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  1. Article ; Online: A 72-Year-Old Kidney Transplant Recipient With Visual Changes.

    Bhatti, M Tariq / Gilbert, Aubrey L / Hwang, Thomas N

    JAMA ophthalmology

    2023  Volume 141, Issue 6, Page(s) 602–603

    MeSH term(s) Aged ; Humans ; Kidney Transplantation/adverse effects ; Vision, Ocular
    Language English
    Publishing date 2023-05-03
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2701705-9
    ISSN 2168-6173 ; 2168-6165
    ISSN (online) 2168-6173
    ISSN 2168-6165
    DOI 10.1001/jamaophthalmol.2023.1122
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  2. Article ; Online: Telemedicine in neuro-ophthalmology.

    Ramakrishnan, Meera S / Gilbert, Aubrey L

    Current opinion in ophthalmology

    2021  Volume 32, Issue 6, Page(s) 499–503

    Abstract: Purpose of review: The COVID-19 public health emergency accelerated the adoption of telemedicine in neuro-ophthalmology. This review surveys the current telemedicine landscape and discusses associated limitations and opportunities.: Recent findings: ... ...

    Abstract Purpose of review: The COVID-19 public health emergency accelerated the adoption of telemedicine in neuro-ophthalmology. This review surveys the current telemedicine landscape and discusses associated limitations and opportunities.
    Recent findings: Logistic considerations and regulatory changes related to the COVID-19 pandemic have spurred a proliferation of tele-neuro-ophthalmic practice. One significant benefit of telemedicine is increased access to the limited number of neuro-ophthalmologists in the country. Certain elements of the neuro-ophthalmic examination can be ascertained during a video visit or through the use of mobile applications. However, data quality can be limited and more direct evaluation of the fundus currently requires the implementation of imaging techniques, such as fundus photography and/or optical coherence tomography. For cases that require it, a 'hybrid' model can be adopted in which patients physically present to designated locations for testing and subsequently participate in televisit with the physician to discuss the assessment and plan.
    Summary: Telemedicine provides an alternate pathway for patients to access the limited resource of neuro-ophthalmic care, and it will likely persist beyond the current COVID-19 pandemic. It has some limitations currently but continued progress in technologic, legal, and reimbursement strategies will hopefully facilitate further adoption.
    MeSH term(s) COVID-19 ; Humans ; Ophthalmology ; Pandemics ; SARS-CoV-2 ; Telemedicine
    Language English
    Publishing date 2021-08-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1049383-9
    ISSN 1531-7021 ; 1040-8738
    ISSN (online) 1531-7021
    ISSN 1040-8738
    DOI 10.1097/ICU.0000000000000800
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  3. Article ; Online: SARS-CoV-2 Parainfectious Optic Neuropathy: 3 Case Reports and a Review of the Literature.

    Gluckstein, Jeffrey A / Chwalisz, Bart K / Gilbert, Aubrey L / Bouffard, Marc A

    Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society

    2023  Volume 43, Issue 4, Page(s) 491–498

    Abstract: Background: Parainfectious optic neuritis is an inflammatory reaction that occurs shortly after an infection without direct invasion by a pathogen. The clinical profile depends on the infectious organism. Cases of SARS-CoV-2 parainfectious optic ... ...

