By Andrew G. Lee, Jacinthe Rouleau, Reid Longmuir
Neuro-ophthalmology, like in any box of drugs, has many components the place controversy exists in analysis and remedy. Controversies in Neuro-Ophthalmology offers a accomplished evaluation at the medical presentation, analysis, and administration of neuro-ophthalmic problems and in particular addresses components the place there's a basic loss of consensus among practitioners.
Each bankruptcy opens with a case to demonstrate a pertinent controversy after which poses a medical query. the problem is then mentioned via global best specialists to supply a balanced perspective. Designed to foster full of life debate between colleagues, this ebook is vital examining for neuro-ophthalmologists, ophthalmologists, and neurologists.
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Additional info for Controversies in Neuro-Ophthalmology
If your surgeon is providing only small amounts of artery, then a bilateral biopsy would be indicated to yield twice as much tissue and much greater confidence in a negative result. Three studies have evaluated the role of bilateral temporal artery biopsies vs. The authors determined how often a negative result occurred on one side and a positive result on the opposite side. These studies found that biopsy of the second side would increase the yield between 1 and 5 % over a unilateral biopsy alone.
Liu et al. (1993) reviewed 45 biopsy-proven cases of GCA with visual symptoms, 41 of which had visual loss. Twenty received only oral prednisone (40 to 100 mg daily). Twenty-three received IV steroids (250 mg four times daily for 3 to 5 days), but only 13 received it as initial treatment while the remaining 12 received their IV therapy a variable time into their oral prednisone treatment. Although not a statistically significant difference, a higher percentage, 39% (9 out of 23) in the IV steroid group had a measured improvement in Snellen visual acuity compared to 28% (5 out of 18) in the oral steroid group.
27) Volpe et al reviewed 88 patients who underwent unilateral TAB and were felt to be at low risk for GCA. (28) Interestingly from an anecdotal viewpoint most GCA malpractice cases do not involve patients with an initial negative biopsy who then develop complications of GCA but involve patients in whom the diagnosis is not made at the onset of symptoms. These series support the notion that the combination of a single negative biopsy of adequate length plus clinical diagnosis does an excellent job in eliminating or reducing false negatives in the diagnosis of GCA.