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Background and Purpose: The relation between anterior ischemic optic neuropathy and carotid artery atherosclerotic disease is unclear. We studied patients with anterior ischemic optic neuropathy to determine if they had an increased occurrence of carotid artery stenosis.Methods: Fifteen consecutive patients with anterior ischemic optic neuropathy were evaluated prospectively for cervical carotid artery stenosis and compared with 30 age-and sex-matched asymptomatic patients and also with 11 age-and sex-matched patients experiencing transient monocular blindness.Results: There was no difference in the mean stenosis of the internal carotid artery between patients with anterior ischemic optic neuropathy (mean carotid stenosis, 19%) and asymptomatic patients (mean carotid stenosis, 9%;/»>0.05), whereas patients with transient monocular blindness had significantly more stenosis (mean, 77%) in the cervical carotid arteries than both control subjects (p<0.0001) and patients with anterior ischemic optic neuropathy (p<0.0001). There was also no difference in the percentage of patients with stenosis >30% in anterior ischemic optic neuropathy (two of 15) and asymptomatic patients (five of 30), whereas 10 of 11 patients with transient monocular blindness had stenoses >30%, significantly more than patients with anterior ischemic optic neuropathy (p<0.0001) and asymptomatic patients (p<0.0001).Conclusions: Anterior ischemic optic neuropathy is not a marker for atherosclerotic carotid artery stenosis. The pathogenesis of nonarteritic anterior ischemic optic neuropathy does not involve carotid artery stenosis in most patients.

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References

Plasminogen deficiency is a rare disorder complicated by the subsequent formation of firm "woody" plaques in the eye (ligneous conjunctivitis) or other mucosal sites as the result of inflammation or trauma. The plaques are composed of fibrinogen, granulation tissue, and inflammatory cells. The findings may be considered nonspecific by the unsuspecting surgical pathologist and delay the appropriate diagnosis. We report the first case of lymph node involvement with characteristic eosinophilic hyaline deposits that are periodic acid Schiff positive, stain dark red with Masson trichrome, and contain fibrinogen as detected by immunofluorescence and describe the longitudinal evolution of this patient's disease over a 15-year period. The differential diagnosis of amorphous hyaline material in lymph node biopsies is discussed.

Higher ABSM were associated with the increased frequency of uveal melanoma diagnosis in the regions studied. Extrapolating from similar trends observed with non-ocular cancers, this may signify a need for increased access to ophthalmologic care to ensure timely diagnosis.

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The purpose of this study is to investigate the applicability of the current surgical guideline, known as '24-12-6' surgical guideline, in the Hispanic and European populations. This guideline is used during numerous orbital surgeries and states that the distance between the anterior lacrimal crest (ALC) to the anterior ethmoidal foramen (AEF) (24 mm), the AEF to the posterior ethmoidal foramen (PEF) (12 mm), and the PEF to the optic canal (OC) (6 mm) follows a Rule of Halves. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data has been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 79 orbits (52 cadavers) donated to the Human Anatomy Program at UT Health San Antonio. The ALC, AEF, posterior ethmoidal foramen, and OC were identified; the orbit was enucleated and all remaining soft tissue removed. The distance between each landmark was recorded using a digital caliper. For all cadavers studied, the distances between the ALC, AEF, posterior ethmoidal foramen, and OC were 24.76 mm, 13.89 mm, and 7.61 mm, respectively. Thus, the '24-12-6' surgical guideline was not applicable to the sample studied. Based on ethnicity data, these relationships were also not true for the European or the Hispanic populations. Therefore, significant anatomical variations exist in the current surgical guideline. Clinicians may need to adjust their methodology during surgical procedures in order to optimize patient care.