Controversies in Neuro-Ophthalmology

Andrew G Lee, Jacinthe Rouleau, Reid Longmuir

• 1. Should a patient with unexplained isolated optic atrophy have neuroimaging and further laboratory evaluation?2. Should a young patient with a new diagnosis of optic neuritis have testing and treatment for multiple sclerosis (MS)?3. Should a patient with optic disc edema with macular star figure (neuroretinitis) have lab testing and treatment?4. Should a vasculoplastic patient with non arteritic anterior ischemic optic neuropathy have any testing?5. What is the treatment for giant cell arteritis?6. Should I do a bilateral or unilateral temporal artery biopsy in suspected giant cell arteritis?7. Should I treat traumatic optic neuropathy?8. Should I do a MRI or MR venogram in every patient with pseudotumor cerebri?9. Should we perform carotid Doppler and cardiac echo on young patients with transient visual loss?10. What is the best visual field test for neuro-ophthalmology?11. Does visual rehabilitation therapy (e.g. Novavision) help patients with homonymous hemianopsia12. Should a patient with a pupil involved third nerve palsy have an angiogram is the MRA or CTA are negative?13. Do erectile dysfunction agents cause anterior ischemic optic neuropathy?14. Does amiodarone produce an optic neuropathy?15. Should I start my patient with myasthenia gravis on steroids to reduce the chance of generalized myasthenia gravis?16. Does radiation therapy work for thyroid ophthalmopathy?17. Should I do topical pharmacologic testing in the Horner syndrome?18. Should a patient with giant cell arteritis have a fluorescein angiogram?19. Does pseudotumor cerebri without papilledema exist?20. Does a patient with an isolated vasculopathic ocular motor cranial nerve palsy need a neuroimaging study?