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Yang Y, Tan H, Xiang S, Chen X, Guo X. Ping-Pong Gaze in Sporadic Creutzfeldt-Jakob Disease. Mov Disord Clin Pract 2024; 11:301-302. [PMID: 38173310 DOI: 10.1002/mdc3.13914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/03/2023] [Accepted: 10/08/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Yuan Yang
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hua Tan
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shuli Xiang
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiu Chen
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaoyan Guo
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Goodwill VS, Dryden I, Choi J, De Lillo C, Soldau K, Llibre-Guerra J, Sanchez H, Sigurdson CJ, Lin JH. Minimal change prion retinopathy: Morphometric comparison of retinal and brain prion deposits in Creutzfeldt-Jakob disease. Exp Eye Res 2022; 222:109172. [PMID: 35803332 PMCID: PMC9946801 DOI: 10.1016/j.exer.2022.109172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 02/04/2023]
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is the most commonly diagnosed human prion disease caused by the abnormal misfolding of the 'cellular' prion protein (PrPC) into the transmissible 'scrapie-type' prion form (PrPSc). Neuropathologic evaluation of brains with sCJD reveals abnormal PrPSc deposits primarily in grey matter structures, often associated with micro-vacuolar spongiform changes in neuropil, neuronal loss, and gliosis. Abnormal PrPSc deposits have also been reported in the retina of patients with sCJD, but few studies have characterized the morphology of these retinal PrPSc deposits or evaluated for any retinal neurodegenerative changes. We performed histopathologic and morphometric analyses of retinal and brain prion deposits in 14 patients with sCJD. Interestingly, we discovered that the morphology of retinal PrPSc deposits generally differs from that of brain PrPSc deposits in terms of size and shape. We found that retinal PrPSc deposits consistently localize to the outer plexiform layer of the retina. Additionally, we observed that the retinal PrPSc deposits are not associated with the spongiform change, neuronal loss, and gliosis often seen in the brain. The stereotypic morphology and location of PrPSc deposits in sCJD retinas may help guide the use of ocular imaging devices in the detection of these deposits for a clinical diagnosis.
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Affiliation(s)
- Vanessa S Goodwill
- Department of Pathology, University of California, San Diego, CA, 92093, USA.
| | - Ian Dryden
- Departments of Pathology and Ophthalmology, Stanford University, CA, 94305, USA; VA Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
| | - Jihee Choi
- Departments of Pathology and Ophthalmology, Stanford University, CA, 94305, USA; VA Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
| | - Chiara De Lillo
- Departments of Pathology and Ophthalmology, Stanford University, CA, 94305, USA
| | - Katrin Soldau
- Department of Pathology, University of California, San Diego, CA, 92093, USA
| | - Jorge Llibre-Guerra
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63108, USA; Global Brain Health Institute, University of California, San Francisco, CA, 94143, USA
| | - Henry Sanchez
- Department of Neurology, University of California, San Francisco, CA, 94143, USA
| | | | - Jonathan H Lin
- Departments of Pathology and Ophthalmology, Stanford University, CA, 94305, USA; VA Palo Alto Healthcare System, Palo Alto, CA, 94304, USA.
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Aguilar-Calvo P, Sevillano AM, Rasool S, Cao KJ, Randolph LM, Rissman RA, Sarraf ST, Yang J, Sigurdson CJ. Noninvasive Antemortem Detection of Retinal Prions by a Fluorescent Tracer. J Alzheimers Dis 2022; 88:1137-1145. [PMID: 35754278 PMCID: PMC10080909 DOI: 10.3233/jad-220314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neurodegenerative diseases are widespread yet challenging to diagnose and stage antemortem. As an extension of the central nervous system, the eye harbors retina ganglion cells vulnerable to degeneration, and visual symptoms are often an early manifestation of neurodegenerative disease. OBJECTIVE Here we test whether prion protein aggregates could be detected in the eyes of live mice using an amyloid-binding fluorescent probe and high-resolution retinal microscopy. METHODS We performed retinal imaging on an experimental mouse model of prion-associated cerebral amyloid angiopathy in a longitudinal study. An amyloid-binding fluorophore was intravenously administered, and retinal imaging was performed at timepoints corresponding to early, mid-, and terminal prion disease. Retinal amyloid deposits were quantified and compared to the amyloid load in the brain. RESULTS We report that by early prion disease (50% timepoint), discrete fluorescent foci appeared adjacent to the optic disc. By later timepoints, the fluorescent foci surrounded the optic disc and tracked along retinal vasculature. CONCLUSION The progression of perivascular amyloid can be directly monitored in the eye by live imaging, illustrating the utility of this technology for diagnosing and monitoring the progression of cerebral amyloid angiopathy.
