Journal of Neuro-Ophthalmology最新文献

Background: The prevalence of idiopathic intracranial hypertension (IIH) is rising with the global obesity epidemic. Carbonic anhydrase inhibitors (CAIs), such as acetazolamide, have been shown to be effective in IIH but can also lead to kidney stone formation. This study evaluates the risk of kidney stone development in patients with IIH treated with CAIs.

Methods: A retrospective cohort study using the TriNetX database was performed to compare patients with IIH treated with CAIs vs. untreated controls. Propensity score matching (PSM) balanced demographic and clinical variables. The primary outcome was kidney stone incidence for 3 time intervals: 1 year, 1-2 years, and 2-3 years, identified using International Classification of Diseases-10 codes. Risk ratios (RRs) with 95% confidence intervals (CIs) assessed the association between CAI treatment and kidney stone formation.

Results: The study evaluated 23,182 patients with IIH treated with CAIs compared with 50,080 untreated controls. After applying PSM, each group was balanced to include 22,464 patients. The treated group had a significantly higher risk of developing kidney stones than the control group, with an RR of 1.49 (95% CI: 1.22-1.84) at 1 year, 2.24 (95% CI: 1.61-3.12) at 1-2 years, and 1.51 (95% CI: 1.05-2.18) at 2-3 years. Sensitivity analysis of patients treated with at least 500 mg of acetazolamide shared this elevated trend, and the risk remained persistently high at 2-3 years (RR: 2.18, 95% CI: 1.13-4.20). Subgroup analysis revealed higher risks in males, while Black or African American patients had a lower risk.

Conclusions: Carbonic anhydrase inhibitor use in patients with IIH may increase kidney stone risk, particularly in certain populations. Further research is needed to understand the mechanisms behind this risk and to optimize treatment strategies.

Background: Most of the data on visual functions in Leber hereditary optic neuropathy (LHON) is based on patient questionnaires. Our study assessed the impact of LHON on visual function by testing facial recognition and execution of purposeful actions.

Methods: Twelve participants with LHON with central scotoma ranging from 5° to 20° and 12 unaffected age-matched controls were involved in our study. In the face recognition test, participants were asked to recognize the sex and the facial expression of photographs of faces increasing in size to simulate approaching faces. In the purposeful action test, they were asked to manipulate real objects while their eye movements were recorded.

Results: Although most patients were able to recognize the correct sex of a face at a size corresponding to a 1-m viewing distance, recognition of facial expressions was severely impaired. Patients were slower than control subjects in executing purposeful tasks. A dynamic strategy to sample information needed for the execution of a task was documented in a longer scanpath and in higher frequency of saccades and fixation eye movements in patients than in control subjects.

Conclusions: Face perception is strongly impaired in patients with LHON. In addition, although the selection and manipulation of real objects to execute a task are slowed, they can be performed efficiently using peripheral vision.

Background: Concussions are mild traumatic brain injuries that often cause vision problems. They have significant impacts on everyday life, cognitive capacity, and sports performance, and may affect injury prevalence in fast contact sports such as ice hockey. A functional vision questionnaire specifically designed for sports was used here to study the correlation between vision problems and concussion history.

Methods: In this national cross-sectional concussion study, 860 Finnish elite-level male adolescent ice hockey players (aged 13-21 years) answered a functional vision questionnaire and performed a computerized neurocognitive test, ImPACT. Totally 265 athletes reported a history of at least 1 concussion. All data were statistically compared with age-matched athletes with no concussion history (n = 595). For further analysis, athletes were divided into subgroups by age and number of previous concussions.

Results: Previously concussed athletes reported more general and eye-specific symptoms than their healthy controls. Increases in eye fatigue, frontal headaches, and blinking were statistically significant. Also statistically more problems with depth perception and evaluating distances, concentration problems, blurred vision, and losing the object in sight were observed among athletes with concussion history.

Conclusions: Concussion history reflects an increase in the prevalence of vision deficits, as determined by multiple disturbances in the near triad. The significant number of vision problems in the concussion history groups strongly suggests that functional vision should routinely be evaluated in athletes. The vision problems observed in the athletes with concussion history may indicate an increased injury risk that should be addressed.