Abstract
A 62-year-old female complained of vision loss following multiple abdominal surgeries for mesenteric ischemia. The patient’s visual acuity was no light perception (NLP) in the right eye and hand motion (HM) at 1’ in the left eye. Both pupils were unreactive and no relative afferent pupillary defect was noted. Anterior segment and fundus examination were unremarkable. T1 and T2 weighted MRI imaging of the brain was normal but diffusion weighted imaging (DWI) revealed areas of bright signal within both intraorbital optic nerves, confirming the diagnosis of posterior ischemic optic neuropathy.
Highlights
A 62-year-old female complained of vision loss following multiple abdominal surgeries for mesenteric ischemia
posterior ischemic optic neuropathy (PION) lacks optic disc edema, flame hemorrhages, and cotton wool spots that are diagnostic of anterior ischemic optic neuropathy (AION)
The optic nerve looks healthy until optic nerve pallor develops up to 6 - 12 weeks after the initial event [1]
Summary
A 62-year-old female complained of vision loss following multiple abdominal surgeries for mesenteric ischemia. The patient’s visual acuity was no light perception (NLP) in the right eye and hand motion (HM) at 1’ in the left eye. Both pupils were unreactive and no relative afferent pupillary defect was noted. T1 and T2 weighted MRI imaging of the brain was normal but diffusion weighted imaging (DWI) revealed areas of bright signal within both intraorbital optic nerves, confirming the diagnosis of posterior ischemic optic neuropathy.
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