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NEURO-OPHTHALMOLOGY |
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Raynaud’s
Disease and Ischemic Optic Neuropathy |
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Larry
P. Frohman, MD |
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Non-arteritic ischemic optic neuropathy (NAION), the most
common condition affecting the optic nerve in adults older than 40 years,
is often a bilateral blinding condition. Although it is seen in patients
with known vascular risk factors (diabetes, hypertension), its cause
it not known, nor is there a therapy. The best we can do for patients
is to offer them aspirin, which reduces the risk to the second eye.
It has recently been shown that Raynaud’s disease (RD), the most
common of the group of diseases known as collagen vascular diseases,
is associated with a reduction in blood flow to the brain, particularly
after exposure to cold. Dr. Frohman is studying the incidence of RD
in patients with NAION and determining whether cold alters blood flow
in the area of the retina around the optic nerve. |
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Neuroophthalmic Sarcoidosis |
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Larry
P. Frohman, MD |
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Several studies related to this disorder are ongoing,
including a review of the clinical features and laboratory assessment
of sarcoid optic neuropathy; a study of whether the location of the
optic nerve lesion on MRI scan predicts the visual outcome of sarcoid
optic neuropathy; and a study as to whether lacrimal gland enlargement
on MRI scan is a diagnostic sign of sarcoid optic neuropathy. |
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Clinical Features
of Autoimmune-Related Retinopathy and Optic Neuropathy (ARRON) Syndrome |
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Larry
P. Frohman, MD |
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The goal of this research, performed in conjunction with
the University of California at Davis, is to study paraneoplastic or
autoimmune retinal or optic nerve degenerations. Specifically, the goal
is to describe the clinical features for this group of disorders, conduct
laboratory investigation, and determine potential therapies.These conditions
cause visual loss because antibodies attack the retina or the optic
nerve (or both). Paraneoplastic disease is probably a remote effect
of cancer and occurs whjen the immune system attacks the normal visual
tissue instead of the cancer. Although cancer is not associated with
the autoimmune form of this disease, it is believed that the immune
system is “tricked” into attacking the body’s own normal
visual tissue. We propose to define the clinical manifestations of these
diseases and the appropriate lab tests to identify them, with the ultimate
goal of detecting these disorders before irreversible visual damage
occurs. This is a retrospective review of the records of previously
identified patients with this condition from the neuro-ophthalmology
service of NJMS. |
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Pseudotumor Cerebri
in Pregnancy |
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Larry
P. Frohman, MD |
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In conjunction with researchers at SUNY - Syracuse, this
project will monitor the outcomes of pseudotumor cerebri in pregnancy,
specifically, to determine whether patients require therapy or whether
this is a self-limited disorder. |
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Traumatic Optic Neuropathy |
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Larry
P. Frohman, MD |
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Dr. Frohman is conducting 2 studies in this research area:
(1) evaluation and outcome of patients diagnosed with traumatic optic
neuropathy during a coma, and (2) examination of outcome data from all
cases diagnosed with this disorder. |
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Relationship of Myasthenia
Gravis to Graves Ophthalmopathy |
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Larry
P. Frohman, MD |
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This study at whether the incidence of developing
general myasthenia is different in patients with ocular myasthenia with
concomitant Graves disease as compared to those without Graves disease. |
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Visual Loss in Rosenberg-Chutorian
Syndrome |
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Larry
P. Frohman, MD |
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This study seeks to verify whether visual loss due to
this neurologic condition is associated with the optic nerve—which
is part of the classical teaching—rather than the retina. |
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ProVision: Development
of Patient Simulation Teaching Strategies for Lifelong Education for
the Ophthalmologist |
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Larry
P. Frohman, MD |
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Dr. Frohman chairs the subcommittee that develops remote
assessment/reinstruction tools for the American Academy of Ophthalmology
(AAO). The development of these teaching strategies and internet-based
programs for patient simulations is linked to the new development of
core curriculum by the American Boards of Ophthalmology and the AAO.
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Treatment of Optic
Neuritis With Megadose Oral Steroids Versus Intravenous Steroids: MRI
Response |
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Larry
P. Frohman, MD |
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Dr. Frohman, in conjunction with Drs. Cook and Wolansky,
is studying optic neuritis (as well as 2 other common first symptoms
of multiple sclerosis). Patients will be randomly assigned to 2 treatment
groups: one will receive traditional doses of intravenous steroids and
the other will receive a high-dose of oral steroids. MRI results will
be compared to determine if there is a difference in radiologic improvement
of acute lesions between these 2 groups. |
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Radiation Treatment
for Optic Nerve Sheath Meningioma |
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Roger E. Turbin,
MD |
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Optic nerve sheath meningioma, a neoplastic tumor of the
optic nerve sheath, affects people of all ages, although it is most
common in middle-aged women. The tumor causes visual loss by compression
of optic nerve, as well as mass effect and compression of other important
local structures. Treatment is controversial, and no consensus exists
among the experts treating this condition. Dr. Turbin is analyzing long-term
visual outcomes of patients treated with various modalities, including
observation only, surgery, and radiotherapy. Outcomes of the study should
help to establish radiotherapy as “standard of care.” |
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Leber’s Optic
Hereditary Optic Neuropathy |
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Roger E. Turbin,
MD |
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Dr. Turbin has secured NJMS as a clinical research site
for a 3-year open-label, multi-institutional study, funded by Allergan
Pharmaceuticals. The study enrolls patients who have Leber’s hereditary
optic neuropathy, which is the phenotypic expression of a hereditary
mitochondrial DNA mutation. The study prospectively assesses the ability
of the test drug to change the course of this blinding disease, which
typically causes irreversible blindness in young healthy men during
the prime of their life. |
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