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Review
. 2024 Nov 1;72(11):1544-1559.
doi: 10.4103/IJO.IJO_594_24. Epub 2024 Oct 26.

Recent advances in neuro-ophthalmology

Shikha T Bassi  1 , Nancy J Newman  2 , John J Chen  3   4 , Nanthaya Yui Tisavipat  4 , Susan P Mollan  5   6 , Heather E Moss  7 , Dan Milea  8   9
Affiliations
Review

Recent advances in neuro-ophthalmology

Shikha T Bassi et al. Indian J Ophthalmol. .

Abstract

This review article represents a collaborative effort across continents, bringing together the latest developments in neuro-ophthalmology with a focus on innovative diagnostic and therapeutic modalities that are shaping the future of the field. Among the most significant advancements is the rise of optical coherence tomography (OCT), now recognized as an indispensable tool in neuro-ophthalmological research, providing unparalleled insights into optic nerve and central nervous system pathologies. Gene therapy, particularly for conditions such as Leber's hereditary optic neuropathy, marks a new frontier in personalized medicine, offering hope for previously untreatable conditions. The article also examines the transformative role of telemedicine and artificial intelligence (AI) in clinical practice, which are revolutionizing patient care and enhancing diagnostic precision. Furthermore, it highlights the impact of novel serological biomarkers on the understanding and management of immune-mediated optic neuritis, and discusses the introduction of new therapeutic agents like Tocilizumab and Teprotumumab, which are redefining treatment paradigms. Collectively, these advancements reflect the profound influence of modern medicine on neuro-ophthalmology, paving the way for improved patient outcomes and fostering new avenues for research and clinical practice.

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Conflict of interest statement

Nancy Newman: NJN is a consultant for GenSight Biologics, Santhera/Chiesi, Stoke, Neurophoenix, Neurophth and Avidity; received research support from GenSight Biologics and Santhera/Chiesi; and was a participant in educational webinars sponsored by WebMD Global Medscape and First Class/. John J Chen:JJC is a consultant to UCB and Amgen. Susan Mollan: SPM reports consultancy fees (Invex Therapeutics, Velux foundation), advisory board fees (Invex Therapeutics, Gensight, Ocular therapeutix), and speaker fees (Heidelberg engineering, Chugai Roche Ltd, Allergan, Santen, Teva UK, Chiesi, and Santhera). Dan Milea :DM is an advisory board member of Optomed, Finland.

Figures

Figure 1
Figure 1
Spectral-domain optical coherence tomography image of a patient with chronic papilledema with an intracranial pressure of 360 mmH2O, depicting increased retinal nerve fiber layer thickness (a), decreased ganglion cell complex layer (b), fundus photograph of both the eyes showing chronic papilledema (c and d), and enhanced depth imaging of both the optic discs revealing the inward denting of retinal pigment epithelium/Bruch's membrane (e and f)
Figure 2
Figure 2
Typical fundoscopic and imaging findings of antibody-mediated optic neuropathies: (a) Optic chiasm enhancement (arrowheads) in AQP4 + NMOSD; (b) bilateral optic disc edema and bilateral longitudinally extensive optic nerve enhancement with optic nerve sheath and periorbital fat involvement (arrowheads) in MOGAD; (c) linear radial periventricular enhancement (arrowheads) in GFAP autoimmunity; (d) bilateral optic disc edema and bilateral vitreous cells (arrowhead) and retinal nerve fiber layer swelling (arrows) in CRMP5 optic neuropathy with vitritis. AQP4 + NMOSD = aquaporin-4-IgG–positive neuromyelitis optica spectrum disorder, CRMP5 = collapsin response-mediator protein 5, GFAP = glial fibrillary acidic protein, MOGAD = myelin oligodendrocyte glycoprotein antibody-associated disease
Figure 3
Figure 3
Native fundus photography of a nonarteritic ischemic optic neuropathy (left image) and its heatmap (right image), the latter displaying the regions of high interest (in red) for the deep learning system, when making this diagnosis
See this image and copyright information in PMC

References

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