Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 49-year old female in the course of chemotherapy for adult T-cell leukemia (ATL) noticed blurred vision and visual field defect in her right eye on February 26, 1991. Ophthalmoscopic findings showed exudative necrotizing retinitis with white exudative patches and scattered retinal hemorrhages in both eyes. CMV was isolated from the urine by the shell vial cell culture assay. Anti-viral therapy was commenced using ganciclovir and gamma-globulin, which are rich in anti-CMV antibodies. The exudative lesions were absorbed gradually. The ocular signs and symptoms agreed with the patient's systemic immunosuppressed T cell function state. CMV retinitis should be considered in the differential diagnosis of retinitis in immunocompromised patients. CMV retinitis will certainly be found more frequently in accordance with the increasing number of immunocompromised hosts who have received immunosuppressive therapy or transplantation.
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PMID:[Adult T cell leukemia with cytomegalovirus retinitis]. 131 31

Cytomegalovirus retinitis, the most frequently encountered ophthalmologic manifestation of acquired immunodeficiency syndrome (AIDS), emerges in up to 46% of such patients. In the period between april 1989-May 1990, 4 cases of AIDS-related cytomegalovirus retinitis were diagnosed in Singapore and treated at Tan Tock Hospital. Presenting complaints included blurred vision, visual field scotoma, and a field defect. Clinically, cytomegalovirus retinitis is characterized by lesions, usually in the posterior pole, that take the form of fluffy white infiltrates with irregular, translucent, granular appearing margins. There is associated retinal hemorrhage and inflammatory sheathing, leading eventually to a profound loss of vision. The treatment of choice is ganciclovir, and the lack of enlargement of existing lesions is the indicator of successful maintenance therapy. Since ganciclovir is virustatic rather than virucidal, continuous treatment is required to prevent reactivation. Even with full maintenance therapy, 30-50% of patients experience breakthrough infection. Complications of ganciclovir include conjunctival scarring, scleral induration, and neutropenia. Moreover, ganciclovir cannot be taken concurrently with zidovudine, a drug that promotes the overall well-being and survival status of AIDS patients. The development of new drugs such as foscarnet is expected to eliminate the need for AIDS patients to make a choice between preserving their eyesight and controlling virus replication.
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PMID:AIDS-CMV retinitis: Singapore's first cases. 196 62

Visual field defect due to pituitary adenoma ordinarily shows bitemporal hemianopsia. But we experienced a case presenting binasal inferior quadrants hemianopsia. A 60-year-old woman was admitted to our hospital complaining of headache and blurred vision. At ophthalmologic examination, the visual acuity on the right was 0.02 and on the left 0.3. Visual field showed a loss of bilateral inferior nasal quadrants. There was neither pallor nor edema of either of the optic disks. A computerized tomography (CT) scan showed an enhancing mass in the intra- and suprasellar region. But despite remarkable suprasellar expansion of the tumor, the straight view of bilateral carotid angiograms revealed no elevation of the first part of the anterior cerebral arteries (ACA). On the lateral view, the terminal portion of the precommunicating part of the left ACA showed rather marked anteroinferior displacement. 2 mm thin sliced CT scans at the suprasellar region revealed that the left internal carotid artery had been touching the lateral portion of the tumor and the ACA had been displaced anteriorly by the tumor. Two weeks after admission, transsphenoidal tumor resection was carried out. Total removal was achieved and histological examination showed that the tumor was nonfunctioning chromophobe adenoma. The postoperative course was uneventful except for transient diabetes insipidus. The patient's visual acuity rapidly improved to 0.8 on the right and 0.5 on the left two weeks after operation. Although there was still a tendency for left inferior nasal field defect, remarkable improvement was obtained subjectively and objectively. According to the findings of CT scans and cerebral angiograms, binasal hemianopsia may have been produced by the mechanism as follows.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of pituitary adenoma presenting binasal inferior quadrants hemianopsia]. 261 6

