Abstract
A 41-year-old man complained of blurred vision in his left eye. This progressed over the course of 3 months to the point that he was unable to read with his left eye. Color perception was decreased. He felt a pressure-like sensation behind his left eye. Ophthalmologic evaluation revealed ‘‘Drusen’’ in his left eye. On neurologic examination a relative afferent pupillary defect was found on the left. There was no papilledema on either side but venous pulsations were absent on the left. Magnetic resonance imaging of the orbit with fat suppression and gadolinium administration showed linear enhancement along the optic nerve sheath within the optic canal (white arrows). The optic nerve is seen as negative contrast (‘tram track sign’; PF pituitary fossa, IC internal carotid artery, LR lateral rectus muscle).
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