With the development of ophthalmic optical coherence tomography (OCT) and OCT angiography (OCTA), including the improving of light source, resolution, scanning depth and upgrade of analysis softwares, they can more accurately display the structure of retinal layers and give accurate quantitative measurement. In neuro-ophthalmic diseases, the OCT indicators (the thickness of retinal nerve fiber layer around optic disc and plexus layer in macular gangle cells) and OCTA indicators (the blood flow density of capillaries around optic disc, superficial and deep capillaries in macular area, and the area of foveal avascualr zone) had special changes. It has important value in the differential diagnosis of central nervous system diseases and retinal diseases with visual dysfunction as the first symptom, the diagnosis and differential diagnosis of neuro-ophthalmic disease, the evaluation of progression of neurodegenerative diseases. Neuro-ophthamologists should pay more attention to the exploration and application of OCT and OCTA in the field of neuro-ophthalmology.
Currently, coronavirus disease 2019 (COVID-19) is still widely prevalent around the world, leading to a major threat to the global public health. COVID-19 mainly involves the respiratory system, but extrapulmonary manifestations including that of the nervous system also exist in the setting of COVID-19. Misdiagnosis and delayed treatment of the disease may easily cause when ocular, especially neuro-ophthalmological symptoms are the first symptoms in early COVID-19, as the neuroophthalmological manifestations are rarely reported. First-line clinicians need to ask about not only respiratory symptoms such as fever, cough and sore throat, but also diplopia, impaired vision, eye motion pain, abnormal gait or other neurological deficits at the first reception, as these extrapulmonary manifestations are often signs of serious infection. The neuroophthalmological manifestations and possible underlying etiology of COVID-19 were summarized in this review, hoping to provide an early identification and effective treatment of COVID-19 for clinicians. More extensive studies are needed in the future to confirm the causal relationship between COVID-19 and neuroophthalmological disease to provide a sufficient basis for a comprehensive understanding of COVID-19.
Idiopathic intracranial hypertension (IIH) is a neurological disorder that causes an unexplained increase in intracranial pressure. Its main clinical manifestations include chronic headache, visual impairment, and typical unilateral or bilateral disk edema found on fundus examination. The diagnosis of IIH depends on the exclusion of other diseases that may cause increased intracranial pressure and further confirmation by systemic and neurological imaging. Current treatment strategies for IIH include lifestyle adjustments for weight loss, pharmacological interventions, and surgery if necessary to reduce intracranial pressure and relieve patient-related symptoms. Maximum protection and restoration of visual function. In the future, it is necessary to further improve the IIH diagnostic process and criteria to guide personalized treatment and prognosis judgment. The effective use of artificial intelligence technology for image segmentation and combined image omics analysis is expected to improve the accuracy of IIH intelligent diagnosis, achieve earlier and more accurate disease detection, and provide patients with a more personalized treatment path.