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101 Systemic Disorders With Optic Nerve and Retinal FindingsJohn A. Charley, MDA hypercoagulable state may result from deficiency of various factors involved in the clotting pathway, such as factor V. This may result in venous thrombosis and a branch or central retinal vein occlusion. Consideration for testing for an underlying coagulopathy, including the factor V deficiency, ...
102 Orbital TumorsLarry P. Frohman, MDThis 30-year-old man had a retrobulbar intraconal mass OS. The CT scans showed a heterogeneous lobulated enhancing mass, 2.2 x 1.9 x 1.8 cm. The case beautifully exhibits chorodial folds. The ultrasound showed internal reflectivity. The patient refused surgery. Pair with Images 97_60, 97_62, 97_63, ...
103 Orbital TumorsLarry P. Frohman, MDThis 30-year-old man had a retrobulbar intraconal mass OS. The CT scans showed a heterogeneous lobulated enhancing mass, 2.2 x 1.9 x 1.8 cm. The case beautifully exhibits chorodial folds. The ultrasound showed internal reflectivity. The patient refused surgery. Pair with Images 97_60, 97_61, 97_63, ...
104 Orbital TumorsLarry P. Frohman, MDThis 30-year-old man had a retrobulbar intraconal mass OS. The CT scans showed a heterogeneous lobulated enhancing mass, 2.2 x 1.9 x 1.8 cm. The case beautifully exhibits chorodial folds. The ultrasound showed internal reflectivity. The patient refused surgery. Pair with Images 97_61, 97_62, 97_63, ...
105 Neuro-Ophthalmic Manifestations of Brain TumorsSteven Galetta, MDThe patient is a 45-year-old recluse found to harbor this frontal lobe mass. Remarkably, this patient had only mild bilateral optic neuropathies with visual acuities in the 20/25 range. This right disc was mildly swollen and the left mildly pale. He could not fit into the fundus camera for disc phot...
106 Isolated Congenital Optic Disc AnomaliesLarry P. Frohman, MDThis 63-year-old man with amblyopia OD was seen for a question of ischemic optic neuropathy with a pale, swollen disc OD. The correct diagnosis is an exophytic capillary angioma of the optic nerve head. Disease/Diagnosis: Capillary Angioma.
107 Optic NeuropathiesLarry P. Frohman, MDThis healthy 29-year-old man with dense amblyopia OS presented with a foreign-body sensation OS and further visual loss in his amblyopic eye. He was noted to have bilateral disc edema and lesions in the left eye consistent with unilateral acute multifocal placoid pigment epitheliopathy (AMPPE). He r...
108 Optic NeuropathiesLarry P. Frohman, MDThis healthy 29-year-old man with dense amblyopia OS presented with a foreign-body sensation OS and further visual loss in his amblyopic eye. He was noted to have bilateral disc edema and lesions in the left eye consistent with unilateral acute multifocal placoid pigment epitheliopathy (AMPPE). He r...
109 Optic NeuropathiesLarry P. Frohman, MDThis healthy 29-year-old man with dense amblyopia OS presented with a foreign-body sensation OS and further visual loss in his amblyopic eye. He was noted to have bilateral disc edema and lesions in the left eye consistent with unilateral acute multifocal placoid pigment epitheliopathy (AMPPE). He r...
110 Optic NeuropathiesLarry P. Frohman, MDThis healthy 29-year-old man with dense amblyopia OS presented with a foreign-body sensation OS and further visual loss in his amblyopic eye. He was noted to have bilateral disc edema and lesions in the left eye consistent with unilateral acute multifocal placoid pigment epitheliopathy (AMPPE). He r...
111 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDAt age 41, in 1984, this woman, who grew up in the Ohio River Valley, had 3 days of ocular pain OD, and her vision declined to 20/80 OD she has had no visual changes since, nor has she had any other neurologic symptoms. The ""presumed"" diagnosis is optic neuropathy in presumed ocular histoplasmosis...
