Rapid, painless unilateral vision loss in a 37-year-old healthy woman.
A 37-year-old woman experienced painless, progressive vision loss to no light perception in the left eye over the course of 3 days. The right eye was unaffected. On examination, the only other abnormal finding was a +4 left afferent pupillary defect. She was initially diagnosed with retrobulbar optic neuritis and admitted for treatment with intravenous methylprednisolone. Neuro-imaging revealed a large right anterior cerebral artery aneurysm that crossed the midline to compress the left optic nerve. The aneurysm was treated with coil embolization, which was technically successful but which did not lead to significant improvement in vision.
Craenen
Geert
G
Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Brown
Sandra M
SM
Freedman
Kenn A
KA
Windisch
Thomas R
TR
Corona
Jorge
J
D000328:Adult; D000792:Angiography; D001766:Blindness / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010146:Pain; D014792:Visual Acuity; D014796:Visual Perception