Background: In recent decades, the problem of toxic damage of the visual system due to poisoning by various medicines has become particularly relevant. The clinical case of a bilateral acute optic neuropathy of toxic genesis in a patient by the unintentional application of closantel used in veterinary practice is presented in the report. Closantel is a structural derivative of the salicylanilides, which is used exclusively in veterinary medicine for the prevention and treatment of large and small-scale cattle. Neurological and ophthalmic symptoms are often associated with the intoxication of closantel. Objective: To describe the toxic damage of the optic nerve due to unintentional poisoning by closantel. Methods: A patient aged 55 years is examined. A standard survey of ophthalmology was carried out. Photoregistration of the ocular fundus was used by a funduscamera Visucam 500 (Carl Zeiss Meditec AG, Germany), from special methods of research - the spectral optical coherence tomography (OCT) with a study of the macular area of the retina and the disc of the optic nerve on the device Zeiss Cirrus 5000 (Carl Zeiss Meditec, USA) and the optical coherence tomography with the function of angiography (OCT-A) of the macular area of the retina using RTVue XR Avanti (Optovue, USA) Results: The patient complained of a severe, yet painless, reduction in vision of both eyes after an accidental intramuscular injection of the medicine called "Closantrem" in dose 4.0 ml. The visual acuity OU - an accounting of fingers on the face at a distance of 10 cm. By ophthalmoscopy OU: the disc of the optic nerve is discolourated, its boundaries are indistinct, the arteries and the veins are narrowed, in the macular area of the retina without a visible physical pathology. The perimetry is in the correct projection of the light. A reduction in the thickness of the external and internal layers of the retina was observed as a result of the OCT of the macular zone OU. According to OCT of the disc of the optic nerve: the thickness of the layer of nerve fibres is in the upper and lower nasal segments. OS – the prominence of the disc of the optic nerve in vitreous. The fascinated changes of the cerebral cortex have not been found during the MRT. The diagnosis was made OU: Acute optic neuropathy of toxic genesis. A course of integrated conservative treatment has been introduced: the anti-inflammatory, metabolic, nootropic, vitamin therapy, magnetotherapy, electrostimulation and electrophoresis. Conclusion: Potentially, any medicines are toxic, which may cause a number of side effects from the visual and central nervous system. The toxic damage of the ganglion cells of the retina was initially occurring due to unintentional application of closantel, resulting in a reduction of the central visual acuity, followed by the development of the optic nerve atrophy.
Purpose To develop an algorithm testing of patients with optic nerve atrophy by microperimetry with different types of functional disorders. Methods The study included 40 patients with bilateral atrophy of the optic nerve, age 33.0 ± 1.88 years, with confirmed diagnosis of multiple sclerosis. 11 patients had a history of monocular optic neuritis – the first group (11 eyes), 29 without a history of optic neuritis – the second group (29 eyes). Preliminary, a Humphrey HFA‐75i survey was conducted on a 120‐point testing program. Microperimetry was performed on the MR‐1 (Nidek technologies, Vigonza, Italy). We selected a pattern, fixation target, stimulus, test mode. In some cases it is necessary an individual selection of study parameters. Results The authors developed an algorithm for testing patients with optic nerve atrophy due to multiple sclerosis. The first group (11 patients) – visus 0.1‐0.4 – pattern macula 12° 10 dB, stimulus Goldmann III, fixation target – single cross 4°. In the first group mean sensivity 8.21 ± 2.3 dB, central visual field defects and unstable fixation 91.81 ± 2.72%.The second group (29 patients) – visus 0.5‐1.0 – pattern retina 40° 20 dB, stimulus Goldmann III, fixation target – four crosses 4°. In the second group mean sensivity 15.32 ± 0.84 dB, central and paracentral visual field defects and stable fixation 91.81 ± 2.72%.The results of microperimetry differed depending on the size of visual field defects and visual acuity. Thus, in the group with low visual acuity, there was a lower central sensitivity and more significant defects of the central field of vision compared to the group with a high visual acuity. Conclusions In the “Eye Microsurgery Complex”, Moscow, at the first has been developed an algorithm of microperimetry in patients with MS with different visual acuity and stability of fixation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.