    Abstract Background: Parainfectious optic neuritis is an inflammatory reaction that occurs shortly after an infection without direct invasion by a pathogen. The clinical profile depends on the infectious organism. Cases of SARS-CoV-2 parainfectious optic neuritis have been reported in the literature, but there are no reviews that have applied strict inclusion criteria to more definitively establish the clinical profile associated with SARS-CoV-2.
    Methods: We present 3 new cases of SARS-CoV-2 parainfectious optic neuritis. We also review the literature for definite cases by selecting only those with unambiguous clinical features and MRI findings of optic neuritis, positive SARS-CoV-2 polymerase chain reaction or serology, and the absence of myelin oligodendrocyte-glycoprotein or aquaporin-4 antibodies or other diseases associated with optic neuritis.
    Results: We report 2 cases of monophasic, unilateral SARS-CoV-2 parainfectious optic neuritis with optic disc edema and nadir visual acuities of finger counting. We report 1 case of mild SARS-CoV-2 parainfectious optic neuritis that featured cotton wool spots, peripapillary wrinkles and hemorrhages, and recurrence after an initial steroid taper. We identified 6 cases of unambiguous SARS-CoV-2 parainfectious optic neuritis from the literature. Combining our case series with the case reports in the literature, the average age was 42.8 years, 3/9 had bilateral disease, 6/8 had optic disc edema, 8/9 had nadir visual acuity of finger counting or worse, and all recovered visual acuity to 20/40 or better after therapy with steroids.
    Conclusions: SARS-CoV-2 parainfectious optic neuritis has a clinical profile that is atypical for idiopathic optic neuritis but fairly typical of parainfectious forms of optic neuritis with a severely reduced nadir visual acuity, high likelihood of bilaterality, high incidence of optic disc edema, and prompt and significant response to corticosteroids. Further study with long-term follow-up and epidemiologic investigation will be needed to further characterize this clinical entity.
    MeSH term(s) Humans ; Papilledema/etiology ; Papilledema/complications ; SARS-CoV-2 ; Retrospective Studies ; COVID-19/complications ; Optic Nerve Diseases/etiology ; Optic Nerve Diseases/complications ; Optic Neuritis/diagnosis ; Optic Neuritis/drug therapy ; Optic Neuritis/etiology ; Vision Disorders/diagnosis ; Vision Disorders/etiology
    Language English
    Publishing date 2023-03-02
    Publishing country United States
    Document type Review ; Case Reports ; Journal Article
    ZDB-ID 1189901-3
    ISSN 1536-5166 ; 1070-8022
    ISSN (online) 1536-5166
    ISSN 1070-8022
    DOI 10.1097/WNO.0000000000001822
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    Zs.A 1670: Show issues Location:
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  4. Article ; Online: Autoimmune Retinopathy in a Patient with Stiff-Person Syndrome: A Case Report.

    Shah, Ronak M / Maloney, Maya H / Gilbert, Aubrey L / Patel, Amar P / Vora, Robin A

    Retinal cases & brief reports

    2023  

    Abstract: Purpose: To describe a patient who developed retinal degeneration associated with autoimmune retinopathy (AIR) and who was also found to have anti-glutamic acid decarboxylase (GAD65) autoantibodies and the diagnosis of stiff-person syndrome (SPS).: ... ...

    Abstract Purpose: To describe a patient who developed retinal degeneration associated with autoimmune retinopathy (AIR) and who was also found to have anti-glutamic acid decarboxylase (GAD65) autoantibodies and the diagnosis of stiff-person syndrome (SPS).
    Methods: Ophthalmologic workup consisted of clinical examination, multi-modality retinal imaging, and electrophysiologic testing. Further neurologic assessment including relevant serum and cerebrospinal fluid studies was also conducted.
    Results: We highlight the case of a 45-year-old patient who developed subacute, sequential vision loss, along with bilateral lower extremity weakness. On initial presentation, optical coherence tomography (OCT) of the left eye was notable for diffuse attenuation of the outer retinal bands. Fundus autofluorescence demonstrated a ring of hyper-autofluorescence encircling the fovea of the left eye. At fifteen-month follow-up, the right eye also became similarly affected. He was found to have elevated serum and cerebrospinal anti-GAD65 autoantibodies and was diagnosed with both SPS and AIR.
    Conclusion: There is a potential association of anti-GAD65 autoantibodies with the development of AIR.
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article
    ISSN 1937-1578
    ISSN (online) 1937-1578
    DOI 10.1097/ICB.0000000000001543
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  5. Article ; Online: Bilateral lens dislocation in a patient with homocystinuria.

    Gilbert, Aubrey L

    JAMA ophthalmology

    2015  Volume 133, Issue 3, Page(s) e143538

    MeSH term(s) Accidental Falls ; Female ; Homocystinuria/complications ; Humans ; Lens Subluxation/diagnosis ; Lens Subluxation/etiology ; Middle Aged ; Tomography, X-Ray Computed
    Language English
    Publishing date 2015-03
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2701705-9
    ISSN 2168-6173 ; 2168-6165
    ISSN (online) 2168-6173
    ISSN 2168-6165
    DOI 10.1001/jamaophthalmol.2014.3538
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  6. Article ; Online: Spontaneous cerebrospinal fluid leak and idiopathic intracranial hypertension.

    Tam, Emily K / Gilbert, Aubrey L

    Current opinion in ophthalmology

    2019  Volume 30, Issue 6, Page(s) 467–471

    Abstract: Purpose of review: To review the most recent literature on the relationship of spontaneous cerebrospinal fluid (CSF) leak with idiopathic intracranial hypertension (IIH) and considerations in management of these conditions.: Recent findings: A link ... ...

