-
Bailliere's Clinical Neurology Aug 1993Visual illusions and hallucinations may accompany a wide variety of disorders with many different aetiologies; therefore, they are non-specific phenomena. Lesions in the... (Review)
Review
Visual illusions and hallucinations may accompany a wide variety of disorders with many different aetiologies; therefore, they are non-specific phenomena. Lesions in the visual pathway may be associated with visual misperceptions. In these cases more exact information about the misperceptions--whether they are monocular or binocular, present in the whole visual field or a hemifield--may contribute to diagnostic accuracy and to a more comprehensive understanding of the patient and his state of mind. Illusions such as perseveration, monocular diplopia and polyopia, and dysmorphopsia may also occur in healthy individuals, but they are found most often in patients with epilepsy, migraine and stroke. These phenomena do not permit exact localization and definition of an aetiology, but lesions in the occipital and occipitotemporal regions near the visual pathway are involved in most cases. Hallucinations always represent a pathological form of perception. They are classified as unformed (photopsias) or formed (complex). Photopsias may be described in terms of colour, shape and brightness. Their wide variety makes it difficult, if not impossible, to arrive at an exact description of their aetiology, but it is possible to define their anatomical origin in some cases. Complex hallucinations suggest an occipitotemporal locus. Whether they appear in the whole visual field or in the hemifield may prove decisive in determining pathogenesis. A number of characteristics permit a rough classification of these phenomena. Complex hallucinations accompany physical illness and are susceptible to psychodynamic interpretation.
Topics: Diplopia; Hallucinations; Humans; Optical Illusions; Vision Disorders; Vision, Ocular
PubMed: 8137001
DOI: No ID Found -
World Journal of Experimental Medicine May 2021Spontaneous posterior vitreous detachment (PVD) is a common age-related condition in which prevalence tends to increase with age. Acute PVD can cause the onset of... (Review)
Review
Spontaneous posterior vitreous detachment (PVD) is a common age-related condition in which prevalence tends to increase with age. Acute PVD can cause the onset of symptoms that include visual disturbances, myodesopsia and photopsia. The goal of this short review was to provide a quick glance at the important factors related to PVD based on current literature in this field, which includes incidence, symptoms, diagnosis, risk factors, and education for patients with acute symptoms, and treatments. The take home message is that an ophthalmic examination at the onset of symptoms is of utmost importance, considering that irreversible sight-threatening complications can be prevented if diagnosed and treated promptly.
PubMed: 34141604
DOI: 10.5493/wjem.v11.i3.30 -
International Ophthalmology Clinics 1996The subretinal fibrosis and uveitis syndrome is a rare posterior uveitis characterized in the early stages by a multifocal choroiditis, followed by progressive... (Review)
Review
The subretinal fibrosis and uveitis syndrome is a rare posterior uveitis characterized in the early stages by a multifocal choroiditis, followed by progressive subretinal fibrosis. It usually is seen in otherwise healthy, young myopic women with no systemic disease. Symptoms include acute, unilateral visual loss, scotomas, metamorphopsia, and photopsias. Ophthalmic examination reveals a mild anterior or posterior uveitis, and transient, multiple, small, whitish-yellow RPE or choroidal lesions in the posterior pole and midperiphery. These lesions fade or enlarge and coalesce to create areas of white subretinal fibrosis, a progression that occurs over weeks to months. The visual prognosis generally is poor, and recurrences are common. Treatment is controversial, with some authors finding an early beneficial effect of steroids and chemotheraphy in severe cases. The etiology is not known, but is believed to be a localized autoimmune reaction to the RPE.
Topics: Blindness; Female; Fibrosis; Humans; Male; Prognosis; Recurrence; Retina; Syndrome; Uveitis, Posterior
PubMed: 8778060
DOI: 10.1097/00004397-199603610-00015 -
JNMA; Journal of the Nepal Medical... Feb 2021Idiopathic Intracranial Hypertension is a rare occurrence in young, physically fit male and a diagnosis of exclusion among most patients presenting with signs and...
Idiopathic Intracranial Hypertension is a rare occurrence in young, physically fit male and a diagnosis of exclusion among most patients presenting with signs and symptoms of raised intracranial pressure. Here we describe a case of a young male in the ideal weight range with no previous exposure to offending chemicals presented with a history of headache, obscuration of vision, and photopsia. On examination, there were no positive neurological findings. Increased opening pressure was found on the lumbar puncture. Ophthalmological examination revealed bilateral papilledema. Humphrey’s Visual field test showed peripheral field loss. Magnetic resonance imaging scan of the brain and orbits were normal. The patient was diagnosed and managed in primary care setting after neurosurgical consultation. Though rare, we should suspect idiopathic intracranial hypertension in ideal body weighted male if the headache is persistent after other causes of headache have been ruled out.
