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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:
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Neuro-Ophthalmology
Case 13
Patient Presentation: A 38-year-old female was referred to an ophthalmologist after her optometrist detected an abnormality in one of her optic discs on fundoscopy. Her visual acuity on presentation is 20/20 OU with no RAPD. Humphrey’s visual fields were performed below.
An OCT Enhanced Depth Imaging 5-line raster of both optic nerves was performed and is shown below.
Question: What abnormality does the patient likely have?
The optic nerve photos on fundoscopy are shown above highlighting the optic disc edema and peri-papillary wrinkles (green arrows).
Question: The OCT of the RNFL and macular GCIPL are shown above. Which of the following is seen?
Question: The OCT macula 5-line raster is shown above. What abnormality is seen?
Question: Considering that the patient has normal visual function, mild left optic disc edema and irregular contour of the globe, what is the most likely diagnosis?
Learning Objectives:
1. To recognize the manifestations of cavernous hemangioma on OCT
2. Identify neuroimaging features that suggest cavernous hemangioma
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