Gordon T. Plant

TL;DR: Optical coherence tomography is used to demonstrate for the first time progressive thinning of the retinal nerve fibre layer following occipital lobe/optic radiation damage due to stroke and adds weight to the previous demonstration that this type of degeneration does indeed occur in the human visual system by showing that it can be monitored over time.

TL;DR: This is the first example of a clinically proven therapy being delivered effectively to stroke patients over the internet, using a web-based application for patients with a right-sided hemianopia causing slow text reading to produce significant improvements in text reading speeds.

TL;DR: In contrast to the CSF, neither serum GFAP nor S100B levels were of major diagnostic value for the laboratory supported differential diagnosis between optic neuritis in the context of NMO and other optic neuropathies.

TL;DR: Read-Right is not designed to replace standardised visual perimetry; it does, however, offer a quick and easy assessment that can be used to screen patients.

Abstract: A 39-YEAR-OLD MAN presented with 8 weeks of unilateral superior hemifield visual loss. He reported a generalized headache and a nonproductive cough for 3 months. Visual acuity was 20/1200 OS and normal in the right eye. Slitlamp evaluation revealed an ischemic left branch retinal vein occlusion with macular edema, no evidence of uveitis, and no changes in the right eye. At 2 weeks’ follow-up, bilateral disc edema was noted but with no focal neurological deficit. Enlarged cervical lymph nodes were found on systemic examination. A fluorescein angiogram did not demonstrate evidence of vasculitis or retinitis (Figure 1). Contrast-enhanced computed tomography and magnetic resonance imaging of the brain demonstrated symmetrical almost confluent small enhancing lesions involving the parieto-occipital gyri. These were hypointense on T2-weighted imaging, with localized gyriform swelling, white matter edema, and overlying pachymeningeal enhancement. The imaging characteristics (Figure 2) were suggestive of a granulomatous process such as coalescent tuberculomata or sarcoidosis with localized pachymeningitis, although the symmetry and parieto-occipital location were atypical. Lumbar puncture opening pressure was 17 cm of water, with an elevated protein level and a low glucose level. A lymph node biopsy revealed caseating epithelioid granulomas and Langerhans giant cells, with no acid-fast bacilli on ZiehlNeelsen stain. Test results for bloodborne viruses were negative. A diagnosis of tuberculosis was made and the patient commenced triple therapy. Despite extensive parieto-occipital changes, neuropsychological testing of higher visual processing was normal. The head-