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Neurofibromatosis type 1 - Ophthalmologic Exam is recommended

5-year-old boy was diagnosed with neurofibromatosis type 1 (NF1) eight months after birth. He has displayed café-au-lait spots, axillary freckling, macrocephaly, sphenoid dysplasia, brain hamartomas, right temporal arachnoid cyst, and optic glioma. Visual evoked potentials showed evidence of bilateral functional deficit.

NF-1 and optic nerve glioma – additional opinion

5-year-old boy with diagnosis of neurofibromatosis type 1 underwent ophthalmological evaluation that showed reduction in visual acuity and reduction of the bilateral visual field. MRI showed presence of a big expansive lesion and of temporopolar arachnoid cyst. The treating doctors recommended an urgent surgery in order to reduce the cerebral hypertension. In the expert's opinion, after having seen the images, the arachnoid cyst has not changed that much, and probably has little impact or effect, and therefore meanwhile no surgery is warranted.

Child suffering from NF-1 and optic nerve glioma

5-year-old boy with diagnosis of neurofibromatosis type 1 underwent ophthalmological evaluation that showed picture of slight reduction in visual acuity of the right eye and severe hypovision of the left eye with slight reduction of the bilateral visual field. MRI showed presence of a big expansive lesion and of right temporopolar arachnoid cyst. The treating doctors recommended an urgent surgery in order to reduce the cerebral hypertension.

Age Related Macular Degeneration – additional opinion

62-year-old male complained of decreased visual acuity in his right eye for 1 week. His past ocular history was relevant for an episode of central serous choroidopathy. Upon examination there was a large subretinal hemorrhage in the macular area , with a visible choroidal neovascularization. Intravitreal Bevacizumab (Avastin) was injected. One week following treatment, there was still macular bleeding and no improvement in visual acuity. Therefore, a vitrectomy was performed. There was impressive resolution of the subretinal hemorrhage but still some intraretinal fluids.

Degenerative Maculopathy - additional opinion

81-year-old female with age related macular generation in both eyes. In the expert's opinion, she suffers from Non- Neovascular AMD with high risk characteristics to transform to the Neovascular form, and therefore she should have a retinal follow-up every 4 months, and receive the AREDS formulations of vitamins and minerals, that reduce the risk of losing vision from this condition.

Optic Neuropathy

Child with progressive exotropia secondary to the profound vision loss that appears to be to an optic neuropathy. The expert recommends to obtain additional studies in order to exclude potential diagnosis such as glioma, pathological disc edema, optic nerve drusen or dominant optic atrophy OPA-1 gene related.

Demyelinizing Disease

47-year-old female with a diagnosis of Multiple Sclerosis ,who suffers from progressive tetraparesis, more pronounced in the lower extremities. Her treatment included mitoxantrone and Interferon-beta treatment, both were discontinued because of side effects. Her movement difficulties, due to the left lower limb rigidity, are increasing progressively.

Age Related Macular Degeneration and Polypoidal Choroidal Vasculopathy

61-year-old male with a history of Central Serous Chorioretinopathy had a sudden decrease in vision in his right eye. He was seen by an ophthalmologist who found a large hemorrhage in the macula. He then consulted with professor who diagnosed him as having Polypoidal Choroidal Vasculopathy and he had an intravitreal injection of Avastin. Following this, the patient had a Vitrectomy operation. Photographs and Indocyanine angiography show a large subretinal hemorrhage, consistent with Age Related Macular Degeneration, and perhaps Polypoidal Choroidal Vasculopathy.

Degenerative Maculopathy

81-year-old female with age related macular generation in both eyes, most probably of the dry type. In the expert's opinion, she should have a retinal follow-up every 4 months and check her central vision on a daily basis. As for treatment, she should receive the AREDS formulations of vitamins and minerals, because these medications reduce the risk of losing vision.