James F Acheson

Publications of James F Acheson

• Saccadic lateropulsion or ipsipulsion.

  Authors: Niaz Islam, Gordon T Plant, James F Acheson

  Acta ophthalmologica. 12/2007;

• A pharmacogenetic exploration of vigabatrin-induced visual field constriction.

  Authors: Peter Kinirons, Gianpiero L Cavalleri, Rinki Singh, Amre Shahwan, James F Acheson, Nicholas W Wood, David B Goldstein, Sanjay M Sisodiya, Colin P Doherty, Norman Delanty

  Epilepsy research. 09/2006; 70(2-3):144-52.

  INTRODUCTION: Use of the antiepileptic drug (AED) vigabatrin is severely limited by irreversible visual field constriction, an adverse reaction to the drug reported in approximately 40% of patients.INTRODUCTION: Use of the antiepileptic drug (AED) vigabatrin is severely limited by irreversible visual field constriction, an adverse reaction to the drug reported in approximately 40% of patients. Given the evidence suggesting an idiosyncratic drug response, we set out to detect genetic variation of strong, clinically relevant effect that might guide clinicians in the safe, controlled prescribing of this otherwise usefuldrug. METHODS: Patients with a history of at least 1-year exposure to vigabatrin were enrolled at two independent referral centers. Using Goldmann perimetry, visual fields and the extent of constriction were calculated for each patient. We examined the correlation between the extent of vigabatrin induced visual field constriction and genetic variation across six candidate genes (SLC6A1, SLC6A13, SCL6A11, ABAT, GABRR1 and GABRR2). We availed of HapMap data and used a tagging SNP technique in an effort to efficiently capture all common variation within these genes. We attempted to replicate any positive associations before drawing conclusions from our results. RESULTS: The degree of visual field constriction correlated with three SNPs and one haplotype in a cohort of 73 patients. However we were unable to replicate these findings in a second independent cohort consisting of 58 patients, suggesting the initial results were possibly false positives, or variants of weak effect. CONCLUSION: Common variants of strong, clinically relevant effect do not appear to reside in the candidate genes studied here. This does not rule out the presence of genetic variants of weak effect in these genes, nor of variants of strong effect in other genes.

• Idiopathic intracranial hypertension and visual function.

  Authors: James F Acheson

  British medical bulletin. 02/2006; 79-80:233-44.

  BACKGROUND: Idiopathic intracranial hypertension is a relatively common condition (incidence up to 19/100 000/year in the high-risk group of obese women in reproductive age range) causing headachesBACKGROUND: Idiopathic intracranial hypertension is a relatively common condition (incidence up to 19/100 000/year in the high-risk group of obese women in reproductive age range) causing headaches with papilloedema. Detailed investigations are required to exclude other causes of raised intracranial pressure. The condition may be self-limiting or enter a chronic phase with significant morbidity because of headache and visual loss. METHODS AND RESULTS: This includes an overview of literature and internal audit date. DISCUSSION AND CONCLUSIONS: Management of hypertension is initially medical, utilizing a combination of managed weight reduction and diuretic therapy. Cerebrospinal fluid (CSF) diversion surgery may be required to stabilize vision. Options include neurosurgical shunting by lumbar-peritoneal of ventriculo-peritoneal routes or by optic nerve sheath fenestration or both. High category evidence from randomized trials to guide management decisions is lacking. This article sets out to guide current best practice.

• Twin and triple peaks papilledema.

  Authors: Jodhbir S Mehta, Gordon T Plant, James F Acheson

  Ophthalmology. 08/2005; 112(7):1299-301.

  PURPOSE: To describe 2 adult patients who presented with papilledema after band atrophy (i.e., twin and triple peaks papilledema). DESIGN: Retrospective small case series. PARTICIPANTS: TwoPURPOSE: To describe 2 adult patients who presented with papilledema after band atrophy (i.e., twin and triple peaks papilledema). DESIGN: Retrospective small case series. PARTICIPANTS: Two outpatients. METHODS: Observations made on 2 patients whose cases were reviewed in the neuro-ophthalmology clinic. RESULTS: The first patient had a pituitary tumor presenting with papilledema, causing a triple peaks clinical sign. Color photographs, optical coherence tomograms, and magnetic resonance images are shown. The second patient developed twin peaks papilledema due to a chiasmal glioma causing secondary raised intracranial pressure. CONCLUSION: Twin peaks papilledema is a rare clinical sign that may develop in adults as well as in children. The first report and optical coherence tomography features of triple peaks papilledema illustrate a new clinical sign.

• Familial Bell's palsy in females: a phenotype with a predilection for eyelids and lacrimal gland.

  Authors: Farhan H Zaidi, Kevin Gregory-Evans, James F Acheson, Veronica Ferguson

  Orbit (Amsterdam, Netherlands). 07/2005; 24(2):121-4.

  The authors report a family with familial Bell's palsy affecting seven individuals, six of whom are females. This is a distinct subtype of Bell's palsy with a predilection for juvenile females,The authors report a family with familial Bell's palsy affecting seven individuals, six of whom are females. This is a distinct subtype of Bell's palsy with a predilection for juvenile females, previously reported only very rarely. In conjunction with a review of the literature, this case suggests that this phenotype carries with it a greater risk of serious complications affecting the eyelids and lacrimal gland. These carry significant functional and cosmetic implications owing to aberrant regeneration of the seventh, sixth and possibly third cranial nerves, chronicity and relapses. Clinical features include synkinesis of the eyelids with the orbicularis oris causing synkinetic ptosis, recurrent paralytic ectropion, paralysis of facial muscles of expression with dry eye, hyperlacrimation (crocodile tears), and transient strabismus. Clinically, the decision to offer surgery in place of conservative treatment should consider the natural history of chronicity and relapses often seen with this subtype of familial Bell's palsy. Botulinum toxin injections are especially versatile in managing the complications associated with this phenotype.

• Changes in intraocular pressure in anesthetized prone patients.

  Authors: Katharine Hunt, Rahul Bajekal, Ian Calder, Rosanne Meacher, Joseph Eliahoo, James F Acheson

  Journal of neurosurgical anesthesiology. 10/2004; 16(4):287-90.

  BACKGROUND: Postoperative visual loss occurs more commonly in patients placed prone. The mechanism may be raised intraocular pressure (IOP) causing an ischemic oculopathy. METHODS: IOP was measuredBACKGROUND: Postoperative visual loss occurs more commonly in patients placed prone. The mechanism may be raised intraocular pressure (IOP) causing an ischemic oculopathy. METHODS: IOP was measured in 20 patients undergoing spinal surgery. The IOP was measured prior to intubation, immediately after pronation, and at the end of surgery before the patient was returned to the supine position. Duration of surgery, method of head stabilization and standard physiological parameters were recorded. RESULTS: Both measurements of median IOP in the prone position were significantly higher than that in the supine position (P < 0.001). There was no evidence of a relationship between rise in IOP and duration of surgery, age, or body mass index. There was weak evidence of a tendency for patients whose heads were on pillows to have higher values of IOP at the end of surgery than patients whose heads were supported in pins. CONCLUSION: IOP increases when anesthetized patients are placed in the prone position.