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Functional and structural analysis of partial optic nerve avulsion due to blunt trauma: case report.

Mumcuoglu T, Durukan HA, Erdurman C, Hurmeric V, Gundogan FC - Indian J Ophthalmol (2010 Nov-Dec)

Bottom Line: The patient was diagnosed with partial ONA.Optical coherence tomography (OCT) revealed deep cavity at the inferior-temporal half of the optic disc.Retinal nerve fiber layer thickness was also thin at the inferior quadrant with circumpapillary OCT scan.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gulhane Military Medical School, Etlik, Ankara, Turkey. tarkanmumcuoglu@yahoo.com

ABSTRACT
Partial optic nerve avulsion (ONA) secondary to finger gouging is an uncommon but devastating injury. A 21-year-old man who had an acute vision loss after accidentally getting poked by himself in his right eye when he fell down during jogging is reported. The patient was diagnosed with partial ONA. Magnetic resonance imaging revealed intact optic nerve. Optical coherence tomography (OCT) revealed deep cavity at the inferior-temporal half of the optic disc. Retinal nerve fiber layer thickness was also thin at the inferior quadrant with circumpapillary OCT scan. Visual field test and electrophysiological tests showed functional abnormality compatible with optic nerve lesion. Diagnostic tools for anatomical and functional evaluation may reveal the course of this injury.

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Related in: MedlinePlus

Fluorescein angiography showing peripapillary subretinal hemorrhages and vitreous hemorrhage at the first examination
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Figure 0001: Fluorescein angiography showing peripapillary subretinal hemorrhages and vitreous hemorrhage at the first examination

Mentions: A 21-year-old man presented with acute vision loss immediately following his own finger gouging of his right eye while accidentally falling down during jogging. Visual acuity was counting fingers at 1 meter in the right eye and 20/20 in the left. The left eye was normal. A relative afferent pupillary defect was noted in the right eye. Intraocular pressure was 12 mmHg. Slit-lamp examination revealed a subconjunctival hemorrhage affecting the temporal aspect of the right eye. The cornea and lens were intact and clear. Dilated fundus examination revealed peripapillary subretinal hemorrhages and vitreous hemorrhage most prominently in the inferior vitreous cavity. Mild peripapillary edema and choroidal folds were observed. Fluorescein angiography revealed the masking of fluorescence due to intravitreal hemorrhage around the optic disc [Fig. 1]. The patient was treated with a 20-day course of tapering systemic steroid (prednisolone, 64 mg, peroral). Subsequently, vitreous hemorrhage settled and partial ONA at the lower half of the optic disc was recognized 20 days after the injury [Fig. 2].


Functional and structural analysis of partial optic nerve avulsion due to blunt trauma: case report.

Mumcuoglu T, Durukan HA, Erdurman C, Hurmeric V, Gundogan FC - Indian J Ophthalmol (2010 Nov-Dec)

Fluorescein angiography showing peripapillary subretinal hemorrhages and vitreous hemorrhage at the first examination
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2993985&req=5

Figure 0001: Fluorescein angiography showing peripapillary subretinal hemorrhages and vitreous hemorrhage at the first examination
Mentions: A 21-year-old man presented with acute vision loss immediately following his own finger gouging of his right eye while accidentally falling down during jogging. Visual acuity was counting fingers at 1 meter in the right eye and 20/20 in the left. The left eye was normal. A relative afferent pupillary defect was noted in the right eye. Intraocular pressure was 12 mmHg. Slit-lamp examination revealed a subconjunctival hemorrhage affecting the temporal aspect of the right eye. The cornea and lens were intact and clear. Dilated fundus examination revealed peripapillary subretinal hemorrhages and vitreous hemorrhage most prominently in the inferior vitreous cavity. Mild peripapillary edema and choroidal folds were observed. Fluorescein angiography revealed the masking of fluorescence due to intravitreal hemorrhage around the optic disc [Fig. 1]. The patient was treated with a 20-day course of tapering systemic steroid (prednisolone, 64 mg, peroral). Subsequently, vitreous hemorrhage settled and partial ONA at the lower half of the optic disc was recognized 20 days after the injury [Fig. 2].

Bottom Line: The patient was diagnosed with partial ONA.Optical coherence tomography (OCT) revealed deep cavity at the inferior-temporal half of the optic disc.Retinal nerve fiber layer thickness was also thin at the inferior quadrant with circumpapillary OCT scan.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gulhane Military Medical School, Etlik, Ankara, Turkey. tarkanmumcuoglu@yahoo.com

ABSTRACT
Partial optic nerve avulsion (ONA) secondary to finger gouging is an uncommon but devastating injury. A 21-year-old man who had an acute vision loss after accidentally getting poked by himself in his right eye when he fell down during jogging is reported. The patient was diagnosed with partial ONA. Magnetic resonance imaging revealed intact optic nerve. Optical coherence tomography (OCT) revealed deep cavity at the inferior-temporal half of the optic disc. Retinal nerve fiber layer thickness was also thin at the inferior quadrant with circumpapillary OCT scan. Visual field test and electrophysiological tests showed functional abnormality compatible with optic nerve lesion. Diagnostic tools for anatomical and functional evaluation may reveal the course of this injury.

Show MeSH
Related in: MedlinePlus