Cortical blindness is an uncommon, but dramatic, complication of preeclampsia. We present a case in which diffusion-weighted magnetic resonance imaging played a critical role in determining the etiology of the cortical blindness and its subsequent management.
[Show abstract][Hide abstract] ABSTRACT: Visual changes in pregnancy are common, and many are specifically associated with the pregnancy itself. Serous retinal detachments and blindness occur more frequently during preeclampsia and often subside postpartum. Pregnant women are at increased risk for the progression of preexisting proliferative diabetic retinopathy, and diabetic women should see an ophthalmologist before pregnancy or early in the first trimester. The results of refractive eye surgery before, during, or immediately after pregnancy are unpredictable, and refractive surgery should be postponed until there is a stable postpartum refraction. A decreased tolerance to contact lenses also is common during pregnancy; therefore, it is advisable to fit contact lenses postpartum. Furthermore, pregnancy is associated with a decreased intraocular pressure in healthy eyes, and the effects of glaucoma medications on the fetus and breast-fed infant are largely unknown. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to list the various ocular changes that occur during pregnancy, summarize the ocular disturbances that occur with preeclampsia and diabetes, and describe the management of some ocular problems during pregnancy.
[Show abstract][Hide abstract] ABSTRACT: To provide an update on imaging of the brain and orbit for ophthalmologists.
A systematic English-language medline search and summary of recent literature on imaging of brain and orbit was performed.
Computed tomography and magnetic resonance (MR) scanning are the mainstays for the evaluation of most disorders involving the brain and orbit. Computed tomography angiography and magnetic resonance angiography are relatively newer applications that are useful for the evaluation of arterial and venous disorders. Special sequences such as fat suppression and fluid attenuation inversion recovery are useful techniques for specific ophthalmic indications. Diffusion weighted imaging and perfusion-weighted imaging are improving the evaluation of acute stroke. Functional MRI, positron emission tomography scanning and single photon emission computed tomography may provide useful information regarding brain or tumor metabolism. Magnetic resonance spectroscopy has expanded our knowledge of brain function. Newer imaging studies have improved our diagnostic abilities on many fronts, including new sequences, new applications of imaging studies, and functional imaging of brain.
New imaging techniques for brain and orbit have an increased potential for improving diagnostic yield. Accurate and timely communication with the neuroradiologist can optimize the prescription and interpretation of imaging in ophthalmology.
American Journal of Ophthalmology 12/2004; 138(5):852-62. DOI:10.1016/j.ajo.2004.06.069 · 3.87 Impact Factor
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