Fluoroangiographic Picture of the Acute Stage of the Retinal Lesion in Subacute Sclerosing Panencephalitis

Kovàcs, Bálint; O, Vastag

doi:10.1159/000308778

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…Although reviews of large numbers of childhoodonset SSPE describe early visual disturbances as uncommon (27) or fail to mention visual dysfunction at any stage (l), the ophthalmological literature does emphasize the occurrence of visual symptomatology in 250% of patients (7,(29)(30)(31)(32). A broad spectrum of visual disorders has been described, including "papilledema/papillitis," retinitis, chorioretinitis, and optic nerve pallor (29) as well as homonymous visual field defects and cortical blindness (33).…”

Section: Visual Symptomatologymentioning

confidence: 99%

Adult‐onset subacute sclerosing panencephalitis: Case reports and review of the literature

1997

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Subacute sclerosing panencephalitis (SSPE) is mainly thought of as a disorder of childhood and adolescence and may not be readily recognized when presenting later in life. Prior reports have suggested that adult-onset SSPE may have atypical features. We have added two cases to the existing literature on adult-onset SSPE, compared them with a more classic juvenile presentation, and extensively reviewed those reports that were published after the etiological link with the measles virus had been established. Adult-onset SSPE patients present at a mean age of 25.4 years (range 20-35 years). They have a higher proportion of either negative history of measles exposure or undocumented history by the reporting authors. Those with available history of measles exposure tend to have it either earlier (younger than 3 years old) or later (after 9 years) than the usual childhood measles infection. Where the primary infection is known, unusually long measles-to-SSPE intervals have been documented, ranging from 14 to 22 years. None of the cases followed measles vaccination. Visual symptomatology was very frequent, with 8 of the 13 cases reviewed having a purely ophthalmological presentation; only 2 patients presented with behavioral changes. Although the course of the disease was progressive and fatal in the majority, there appeared to be a higher rate of spontaneous remission as compared with childhood-onset SSPE. Myoclonus, spastic hemiparesis, bradykinesia, and rigidity were the predominant motor manifestations. Neuropathology revealed cortical and subcortical gray matter involvement preferentially of the occipital lobes, thalamus, and putamen. The importance of recognizing the spectrum of potential presentations of SSPE and providing an early diagnosis will increase as more effective treatments become available.

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Section: Visual Symptomatologymentioning

confidence: 99%

Adult‐onset subacute sclerosing panencephalitis: Case reports and review of the literature

1997

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Alteration of the blood-retina barriers in cases of viral retinitis

Kovàcs¹

1985

Int Ophthalmol

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This paper presents three cases of serologically documented viral retinitis, and the great value of fluorescein angiography in outlining the structural abnormalities and the site of the lesions. Of our series in the case of influenza retinitis, the fluoroangiographic findings showed dye leakage from retinal vessels in the posterior pole. The dye leakage did not appear completely in the sites of macular edema. This edema was similar to the clinical appearance of cotton-wool spots and was arranged in a star-like pattern. One of the cases of cytomegalovirus retinitis (Case 3), a previously healthy adult with dysfunction of the cellular immune system, seems to be a further example of an inflammation in the inner retina presenting cotton-wool spots at the early stage. Case 2, a previously healthy adult, fulfilled the criteria for Vogt-Koyanagi-Harada syndrome. The patient had serologically documented cytomegalovirus infection with dysfunction of the cellular immune system. The fluorescein angiographic examination showed alteration both in the inner and outer blood-retina barriers as it is characteristic in cases of Harada syndrome. The cytomegalovirus infection might be assumed to play a role in the clinical picture as well as in the etiology of this disease.

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Subacute sclerosing panencephalitis: fundus changes and histopathologic correlations

Laey

Hanssens

et al. 1983

Doc Ophthalmol

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This paper describes the fundus changes in 2 patients with subacute sclerosing panencephalitis (SSPE). In both cases the ocular involvement preceded the neurological symptoms by several months. In one patient a localized serous detachment in the macular region was associated with retinal infiltrates and in the second patient an atypical unilateral macular chorioretinitis was first diagnosed. The diagnosis of SSPE was suspected when neurological signs appeared and it was confirmed by the typical EEG changes and especially by the high titers of measles antibodies in serum and CSF. The affected left eye of the second patient could be studied histopathologically and presented mainly pigment epithelial changes at the level of the scar, edema of the external plexiform layer, retinal folds and a detachment and rupture of the internal limiting membrane.

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Fluoroangiographic Picture of the Acute Stage of the Retinal Lesion in Subacute Sclerosing Panencephalitis

Cited by 6 publications

References 3 publications

Adult‐onset subacute sclerosing panencephalitis: Case reports and review of the literature

Adult‐onset subacute sclerosing panencephalitis: Case reports and review of the literature

Alteration of the blood-retina barriers in cases of viral retinitis

Subacute sclerosing panencephalitis: fundus changes and histopathologic correlations

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