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Affiliation(s)
| | | | | | - Kevin J. Cao
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, USA
| | | | | | | | - Jerry Yang
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, USA
| | - Christina J. Sigurdson
- Department of Pathology, UC San Diego, La Jolla, CA, USA
- Department of Pathology, Microbiology, and Immunology, UC Davis, Davis, CA, USA
- Department of Medicine, UC San Diego, La Jolla, CA, USA
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4
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Tian G, Sun X. Cortical Blindness. Neuroophthalmology 2022. [DOI: 10.1007/978-981-19-4668-4_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
PURPOSE OF REVIEW Dementia is a term for loss of memory, language, problem-solving, and other thinking abilities, which significantly interferes with daily life. Certain dementing conditions may also affect visual function. The eye is an accessible window to the brain that can provide valuable information for the early diagnosis of people who suffer from Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies as well as from more rare causes of dementias, such as Creutzfeldt-Jacob and Huntington's diseases. Herein, we present the ocular manifestations of neurocognitive disorders focusing on the neuro-ophthalmic ones and further discuss potential ocular biomarkers that could help in early detection of these disorders. RECENT FINDINGS Ophthalmic examination along with the recent developments in in-vivo testing have provided a strong foundation of useful knowledge about brain disorder in neurodegenerative diseases without the need for invasive studies. Currently, a number of visual measures, such as visual acuity, contrast sensitivity, pupil response, and saccades in addition to various ophthalmic tests, such as electroretinogram, visual evoked potential, optical coherence tomography (OCT), and OCT-angiography have been widely used and evaluated as potential biomarkers for different stages of dementia. SUMMARY Ophthalmologic and neuro-ophthalmic evaluation is evolving as an important part of the early diagnosis and management of people with dementia. A particular focus on ocular biomarkers in dementing illnesses has arisen over the past few years and there are several promising measures and imaging tools that have been proposed as potential biomarkers for these diseases.
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Affiliation(s)
- Vivian Paraskevi Douglas
- Division of Neuro-ophthalmology, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
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6
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An Heidenhain variant of the Creutzfeldt-Jakob disease misdiagnosed as a DSM-5 conversion disorder: a case report. CNS Spectr 2021; 26:440-441. [PMID: 32372735 DOI: 10.1017/s1092852920001327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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7
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Ziukelis ET, Sharma VK, Gome JJ. Premortem diagnosis of pathologically confirmed sporadic Creutzfeldt-Jakob disease. Clin Case Rep 2021; 9:e04461. [PMID: 34322245 PMCID: PMC8299091 DOI: 10.1002/ccr3.4461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022] Open
Abstract
Sporadic Creutzfeldt-Jakob disease should be considered in any case of rapid neuropsychiatric decline. While neuropathological examination of a brain biopsy specimen remains the only definitive diagnostic method and real-time quaking-induced conversion tests have simplified premortem diagnosis, careful evaluation of magnetic resonance imaging can provide readily accessible clues.
