Anterior ischemic optic neuropathy in a patient with papilledema from idiopathic intracranial hypertension

Jingyi Ma; Jonathan A Micieli

doi:10.1016/j.ajoc.2020.100593

Anterior ischemic optic neuropathy in a patient with papilledema from idiopathic intracranial hypertension

Am J Ophthalmol Case Rep. 2020 Jan 7:17:100593. doi: 10.1016/j.ajoc.2020.100593. eCollection 2020 Mar.

Authors

Jingyi Ma¹, Jonathan A Micieli^{2

3

4

5}

Affiliations

¹ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
² Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
³ Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Kensington Vision and Research Centre, Toronto, Ontario, Canada.
⁵ Department of Ophthalmology, St. Michael's Hospital, Toronto, Ontario, Canada.

Abstract

Patients may lose vision in idiopathic intracranial hypertension from worsening papilledema and optic nerve dysfunction. Acute vision loss may also occur in this context from anterior ischemic optic neuropathy. We report a case of a 29-year-old woman with bilateral moderate papilledema from idiopathic intracranial hypertension who experienced sudden loss of vision in the superior part of the visual field of her right eye. She was found to have a new relative afferent pupillary defect and a stable superior altitudinal defect with optic disc pallor. Papilledema often creates crowding of the optic nerve head and places patients at risk for anterior ischemic optic neuropathy.

Keywords: Idiopathic intracranial hypertension; Ischemic optic neuropathy; Papilledema.