Table of Contents - WOC 2012

WOC2012 Abstract Book
Neuro-ophthalmology
PO-NEO-01
Intracranial pathology detection by brain magnetic resonance
imaging in young children with apparently isolated nystagmus
Khan Arif (1) , Shammari Mansoor (1) , Elkhamary Sahar (1)
1. King Khaled Eye Specialist Hospital
PURPOSE: To assess incidence of intracranial pathology in young children
who had brain magnetic resonance imaging (MRI) to investigate apparentlyisolated
nystagmus of unclear duration.
Methods: Retrospective institutional review (2003-2008).
Results: Twenty-six children under 6 years old (17 boys, 9 girls) were identified.
Seventeen cases (65%) were described as horizontal pendular, 5 (19%) as
horizontal jerk, 2 (8%) as vertical pendular, and one each as downbeat and
torsional (8%). Three of the 26 patients (12%) had significant MRI findings,
all 3 of whom had temporal optic nerve head pallor noted during clinical
examination. One was an otherwise normal 7-month-old girl with bilateral
torsional nystagmus for whom MRI revealed a suprasellar craniopharyngioma.
The second was an otherwise developmentally-normal 7-month old boy with
bilateral horizontal pendular nystagmus for whom MRI revealed a retrosellar
craniopharyngioma. The third was a 10-month-old boy with developmental
delay and bilateral horizontal pendular nystagmus for whom MRI revealed
periventricular leukomalacia and encephalomalacia.
Conclusions: The optic nerve head should be carefully assessed for signs of
pallor in young children with nystagmus and if present brain MRI should
be performed. Otherwise, isolated early childhood nystagmus without
developmental delay is unlikely to be associated with intracranial pathology.
PO-NEO-02
Ocular Ischemic Syndrome Secondary to stenosis of intracavernous
internal carotid artery.
Bashir Yasfir (1) , Gul Alia (1) , Priya B V (1) , Kumar yadav Naresh (1)
1. Narayana Nethralaya Eye Institute
Purpose: To demonstrate the clinical presentation of Ocular Ischemic
Syndrome secondary to stenosis of intracavernous internal carotid artery.
Methods: A 67 year old male,diabetic and hypertensive presented with history
of progressive visual loss of one month duration in the right eye.Examination
revealed RAPD with rubeosis iridis and normal IOP. Gonioscopy showed
open angles with new vessels .Fundus examination and angiography showed
features suggestive of Ocular Ischemic Syndrome (OIS).Carotid Doppler
ultrasound did not reveal any significant stenosis. He underwent panretinal
laser photocoagulation and presented 3 weeks later with no perception of light
and hemicranial headache and was advised neuro-imaging.
Results: A CT carotid angiography showed 90% blockage of right supraclinoid
internal carotid artery(intracavernous portion) which was missed on carotid
Doppler USG .
Conclusion: In cases with high suspicion of ocular ischemia, routine
investigations like Echocardiography and carotid Doppler USG may not be
sensitive enough to detect intracranial carotid artery stenosis and specialized
diagnostic modalities like CT angiography or MR angiography may be needed.
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PO-NEO-03
Ocular Manifestations of Intracranial Space Occupying Lesions- A
Retrospective Study
Parija Sucheta (1) , Sharat Soumya (1)
1. SCB Medical College and Hospital, Utkal University
Purpose: To study the ocular manifestations of intracranial space occupying
lesions (ICSOL).
Methods: A retrospective study of 42 cases clinico-radiologically diagnosed as
ICSOL had comprehensive ophthalmologic examination during March 2009 to
July 2010 at a tertiary hospital. Informed consent was taken, and a proforma
was filled regarding demographic data, medical and surgical history and
management.
Results: The significant age group affected was 20-40 years (54.8%). Most
common ocular manifestation was papilledema, bilateral in 94.4% and
unilateral in 5.6%. Visual acuity (OU) was 6/60 in 80.9%.
Loss of corneal sensation in 11.9%, 6th nerve palsy in 14.3%, coarse horizontal
nystagmus in 4.8%, bitemporal hemianopia in 4.8%, and diplopia in 7.1% were
observed. Major etiological factor was frontal lobe gliomas in 47.6%, followed
by meningiomas in 26.2%, pituitary tumours in 4.8%, lymphomas in 4.8% and
others in 7.1%.
Conclusion: Bilateral papilledema is the most common ocular manifestation of
ICSOL. Sudden deterioration of vision generates the need for early detection
of papilledema with ICSOL and timely referral for neurosurgical intervention.
PO-NEO-04
Subtle ocular albinism and multifocal ERG in darkly pigmented
patients with congenital nystagmus
Shehri Mohamed (1) , galves alberto (1) , arishi nawal (1) , ghazi nicola (1)
1. King Khalid Eye Specialist Hospital (KKESH)
Purpose: to include the ocular or Oculocutaneous albinism in the differential
diagnosis of darkly pigmented patients with congenital nystagmus & to show
the role of multifocal ERG to diagnose foveal hypoplasia. Method: Case
series of subtle ocular albinism in darkly pigmented patients presented to
neurophthalmology clinic with congenital nystagmus.
Results: patients with congenital nystagmus and decreased VA since early
childhood; clinically they are darkly pigmented people with horizontal
nystagmus, in careful slit lamp exam there is very subtle iris transillumination
defects and abnormal foveal reflex. Global ERG was normal but the multifocal
ERG shows a flat response documents a foveal hypoplasia.
Conclusion: in neurophthalmology clinic pts with congenital nystagmus should
be evaluated to roll out albinism even if darkly pigmented, by careful exam of
iris and fovea with possible use of multifocal ERG.
PO-NEO-05
Alternative method of injection of kenalog at treatment of neuritis of
optic nerve
Dzhumagulov Olzhobai (1) , Gaidamac Victoria (1) , Eshmambetov Asizbec (1)
1. Kyrgyz State Medical Academy
Purpose: To desing new method of injection of corticosteroid - kenalog at
neuritis of optic nerve.
Methods: At the first stage of work, technique of operation and also possible
morphologic consequences of ingection of prolongated corticosteroid - kenalog
into back section of eyeglobe have been studied on experimental animals.
Results: At microscopic investigation of obtained specimen, it wasrevealed that
our intervention did not cause any morphologic disorders of optic nerve. At the
second stage, we applied drug-kenalog for patients with neutitis of optic nerve
in hospital.
Conclusion: Method of subtenon injection of kenalog into patients with neuritis
of optic nerve at start period of disease can be considered as one of the safest
options of treatment of neuritis of optic nerve.