Notes
Slide Show
Outline
1
Neuro-Ophthalmology
Grand Round
May 11, 2006
  • Suzanna Airiani, MD
  • Edward Harkness Eye Institute
  • Columbia University, NY
2
History
  • 60 yo HM referred by optometrist for evaluation of R optic disc hemorrhage
  • No complaints
  • PMH: anxiety / depression
  • PSH: (-)
  • POH: corneal abrasion
  • Meds: zoloft, MVI
3
Ophthalmic Exam
  • Va: 20/25 OU
  • EOM intact
  • Pupils briskly reactive, ř APD
  • CP AOHRR  5.5/6  OU
  • Ta  14 / 14
  • Slitlamp exam: unremarkable
4
Posterior Segment Exam
5
Fluorescein Angiography
6
Cont’d
7
CT Scan Head Orbit
8
Optociliary Shunt Vessels
  • Congenital
  • Acquired
    • CRVO
    • Optic nerve sheath meningiomas
    • ON glioma
    • Chronic atrophic papilledema
    • Glaucomatous optic atrophy
    • Arachnoid cysts of optic nerve
    • Phacomatosis
9
Congenital Optociliary Vessels
  • First described by Elschnig 1898
  • Rare : 5%
  • May be associated with anomalies of the disc and retinal vessels
  • May mimic those seen in CRVO or optic nerve sheath meningioma
10
 
11
FA characteristic
  • Direction of flow from choroid into CRV
  • Filled during early AV phase
  • Reached full venous filling while retinal vein are still in laminar phase
12
 
13
 
14