Arnold-chiari syndrome in ophthalmology (clinical cases)

Abstract

Arnold-Chiari syndrome is a pathology manifested by displacement of the cerebellum and cerebrum through the foramen of the spinal canal, inherited from the inconsistency of the dimensions of the posterior cranial fossa and placement brain structures. Purpose – to evaluate the results of a comprehensive approach to the differential diagnosis of Arnold-Chiari malformation in ophthalmology using two patients as an example. Materials and methods 2 patients (4 eyes) were examined for Arnold-Chiari malformation by generally accepted methods, and optical coherence tomography (OCT). Results There is no pathognomonic symptom or group of symptoms that allow for the clinical diagnosis of Arnold Chiari syndrome, and only neuroimaging diagnostics are possible. Whenever there is inflammation, congestive disc, or optic nerve atrophy, the first action of the ophthalmologist is to refer the patient for magnetic resonance imaging (MRI) or computed tomography (CT) imaging. Identification of relevant ophthalmological disorders at an early stage allows for timely suspicion and detection of this anomaly. Neuroimaging diagnostics justifies the doctor's alertness to this pathology. Conclusion Current diagnostic and treatment advances bring together specialists from various fields – ophthalmologists, radiologists, and neurologists – and present new challenges for physicians. The presented series of clinical cases demonstrated possible manifestations of Arnold-Chiari syndrome, including strabismus and congestion in the optic nerve, which was confirmed by MRI.