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No Light Perception Vision in Neuro-Ophthalmology Practice.

Anubhav Garg1, Edward Margolin, Jonathan A Micieli

  • 1Faculty of Medicine (AG), University of Toronto, Toronto, Canada ; Department of Ophthalmology and Vision Sciences (EM, JAM), University of Toronto, Toronto, Canada ; Division of Neurology (EM, JAM), Department of Medicine (JAM), University of Toronto, Toronto, Canada; and Kensington Vision and Research Centre, University of Toronto, Toronto, Canada.

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No light perception (NLP) vision in neuro-ophthalmic conditions has diverse causes. Vision recovery is most common in optic neuritis (ON), while serious systemic diseases can present with NLP vision.

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Area of Science:

  • Neuro-ophthalmology
  • Ophthalmology
  • Neurology

Background:

  • No light perception (NLP) vision presents a significant challenge in neuro-ophthalmic practice.
  • Understanding the differential diagnosis and visual outcomes is crucial for patient management.

Purpose of the Study:

  • To determine the differential diagnosis of no light perception (NLP) vision.
  • To evaluate the visual outcomes for patients experiencing NLP vision due to neuro-ophthalmic conditions.

Main Methods:

  • Retrospective case series of patients with NLP vision at tertiary neuro-ophthalmology practices.
  • Data collected included final diagnosis, treatment, and visual outcomes.

Main Results:

  • 65 patients (72 eyes) with NLP vision were analyzed.
  • Compressive optic neuropathy (CON) was the most frequent diagnosis (21 patients), often due to meningioma.
  • Vision recovery occurred in 10 patients, primarily those with optic neuritis (ON); corticosteroids aided recovery in ON patients.

Conclusions:

  • No light perception (NLP) vision can stem from various neuro-ophthalmic diagnoses.
  • Optic neuritis (ON) showed the highest rate of vision recovery.
  • NLP vision may indicate serious underlying systemic conditions, including malignancies, warranting prompt clinical attention.