Anterior Ischemic Optic Neuropathy by Sohan Singh Hayreh

By Sohan Singh Hayreh

"No attainment is ever ultimate" Vascular issues of the optic disc and nerve are very important not just to the ophthalmologist but additionally to the neurologist and the internist. To the 1st distinctiveness crew they characterize one reason behind blindness or serious visible impairment; to the second one team the optic disc edema and optic atrophy obvious in those problems can pose severe difficulties of analysis, or provide indica­ tions of the involvement of the cerebral circulate; whereas to the final workforce they're usually indicative of systemic affliction, rather of the cardiovas­ cular approach. fresh advances in our wisdom of the blood provide of the optic nerve head have shed an important new mild at the topic. With the hot creation of fluorescein fundus angiography, an additional measurement has been extra to the examine of the ocular and optic disc circulations, and we have now entered right into a new period within the figuring out of ocular vascular problems "in vivo". within the pre-angiography period, postmortem injection reviews, even supposing very worthwhile, didn't thoroughly display the vascular development of the optic disc within the dwelling, in future health, and illness. The ophthalmoscope, surely, has been worthwhile in assessing optic disc lesions, yet couldn't supply us informa­ tion at the circulate of the attention and optic disc "in vivo".

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1) Late phase showing abnormal fluorescence of the optic disc due to staining-maximum in temporal part. m, n, 0) 5 weeks after onset. m) Fundus photograph showing pallor of temporal part of the optic disc and degeneration of peripapillary region, with normal color of nasal part of the disc. n, 0) Fluoresceinfundus angiograms. n) Retinal arterial phase showing nasal part of the choroid and optic disc (supplied by the medial posterior ciliary artery) filling with fluorescein while the temporal part of the disc and choroid (supplied by the lateral posterior ciliary artery) empty (Compare with j).

Loss of central vision 4. "A shadow over the eye" 5. "A curtain over the eye" 6. "As iflooking through a lace curtain" I 7. Bumped into people on one side because of defective vision on that side 2 8. Sudden onset of blurred vision 2 Total number of patients 12 No. of Pts. A. Most of the patients with bilateral anterior ischemic optic neuropathy reported for an ophthalmic opinion significantly earlier than did those with unilateral anterior ischemic optic neuropathy, because in the latter group the visual disturbance was not as severe.

The electro-oculogram was recorded in the standard manner, described by ARDEN et al. [16], during 12 minutes of dark adaptation, followed by 12 minutes of light adaptation (luminance = 1,700 milli-Iamberts). ). The recording system incorporated a computer of average transients. The electroretinograms were measured in millimicrons, the maximum b-wave being measured from the trough of the a-wave to the peak of the b-wave. Flicker Fusion Frequency of the electroretinogram was recorded to determine whether the response was scotopic (20 Hertz or less), photopic (60 Hertz) or mixed (40 Hertz).

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