From September to December of 1988, 24 cases of clinical diagnosed dengue fever accompanied by visual disturbances were studied. A detailed history and a detailed ocular examination including visual acuity, slit lamp examination, fundus examination through dilated pupil and fluorescein angiography were conducted. In some cases, Amsler grid, visual field, visual evoked potential and color vision test were also evaluated. The chief complaints of these 24 patients were blurred vision, central scotoma, floaters, photophobia and halo vision. The intervals between onset of fever and awareness of blurred vision were 2 to 15 days with an average of 7.26 days. The ocular fundus changes included macular hemorrhage, retinal hemorrhage, maculopathy, Roth's spot, diffuse retinal edema, peripapillary hemorrhage vitreous cells and blurring optic disc. The fluorescein angiographic findings included poor choroidal flushing, delayed disc filling, disc extravasation, block fluorescence, capillary obliteration, non filling of macular network, capillary leakage and window defect. Seventeen cases (30 eyes) were followed-up for 2 weeks to 3 months. Visual recovery was good in most of the cases. However, 2 cases (4 eyes) showed poor visual outcome. In this series studied, the principle ocular fundus change caused by dengue fever was macular hemorrhage. This may be due to the capillary changes near the macular area. But in some of the cases, the direct viral invasion and/or indirect changes of the optic nerve, the retinal pigment epithelium or photoreceptors should be considered.
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PMID:[The ocular fundus findings in dengue fever]. 273 64

Eight patients representing visual field defects associated with hydrocephalus are reviewed. Seven cases had aqueductal stenosis and one had congenital communicating hydrocephalus. We found five cases of defects in visual field typical of a chiasmal or optic nerve lesion: (1) inferior altitudinal hemianopia with inferior nasal quadrantanopia in the opposite eye; (2) inferior binasal quadrantanopia; (3) unilateral inferior nasal depression; (4) unilateral temporal defect; (5) bilateral central scotoma. In these cases CT demonstrated moderate or marked symmetrical dilatation of the third and lateral ventricles. Four out of five cases showed bulging of the third ventricle anteriorly into the sella turcica on CT or ventriculography. Other three patients had incongruous homonymous hemianopia. Characteristic asymmetrical dilatation of the lateral ventricles was noted in all three cases. The more enlarged lateral ventricles were ipsilateral with the affected visual pathways. The sites of lesion responsible for these field defects seemed to be optic tract in one case and optic radiation in two cases. Ventriculoperitoneal shunt was placed in five out of seven cases. Impaired visual field improved in three patients after shunt insertion. A 28-year-old female who had history of blurred vision fos 14 days showed improvement in visual acuity and field when the enlarged ventricles became slit-like by shunting. In the other two patients defects in visual fields improved in spite of consistent ventriculomegaly. These facts suggested that not only the mechanical forces with distended third ventricle but also increased intracranial pressure played an important role in producing visual field defects in hydrocephalic patients.
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PMID:[Visual field defects in hydrocephalus]. 387 34

A 19-year-old man was admitted to the hospital because of blurred vision, visual field defect, diplopia and hypesthesia of the left face. Neurological examination on admission revealed impairments of the II, III, IV, VI cranial nerves bilaterally and the first branch of the V nerve on the left. X-ray films of the skull showed a marked decalcification of the sella and upper portion of the clivus. Cerebral angiography demonstrated a moderately vascularized, large tumor in the sella-clival region. The tumor was supplied mainly by the branches of the right internal carotid artery, which was occluded at the cavernous portion. CT scans showed a large, oval mass located at the mid-portion of the anterior and middle fossa. Hounsfield number of the tumor was approximately 64.0, but several high density spots, probably due to destroyed bone fragments, were seen inside. The tumor was markedly enhanced with contrast medium. Three successive craniotomies were carried out through right fronto-temporal approaches, but total removal of the tumor was not achieved. Histological examination of surgical specimens disclosed that the tumor was consisted of abundant multinucleated giant cells and fewer spindle shaped stromal cells. Postoperative radiotherapy by telecobalt was tried and a total dose of 70Gy was delivered to the residual tumor. Effect of radiotherapy was remarkable and the size of the tumor on CT was markedly reduced to the extent of 10% of the pre-radiation tumor size. The patient was discharged in a good condition and there have been no signs of recurrence for 10 months so far. On the basis of our case and cases reported in the literature so far, the authors discussed clinical and radiological features, difficulty in surgical treatment and radiosensitivity of giant cell tumor of the sphenoid bone.
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PMID:[A case of giant cell tumor of the sphenoid bone--special emphasis on its clinico-radiological features and radiosensitivity]. 646 51