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Affiliation(s)
| | - Vasu Keshav Sharma
- South West HealthcareWarrnamboolVicAustralia
- Health Imaging ServicesWarrnamboolVicAustralia
| | - James J Gome
- South West HealthcareWarrnamboolVicAustralia
- Deakin UniversityBurwoodVicAustralia
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Abstract
This review describes a group of diseases known as the transmissible spongiform encephalopathies (TSEs), which affect animals and humans. Examination of affected brain tissue suggests that these diseases are caused by the acquisition and deposition of prion protein (PrP). Creutzfeldt-Jakob disease (CJD) is the most important form of TSE in humans with at least four different varieties of the disease. Variant CJD (vCJD), a new form of the disease found in the UK, has several features that differ from the classical forms including early age of onset, longer duration of disease, psychiatric presentation (for example, depression) and extensive florid plaque development in the brain. About 10 per cent of patients with CJD exhibit visual symptoms at disease presentation and approximately 50 per cent during the course of the disease. The most commonly reported visual symptoms include diplopia, supranuclear palsies, complex visual disturbances, homonymous visual field defects, hallucinations and cortical blindness. Saccadic and smooth pursuit movements appear to be more rarely affected. The agent causing vCJD accumulates in lymphoid tissue such as the spleen and tonsils. The cornea has lymphoid tissue in the form of corneal dendritic cells that are important in the regulation of the immune response in the anterior segment of the eye. The presence of these cells in the cornea has raised the possibility of transmission between patients via optical devices that contact the eye. Although such transmission is theoretically possible it remains highly improbable.
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9
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Mastrangelo V, Merli E, Rucker JC, Eggenberger ER, Zee DS, Cortelli P. Neuro-Ophthalmological Findings in Early Fatal Familial Insomnia. Ann Neurol 2021; 89:823-827. [PMID: 33386648 DOI: 10.1002/ana.26008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/08/2022]
Abstract
Fatal familial insomnia (FFI) is a rare inherited prion disease characterized by sleep, autonomic, and motor disturbances. Neuro-ophthalmological abnormalities have been reported at the onset of disease, although not further characterized. We analyzed video recordings of eye movements of 6 patients with FFI from 3 unrelated kindreds, seen within 6 months from the onset of illness. Excessive saccadic intrusions were the most prominent findings. In patients with severe insomnia, striking saccadic intrusions are an early diagnostic clue for FFI. The fact that the thalamus is the first structure affected in FFI also suggests its role in the control of steady fixation. ANN NEUROL 2021;89:823-827.
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Affiliation(s)
- Vincenzo Mastrangelo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Elena Merli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Janet C Rucker
- Department of Neurology, New York University School of Medicine, New York, NY.,Department of Ophthalmology, New York University School of Medicine, New York, NY
| | - Eric R Eggenberger
- Departments of Ophthalmology, Neurology, and Neurosurgery, Mayo Clinic, Jacksonville, FL
| | - David S Zee
- Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience, Division of Neuro-Visual and Vestibular Disorders, Johns Hopkins Hospital, Baltimore, MD
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche, UOC Clinica Neurologica Rete Metropolitana NEUROMET, Bologna, Italy
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10
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Abstract
Illusions and hallucinations are commonly encountered in both daily life and clinical practice. In this chapter, we review definitions and possible underlying mechanisms of these phenomena and then review what is known about specific conditions that are associated with them, including ophthalmic causes, migraine, epilepsy, Parkinson's disease, and schizophrenia. We then discuss specific syndromes including the Charles Bonnet syndrome, visual snow syndrome, Alice in Wonderland syndrome, and peduncular hallucinosis. The scientific study of illusions and hallucinations has contributed significantly to our understanding of how eye and brain process vision and contribute to perception. Important concepts are the distinction between topologic and hodologic mechanisms underlying hallucinations and the involvement of attentional networks. This chapter examines the various ways in which pathological illusions and hallucinations might arise in relation to the phenomenology and known pathology of the various conditions associated with them.
