NOVEL - Emory Eye Center
 
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26 Typical Idiopathic Intracranial Hypertension: Optic Nerve Appearance and Brain MRI FindingsA 24-year old African American woman was referred for bilateral optic disc edema that was incidentally noted on a routine eye examination. She had excellent visual function and dilated examination showed bilateral optic disc edema with peripapillary wrinkles in the right eye and pseudodrusen in the ...Jonathan A. Micieli, MD; Valérie Biousse, MD
27 Vitreopapillary TractionA 64-year-old woman was referred for bilateral optic disc edema. Examination of her optic nerves showed indistinct margins at the nasal aspect of both eyes (Figure 1). Humphrey 24-2 SITA-Fast visual fields showed non-specific depressed points in both eyes (Figure 2). Optical coherence tomography (...Jonathan A. Micieli, MD; Valérie Biousse, MD
28 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; Valérie Biousse, MD
29 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
30 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
31 Malignant Hypertension With Bilateral Optic Nerve EdemaThis is a case of malignant hypertension and severe hypertensive retinopathy. A 30-year-old woman with headache and vision loss in the left eye was found to have a markedly elevated blood pressure of 205/100. CT head without contrast showed acute hemorrhage in the right temporal-occipital junction a...Rahul A. Sharma, MD, MPH; Michael Dattilo, MD, PhD; Valérie Biousse, MD
32 Toxoplasmic Chorioretinitis with Unilateral Disc EdemaA 53-year-old man had a history of high myopia and a seronegative spondyloarthropathy treated with immunosuppressive agents. He presented with mild, painless vision loss in his right eye. His examination showed findings of a right anterior optic neuropathy: visual acuity: 20/20 OD (right eye), 20/20...Rahul A. Sharma, MD, MPH; Nancy J. Newman, MD; Valérie Biousse, MD
33 Myelin Oligodendrocyte Glycoprotein (MOG) - Antibody Optic NeuritisThis is an illustrated guide to the clinical diagnosis of myelin oligodendrocyte glycoprotein (MOG)-antibody optic neuritis. Myelin oligodendrocyte glycoprotein (MOG) is a glycoprotein on the surface of myelin and is found exclusively in the central nervous system (CNS). MOG likely mediates a comple...Bryce Buchowicz, MD; Valérie Biousse, MD
34 NeurosarcoidosisThis is an illustrated guide to the clinical diagnosis of neurosarcoidosis. Sarcoidosis is a chronic systemic inflammatory disorder characterized by non-caseating granulomas. It can affect multiple organ systems including the lungs, skin, orbit, and brain. When there is central nervous system (CNS) ...Bryce Buchowicz, MD; Valérie Biousse, MD
35 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
36 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
37 Previous Branch Retinal Artery OcclusionThis is a typical case of an old branch retinal artery occlusion in a 64 year old woman presenting with persistent monocular vision loss. She had sudden onset of painless vision loss in the inferior field of her left eye approximately one year prior. Her past medical history was significant for atri...Benson S. Chen, MBChB FRACP; Valérie Biousse, MD
38 Homonymous Hemianopia Secondary to an Intracranial Bleed from an Arteriovenous MalformationThis case demonstrates a homonymous hemianopia resulting from hemorrhage secondary to a ruptured intracranial arteriovenous malformation (AVM), providing grounds for illustration and discussion of the correlations between localization of this lesion on cerebral imaging and resultant visual field and...Lauren Hudson, MD, PhD; Valérie Biousse, MD
39 Funduscopic Findings of Acute Central Retinal Artery OcclusionA 59-year-old man was referred for assessment acute vision loss in the right eye. His examination showed: best-corrected visual acuity: light perception OD, 20/20 OS; pupils: Relative afferent pupillary defect OD; color vision: unable to visualize control plate OD, 14/14 OS correct Ishihara plates. ...David B. Enfield, MD; Valérie Biousse, MD
40 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
41 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; Aaron M. Yeung, MD; Valérie Biousse, MD
42 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
43 Toxic Retinopathy: Deferoxamine ToxicityNumber of Figures and legend for each: 6 figures Figure 1: Goldmann perimetry showing large cecocentral scotomas in both eyes Figure 2: Fundus photograph of the right eye demonstrating hypopigmentation of the peripapillary and perifoveal retinal pigment epithelium (RPE) with subfoveal yellow lesions...Will Pearce, MD; Valérie Biousse, MD
44 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
45 Nonfunctiong Pituitary Adenoma with Chiasmal CompressionThis is a case of large non-functioning pituitary adenoma with mass effect on the optic chiasm inducing loss of optic nerve fibers and subsequent visual field. Figure 1: Fundus photographs demonstrating bilateral temporal optic nerve head pallor Figure 2: Humphrey visual fields demonstrating a bitem...William Pearce, MD; Valérie Biousse, MD
46 Iris TransilluminationSingle case of iris transillumination in a patient with albinism. Figure 1 : Anterior segment photograph demonstrating reddish hue to iris in albinism Figure 2 : Slit lamp photograph with retroillumination demonstrating iris transillumination Figure 3 : Slit lamp photograph with retroillumination...Jason Peragallo, MD; Valérie Biousse, MD
47 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
48 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
49 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
50 Incipient Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION)A 61-year old white man with hypertension, diabetes, and dyslipidema was seen in neuro-ophthalmology consultation for asymptomatic right optic disc edema. He had a small, crowded optic disc in the left eye known as a "disc-at-risk" (Figure 1). He had normal visual function including normal 24-2 SITA...Jonathan A. Micieli, MD; Valérie Biousse, MD
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