Combined Optic Neuropathy and Myelopathy Secondary to Copper Deficiency

Pineles, Stacy L.; Wilson, Christopher; Balcer, Laura J.; Slater, Robert; Galetta, Steven

doi:10.1016/j.survophthal.2010.02.002

Cited by 61 publications

(36 citation statements)

References 9 publications

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“…Furthermore, copper deficiency in bariatric surgery has mainly been reported in female patients [4,[25][26][27][28] . Buchwald et al reported in a meta-analysis that the percentage of female cases in bariatric surgery was 72.6 [29] .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Nakagawa

Kojima²,

Inokuchi³

et al. 2015

Dig Surg

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Background: Some recent reports have noted that copper deficiency can occur in obese patients who have undergone bariatric surgery, such as Roux-en-Y (RY) gastric bypass or biliopancreatic diversion, or in patients who receive enteral nutrition through a jejunostomy. No reports appear to have assessed the serum copper state of patients following gastrectomy with RY reconstruction for gastric cancer. Methods: A cross-sectional study was conducted from June 2013 to December 2014. Serum copper levels (SCLs) in 242 out-clinic patients who underwent curative gastrectomy were obtained. Patients were classified into an RY group (n = 208) and a non-RY group (n = 34). Results: Hypocupremia was identified in 3 patients in the RY group (1.4%), and 2 patients in the non-RY group (5.9%; p = 0.146), but none experienced any symptoms caused by hypocupremia. No significant difference in the mean SCL was seen between the RY group (105.8 ± 21.2 µg/dl) and non-RY group (107.9 ± 22.7 µg/dl; p = 0.499). In the RY group, the mean SCL was significantly lower in younger patients, patients with follow-up period <3 years, and male patients. Conclusion: Some patients developed hypocupremia after gastrectomy with RY reconstruction, but the number is acceptably low, and physical symptoms were unusual.

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Section: Discussionmentioning

confidence: 99%

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Nakagawa

Kojima²,

Inokuchi³

et al. 2015

Dig Surg

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“…The OCT of toxic optic neuropathy usually demonstrates a bilateral and progressive loss of RNFL. We recently noted that patients with copper deficiency may show retinal nerve fiber loss [90]. Since the human diet requires only a trace amount of copper, it may take decades before the changes are noted.…”

Section: Toxic Optic Neuropathiesmentioning

confidence: 99%

Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

et al. 2011

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Summary: Axonal and neuronal degeneration are important features of multiple sclerosis (MS) and other neurologic disorders that affect the anterior visual pathway. Optical coherence tomography (OCT) is a non-invasive technique that allows imaging of the retinal nerve fiber layer (RNFL), a structure which is principally composed of ganglion cell axons that form the optic nerves, chiasm, and optic tracts. Since retinal axons are nonmyelinated until they penetrate the lamina cribrosa, the RNFL is an ideal structure (no other central nervous system tract has this unique arrangement) for visualizing the processes of neurodegeneration, neuroprotection and, potentially, even neuro-repair. OCT is capable of providing high-resolution reconstructions of retinal anatomy in a rapid and reproducible fashion and permits objective analysis of the RNFL (axons) as well as ganglion cells and other neurons in the macula. In a systematic OCT examination of multiple sclerosis (MS) patients, RNFL thickness and macular volumes are reduced when compared to disease-free controls.Conspicuously, these changes, which signify disorganization of retinal structural architecture, occur over time even in the absence of a history of acute demyelinating optic neuritis. RNFL axonal loss in MS is most severe in those eyes with a corresponding reduction in low-contrast letter acuity (a sensitive vision test involving the perception of gray letters on a white background) and in those patients who exhibit the greatest magnitude of brain atrophy, as measured by validated magnetic resonance imaging techniques. These unique structure-function correlations make the anterior visual pathway an ideal model for investigating the effects of standard and novel therapies that target axonal and neuronal degeneration. We provide an overview of the physics of OCT, its unique properties as a non-invasive imaging technique, and its potential applications toward understanding mechanisms of brain tissue injury in MS, other optic neuropathies, and neurologic disorders.

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“…Copper deficiency can, in rare cases, affect the optic nerve and cause an optic neuropathy [10,11], but the usual presentation is a myelopathy or myeloneuropathy, which main signs and symptoms include subacute gait disorder with prominent sensory ataxia and/or spasticity [12].…”

Section: Nutrientsmentioning

confidence: 99%

“…Vitamin A, copper, and thiamine deficiencies and their ophthalmic complications have already occurred in patients after bariatric surgery [11,13,14]. Symptomatic vitamin E deficiency after gastrectomy for gastric cancer has been reported [9], but reports after bariatric surgery are lacking.…”

Section: Nutrientsmentioning

confidence: 99%

Ophthalmic Complications of Bariatric Surgery

Guerreiro

Ribeiro

2014

OBES SURG

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Obesity is increasing vastly in the world, and the number of bariatric surgeries being performed is also increasing. Patients being submitted to bariatric surgeries, especially malabsorptive procedures, have an increased risk of developing nutrient deficiencies, which can culminate in symptomatic hypovitaminosis, if supplementation is not done correctly. The eye and the optic system need an adequate level of several vitamins and minerals to perform properly, especially vitamin A, and this article wants to cover the main nutrients involved, the possible ophthalmic complications that can arise by their deficiency, and the management of those complications.

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Combined Optic Neuropathy and Myelopathy Secondary to Copper Deficiency

Cited by 61 publications

References 9 publications

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

Ophthalmic Complications of Bariatric Surgery

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