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Affiliation(s)
- Clare L Fraser
- Department of Ophthalmology, Save Sight Institute, Faculty of Health and Medicine, University of Sydney, Sydney, Australia.
| | - Christian J Lueck
- Department of Neurology, Canberra Hospital, and Australian National University Medical School, Canberra, Australia
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Yap TE, Balendra SI, Almonte MT, Cordeiro MF. Retinal correlates of neurological disorders. Ther Adv Chronic Dis 2019; 10:2040622319882205. [PMID: 31832125 PMCID: PMC6887800 DOI: 10.1177/2040622319882205] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
Considering the retina as an extension of the brain provides a platform from which to study diseases of the nervous system. Taking advantage of the clear optical media of the eye and ever-increasing resolution of modern imaging techniques, retinal morphology can now be visualized at a cellular level in vivo. This has provided a multitude of possible biomarkers and investigative surrogates that may be used to identify, monitor and study diseases until now limited to the brain. In many neurodegenerative conditions, early diagnosis is often very challenging due to the lack of tests with high sensitivity and specificity, but, once made, opens the door to patients accessing the correct treatment that can potentially improve functional outcomes. Using retinal biomarkers in vivo as an additional diagnostic tool may help overcome the need for invasive tests and histological specimens, and offers the opportunity to longitudinally monitor individuals over time. This review aims to summarise retinal biomarkers associated with a range of neurological conditions including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and prion diseases from a clinical perspective. By comparing their similarities and differences according to primary pathological processes, we hope to show how retinal correlates can aid clinical decisions, and accelerate the study of this rapidly developing area of research.
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Affiliation(s)
- Timothy E. Yap
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | - Shiama I. Balendra
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
| | - Melanie T. Almonte
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | - M. Francesca Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, NW1 5QH, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, NW1 5QH, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, 11–43 Bath Street, London, EC1V 9EL UK
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12
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Orrù CD, Soldau K, Cordano C, Llibre-Guerra J, Green AJ, Sanchez H, Groveman BR, Edland SD, Safar JG, Lin JH, Caughey B, Geschwind MD, Sigurdson CJ. Prion Seeds Distribute throughout the Eyes of Sporadic Creutzfeldt-Jakob Disease Patients. mBio 2018; 9:e02095-18. [PMID: 30459197 PMCID: PMC6247090 DOI: 10.1128/mbio.02095-18] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 12/16/2022] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is the most common prion disease in humans and has been iatrogenically transmitted through corneal graft transplantation. Approximately 40% of sCJD patients develop visual or oculomotor symptoms and may seek ophthalmological consultation. Here we used the highly sensitive real-time quaking-induced conversion (RT-QuIC) assay to measure postmortem prion seeding activities in cornea, lens, ocular fluid, retina, choroid, sclera, optic nerve, and extraocular muscle in the largest series of sCJD patient eyes studied by any assay to date. We detected prion seeding activity in 100% of sCJD eyes, representing three common sCJD subtypes, with levels varying by up to 4 log-fold among individuals. The retina consistently showed the highest seed levels, which in some cases were only slightly lower than brain. Within the retina, prion deposits were detected by immunohistochemistry (IHC) in the retinal outer plexiform layer in most sCJD cases, and in some eyes the inner plexiform layer, consistent with synaptic prion deposition. Prions were not detected by IHC in any other eye region. With RT-QuIC, prion seed levels generally declined in eye tissues with increased distance from the brain, and yet all corneas had prion seeds detectable. Prion seeds were also present in the optic nerve, extraocular muscle, choroid, lens, vitreous, and sclera. Collectively, these results reveal that sCJD patients accumulate prion seeds throughout the eye, indicating the potential diagnostic utility as well as a possible biohazard.IMPORTANCE Cases of iatrogenic prion disease have been reported from corneal transplants, yet the distribution and levels of prions throughout the eye remain unknown. This study probes the occurrence, level, and distribution of prions in the eyes of patients with sporadic Creutzfeldt-Jakob disease (sCJD). We tested the largest series of prion-infected eyes reported to date using an ultrasensitive technique to establish the prion seed levels in eight regions of the eye. All 11 cases had detectable prion seeds in the eye, and in some cases, the seed levels in the retina approached those in brain. In most cases, prion deposits could also be seen by immunohistochemical staining of retinal tissue; other ocular tissues were negative. Our results have implications for estimating the risk for iatrogenic transmission of sCJD as well as for the development of antemortem diagnostic tests for prion diseases.