Though most of ectopic pinealoma occurs in the midline of cerebral base, only ten cases of frontal subcortical germinomas were reported in Japan as far as we know in literature. The patient, 20 year-old male, was admitted to our hospital because of blurred vision of the right eye and somnolence. Neurological examination on admission revealed bilateral choked discs and impaired visual acuity of both eyes with visual field defect of the right eye. A large deep bifrontal tumor was noted by cerebral angiography and pneumoventriculography done at the time of ventricular drainage. After subtotal removal of left frontal tumor and bifrontal V-P shunt, he came alert. No abnormality of posterior part of third ventricle was noted on the post-operative pneumonencephalogram. As the microscopic examination revealed that the tumor was germinoma of two-cell pattern, Co60 with a total dose of 5,900 rads was irradiated to the rest of the tumor. Brain scan with Tc99m 6 months after the surgery showed the disappearance of the tumor and CT scan 3 years later confirmed no recurrence of the tumor. Fine structure of the tumor was also presented and discussed.
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PMID:[A case of large germinoma in bilateral frontal region (author's transl)]. 739 99

Optic neuritis occurred in three of our patients receiving treatment with alpha interferon-2b (Intron-A; 3MU thrice weekly) for chronic hepatitis. The complication appeared within, 1, 9 1/2 and 10 months of treatment, respectively. In all cases, blurred vision was the initial complaint and subsequent electrophysiologic investigation confirmed the presence of optic tract neuropathy. The patients had no other neurologic signs. Computerized tomography and magnetic resonance image of the brain were not remarkable. Psychiatric symptoms, in the form of an interferon-associated depressive reaction, were present in two of them; in one case, it was severe enough to require immediate discontinuation of treatment. In two patients the visual symptoms resolved and the parameters of neurophysiologic testing returned to normal within 1 month after stopping interferon. In one case, however, residual optic tract impairment associated with a unilateral central scotoma and a substantial decrease of visual acuity was present 2 years later, despite a course of methylprednizolone. In this patient the interferon treatment was continued for 3 months despite the visual symptoms, and he later received two additional interferon courses because of relapses of hepatitis. We conclude that clinically evident optic tract neuropathy may complicate interferon administration. Candidates for interferon treatment may need routine examination of optic fields and visual evoked potentials, before and during administration of the drug to avoid possibly permanent visual sequelae.
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PMID:Optic tract neuropathy complicating low-dose interferon treatment. 783 21

A 35-year-old man with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with acute bilateral optic neuritis is described. At age 33, he noticed a tingling sensation in his toes followed by weakness in the lower limbs. He was admitted to our hospital because he became unable to walk without support. His motor and sensory symptoms gradually resolved during 7 months admission only with physical rehabilitation. At age 35, in July 1988, he noticed a tingling sensation in his toes and fingers, which reached to the knees and elbows in October 1988, when he developed weakness in the lower limbs. Motor and sensory symptoms were almost stationary thereafter and in March 1989, he experienced bilateral blurred vision of acute onset without ocular pain. He was readmitted to our hospital in April 1989. The neurological examination revealed decreased visual acuity of both eyes without any abnormality of the optic disks, mild weakness on flexion and extension of toes, an absence of Achilles reflex, and distal impairment of pain and touch sensations in the upper limbs, and of pain, touch and vibration sensations in the lower limbs. After laboratory examinations, CSF protein was elevated (122 mg/dl), and sensory nerve conduction velocity of the right median nerve was decreased (37.1 m/sec). The sural nerve action potential was not elicited on electrical stimulation. Central scotoma was found in both eyes by the visual field examination. P100 latency was seen to be normal by repeated pattern-reversal visual evoked potential (VEP) studies. CT and MRI of the brain were unremarkable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with acute bilateral optic neuritis with normal findings on pattern-reversal visual evoked potential study]. 801 88

Reduction of visual acuity or of the contrast of the stimulus induces a prolongation of the pattern reversal visual evoked potential (PR-VEP) latencies, perhaps because these conditions cause deterioration of the visual capacity to recognize objects and may preferentially activate the slower central retina channel. The PR-VEP was obtained with a video stimulator and 3 kinds of stimuli: total video field, video with a central scotoma and a restricted central stimulus. The subjects were tested under conditions of normal (20/20) and reduced visual acuity (20/200) with 14' and 56' checks and 60% contrast, and under conditions of normal visual acuity (20/20) with 14' checks and with stimulus contrast of 60% and 25%. Blurring increased latencies and decreased amplitudes only with the 14' checks stimulus but no with 56' checks, and the amplitudes obtained with the central stimulus became greater than those obtained with a central scotoma. Reducing contrast increased only latency, and there was not difference between amplitudes obtained with a central stimulus or a central scotoma. We conclude that blurring small checks induces a preferential stimulation of receptors in the central retina, but the same effect was not observed when stimulus contrast was reduced.
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PMID:Comparison of the mechanisms of latency shift in pattern reversal visual evoked potential induced by blurring and contrast reduction. 907 59


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