
8 Optic Nerve HypoplasiaThis is an illustrated guide to the clinical diagnosis of optic nerve hypoplasia. Optic nerve hypoplasia (ONH) is the most common congenital optic nerve anomaly, with an estimated incidence of 1 in 2287 live births. It may present unilaterally or bilaterally. It is seen in isolation or in associati...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
9 Retrograde Trans-Synaptic Degeneration from a Longstanding Occipital Lobe TumorThis is an illustrated guide that (1) discusses the localization of paracentral homonymous hemianopic scotomatous visual field defects and (2) discusses the concept of trans-synaptic retrograde degeneration. A 43-year-old woman was assessed for longstanding blurred vision in both eyes. Her examinati...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
10 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; Valérie Biousse, MD
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, MD; Valérie Biousse, MD
12 Large Sellar and Suprasellar Mass (Pituitary Macroadenoma) With Left Third Nerve Palsy and Left Optic Tract CompressionA case of a large sellar and suprasellar pituitary macroadenoma with an associated left third nerve palsy and left optic tract compression. Images from an MRI of the brain with contrast illustrate the imaging characteristics and extent of the tumor. Figure 1 : Humphrey Visual Fields (24-2 SITA-Fast)...Devin D. Mackay, MD; Valérie Biousse, MD
13 Metastatic Ovarian Cancer to the Left Occipital Lobe With Complete Right Homonymous HemianopiaA case of metastatic ovarian cancer to the left occipital lobe with a complete right homonymous hemianopia. Humphrey visual fields as well as images from an MRI of the brain are included. Figure 1 : Humphrey visual fields showing a complete right homonymous hemianopia Figure 2 : MRI brain T1 axial...Devin D. Mackay, MD; Valérie Biousse, MD
14 MRI Characteristics of Cavernous Sinus and Superior Ophthalmic Vein Septic ThrombosisSeptic 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 ...Devin D. Mackay, MD; Valérie Biousse, MD
15 Ocular Fundus ExaminationReview of various techniques of ocular fundus examination, including direct ophthalmoscopy, binocular indirect ophthalmoscopy, slit lamp binocular indirect ophthalmoscopy, and fundus photography. Advantages and disadvantages of each technique are discussed.Devin D. Mackay, MD; Valérie Biousse, MD
16 Posterior Circulation Infarctions Secondary to a Post Traumatic Vertebral Artery DissectionA case of a young man with a vertebral artery dissection that caused multiple posterior circulation brain infarcts. Images from an MRI of the brain, digital subtraction angiography, and Humphrey visual fields are included. Figure 1 : Humphrey visual fields showed a right homonymous hemianopia with ...Devin D. Mackay, MD; Valérie Biousse, MD
17 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; Valérie Biousse, MD
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; Valérie Biousse, MD
19 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; Valérie Biousse, MD
20 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; Valérie Biousse, MD
21 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; Valérie Biousse, MD
22 Normal Retinal AnatomyNormal posterior vitreous, retinal and chroroidal anatomy (pictures, fluorescein angiography and optical coherence tomography). Figure 1: Normal fundus photograph of the left eye o a : Optic disc and fovea o b : Foveal reflex in young patients o c : Macular and foveal areas share the same center o d...Rabih Hage, MD; Valérie Biousse, MD
23 Occipital Pyogenic Abscess with Homonymous HemianopiaThis is a case of right occipital abscess with a left homonymous hemianopia. Number of Figures and legend for each: 8 figures Figure 1: Humphrey visual fields: Dense left homonymous hemianopia Figure 2: T2-weighted axial MRI : Round, hyperintense lesion (yellow arrow) in the right occipital lobe sur...Rabih Hage, MD; Valérie Biousse, MD
24 Sellar Aneurysm with Chiasmal CompressionThis is a case of aneurysm of the internal carotid artery, invading the sella and complicated by chiasmal compression and bitemporal hemianopia. Figure 1 : Humphrey visual fields (gray scale and pattern deviations) Figure 2a : T1-weighted axial brain MRI (1): well defined circular intracerebral mass...Rabih Hage, MD; Valérie Biousse, MD
25 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; Amit M. Saindane, MD; Valérie Biousse, MD
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