Biosimilars

COVID-19

Cataract Surgery

Cataract

Cataract Therapeutics

NeuroOp Guru

Clinical Diagnosis

Cornea

Dry Eye Awareness

Dry Eye

Gene Therapy

Geographic Atrophy

IOL Advances

Imaging

Glaucoma Awareness

Glaucoma Insights

Therapeutic Glaucoma

Interventional Glaucoma

Ocular Allergy

Ocular Surface Disease

Optic Relief

Optometry

Pediatrics

Pharmacy

Indispensable

Practice Management

Presbyopia

Ptosis

Refractive Surgery

Refractive

Retina

Surgery

Technology

Therapeutics

Understanding Antibiotic Resistance

Workplace

News

All News

Contributors

Money Matters

Media

All Videos

Expert Interviews

Medical World News

Podcasts

Case Based Roundtable Series

Case of the Quarter

EyeView

Grand Rounds

Insights

Rapid Readout

Viewpoints

What’s Your WhEYE?

Conferences

Conference Coverage

Conference Listing

Events

Publications

Digital Edition

Europe Ophthalmology Times

Modern Retina

Supplements and Featured Publications

Partners

Subscribe

Resources

Job Board

Articles

The award honors Ludwig von Sallmann, MD, a “distinguished international ophthalmologist and ophthalmic investigator whose contributions greatly increased the basic and clinical understanding of vision and ophthalmology.”

ARVO announces Swathi Kaliki, MD, as recipient of 2025 Ludwig von Sallmann Clinician-Scientist Award

24-week topline data from the phase 2b ASPIRE study in diabetic macular edema (DME) are expected to be released in Q1 of 2025.

Unity Biotechnology announces upcoming trial data and new board of directors member

A survey conducted by the Preservative Freedom Coalition, asked 558 patients with glaucoma or ocular hypertension how they felt about their treatments, the future of their eye health, trust in their doctors and more. 

Survey reveals gaps in patient awareness of preservative-free glaucoma treatments

Cationic emulsion drops are characterized by their ability to retain cyclosporine A on the ocular surface.

Cyclosporine A eye drops ease ocular discomfort after cataract surgery

Ophthalmology Times - ophthalmology news, articles, and events in a timely and accurate manner for members of the ophthalmic community.

About

Advertise

Privacy

Editorial Info

Editorial Board

Terms and Conditions

Contact Us

Do Not Sell My Personal Information

Ophthalmology Times - Ophthalmology news, articles, and events

Facebook

Instagram

LinkedIn

Spotlight

Clinical

Glaucoma

1rem

is a peer-to-peer discussion series that offers insight into recent clinical study data in digestible episodes, hosted by Andrew G. Lee, MD, the chair of the Blanton Eye Institute at Houston Methodist Hospital and a professor of ophthalmology, neurology, and neurosurgery at the Weill Cornell Medical College.

NeuroOp Guru: The role of muscle biopsy in heteroplasmy detection

This latest episode of the “NeuroOp Guru”—hosted by Andrew G. Lee, MD, from Houston Methodist, and joined by Drew Carey, MD, from Johns Hopkins University—features a retrospective study

 on somatic mitochondrial mutations and their variable neuro-ophthalmic manifestations. 

Mitochondrial diseases are typically inherited maternally, but mutations can also arise post-fertilization and affect specific tissues. These somatic mutations may present with mild symptoms like muscle manifestations or isolated optic neuropathy, without the full spectrum of mitochondrial disease features (eg, seizures or cardiac issues). 

Traditionally, high heteroplasmy (a higher percentage of affected mitochondria) was thought to be necessary for symptoms to manifest, but this study challenges that view. 

Even low heteroplasmy (less than 5%) may cause disease, particularly in tissues like the optic nerve or extraocular muscles, which might show higher heteroplasmy despite muscle biopsies showing low levels. The take-home message is that mitochondrial disease can present variably, and muscle biopsy should be considered if genetic testing is inconclusive, especially when muscle-based symptoms are predominant.

Carey AR, Miller NR, Cui H, et al. Myopathy and ophthalmologic abnormalities in association with multiple skeletal muscle mitochondrial DNA deletions. 

. 2024;44(2):247-252. doi:10.1097/WNO.0000000000001984

Videos

Andrew G. Lee, MD, and Drew Carey, MD, return for this latest episode of the "NeuroOp Guru" to discuss the variable presentations of somatic mitochondrial mutations and the importance of muscle biopsy in diagnosing low heteroplasmy in mitochondrial diseases.

(VLOG) NeuroOp Guru: Can a dead nerve swell?

This latest episode of the NeuroOp Guru—hosted by Andrew G. Lee, MD, from Houston Methodist, and joined by Drew Carey, MD, from Johns Hopkins University—explores whether atrophic optic nerves can exhibit swelling or thickening in patients with recurrent papilledema. Carey explains that papilledema can be due to various conditions, including idiopathic intracranial hypertension, hydrocephalus, or brain tumors, and that recurrent headaches may indicate increased pressure. A retrospective study

 of 165 patients with papilledema found that 63% experienced at least one relapse, with 50% showing recurrent papilledema. OCT scans were crucial in detecting these relapses, even in atrophic nerves, suggesting that OCT remains a valuable tool in monitoring neurological conditions. Carey stresses the importance of OCT in detecting intracranial pressure changes in atrophic nerves, contrasting it with glaucoma management. The episode concludes with a proposed revised adage: “A dead nerve can't swell, but it can thicken.”

Xie JS, Donaldson L, Margolin EA. Swelling of atrophic optic discs in idiopathic intracranial hypertension. 

. 2024;44(2):212-218. doi:10.1097/WNO.0000000000001932

Andrew G. Lee, MD, and Drew Carey, MD, return for this latest episode of the NeuroOp Guru to discuss whether a dead nerve can swell, focusing on the condition of papilledema caused by elevated intracranial pressure.

NeuroOp Guru: Can a dead nerve swell?