    Abstract Purpose of review: To review the most recent literature on the relationship of spontaneous cerebrospinal fluid (CSF) leak with idiopathic intracranial hypertension (IIH) and considerations in management of these conditions.
    Recent findings: A link has been proposed between spontaneous CSF leak and IIH based on similar demographics, radiologic, and clinical findings in these patients, and on a plausible mechanism of skull base erosion in the setting of high CSF pressure over time. IIH patients with CSF leak may not present with classic IIH signs and symptoms as the leak can alleviate excess pressure; however, they may develop these after a leak is repaired. There may also be a higher risk of leak recurrence if intracranial hypertension is not treated postoperatively.
    Summary: A growing body of evidence supports an association between IIH and spontaneous CSF leak. However, this relationship is still not fully elucidated, and there is no current agreement on how to incorporate screening, management, or counseling guidelines for CSF leak into the care of IIH patients. There are also no specific guidelines for evaluation/management of IIH in patients with spontaneous CSF leak. Further interdisciplinary research is needed to explore this connection and to establish screening, evaluation, and management guidelines.
    MeSH term(s) Cerebrospinal Fluid Leak/physiopathology ; Cerebrospinal Fluid Leak/therapy ; Cerebrospinal Fluid Pressure ; Humans ; Intracranial Hypertension/physiopathology ; Intracranial Hypertension/therapy ; Pseudotumor Cerebri/physiopathology ; Recurrence ; Skull Base
    Language English
    Publishing date 2019-08-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1049383-9
    ISSN 1531-7021 ; 1040-8738
    ISSN (online) 1531-7021
    ISSN 1040-8738
    DOI 10.1097/ICU.0000000000000603
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  7. Article ; Online: Glioblastoma multiforme mimicking optic neuritis.

    Ramakrishnan, Meera S / Vora, Robin A / Gilbert, Aubrey L

    American journal of ophthalmology case reports

    2020  Volume 17, Page(s) 100594

    Abstract: Purpose: To present a case of glioblastoma multiforme which initially presented with only ophthalmic manifestations.: Observations: A 48-year-old man presented with decreased vision and pain with eye movements of the right eye. MRI of the brain ... ...

    Abstract Purpose: To present a case of glioblastoma multiforme which initially presented with only ophthalmic manifestations.
    Observations: A 48-year-old man presented with decreased vision and pain with eye movements of the right eye. MRI of the brain showed increased T2/FLAIR signal involving the right optic nerve with no other identified abnormalities. He was treated with intravenous steroids for presumed optic neuritis. His visual acuity then rapidly worsened to no light perception, with new orbital apex symptoms including central retinal artery and vein occlusions and inferior division third and fourth nerve palsies. Repeat MRI with contrast showed perineural enhancement surrounding the right optic nerve and markedly reduced diffusion along its entire course. After an unrevealing initial workup and then a 7 month period during which the patient refused follow up, he re-presented with left sided weakness, headache, and confusion. Repeat brain MRI revealed a large mass involving the right optic nerve, optic chiasm, basal ganglia, corpus callosum and brainstem. Biopsy led to a diagnosis of WHO grade IV glioblastoma multiforme. The disease was poorly responsive to temozolomide, bevacizumab and external beam radiation, and the patient passed away 5 months later.
    Conclusions and importance: Malignant optic glioma of adulthood is a challenging diagnosis with a poor prognosis. This rare case highlights the importance of maintaining neoplasm in the differential for optic neuritis masqueraders.
    Language English
    Publishing date 2020-01-07
    Publishing country United States
    Document type Case Reports
    ISSN 2451-9936
    ISSN (online) 2451-9936
    DOI 10.1016/j.ajoc.2020.100594
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  8. Article ; Online: Shot in the dark.

    Bhatti, M Tariq / Gilbert, Aubrey L / Watson, George / Waheed, Mark / Spencer, Doran

    Survey of ophthalmology

    2022  Volume 68, Issue 4, Page(s) 821–829

    Abstract: A 43-year-old woman presented with decreased vision in the right eye associated with painful eye movements 10 days after receiving her first dose of Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine (Pfizer Inc, New York, NY). Two days later ... ...