112 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis 57-year-old man had a neuro-ophthalmology consult, requested the night before his 2-cm pituitary tumor was to be resected. His examination revealed his acuities to be 20/70 OU, with a visual field not consistent with chiasmal compression. The fundus appearance, with peripheral salt and pepperin...
113 Neuro-Ophthalmic Vascular DiseaseSteven A. Newman, MDOcclusion of a branch or central retinal artery may result in acute visual loss. The ophthalmoscopic findings are retinal whitening due to ischemic retina in the distribution of the occluded artery. Sparing or selective involvement of cilioretinal artery branches may occur. Patients with a central r...
114 Neuro-Ophthalmic Vascular DiseaseSteven A. Newman, MDOcclusion of a branch or central retinal artery may result in acute visual loss. The ophthalmoscopic findings are retinal whitening due to ischemic retina in the distribution of the occluded artery. Sparing or selective involvement of cilioretinal artery branches may occur. Patients with a central r...
115 Neuro-Ophthalmic Imaging-MRIScott Forman, MDThis 23-year-old right-handed man had a history of idiopathic recurrent optic neuritis. The patient presented with acuity of 20/400 OD and 20/100 OS, with a central scotoma OD and a complete temporal defect OS. MRI with fat suppression and gadolinium revealed enhancement of the intracranial nerve an...
116 Neuro-Ophthalmic Imaging-MRIScott Forman, MDThis 23-year-old right-handed man had a history of idiopathic recurrent optic neuritis. The patient presented with acuity of 20/400 OD and 20/100 OS, with a central scotoma OD and a complete temporal defect OS. MRI with fat suppression and gadolinium revealed enhancement of the intracranial nerve an...
117 Systemic Disorders With Optic Nerve and Retinal FindingsRobert L. Lesser, MDIntraocular lymphoma may present with an unexplained vitritis, optic disc infiltration, or choroidal infiltration. One unusual manifestation of large-cell lymphoma is this leopard-spot appearance. Pair with 94_32, 94_33, and 94_35. This is a fundus photo.
118 Systemic Disorders With Optic Nerve and Retinal FindingsRobert L. Lesser, MDIntraocular lymphoma may present with an unexplained vitritis, optic disc infiltration, or choroidal infiltration. One unusual manifestation of large-cell lymphoma is this leopard-spot appearance. Pair with 94_32, 94_34, and 94_35. This is a fundus photo.
119 Systemic Disorders With Optic Nerve and Retinal FindingsRobert L. Lesser, MDIntraocular lymphoma may present with an unexplained vitritis, optic disc infiltration, or choroidal infiltration. One unusual manifestation of large-cell lymphoma is this leopard-spot appearance. Pair with 94_33, 94_34, and 94_35. This is a fundus photo.
120 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
121 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
122 Optic NeuropathiesDaniel M. Jacobson MDThis 34-year-old otherwise-healthy woman was referred for a neuro-ophthalmologic consultation for unexplained loss of vision OD following head trauma. Two months earlier, she was involved in a motor vehicle accident that resulted in a closed head injury complicated by a spontaneously resolving small...
123 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 27-year-old woman had no past ocular history and presented with 3 weeks of redness OS that has been treated by the referring doctor as allergic conjunctivitis. She was referred for evaluation when she developed binocular diplopia. Her past medical history included phlebitis and one miscarriage ...
124 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 27-year-old woman had no past ocular history and presented with 3 weeks of redness OS that has been treated by the referring doctor as allergic conjunctivitis. She was referred for evaluation when she developed binocular diplopia. Her past medical history included phlebitis and one miscarriage ...
125 Ocular Manifestations of Congenital/Inherited DiseasesSteven Galetta, MDThis 21-year-old woman had a 2-year history of blurred vision. A computerized visual field demonstrated a temporal defect OS. MRI confirmed a chiasmal mass lesion. The pathology was consistent with hemangioblastoma. Further workup revealed retinal angiomas and multiple other hemangioblastomas of the...
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