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Affiliation(s)
- Christina D Orrù
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, USA
| | - Katrin Soldau
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Christian Cordano
- Department of Neurology, Multiple Sclerosis Center, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Jorge Llibre-Guerra
- Cognitive and Behavioral Research Unit, National Institute of Neurology, Havana, Cuba
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Ari J Green
- Department of Neurology, Multiple Sclerosis Center, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Henry Sanchez
- Department of Pathology, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Bradley R Groveman
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, USA
| | - Steven D Edland
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, California, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - Jiri G Safar
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jonathan H Lin
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, USA
| | - Michael D Geschwind
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Christina J Sigurdson
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
- Department of Pathology, Immunology, and Microbiology, University of California, Davis, Davis, California, USA
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14
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Chin EK, Hershewe G, Keltner JL. Rapidly Progressive Homonymous Hemianopia in the Heidenhain Variant of Creutzfeldt-Jakob Disease. Neuroophthalmology 2012. [DOI: 10.3109/01658107.2012.654925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Once upon a cataract surgeon. Surv Ophthalmol 2011; 57:379-85. [PMID: 22018677 DOI: 10.1016/j.survophthal.2011.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 05/16/2011] [Accepted: 05/17/2011] [Indexed: 11/22/2022]
Abstract
A 60-year-old man presented with diplopia and neurocognitive deficits, which progressed rapidly over several months. Magnetic resonance imaging of the head revealed bilateral signal abnormalities and diffusion-weighted imaging restriction in bilateral basal ganglia, thalami, mesial temporal regions, and periaqueductal gray matter. Cerebrospinal fluid analysis was positive for 14-3-3 and tau proteins. The patient developed progressive neurocognitive decline followed by sleep disturbance and myoclonic jerking consistent with probable Creutzfeldt-Jakob disease.
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16
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Affiliation(s)
- Courtney Flanagan
- Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL 35233, USA
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17
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Danchaivijitr C, Kennard C. Chapter 14 Cortical Visual Disorders—Functional Localization and Pathophysiology. Neuroophthalmology 2008. [DOI: 10.1016/s1877-184x(09)70044-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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18
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Hamaguchi T, Noguchi-Shinohara M, Nakamura Y, Sato T, Kitamoto T, Mizusawa H, Yamada M. Ophthalmic surgery in prion diseases. Emerg Infect Dis 2007; 13:162-4. [PMID: 17370537 PMCID: PMC2725820 DOI: 10.3201/eid1301.061004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Eleven (1.8%) of 597 patients underwent ophthalmic surgery within 1 month before the onset of prion disease or after the onset. All ophthalmologists reused surgical instruments that had been incompletely sterilized to eliminate infectious prion protein. Ophthalmologists should be aware of prion diseases as a possible cause of visual symptoms and use disposable instruments whenever possible.
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Affiliation(s)
- Tsuyoshi Hamaguchi
- Kanazawa University Graduate School of Medical S cience, Kanazawa, Japan
- Present affiliation: Ishikawa Prefecture Central Hospital, Kanazawa, Japan
| | | | | | - Takeshi Sato
- National Center for Neurology and Psychiatry, Ichikawa, Japan
| | | | | | - Masahito Yamada
- Kanazawa University Graduate School of Medical S cience, Kanazawa, Japan
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20
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Abstract
Progressive supranuclear palsy (PSP) is a neurodegenerative disorder characterized by an akinetic rigid syndrome with vertical supranuclear ophthalmoplegia, early falls, and levodopa resistance. The pathological substrate of PSP consists of filamentous tau degenerative lesions affecting neurons and glia. Other disorders can present with a similar clinical picture, most commonly corticobasal degeneration and multiple system atrophy. Non-neurodegenerative disorders are rare causes of the PSP syndrome. In this report we describe clinical and pathological features of two cases of Creutzfeldt-Jakob disease (CJD) presenting with the PSP syndrome and discuss which features may help prevent misdiagnosis. To our knowledge, this is the first report of cases of CJD with autopsy confirmation that presented with a PSP syndrome.
