top of page
Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
.png)
Neuro-Ophthalmology
Case 11
Patient Presentation: A 15-year-old asymptomatic male presented to clinic for abnormal visual fields (shown below). His visual acuity was 20/20 OU with IOP within normal limits.
Question: What visual field defects are present?
Question: OCT RNFL and Ganglion Cell Inner Plexiform Layer (GCIPL) Analysis were performed and shown above. What is the most significant finding?
Question: Fundus photography was performed and is shown above. What is the patient's most likely diagnosis?
Question: What maternal medical condition/finding is thought to be associated with optic nerve hypoplasia?
Question: What issues are patients with optic nerve hypoplasia at risk of developing?
References:
1. Birkebæk NH, Patel L, Wright NB, Grigg JR, Sinha S, Hall CM, Price CA, Lloyd IC, Clayton PE. Endocrine Status in Patients with Optic Nerve Hypoplasia: Relationship to Midline Central Nervous System Abnormalities and Appearance of the Hypothalamic-Pituitary Axis on Magnetic Resonance Imaging. J Clin Endocrinol Metab. 2003;99(11):5281-6.
2. Mohney BG, Young RC, Diehl N. Incidence and Associated Endocrine and Neurologic Abnormalities of Optic Nerve Hypoplasia. JAMA Ophthalmol. 2013;131(7):898–902.
Learning Objectives:
1. To recognize and diagnose optic nerve hypoplasia on OCT
2. To recognize the conditions commonly associated with optic nerve hypoplasia
bottom of page