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Scott DA, Wang MT, Danesh-Meyer HV, Hull S. Optic atrophy in prematurity: pathophysiology and clinical features. Clin Exp Optom 2024; 107:245-254. [PMID: 37867148 DOI: 10.1080/08164622.2023.2256734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/05/2023] [Indexed: 10/24/2023] Open
Abstract
Optic atrophy is an important cause of visual impairment in children, and the aetiological profile has changed over time. Technological advancements led by neuroimaging of the visual pathway and imaging of the optic nerve with optical coherence tomography have accelerated the understanding of this condition. In the new millennium, an increasing prevalence of prematurity as a cause of optic atrophy in children has been highlighted. This new shift has been linked with increasing rates of premature births and improved neonatal survival of preterm infants. The available literature is limited to hospital and registry-based cohorts with modest sample sizes, methodological heterogeneity and selection bias limitations. Larger studies that are better designed are required to better understand the contribution of prematurity to the disease burden. In addition to considering other life-threatening aetiologies, screening for premature birth should be covered as part of a comprehensive history when evaluating a child with paediatric optic atrophy.
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Affiliation(s)
- Daniel Ar Scott
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Michael Tm Wang
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | | | - Sarah Hull
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
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2
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Determination of ventriculoperitoneal shunt dysfunction using optic nerve sheath diameter measurement on CT scan in pediatric patients with hydrocephalus. Childs Nerv Syst 2021; 37:1895-1900. [PMID: 33694128 DOI: 10.1007/s00381-021-05097-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 02/18/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE We aimed to evaluate whether optic nerve sheath diameter (ONSD) measurement by computed tomography (CT) can be a diagnostic criteria for the detection of ventriculoperitoneal shunt dysfunction among children whose fontanels are still open. METHODS Patients with a ventriculoperitoneal shunt who were currently showing clinical and radiological signs of acute hydrocephalus depending on the shunt dysfunction were included in this study. The study was designed to compare the preoperative and postoperative ONSDs of three groups of patients divided according to their ages: group 1, patients aged < 4 months; group 2, patients aged 4-18 months; and group 3, patients aged > 18 months. RESULTS We included 138 patients (mean age, 35.18 ± 51.01 months). Among the patients, 46.4% were females and 53.6% were males. ONSD measurements in the preoperative period were < 2.86 ± 0.59 in group 1, 3.93 ± 0.82 in group 2, and 5.40 ± 0.81 in group 3 and those in the postoperative period were 2.02 ± 0.38 in group 1, 2.72 ± 0.62 in group 2, and 3.64 ± 0.81 in group 3. Right, left, and mean ONSDs increased significantly in the three groups and were found to be statistically significant. CONCLUSION ONSD measurement in CT has been evaluated as an appropriate finding that can be used especially in acute hydrocephalus, when clinical and radiological findings are not diagnostic.
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Boets S, Johannesen KM, Destree A, Manti F, Ramantani G, Lesca G, Vercueil L, Koenig MK, Striano P, Møller RS, Cooper E, Weckhuysen S. Adult phenotype of KCNQ2 encephalopathy. J Med Genet 2021; 59:528-535. [PMID: 33811133 DOI: 10.1136/jmedgenet-2020-107449] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Pathogenic KCNQ2 variants are a frequent cause of developmental and epileptic encephalopathy. METHODS We recruited 13 adults (between 18 years and 45 years of age) with KCNQ2 encephalopathy and reviewed their clinical, EEG, neuroimaging and treatment history. RESULTS While most patients had daily seizures at seizure onset, seizure frequency declined or remitted during childhood and adulthood. The most common seizure type was tonic seizures (early) infancy, and tonic-clonic and focal impaired awareness seizures later in life. Ten individuals (77%) were seizure-free at last follow-up. In 38% of the individuals, earlier periods of seizure freedom lasting a minimum of 2 years followed by seizure recurrence had occurred. Of the 10 seizure-free patients, 4 were receiving a single antiseizure medication (ASM, carbamazepine, lamotrigine or levetiracetam), and 2 had stopped taking ASM. Intellectual disability (ID) ranged from mild to profound, with the majority (54%) of individuals in the severe category. At last contact, six individuals (46%) remained unable to walk independently, six (46%) had limb spasticity and four (31%) tetraparesis/tetraplegia. Six (46%) remained non-verbal, 10 (77%) had autistic features/autism, 4 (31%) exhibited aggressive behaviour and 4 (31%) destructive behaviour with self-injury. Four patients had visual problems, thought to be related to prematurity in one. Sleep problems were seen in six (46%) individuals. CONCLUSION Seizure frequency declines over the years and most patients are seizure-free in adulthood. Longer seizure-free periods followed by seizure recurrence are common during childhood and adolescence. Most adult patients have severe ID. Motor, language and behavioural problems are an issue of continuous concern.
