Objective:Rare disease Background:Optic neuritis is a rare but possible complication of sphenoid sinusitis. Case Report:We present a case of a young woman with recurrent optic neuritis associated with chronic sphenoid sinusitis.A 29-year-old woman with visual impairment of the left eye to Snellen distance best-corrected visual acuity (DBCVA) of 0.5 and migraine headaches accompanied by vomiting and dizziness reported to the ophthalmic emergency room. The preliminary diagnosis was demyelinating optic neuritis. On head computed tomography, a polypoid lesion of the sphenoid sinus was found and qualified for elective endoscopic treatment. During a 4-year follow-up, evaluation of DBCVA, fundus appearance, visual field, ganglion cells layer (GCL), peripapillary retinal nerve fiber layer (RNFL) thickness, and ganglion cells and visual pathway function (pattern electroretinogram -PERG, pattern visual evoked potentials -PVEPs) were performed. Four years after the occurrence of the initial symptoms, surgical drainage of the sphenoid sinus was performed, which revealed a chronic inflammatory infiltrate and a sinus wall defect on the left side around the entrance to the visual canal. After surgery, headaches and other neurological symptoms resolved, but DBCVA deteriorated in the left eye to finger counting/hand motion, partial atrophy of the optic nerve developed, the visual field defect progressed to 20 central degrees, GCL and RNFL atrophy appeared, and deterioration of ganglion cells and visual pathway function were observed. Conclusions:In patients with optic neuritis and atypical headaches, sphenoid sinusitis should be considered in the differential diagnosis. Delayed laryngological intervention can cause irreversible damage to the optic nerve.

The purpose of this publication is to present an extremely rare case of Sjögren’s pigment epithelial reticular dystrophy. So far, 10 such publications have been found in world literature. A 16-year-old boy was diagnosed due to a slight loss of visual acuity, confirmed in static perimetry/24-2/. Abnormal dense clusters of retinal pigment epithelium (RPE) cells forming a reticular network pattern (resembling a fishing net) with marked knots were detected by fundoscopy in the macular area and the mid-periphery of the retina. No abnormalities were found in the anterior segment, intraocular pressure, kinetic perimetry, Ishihara or Farnsworth D-15 tests or OCT. Fluorescein angiography confirmed blocked fluorescence from the choroidal vessels caused by the pigment in RPE. An autofluorescence test showed hypofluorescent foci corresponding to symmetrical and bilateral retinal hyperpigmentation with an RPE reticular pattern. Multifocal ERG (mfERG) revealed slight cone photoreceptor and bipolar bioelectrical dysfunction. Electrooculography (EOG) showed significant asymmetry (Arden Ratio 1.8), suggesting bioelectrical dysfunction of RPE/photoreceptors. Flash ERG (ERG) revealed only slight increase in implicit time of the a and b waves of the rod and cone responses and exclude cone-rod dystrophies. This article highlights the importance of the results of ophthalmoscopy, fluorescein angiography, autofluorescence, mfERG, fERG, EOG and genetic tests for Sjögren’s reticular dystrophy with a pathogenic variant in the region of the C2 gene-c.841_849+19del (dbSNP rs9332736).

Background. Major depression (MD) is the one of the most debilitating diseases, affecting millions of people all around the world.Objectives. To establish visual pathway function in untreated individuals with MD. Materials and methods.In 29 untreated, newly diagnosed, ophthalmologically asymptomatic individuals (58 eyes) with MD (mean age: 47.3 years) and in 29 (58 eyes) of age-, sex-and refractive error-matched healthy controls (mean age: 46.8 years), the following examinations were performed: 1) best corrected distance visual acuity (BCDVA); 2) intraocular pressure (IOP); 3) and 4) biomicroscopy of anterior and posterior segment of eye; 5) macular structure (SD-OCT-Zeiss); and 6) pattern visual evoked potentials (PVEPs) measurements according to the International Society for Clinical Electrophysiology of Vision (ISCEV) standard (ISCEV-standard PVEPs). An analysis of correlation between the parameters of PVEPs and the depression severity (Hamilton Depression Rating Scale (HAMD)) was performed. To estimate the diagnostic power of PVEPs test, a receiver operating characteristics (ROC) curve was used. Data were analyzed with the significance level of p < 0.05.Results. In the study group and in healthy control, the clinical results and macular structure were normal and not different. In the MD group, in PVEPs test (check size: 1°4'and 0°16'), a significant decrease of amplitudes of P100 (AP100), associated with prolonged P100 peak time (PTP100; check size: 0°16' , p < 0.004) were detected. The most frequent abnormality in PVEPs examination in the MD group was AP100 reduction (in 69% of individuals) detected using stimulation check size 0°16' . The statistically significant positive correlation between PTP100 (check size: 0°16') and HAMD score was found in severe MD (p = 0.03). The analysis of ROC curve revealed the highest sensitivity of 0.759 and specificity of 1.0 for AP100 (0°16'). The area under the curve (AUC) was 0.841 (p < 0.001). Conclusions.In individuals with newly diagnosed, ophthalmologically asymptomatic and untreated MD, a dysfunction of visual pathway is present without other signs of ocular pathology. The visual pathway dysfunction measured with ISCEV PVEPs has a potential value to be an objective biomarker of MD.