Hepatic cortical blindness

Xu, Jingjing; Huang, Jie; Gao, Yi Qin; Shang, L.; Lü, Qian; Zhao, Hengfang

doi:10.1016/j.amjms.2022.04.034

Cited by 3 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Changes in retinal blood vessels are expected to lead to various clinical symptoms. Previous studies have identi ed several ocular manifestations in individuals with cirrhosis, including dry eye syndrome (31), night blindness (32), color blindness (33), and hepatic cortical blindness in hepatic encephalopathy (34). Similarly, in this study, we found that the tear lm break-up time and tear meniscus height of patients with liver cirrhosis were signi cantly shorter than those of healthy controls (P < 0.05).…”

Section: Discussionsupporting

confidence: 79%

A novel approach: exploring the potential of retinal thickness and microvascular alterations for diagnosing cirrhosis

Li,

Zou,

Jin

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: The objective of this study was to investigate the correlation between fundus alterations and cirrhosis through the use of optical coherence tomography angiography (OCTA). Methods: This study involved 17 patients with cirrhosis (34 eyes) and 17 healthy controls (HCs; 34 eyes). The OCTA fundus data were segmented into various layers and regions and categorized according to the subzones of the Early Treatment Diabetic Retinopathy Study for comparison. Results: Patients with cirrhosis had a lower full retinal thickness (RT) in the IS, OS, and ON regions than did healthy controls (HCs) (P < 0.001), and the RT was also lower in the IN and central regions (p<0.05). Additionally, the inner layer RT was lower in the IS, OS, IT, and OT regions in patients with cirrhosis (P < 0.05), and the outer layer RT was lower in the IS, IN, and ON regions in patients with cirrhosis than in HCs (P < 0.05). The ROC curve of the inner RT of the IS region showed a greater sensitivity to the pathological changes associated with the disease, with an AUC of 0.9324 (95% CI: 0.8665-0.9983). Furthermore, compared with HCs, patients with cirrhosis exhibited significantly lower superficial vessel density (SVD) in the IS, OS, IT, and OT regions (P < 0.001) and lower SVD density in the ON and central regions (P < 0.05). The AUC for the IT region was 0.9429 (95% CI: 0.8928–0.9930), indicating good diagnostic sensitivity. Conclusion: The RT and SVD of specific subregions in the macular retina of patients with cirrhosis were lower than those in the macular retina of HCs. OCTA measurement could be a valuable aid for imaging in cirrhosis patients.

show abstract

Section: Discussionsupporting

confidence: 79%

A novel approach: exploring the potential of retinal thickness and microvascular alterations for diagnosing cirrhosis

Li,

Zou,

Jin

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In hepatic encephalopathy, metabolic disturbance can lead to CB. Most hepatic CB patients who undergo MRI scanning show no abnormal findings [ 12 ].Although this patient presented high levels of blood ammonium, there were no other symptoms of hepatic encephalopathy. After receiving oral lactulose therapy, his blood ammonia dropped, but the patient's symptoms continued to worsen.…”

Section: Discussionmentioning

confidence: 99%

Acute hearing and visual loss caused by thiamine deficiency

Xu,

Li,

Xue

2023

BMC Neurol

Self Cite

View full text Add to dashboard Cite

Background Wernicke encephalopathy (WE) is a devastating acute or subacute neurological disorder caused by thiamine deficiency. Wernicke encephalopathy is characterized by the triad of ocular signs, cerebellar dysfunction, and confusion. Visual loss and hearing loss are less common findings in WE. Here, we report a case of Wernicke encephalopathy in a nonalcoholic liver cirrhosis patient who presented with acute bilateral deafness and bilateral blindness. Case presentation A 60-year-old Chinese man presented with a history of bilateral blindness and bilateral hypoacousia for 3 days. He had a history of liver cirrhosis and chronic hepatitis C virus infection and did not have a habit of alcohol consumption. Ophthalmologic and otologic examinations showed no obvious abnormalities. MRI findings revealed symmetric fluid-attenuated inversion recovery (FLAIR) hyperintensities in the bilateral medial dorsal thalamus, periventricular region around the third ventricle and tectum, and dorsal medulla oblongata. One day after hospitalization, the patient developed a mild coma. Based on the laboratory and neuroimaging findings, we diagnosed the patient with Wernicke encephalopathy. He soon regained consciousness after administration of thiamine. Both his visual acuity and his hearing function improved gradually. Conclusions We suggest that Wernicke encephalopathy can present with bilateral blindness and bilateral deafness.

show abstract

“…Liver disease could disrupt these processes and then resultant. high plasma ammonia (0.2-1 mM) could obstacle the citric acid cycle and mitochondrial respiratory chain, causing great toxicities to retinal Müller cells (vacuolization, swelling, and even necrosis) as well as to optic nerves [ 135 – 137 ]. The nitrogen metabolism patterns of retina that primarily rely on glutamine synthesis to remove ammonia make it vulnerable to ammonia toxicity [ 133 ].…”

Section: Molecular Pathways and Pathophysiological Regulationmentioning

confidence: 99%

Insights into the liver-eyes connections, from epidemiological, mechanical studies to clinical translation

Wu,

Duan,

Yang

et al. 2023

J Transl Med

View full text Add to dashboard Cite

Maintenance of internal homeostasis is a sophisticated process, during which almost all organs get involved. Liver plays a central role in metabolism and involves in endocrine, immunity, detoxification and storage, and therefore it communicates with distant organs through such mechanisms to regulate pathophysiological processes. Dysfunctional liver is often accompanied by pathological phenotypes of distant organs, including the eyes. Many reviews have focused on crosstalk between the liver and gut, the liver and brain, the liver and heart, the liver and kidney, but with no attention paid to the liver and eyes. In this review, we summarized intimate connections between the liver and the eyes from three aspects. Epidemiologically, we suggest liver-related, potential, protective and risk factors for typical eye disease as well as eye indicators connected with liver status. For molecular mechanism aspect, we elaborate their inter-organ crosstalk from metabolism (glucose, lipid, proteins, vitamin, and mineral), detoxification (ammonia and bilirubin), and immunity (complement and inflammation regulation) aspect. In clinical application part, we emphasize the latest advances in utilizing the liver-eye axis in disease diagnosis and therapy, involving artificial intelligence-deep learning-based novel diagnostic tools for detecting liver disease and adeno-associated viral vector-based gene therapy method for curing blinding eye disease. We aim to focus on and provide novel insights into liver and eyes communications and help resolve existed clinically significant issues.

show abstract

Hepatic cortical blindness

Cited by 3 publications

References 19 publications

A novel approach: exploring the potential of retinal thickness and microvascular alterations for diagnosing cirrhosis

A novel approach: exploring the potential of retinal thickness and microvascular alterations for diagnosing cirrhosis

Acute hearing and visual loss caused by thiamine deficiency

Insights into the liver-eyes connections, from epidemiological, mechanical studies to clinical translation

Contact Info

Product

Resources

About