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Affiliation(s)
- Stephanie Boets
- Neurology Department, University Hospital Antwerp, Antwerp, Belgium
| | - Katrine M Johannesen
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre Filadelfia, Dianalund, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anne Destree
- Department of Human Genetics, Institute of Pathology and Genetics, Gosselies, Belgium
| | - Filippo Manti
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Georgia Ramantani
- Department of Neuropediatrics, University Children's Hospital, Zurich, Switzerland
| | - Gaetan Lesca
- Department of Genetics, University Hospitals of Lyon, Lyon, France.,Neuroscience Research Center, Claude Bernard Lyon I University, Lyon, France
| | - Laurent Vercueil
- Grenoble Institute of Neurosciences (GIN), University Grenoble Alpes, La Tronche, France
| | - Mary Kay Koenig
- Department of Pediatrics, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, "G Gaslini" Institute, Genova, Italy.,Pediatric Neurology and Muscular Diseases Unit, IRCCS' G Gaslini" Institute, Genova, Italy
| | - Rikke Steensbjerre Møller
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre Filadelfia, Dianalund, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Edward Cooper
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - Sarah Weckhuysen
- Neurology Department, University Hospital Antwerp, Antwerp, Belgium .,Applied & Translational Neurogenomics Group, VIB-Center for Molecular Neurology, VIB, Antwerp, Belgium.,Translational Neuroscience Group, University of Antwerp, Antwerp, Belgium
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Venugopal NP. Visual Loss in Biotinidase Deficiency. Ann Indian Acad Neurol 2021; 23:821. [PMID: 33688141 PMCID: PMC7900731 DOI: 10.4103/aian.aian_503_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 10/13/2019] [Indexed: 11/04/2022] Open
Affiliation(s)
- Nataraja P Venugopal
- Neuro-Ophthalmology Clinic and Glaucoma Service, AG Eye Hospital, Puthur, Trichy, Tamil Nadu, India
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Nasir J, Javed A, Arshad O, Chatni MH. Spectral Domain - Optical Coherence Tomography findings in Triple-A Syndrome - A case series from Pakistan. Pak J Med Sci 2020; 37:267-271. [PMID: 33437289 PMCID: PMC7794165 DOI: 10.12669/pjms.37.1.3310] [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] [Indexed: 11/16/2022] Open
Abstract
Triple A Syndrome is an autosomal recessive entity involving multiple systems usually characterized by adrenal insufficiency, alacrimia and achalasia. The disease features include variable degrees of neurological and neuro-ophthalmic manifestations. Protein ALADIN encoded by the AAAS gene is found to be defective in Triple A Syndrome. Here we discuss a case series of five patients diagnosed as Triple A Syndrome. Clinically there was variable degree of optic atrophy in all the cases, which was further confirmed with spectral domain Optical Coherence Tomography The aim of this study was to publish the OCT based ONFL graphs of these unique cases, so that being an ophthalmologist we can take a multidisciplinary approach and decisions accordingly.
