These are the notes from Dr. Liu. I've tried to supply hyperlinks for all of the terms used.
Visit with Dr. Liu on January 13, 2005
I saw Max Kimpland for neuro-ophthalmic follow-up regarding his optic pathway glioma in the setting of neurofibromatosis.
I reviewed the MRI from 1/11/05. The optic nerve gliomas were stable, but there was increased prominence of the pontine glioma on the left. A hypothalamic glioma was unchanged.
He is on Carboplatin, Vincristine, Zofran, Glycolax, Bactrim and Fluconazole. His father feels his vision function is about the same.
Using Snellen lines he saw 20/70 with the right eye and 20/400, difficulty with the left. He saw 4/8 color plates but 1.5/8 with the left. He had constriction of the visual field with the left eye. He had a trace afferent pupillary defect on the left versus no APD. This was difficult because the lack of cooperation. Penlight examination of the anterior segment is unremarkable. Ocular ductions are full. On the undilated funduscopic examination he has pale optic nerves bilaterally. Facial sensation and strength were normal.
His visual acuity on the left is a little bit worse than it was on December 2nd, but his examination is comparable to the way it looked on 7/29/04. Perhaps this represents variation in a child who is not fully cooperative. it is hard to say whether there is definite worsening or not. I suspect the best thing to do again is to repeat the examination in six weeks.