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Gianella - Optic atrophy (Argentina) Updated on January 16, 2014

Author Julia Views Posted at 2014/06/20

Name: Gianella Melani Hermann

Sex: Female

Country: Argentina

Age: 11

Diagnosis: Optic atrophy

Admission Date: September 22, 2012

Days Admitted to Hospital: 28 days

Before Treatment:

When Gianella was 3 years old, her parents found her vision was obviously more reduced than a normal child. So she was sent to a local hospital for treatment. She was diagnosed as short-sighted by the local hospital. The disease progressed gradually. Her binocular vision had decreased by degrees. When she was 5 years old, she went to the Capital Hospital of Argentina. After the optic examination and Hematologic examination, she was diagnosed with optic nerve hypoplasia and as being blind in her left eye. The patient was operated on for retinal detachment and repairing for treatment. But the treatment effect was not effective. Before the treatment, the patient was blind in her left eye and her right vision had obviously declined.

Nervous System Examination:

Gianella was alert and her speech was clear. Her orientation and memory were normal. The diameter of the right pupil was 3.0mms, and the right pupil was sensitive to light stimuli. The uncorrected visual acuity of the right eye's vision was 0.12 from 2 meters distance. And the right vision was 0.15 from 1 meter distance. The right eye's vision when wearing reading glasses was 0.2 from 2 meters distance and 0.3 from 1 meter distance. The peripheral visual field of the right eye was defective. The central visual field was almost normal. The right eye could distinguish each color from 2 meters distance. Under the examination of ophthalmoscope: The eye ground had plenty of black sediment. And the patient had optic atrophy. The left eye was completely blind, with no light sensation. The left pupil was presently milk white. The direct light reflex of the left eye had disappeared. The consensual reflex of the left eye existed. The left eye had a cataract and the fundus couldn't be seen. Both eyes could move flexibly to each side. There was no obvious nystagmus. The forehead wrinkle pattern was symmetrical, the nasolabial sulcus was equal in depth, the teeth were symmetrical and the tongue was centered in the oral cavity. There was flexible movement in the neck. The muscle tone of all four limbs was almost normal; the muscle strength of all four limbs was about level 5. The abdominal reflexes were normal; the tendon reflex of the four limbs was normal. The sucking reflex, palm and jaw reflex were negative. Bilateral Hoffmann sign was negative. The Rossolimo sign of both upper limbs was negative. The pathological reflex of both lower limbs was negative. The deep sensation and superficial sensation were normal. She was unable to cooperate with the coordinated examination.

Treatment:

We gave Gianella a complete examination. Combined with the disease history and clinical manifestation, she was diagnosed with optic atrophy. She received treatment to improve the blood circulation in order to increase the blood supply and nourish the damaged neurons. She also received treatment to boost immunity. This was accompanied with daily physical rehabilitation training.


Post-treatment:

Gianella's right vision is better than before. The uncorrected visual acuity of the right eye's vision is 0.25 from 2 meters distance. And it is 0.3 from 1 meter. With reading glasses, the right eye's vision is 0.3 from 2 meters distance. The right eye's vision is 0.5 from 1 meter distance under good light. And it is 0.4 from 3 meters distance under good light. The visual field of the right eye is enlarged 1 degree. Under ophthalmoscope it shows that the black sediment in the right eye is more less than before. The blood circulation is better than before.

Gianella's father take picture with our doctors:

Name: Gianella Melani Hermann

The second round treatment:

Admission Date: September 23, 2013

Days Admitted to Hospital: 28 days

Before Treatment:

The patient has received significant progress from the treatment in 2012. The vision of right eye had obvious progress. Standard visual acuity chart: With reading glasses, the right eye's vision is 0.5 from 3 meters distance. The right eye's vision is 0.6 from 2 meter distance. And it is 1.2 from 1 meter distance under good light.The uncorrected visual acuity of the right eye's vision is 0.1 from 1 meter distance. The left eye was completely blind. From the onset of disease, the patient has good spirit, the development is normal. The diet and sleep quality are almost normal.

Admission PE:

Bp: 108/65mmHg; Hr: 89/min, Br: 19/min. The skin mucosa was normal. There was flake hyperpigmentation in both lower limbs and ankles. There was no hemorrhaging spots or yellow stains in other skin.

Nervous System Examination:

Gianella was alert and her speech was clear. Her memory, orientation and comprehension were normal. The diameter of the right pupil was 3.0mms, and the right pupil was sensitive to light stimuli. The uncorrected visual acuity of the right eye's vision was 0.10 from 1 meters distance. The right eye's vision with wear reading glasses was 0.5 from 3 meters distance, 0.6 from 2 meter distance, and 1.2 from 1 meter distance. The peripheral visual field of right eye was almost normal. The central visual field was almost normal. The right eye could distinguish each color from 2 meters distance. Under the examination of ophthalmoscope: the color of right eye ground was lighter than normal color. There was a handful of black sediment. The border of papilla nervi optici was not clear. The color of papilla nervi optici was pale. Optic atrophy, the artery of retina was slightly thin than normal. And the optic atrophy. The left eye was completely blind, with no light sensation. The left pupil was presently milk white. The direct reaction of left eye was disappeared. The consensual reflex of left eye existed. The left eye had a cataract and the fundus couldn't be seen. Both eyes could move flexibly to each side. There was no obvious nystagmus. The forehead wrinkle pattern was symmetrical, the nasolabial sulcus was equal in depth, the teeth were symmetrical and the tongue was centered in the oral cavity. There was flexible movement in the neck. The muscle tone of all four limbs was almost normal; the muscle strength of all four limbs was about level 5. The abdominal reflexes were normal; the tendon reflex of the four limbs was normal. The sucking reflex, palm and jaw reflex were negative. Bilateral Hoffmann sign was negative. The Rossolimo sign of both upper limbs was negative. The pathological reflex of both lower limbs was negative. The deep sensation and superficial sensation were normal. The coordinated examination was normal.

Treatment:

Gianella started the second treatment from September 23, 2013. Combined with the disease history and clinical manifestation, she was diagnosed with optic atrophy. She received treatment to improve the blood circulation in order to increase the blood supply and nourish the damaged neurons. She also received treatment to boost immunity. This was accompanied with daily physical rehabilitation training.

Post-treatment:

Gianella's right vision is better than before. The uncorrected visual acuity of the right eye's vision is 1.0 from 1 meter distance, 0.6 from 2 meters distance. And it is 0.4 from 3 meters distance. With reading glasses, the right eye's vision of standard visual acuity chart is 0.6 from 3 meters distance, and 0.8 from 2 meters distance. And it is 1.5 from 1 meter distance. The visual field of right eye is almost normal. She can distinguish each color from a distance place. This is next to normal. Under ophthalmoscope it shows the color of right eye ground is lighter than normal. There is a handful of black sediment in right fundus. The blood vessel was almost normal. The arteriovenous proportion is 2:3. The border of optic disk is clear, the color is pale slightly. There was flake hyperpigmentation in both lower limbs and ankles before admission. After treatment, the hyperpigmentation in her lower limbs and ankles is alleviated obviously. Part skin color has restore to normal color.

 


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Date: 2014-01-15

Subject: dear susan

dear susan, the gianella hermann patient is well, his parents say they have medicines for 10 more days and already completed 3 months and ask if they can and leave the medication? The single patient and going to school by bike and his vision improved a lot, and over the left eye wonder if they can operate in China if they know some medical center that can operate in China.


 

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