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Affiliation(s)
- Javeria Nasir
- Dr. Javeria Nasir, MBBS, MCPS. Department of Ophthalmology, Patel Hospital, Karachi, Pakistan
| | - Anum Javed
- Dr. Owais Arshad, MBBS, FCPS, MRCS, FICO. Department of Ophthalmology, Patel Hospital, Karachi, Pakistan
| | - Owais Arshad
- Dr. Anum Javed, MBBS. Department of Ophthalmology, Patel Hospital, Karachi, Pakistan
| | - Mohammad Hanif Chatni
- Dr. Mohammad Hanif Chatni, MBBS, FRCS. Department of Ophthalmology, Patel Hospital, Karachi, Pakistan
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Jones R, Al-Hayouti H, Oladiwura D, Karim R, Sawczenko A, Dahlmann-Noor A. Optic atrophy in children: Current causes and diagnostic approach. Eur J Ophthalmol 2020; 30:1499-1505. [PMID: 31910664 DOI: 10.1177/1120672119899378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND/AIMS Optic atrophy is one of the leading causes of sight impairment in children. It frequently poses a diagnostic challenge, as it can be caused by many ocular and systemic conditions. We aimed to determine the current causes of optic atrophy at our centre and to describe the use of investigations, including molecular genetic testing. METHODS We reviewed the medical records of children with optic atrophy seen at Moorfields Eye Hospital between 2010 and 2015. We recorded demographic data, reason for referral, history, investigations and diagnosis. RESULTS We studied 143 cases aged below 16 years. A cause could be identified in all cases. Taking a full history was the most important part of the diagnostic workup, identifying a cause in 96 (67%) children. A developmental disorder of the brain and/or optic nerve, sometimes with retinal involvement, was the commonest cause (n = 33, 23%), followed by inheritable optic neuropathies (n = 27, 19%). Other causes included perinatal insults (n = 18, 13%), post-infectious or post-inflammatory conditions (n = 18, 13%), accidental or abusive trauma (n = 14, 10%) and inheritable retinal dystrophies (n = 13, 9%). Rare conditions included neurodegenerative disorders (n = 7, 5%), skeletal developmental disorders such as rickets (n = 4, 3%), tumours (n = 4, 3%), ischaemic events including large optic nerve head drusen (n = 4, 3%) and toxic events/metabolic conditions (n = 1, 0.7%). CONCLUSION In this series, an underlying cause could be identified in all cases. Taking a comprehensive antenatal, perinatal, postnatal and family history will indicate a probable diagnosis in two-thirds of children, and targeted ancillary tests may identify the cause in most remaining cases.
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Affiliation(s)
| | - Huda Al-Hayouti
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | | | - Rushmia Karim
- Paediatric Service, Moorfields Eye Hospital, London, UK
| | | | - Annegret Dahlmann-Noor
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.,Paediatric Service, Moorfields Eye Hospital, London, UK
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Zhi FY, Liu J, Ma XP, Hong J, Zhang J, Zhang D, Zhao Y, Wu LJ, Yang YT, Wu DY, Xie C, Wu LX, Zhang CH. Manual Acupuncture for Optic Atrophy: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:1735967. [PMID: 30713567 PMCID: PMC6332962 DOI: 10.1155/2019/1735967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/11/2018] [Accepted: 12/11/2018] [Indexed: 11/18/2022]
Abstract
Objectives. This systematic review aims to critically evaluate the efficacy of manual acupuncture for optic atrophy. Eight English and Chinese databases, including Cochrane Library, EMbase, PubMed, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and Chinese Biomedical Literature Database (CBM), as well as ongoing trials registered with the WHO International Clinical Trials Registry Platform, were searched to identify eligible randomized controlled trials (RCTs) studying manual acupuncture for optic atrophy compared to medication alone. The quality of evidence was assessed using Cochrane Collaboration's risk of bias tool. Meta-analysis was performed using Review Manager version 5.3. Nine studies were identified and included for meta-analysis. The meta-analysis showed significant differences in favor of manual acupuncture or manual acupuncture plus medication compared with medication alone in the following outcome measures: visual acuity (MD = 0.18, 95% CI [0.17, 0.20], P < 0.00001), mean sensitivity of visual field (MD = 2.11, 95% CI [1.90, 2.32], P < 0.00001), the latent period of P-VEP100 (MD = -6.80, 95% CI [-8.94, -4.66], P < 0.00001), the total effectiveness (264 eyes) (OR = 3.22, 95% CI [1.88, 5.51], P<0.0001), and the total effectiveness (344 participants) (OR = 4.29, 95% CI [2.56, 7.19], P < 0.00001). Despite statistical advantages of manual acupuncture in the literature, due to serious methodological flaws in study design, it cannot be concluded that manual acupuncture is more effective than medicine alone. It is essential that a properly controlled clinical trial is designed and controls are established to exclude placebo effects.
