Neuro-Ophthalmology

When a PCP calls with concern for GCA and is wondering whether to start empiric steroids what data do you prioritize to make that decision and do you ...

4 Answers available

Is there any benefit from oral vs topical steroids in herpes zoster opthalmicus?

Would the management change if there were complications with optic neuritis?

1 Answer available

How do you use optical coherence tomography in the diagnosis and management of patients with multiple sclerosis and related diseases?

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How would you interpret a temporal artery biopsy demonstrating focal chronic inflammation in the adventitia associated with small adventitial vessels and nerves without inflammation of the intima and media and without giant cells?

2 Answers available

Is thyrotropin receptor antibody a good biomarker to predict development of thyroid eye disease?

1 Answer available

How do you work up incidentally found papilledema in the emergency room?

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Do you routinely obtain baseline vascular imaging (CTA, MRA, PET) in patients with suspected GCA, but negative temporal artery biopsy?

Per 2021 GCA Vasculitis Guidelines: low evidence, but conditional recommendation for CTA neck, chest, abd/pelvis. Is anybody following this or do you ...

2 Answers available

How would you work up and manage an isolated CN3 deficit with anisocoria?

MRI Orbits with possible mild enhancement of unilateral CN3; Brain MRI chronic microvascular disease, mild atrophy.

2 Answers available

What workup do you recommend on patients with suspected ischemic cranial nerve six palsy?

1 Answer available

How do you manage a patient with giant cell arteritis treated with weekly tocilizumab and low dose glucocorticoid who develops sudden vision loss?

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How do you evaluate asymptomatic patients referred for benign intracranial hypertension?

If patients are asymptomatic, what work up do you typically proceed with?

3 Answers available

What is the utility and yield of CSF studies for orbital apex syndrome?

Although probably more familiar to ophthalmologists, orbital apex syndrome refers to the consequence of any kind of swelling or mass effect within the...

1 Answer available

How do you decide on a steroid sparing agent for idiopathic orbital inflammation partially responsive to steroids?

1 Answer available

In what conditions can you see roving eye movements?

1 Answer available

Can giant cell arteritis present with a partial cranial neuropathy?

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Do you generally recommend low dose aspirin for patients with giant cell arteritis?

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Would you recommend medical therapy for asymptomatic idiopathic intracranial hypertension with completely normal visual field testing?

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How do you approach the management of patients with one clinical demyelinating event and MOG+ antibody status?

Do you wait for a second clinical event or start immunomodulatory therapy right away?

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How do you approach the management of acute attacks of MOGAD-associated optic neuritis?

Specifically, what do you do if there is minimal improvement with IV steroids and/or IVIG?

2 Answers available

Do you ever attribute oscillopsia to a cortical lesion?

1 Answer available

Do you always perform temporal artery biopsy in patients with positive inflammatory markers and high clinical suspicion of GCA?

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Is either ESR or CRP more sensitive or specific for the diagnosis of GCA?

Additionally, what is the current role for temporal artery ultrasound in workup for GCA?

3 Answers available

What is your approach to evaluation of underlying autoimmune disease in patients with bilateral scleromalacia?

1 Answer available

In a patient with suspected Miller Fisher syndrome, would you wait until antibody testing results to start IVIG or treat empirically?

Is there is a particular pattern of extraocular motility restriction in Miller Fisher syndrome?

1 Answer available

Which method do you prefer to assess for stigmata of old optic neuropathy?

Ex. optical coherence tomography, visual-evoked potentials

1 Answer available

What is your steroid-sparing agent of choice to treat GCA given the current tocilizumab shortage?

Thoughts on sarilumab vs methotrexate, or just treat with steroids alone

1 Answer available

How long do you continue steroid-sparing agents such as tocilizumab for GCA once the disease is in remission off steroids?

1 Answer available

At what point in GCA management do you typically introduce tocilizumab?

2 Answers available

How would you approach a symptomatic patient with with a history of whole brain RT with new bilateral MRI enhancing lesions within the optic nerves?

Would you suspect progressive disease v. radiation necrosis vs optic neuritis due to immunotherapy. Eyes were within radiation field 8 months ago.&nbs...

1 Answer available