    Abstract A 43-year-old woman presented with decreased vision in the right eye associated with painful eye movements 10 days after receiving her first dose of Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine (Pfizer Inc, New York, NY). Two days later she developed painful loss of vision in the left eye. Clinical presentation and magnetic resonance imaging findings were consistent with bilateral optic perineuritis transitioning to optic neuritis. Extensive evaluation including aquaporin-4 immunoglobin G (IgG), myelin oligodendrocyte glycoprotein IgG, and lumbar puncture was unrevealing. Visual acuity at nadir was counting fingers in both eyes, but after receiving intravenous steroids and plasma exchange vision eventually improved to 20/20 in each eye, although she was left with inferior visual field defects and bilateral optic disc pallor. This case highlights the diagnostic challenge in the evaluation of atypical optic neuritis with a review of post-COVID-19 vaccination-associated optic neuritis.
    MeSH term(s) Female ; Humans ; COVID-19 ; COVID-19 Vaccines/adverse effects ; Immunoglobulin G/therapeutic use ; Optic Nerve ; Optic Neuritis/diagnosis ; Optic Neuritis/etiology ; Vision Disorders ; Adult
    Chemical Substances COVID-19 Vaccines ; Immunoglobulin G
    Language English
    Publishing date 2022-09-21
    Publishing country United States
    Document type Case Reports ; Review ; Journal Article
    ZDB-ID 391346-6
    ISSN 1879-3304 ; 0039-6257
    ISSN (online) 1879-3304
    ISSN 0039-6257
    DOI 10.1016/j.survophthal.2022.09.003
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    Zs.A 283: Show issues Location:
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  9. Article ; Online: Duane syndrome with prominent oculo-auricular phenomenon.

    Gilbert, Aubrey L / Hunter, David G

    Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus

    2017  Volume 21, Issue 2, Page(s) 165–167

    Abstract: Duane syndrome is a congenital cranial dysinnervation disorder involving absent or anomalous innervation of the lateral and medial rectus muscles that is sometimes associated with other manifestations of dysinnervation. We describe a patient with right ... ...

    Abstract Duane syndrome is a congenital cranial dysinnervation disorder involving absent or anomalous innervation of the lateral and medial rectus muscles that is sometimes associated with other manifestations of dysinnervation. We describe a patient with right esotropic Duane syndrome with a long-standing retroauricular tugging sensation in right gaze who was noted to have prominent ipsilateral oculo-auricular phenomenon, representing either abnormal enhancement of existing innervation or an uncommon dysinnervation. After successful strabismus surgery the tugging sensation improved but the phenomenon could still be elicited.
    Language English
    Publishing date 2017-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1412476-2
    ISSN 1528-3933 ; 1091-8531
    ISSN (online) 1528-3933
    ISSN 1091-8531
    DOI 10.1016/j.jaapos.2016.09.017
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    Zs.A 5188: Show issues Location:
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  10. Article ; Online: Update on the evaluation of pediatric idiopathic intracranial hypertension.

    Gilbert, Aubrey L / Heidary, Gena

    Current opinion in ophthalmology

    2016  Volume 27, Issue 6, Page(s) 493–497

    Abstract: Purpose of review: Papilledema associated with idiopathic intracranial hypertension (IIH) may result in irreversible, progressive visual loss. The development of tools for the evaluation of pediatric patients with IIH is particularly relevant as many ... ...

    Abstract Purpose of review: Papilledema associated with idiopathic intracranial hypertension (IIH) may result in irreversible, progressive visual loss. The development of tools for the evaluation of pediatric patients with IIH is particularly relevant as many patients may not be able to comply with the detailed clinical evaluation utilized in adults for the treatment and management of this disease. The purpose of this review is to summarize relevant articles on the diagnostic tools used in evaluation and management of pediatric IIH.
    Recent findings: Studies suggest that characteristic pediatric IIH MRI findings include empty sella turcica, decreased pituitary gland size, optic nerve tortuosity, perioptic subarachnoid space enlargement, posterior globe flattering, and intraocular protrusion of the optic nerve head. On optical coherence tomography (OCT), increased retinal nerve fiber layer and macular thickness may be observed in children with IIH compared with controls. The retinal nerve fiber layer thickness seems to coincide with the severity of papilledema and may be more sensitive than funduscopy for detecting optic nerve head elevation. Research on ultrasound of the optic nerve shows increased size of the optic nerve sheath diameter in pediatric IIH patients, and this may correlate with increased opening pressure on lumbar puncture.
    Summary: There appears to be characteristic findings on MRI, OCT, and ultrasound studies in pediatric IIH patients. Although ultrasound is rarely used for monitoring these patients nowadays, MRI and OCT can be useful in the evaluation and management of these individuals.
    MeSH term(s) Child ; Humans ; Magnetic Resonance Imaging ; Optic Nerve/diagnostic imaging ; Pseudotumor Cerebri/diagnostic imaging ; Retinal Neurons ; Tomography, Optical Coherence ; Ultrasonography
    Language English
    Publishing date 2016-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1049383-9
    ISSN 1531-7021 ; 1040-8738
    ISSN (online) 1531-7021
    ISSN 1040-8738
    DOI 10.1097/ICU.0000000000000317
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