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Affiliation(s)
- Fang-Yuan Zhi
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Jie Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Xiao-Peng Ma
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Jue Hong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Ji Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Dan Zhang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Yue Zhao
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Li-Jie Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Yan-Ting Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Dan-Yan Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Chen Xie
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Ling-Xiang Wu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Cui-Hong Zhang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
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Are we missing patients with biotinidase deficiency in France? Rev Neurol (Paris) 2018; 174:273-274. [PMID: 29778138 DOI: 10.1016/j.neurol.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022]
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Mbekeani JN, Fattah MA, Poulsen DM, Hazzaa SA, Dababo MA, Eldali A, Ahmed M. Etiology of optic atrophy: a prospective observational study from Saudi Arabia. Ann Saudi Med 2017; 37:232-239. [PMID: 28578363 PMCID: PMC6150579 DOI: 10.5144/0256-4947.2017.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Optic atrophy (OA) represents permanent retinal ganglion cell loss warranting study to establish etiology. OBJECTIVES To describe neurogenic causes of OA. DESIGN Prospective, observational. SETTING Tertiary care center, Riyadh, Saudi Arabia. PATIENTS AND METHODS We included consecutive patients of all ages with OA caused by lesions affecting the visual pathways who were referred over a 9-month period (November 2013 to July 2014). Diagnosis was based on visual acuity, ophthalmoscopic features and ancillary tests. Patient demographics, results of a clinical examination, test data and etiology were recorded. For each cause of OA, both gender and age group were analyzed as potential risk factors using simple univariate logistic regression. OA associated with glaucoma and retinal diseases was excluded. MAIN OUTCOME MEASURE Description of causes of OA. RESULTS Two hundred and four patients and 353 eyes met inclusion criteria. The median age was 27 years (range 3 months-77 years; interquartile range, 27 years) among 111(54.4%) females and 93(45.6%) males, with no statistically significant difference in age of presentation between the genders. The majority of lesions were bilateral (n=151, 74%). Tumors were the most common cause, accounting for 127 (62.2%) cases. These occurred mostly in adults (72.4%) compared to the pediatric group (OR=3.3, 95% CI: 1.79-6.03; P < .001). Hereditary neoplasia (OR=5.55; 95% CI: 1.67-18.42; P=.005) and metabolic diseases (OR=17.57; 95% CI: 2.15-143.62; P=.007) were more common causes in the pediatric group. There were no significant associations between gender or visual acuity and etiology of OA. In developed nations, OA is frequently the result of ischemia and neuritis. We found many other causes, especially orbital and intracranial tumors. CONCLUSIONS The frequency of tumors as the cause of OA may represent a higher incidence of aggressive tumors coupled with poor recognition/acknowledgement of symptoms and limited access, resulting in late presentations. LIMITATIONS These findings may reflect bias from selective referrals to a tertiary center and may not represent all of Saudi Arabia.
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Affiliation(s)
- Joyce N Mbekeani
- Dr. Joyce N. Mbekeani, Department of Surgery (Ophthalmology),, Jacobi Medical Center,, 5N, 1400 Pelham Parkway, Bronx NY 10461, USA, T: 718-918-4784;, F: 718-918-7379, , ORCID: http://orcid.org/0000-0002-8801-4110
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Zheng L, Do HHJ, Sandercoe T, Jamieson RV, Grigg JR. Changing patterns in paediatric optic atrophy aetiology: 1979 to 2015. Clin Exp Ophthalmol 2016; 44:574-581. [DOI: 10.1111/ceo.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/15/2016] [Accepted: 02/16/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Linda Zheng
- Department of Ophthalmology; The Children's Hospital at Westmead; Westmead Australia
| | - Helen Hyun-Jin Do
- Discipline of Ophthalmology, Save Sight Institute; University of Sydney; Sydney New South Wales Australia
| | - Trent Sandercoe
- Discipline of Ophthalmology, Save Sight Institute; University of Sydney; Sydney New South Wales Australia
| | - Robyn V Jamieson
- Eye Genetics Research Group; Children's Medical Research Institute, The Children's Hospital at Westmead; Westmead Australia
- Discipline of Ophthalmology, Save Sight Institute; University of Sydney; Sydney New South Wales Australia
| | - John R Grigg
- Department of Ophthalmology; The Children's Hospital at Westmead; Westmead Australia
- Eye Genetics Research Group; Children's Medical Research Institute, The Children's Hospital at Westmead; Westmead Australia
- Discipline of Ophthalmology, Save Sight Institute; University of Sydney; Sydney New South Wales Australia
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Author's Reply. Indian J Ophthalmol 2015; 63:360. [PMID: 26244174 PMCID: PMC4463571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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