Topics: Headache; Humans; Intracranial Hypertension; Male; Papilledema; Pseudotumor Cerebri; Vision Disorders
PubMed: 34506475
DOI: 10.31729/jnma.5176 -
Advances in Experimental Medicine and... 2018Acute zonal occult outer retinopathy (AZOOR) is a presumed inflammatory disorder with outer retinal dysfunction. Typically, the onset is acute and it is unilateral, with... (Review)
Review
Acute zonal occult outer retinopathy (AZOOR) is a presumed inflammatory disorder with outer retinal dysfunction. Typically, the onset is acute and it is unilateral, with symptoms of photopsias and nasal field loss; scotoma is usually contiguous with the optic nerve. Later, the other eye is involved in nearly three fourths of patients. The central vision remains good in most cases. Patients are usually young women with myopia. Fundus: May be normal in the beginning, but may show a grayish-white line at the border of normal and involved retina, usually in peripapillary area. This line disappears within weeks and is replaced with an orange zone. With time, retinal vessels attenuate and a large zone of retinal pigment epithelium (RPE) depigmentation appears, sort of a sector retinitis pigmentosa (RP) or unilateral or asymmetric RP. Rarely, mild vitritis may occur, and relative afferent pupillary defect (RAPD) is present in about 75% of cases.
Topics: Acute Disease; Electroretinography; Female; Fluorescein Angiography; Fundus Oculi; Humans; Retinal Diseases; Scotoma; Visual Fields; White Dot Syndromes
PubMed: 30578522
DOI: 10.1007/978-3-319-95046-4_49 -
Journal of Vitreoretinal Diseases 2022This work presents a case of syphilitic outer retinopathy with findings similar to those of acute zonal occult outer retinopathy (AZOOR). We also discuss the clinical... (Review)
Review
PURPOSE
This work presents a case of syphilitic outer retinopathy with findings similar to those of acute zonal occult outer retinopathy (AZOOR). We also discuss the clinical characteristics, treatment, and prognosis of this entity.
METHODS
A case report and systematic literature review are presented.
RESULTS
A 56-year-old woman presented with acute vision loss, localized photopsia, a central scotoma, and retinal findings that were all consistent with AZOOR. A further workup led to a diagnosis of syphilis. Oral prednisone and intravenous penicillin resulted in the resolution of the posterior uveitis and the restoration of visual acuity. However, the central scotoma remained at the 3-year follow-up visit.
CONCLUSIONS
Syphilitic outer retinopathy is a distinct entity characterized by the disruption of the ellipsoid zone visible on optical coherence tomography and a corresponding increase in fundus hyperautofluorescence in the affected areas. Although some patients may present with a demarcation line, as is seen with AZOOR, the fundus is oftentimes unremarkable or may show only subtle retinal pigment epithelium changes. Uveitis resolution and visual acuity restoration may be expected following treatment; however, visual field disturbances may persist.
PubMed: 37007722
DOI: 10.1177/24741264211018300 -
JAMA Neurology Sep 2023
Topics: Humans; Evoked Potentials, Visual; Migraine Disorders; Vision Disorders; Retina
PubMed: 37358862
DOI: 10.1001/jamaneurol.2023.1889 -
Clinical & Experimental Optometry Mar 2003Acute macular neuroretinopathy is an infrequently encountered condition in which there is a sudden mild central vision loss, photopsia and red-brown wedge-shaped lesions...
Acute macular neuroretinopathy is an infrequently encountered condition in which there is a sudden mild central vision loss, photopsia and red-brown wedge-shaped lesions in the macular region with corresponding scotomata in the central visual fields. The condition may be associated with the use of oral contraceptives or with a recent febrile illness. It is self-limiting and non-recurrent. The clinical features of a patient with acute macular neuroretinopathy are described and the nature of the vascular aetiology is discussed.
Topics: Acute Disease; Adult; Female; Fundus Oculi; Humans; Macula Lutea; Ophthalmoscopy; Retinal Diseases; Scotoma; Visual Fields
PubMed: 12643808
DOI: 10.1111/j.1444-0938.2003.tb03070.x -
Journal of Neuro-ophthalmology : the... Sep 2021A 44-year-old woman noticed bilateral irregular scotomata associated with photopsias of 6-month duration. Ophthalmoscopic examination demonstrated multiple bilateral,...
A 44-year-old woman noticed bilateral irregular scotomata associated with photopsias of 6-month duration. Ophthalmoscopic examination demonstrated multiple bilateral, pericentral, hypopigmented, petaloid, macular lesions evident on Amsler grid associated with paracentral hyperreflective lesions on optical coherence tomography in the outer plexiform and nuclear layers. Indocyanine green angiography revealed patches of choroidal ischemia consistent with acute macular neuroretinopathy.
Topics: Adult; Female; Fluorescein Angiography; Fundus Oculi; Humans; Macula Lutea; Multimodal Imaging; Tomography, Optical Coherence; Visual Acuity; Visual Fields; White Dot Syndromes
PubMed: 33136676
DOI: 10.1097/WNO.0000000000001128