NSUCO - The Visionary Spring 2012

THE V ISIONARY • S PRING 2012 — 22 Leasher J. Global Burden of Diseases, Injuries, and Risk Factors Study (GBD): The Vision Loss Group—Early Trends and Considerations of the Global Prevalence of Blindness and Visual Impairment This presentation described the GBD, with emphasis on the global prevalence trends in visual impairment and blindness. The GBD is a complete systemic assessment of the data on all diseases and injuries and produces comprehensive comparable estimates of the burden of diseases, injuries, and risk factors for the time periods 1990, 2005, and 2010 for 199 countries divided into 21 global sub regions. It is directed by the World Health Organization in partnership with global experts in each disease area. Nadeau M, Sowka J. Myelinated Retinal Nerve Fiber Layer, Myopia,and Amblyopia The triad of myelinated retinal nerve fiber layer (RNFL), myopia, and amblyopia is a rarely reported syndrome. Myelinated RNFL is present in approximately one percent of eyes and associated with a variety of ocular and systemic conditions. The lecture presents a case of myelinated RNFL, myopia, and amblyopia as a platform for discussion of the pathogenesis of myeliated RNFL, ocular systemic conditions associated with myelinated RNFL, and visual prognosis in this triad. Yu S, Rego R. Congenital Achromatopsia: A Case Study and Low Vision Aids Congenital achromatopsia (CA) is predominantly an autosomal recessive disease affecting the retinal cone photoreceptors. The condition affects approximately 1 in 30,000 people. Individuals with CA generally have photophobia, pendular nystagmus, abnormal photopic electroretinogram, and lack of color discrimination. Zhang B. The Development of the Receptive-Field Internal Structure of V2 Neurons in Primates The maturation of the receptive-field (RF) internal structure of the V2 neurons is studied in primates. Visual capacities of primates are limited near birth. Physiologically, multiple inputs from the primary visual cortex (V1) neurons tuned to various local stimulus features converge on V2 neurons, and many of these early extrastriate neurons may acquire new sensitivities to more complex features of visual scenes. POSTER PRESENTATIONS Besada E, Frauens B . Branch Retinal Artery Occlusion as an Isolated Acute Complication of Birth Control Medications in a Tobacco Products User This project documents the development of a branch retinal artery occlusion in a female taking birth-control medication while being an active cigarette smoker. A 37- year-old female presented with acute onset of blurred vision in the superior central field. She reported a history of strabismus surgery OD (amblyopia). The patient smoked half a pack a day for 20 years and indicated she was taking Levonorgestrel- Ethestra 0.15 mg. Tyler J, Najman P . Atypical Lid Pseudomembranes in a Patient with Multiple Ocular Herpes Simplex Presentations Herpes simplex virus (HSV) is a common infectious agent with multiple potential ocular presentations. More than 80 percent of adults have antibodies for HSV, but only 20-25 percent manifest ocular disease. Known triggers of the virus include steroid use, UV exposure, stress/fatigue, trauma, and fever. In relation to the anterior segment, vesicular lesions of the lids may be present, as well as corneal epithelial changes that represent active HSV, stromal complications, and endotheliitis. The presented case showcased an unusual anterior segment ocular complication of HSV infection. Duchnowski E, Janoff A , Hill J. Utilizing Anterior Segment Optical Coherence Tomography to Monitor Acute Corneal Hydrops in Keratoconus A 61-year-old male presented with an asymptomatic red eye OD one month post refit from a small corneal gas permeable (GP) lens to a semi-scleral GP lens for advanced keratoconus, prescribed for daily wear use. Acute corneal hydrops, characterized by corneal edema due to a break in Descement’s membrane, was diagnosed and followed with anterior segment optical coherence tomography (AS-OCT) until full resolution was observed. Bi H, Woods A . Enhanced fERG and mfERG Responses in a Patient with Recently Diagnosed Graves’ Disease Thyroid hormones play an important role in the development of cone photoreceptors in the retina. It has been shown that thyroid hormone levels continue to regulate opsin production in mature cones (Glaschke A et al., 2011). A limited number of cases have been reported where the flash electroretinogram (fERG), a global retinal response, shows enhanced or supernormal responses in patients with adult-onset thyroid dysfunction. However, it is unknown how retinal photoreceptor functions are affected topographically, and how this might impact multifocal ERG (mfERG) responses. Woods A, Bi H . Cone Degeneration in Association with Cerebellum Degeneration Cerebellar degeneration or spinocerebellar ataxias (SCA) refers to a heterogeneous group of diseases primarily characterized by progressive loss of motor coordination. Degenerative changes typically occur in areas such as the cerebellum, brainstem, and spinal cord. While ocular motility dysfunctions can often be seen in association with the different forms of SCA, visual loss from an associated retinal degeneration is rare in these patients, with only a limited number of reports in the literature. Drs. Bi and Woods presented a case of central cone dysfunction in association with cerebellar degeneration in a patient without funduscopic abnormalities. Levin M, Shechtman D , Besada E , Posner J. Challenges in the Management of a Patient with Undiagnosed Sturge-Weber Syndrome Sturge-Weber Syndrome (SWS) (encephalotrigeminal angiomatosis) is characterized by neuro-oculocutaneous congenital hamartomas. The primary lesion manifests as a cutaneous facial nevus, known as a port wine stain (PWS). Most cases are diagnosed before age two and oftentimes require a team approach in the management of the patient, including neuro-consult, pediatrician, eye care physician, and retinal specialist. American Academy of Optometry October 12-15, 2011