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Flashes of light or phosphenes are the sensation of light without light actually entering the eye. This phenomenon can be evoked by stimulation of the retina or the visual cortex of the brain and can appear unilaterally or bilaterally. From an ophthalmologic perspective, phosphenes can arise from photoreceptor induction by mechanical,1,2 inflammatory,3 or vascular4 stimuli. Therefore, it is necessary to determine the origin of phosphenes for further management. We encountered a patient who reported having phosphenes while moving his eyes laterally. We performed various ophthalmologic imaging studies to identify the origin of these phosphenes.
Acknowledgments
Acknowledgment: The authors thank Florence Umuhoza, Lise Scandella, and Sarah Exbrayat for technical assistance and the patients for participation in the study.
Footnotes
Coinvestigators are listed at Neurology.org.
Supplemental data at Neurology.org
Author contributions: B.P.: data collection, performed the experiments, data analysis and interpretation, wrote the manuscript. N.S., T.S.-H., M.C., C.L.-F., H.W.: data interpretation, revised the manuscript. F.B.: data collection, performed the experiments. D.B., D.A.-P., O.O., J.-C. Ongagna, J.d.S., B.B., J.-C. Ouallet, M.D., S.P., G.D., N.D., P.H., A.T., P.L., G.C., E.B., J.P., A.R., H.Z., D.L., S.W., W.C., E.T., O.C., T.M., A.F., S.V., C.P., P.V., C.L.-F.: sample and data collection, revised the manuscript. D.B.: study design, data analysis and interpretation, wrote the manuscript.
Study funding: This study received funding from the French Ministry of Health (PHRC 2008-005906-38), ARSEP (French MS Society grants 2009 and 2011), and the EU (BEST-MS, FP7, 305477-2012). B.P. was funded by an ARSEP grant (2016).
Disclosure: B. Pignolet reports no disclosures relevant to the manuscript. N. Schwab received travel funding from Biogen, speaker honoraria from Novartis, and holds a patent for usage of L-selectin as a predictive marker for PML. T. Schneider-Hohendorf received travel funding from Biogen and holds a patent for usage of L-selectin as a predictive marker for the risk to develop PML. F. Bucciarelli, D. Biotti, and D. Averseng-Peaureaux report no disclosures relevant to the manuscript. O. Outtteryck reports personal fees and nonfinancial support from Teva Pharmaceuticals; grants, personal fees, and nonfinancial support from Biogen; grants and nonfinancial support from Novartis; nonfinancial support from Bayer-Pharma; personal fees and nonfinancial support from Genzyme; and nonfinancial support from Merck-Serono, outside the submitted work. J.-C. Ongagna, J. de Seze, B. Brochet, J.-C. Ouallet, M. Debouverie, and S. Pittion report no disclosures relevant to the manuscript. G. Defer reports personal fees from Biogen Idec, Novartis, Sanofi Aventis, Genzyme, and Teva Pharmaceutical Industries Ltd.; other from Merck Serono, Biogen Idec, Guerbet, Sanofi-Aventis, Novartis, Genzyme, and Teva Pharmaceutical Industries Ltd.; and grants from Novartis, Merck Serono, and Teva, outside the submitted work. N. Derache reports personal fees from Biogen-Idec, Genzyme, Novartis, Teva, and Merck-Serono, outside the submitted work. P. Hautecoeur reports no disclosures relevant to the manuscript. A. Tourbah has received in the last year, consulting and lecturing fees, travel grants and research support from Medday, Biogen Idec, Sanofi-Genzyme, Novartis, Merck Serono, Teva Pharma, and Roche. P. Labauge, P. Clavelou, and E. Berger report personal fees from Biogen Idec, personal fees from Genzyme-Sanofi, personal fees from Teva, and personal fees from Novartis, outside the submitted work. J. Pelletier and A. Rico report no disclosures relevant to the manuscript. H. Zéphir reports grants from ARSEP; personal fees and nonfinancial support from Biogen Idec; personal fees and nonfinancial support from Bayer; personal fees and nonfinancial support from Genzyme-Sanofi; grants, personal fees, and nonfinancial support from Teva; personal fees and nonfinancial support from Novartis; and nonfinancial support from Merck, outside the submitted work. D. Laplaud reports personal fees from Biogen, personal fees from Teva Pharma, grants and personal fees from Novartis Pharma, grants and personal fees from Genzyme, and personal fees from Merck-Serono, outside the submitted work. S. Wiertlewski reports personal fees from Novartis, personal fees from Genzyme, personal fees from Biogen Idec, and personal fees from Teva, outside the submitted work. W. Camu and E. Thouvenot report no disclosures relevant to the manuscript. O. Casez reports grants, personal fees, and nonfinancial support from Biogen; grants, personal fees, and nonfinancial support from Novartis; grants, personal fees, and nonfinancial support from Genzyme; grants from Merck; grants and personal fees from Teva; and grants from Bayer Schering, outside the submitted work. T. Moreau reports personal fees and nonfinancial support from Biogen, personal fees and nonfinancial support from Novartis, personal fees and nonfinancial support from Sanofi Genzyme, personal fees and nonfinancial support from Bayer, personal fees and nonfinancial support from Merck, personal fees and nonfinancial support from Teva, personal fees and nonfinancial support from Almirall, and personal fees and nonfinancial support from Roche, outside the submitted work. A. Fromont, S. Vukusic, and C. Papeix report no disclosures relevant to the manuscript. P. Vermersch reports grants, personal fees, and nonfinancial support from Biogen; grants, personal fees, and nonfinancial support from Bayer; personal fees and nonfinancial support from Novartis; grants, personal fees, and nonfinancial support from Genzyme-Sanofi; personal fees and nonfinancial support from Almirall; and personal fees and nonfinancial support from Teva, outside the submitted work. M. Comabella reports personal fees from Bayer Schering Pharma, personal fees from Merck Serono, personal fees from Biogen-Idec, personal fees from Teva Pharmaceuticals, personal fees from Sanofi-Aventis, personal fees from Genzyme, and personal fees from Novartis, outside the submitted work. C. Lebrun-Frenay reports no disclosures relevant to the manuscript. H. Wiendl is on the scientific advisory board for Bayer Healthcare, Biogen Idec, Sanofi-Genzyme, Merck Serono, Novartis, Roche, and Teva; received travel funding and/or speaker honoraria from Bayer Vital GmbH, Bayer Schering AG, Biogen, CSL Behring, EMD Serono, Fresenius Medical Care, Sanofi-Genzyme, Merck Serono, OmniaMed, Novartis, and Teva; is on the editorial board for Journal of Clinical Practice, Journal of Neuroinflammation, and PLoS One; has consulted for Biogen Idec, Merck Serono, Novartis, OmniaMed, Roche, and Sanofi-Genzyme; and received research support from Bayer Healthcare, Bayer Vital, Biogen Idec, Merck Serono, Novartis, Sanofi-Genzyme, Sanofi US, and Teva Pharma. D. Brassat reports personal fees from Bayer Schering Pharma, Biogen Idec, EMD Merck Serono, Genzyme, Novartis, Sanofi-Aventis, and Teva Pharmaceuticals. Go to Neurology.org for full disclosures
- Received April 12, 2016.
- Accepted in final form September 6, 2016.
- © 2016 American Academy of Neurology
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