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Affiliation(s)
- K A Josephs
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
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21
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Armstrong RA. Pathological changes in the primary visual cortex (area V1) in sporadic Creutzfeldt-Jakob disease. Optom Vis Sci 2003; 80:298-304. [PMID: 12692486 DOI: 10.1097/00006324-200304000-00007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the degree of pathological change in the primary visual cortex (area V1) in patients with Creutzfeldt-Jakob disease. METHOD The vacuolation, surviving neurons, glial cells, and deposits of prion protein were quantified in area V1 obtained postmortem in nine cases of the sporadic type of Creutzfeldt-Jakob disease. RESULTS Variations in the density of glial cells and in prion protein deposition were particularly evident between patients. In the upper and lower cortical laminae, vacuoles and prion protein deposits were regularly distributed in clusters with a mean dimensions of 450 to 1000 microm. Vacuolation in area V1 was most severe in lamina III and the glial cell reaction in lamina V or VI. Surviving neurons were most abundant in lamina II or III, whereas prion protein deposition either affected all laminae equally or was maximal in lamina II or III. CONCLUSION The data suggest that pathological changes in area V1 in sporadic type of Creutzfeldt-Jakob disease may affect the transmission of visual information from area V1 to V2 and to subcortical visual areas. In addition, the data suggest an association between the developing pathology and the functional domains of area V1.
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Affiliation(s)
- R A Armstrong
- Vision Sciences, Aston University, Birmingham, United Kingdom.
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Macalister GO, Buckley RJ. The risk of transmission of variant Creutzfeldt–Jakob disease via contact lenses and ophthalmic devices. Cont Lens Anterior Eye 2002; 25:104-36. [PMID: 16303485 DOI: 10.1016/s1367-0484(02)00008-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review collated the available information regarding the risk of transmission of variant Creutzfeldt-Jakob disease (vCJD) via contact lenses and other ophthalmic devices. The topics examined include: the emerging background science of the unconventional infective agent, the prion, particularly those factors affecting transmission; the estimates of the number of undiagnosed infective individuals; and evidence of infectivity in the external eye. Despite many uncertainties in the literature, we conclude that cross-infection is theoretically possible. An assessment of the extensive search for a complete inactivation procedure resulted in the recommendation of the use of sodium hypochlorite (NaOCl), which does not appear to distort rigid lenses. Further tests are required for other devices.
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Affiliation(s)
- Graham O Macalister
- Department of Optometry and Visual Science, City University, Northampton Square, London EC1V OHB, UK
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Nunery WR. Risk of prion transmission with the use of xenografts and allografts in surgery. Ophthalmic Plast Reconstr Surg 2001; 17:389-94. [PMID: 11766016 DOI: 10.1097/00002341-200111000-00001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lueck CJ, McIlwaine GG, Zeidler M. Creutzfeldt-Jakob disease and the eye. I. Background and patient management. Eye (Lond) 2000; 14 ( Pt 3A):263-90. [PMID: 11026987 DOI: 10.1038/eye.2000.75] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This article attempts to summarise our current understanding of TSEs as they affect man. Specific aspects relevant to ophthalmological practice, in particular the management of patients in day-to-day clinical practice and with respect to corneal transplantation, have been discussed. In the companion article we discuss the specific ophthalmic and neuro-ophthalmic features of these diseases.
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Affiliation(s)
- C J Lueck
- Department of Clinical Neuroscience, Western General Hospital, Edinburgh, UK.
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