Table of Contents - WOC 2012

FP-NEO-MO 386 (5)
Toxoplasma Neuroretinitis - A Case Series
Mandal Santanu (1) , Mandal Santanu (1)
1. Disha Eye Hospitals and Research Centre
Aim: Atypical presentation of ocular involvement in Toxoplasmosis is not rare.
We have found three cases of neuroretinitis where Toxoplasma is presumed to
be the causative factor.
Methods: Three subjects of 11 years, 21 years and 29 years of age presented
with features of unilateral neuroretinitis where Toxoplasma antibody titre
(IgM and IgG) were strongly positive in absence of other possible causes
of neuroretinitis. A course of Co-trimoxazole for 6 weeks along with oral
corticosteroid was given.
Results: Vision improved from 3/60 to 6/9, 6/60 to 6/9 and from 6/60 to 6/12
respectively in the above cases. Follow-up of more than one year in all cases
did not reveal any recurrence or any worsening of vision.
Conclusion: Toxoplasma antibody titre should be included in the investigation
for neuroretinitis.
FP-NEO-MO 386 (6)
Neuro Ophthalmic Manifestations of Patient with HIV/AIDS
Vijay Ananth Jeyaraman (1) , Sudharshan Sridharan (1) , Ambika Selvakumar (1) ,
Rashmin Gandhi Anilkumar (1) , Biswas Jothimai (1)
1. Sankara Nethralaya Eye Hospital
Purpose: To study the clinical profile and management in patients with HIV/
AIDS who were presented with neuro ophthalmic manifestations to our centre.
Methods: Retrospective study, HIV/AIDS patients with ophthalmic complaints
seen between January 2004 to December 2010 were included. Neurophthalmic
manifestations were specifically sub grouped and analysed. Detailed history,
ophthalmic evaluation, clinical presentation, etiology, relevant systemic
findings including neurological examination and imaging results, management
and prognosis were noted and analysed. All patients with consecutive optic
nerve head involvement such as post infective retinitis or drug induced were
excluded.
Results:34 patients findings-Papilloedema-12 (Cryptococci-6, TB-3,
toxoplasmosis-2, IIH-1), Optic atrophy-11, Biopsy proven TB disc granuloma,
altitudinal, Homonemus field loss (visual cortex lesion) due to infarct, optic
neuritis(syphilis)-1 each, PML-3, Cranial nerve palsy-7 patients (of which 3
patients had 6th nerve palsy as a consequence of raised ICT).
Conclusions: Neurophthalmic involvement in patients with HIV/AIDS can even
be a primary manifestation of a systemic infection such as seen in PML and
TB. This can cause irreversible vision loss and death. CSF analysis, visual
fields and CNS imaging helps diagnosis. A thorough knowledge of neuroophthalmic
lesions helps early diagnosis and management preventing visual
morbidity and mortality.
WOC2012 Abstract Book
FP-NEO-MO 386 (7)
Causes of Double Vision in Thyroid Associated Ophthalmopathy
Klysik Anna (1) , Guminska Magdalena (1)
1. Medical University of Lodz
Purpose: To investigate the incidence and associations of various types of
double vision and gaze limitations among patients presenting with ocular
complaints related to Thyroid associated ophthalmopathy.
Methods: We included 325 patients (268 female and 57 male) aged 42 to 78
(mean 51.1), referred with eye problems and diagnosis of TAO. 156 sex and
age matched, healthy volunteers served as a control group. Eye movement
restrictions, exophthalmos, horizontal and vertical disparations were
investigated.
Results: 59.8% of patients reported significant double vision. 96% of patients
complaining of double vision reported that it is intermittent, (29% in primary
gaze position and 67% in other than primary.) The most common limitation of
eye movement was elevation (49%). There is a significant correlation between
clinically significant double vision and vertical disparation (p=0.3) as well as
asymmetrical exophthalmos (p=o.34). There is no correlation between the
amount of exophthalmos and double vision.
Conclusions: Diplopia is an extremely common presenting sign of TAO. Most
patients are troubled by diplopia in different than primary gaze direction.
Asymmetrical exophthalmos, and asymmetrical vertical eye muscles
involvement are the most significant factors associated with symptomatic
diplopia.
FP-NEO-MO 386 (8)
Cisplatin-Associated Optic Neuropathy
Eisenack Johannes (1) , Sturm Veit (1)
1. University Hospital of Zurich, Eyeclinic
Objective/Puropose: Diammindichloroplatin (Cisplatin) belongs to a group of
cytostatic drugs which inhibits the DNA sequencing and is used in different
kinds of tumors. Hematopoietic suppression, gastrointestinal and renal sideeffects
as well as visual side-effects are known.
Methods: We report a 65-year old man who was due to a mesothelioma treated
with six cycles of Cisplatin since June 2010 and achieved a partial remission.
He presented with sudden visual loss to 0,4 in the right eye and 0,15 in the left
eye. We found a bilateral swelling of the optic disc. MRI-imaging of the orbitae
and the brain showed no pathologies.
Results: An initial started therapy with high-dosed corticosteroids could be
stopped according to non-elevated infection parameters. Unfortunately, we
could not report a definite gain of visual acuity.
Conclusions: We show the process of an optic neuropathy due to Cisplatin with
non-reversible loss of visual acuity. This side-effect should be part of an
informative guideline prior to treatment.
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