Arteritic Orbital Ischemia Producing Afferent and Efferent Pupillary Defects

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Title Arteritic Orbital Ischemia Producing Afferent and Efferent Pupillary Defects
Creator Mariam Hussain, BA; Ashwini Kini, MD; Bayan Al Othman, MD; Claudia Prospero Ponce, MD; Helen Li, MD; Andrew G. Lee, MD
Affiliation Texas A&M College of Medicine (MH, AGL), Bryan, Texas; Department of Ophthalmology (AK, BAO, CPP, HL, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Genomic Medicine, Ocular Pathology (CPP), Houston Methodist Hospital, Houston, Texas; Community Retina Group (HL), Houston, Texas; The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa.; and Department of Ophthalmology (JMF), Portland, Oregon; Department of Ophthalmology (SLP), UCLA, Los Angeles, California; and Department of Ophthalmology and Visual Sciences (GPVS), Washington University in St. Louis, St. Louis, Missouri.
Abstract A 67-year-old woman presented with acute loss of vision to no light perception (NLP), a right afferent pupillary defect, and anisocoria with a nonreactive and dilated pupil in the right eye. Fundus examination showed pallid optic disc edema and a central retinal artery occlusion (CRAO) in the right eye. A temporal artery biopsy showed giant cell arteritis (GCA). Orbital involvement in GCA has been reported previously. However the combination of an afferent and efferent pupillary defect, NLP vision, pallid disc edema, and a CRAO in an elderly patient is likely a unique clinical combination that should strongly suggest GCA. Clinicians should be aware of the myriad presentations of GCA, including orbital ischemia.
Subject Aged; Biopsy; Female; Fluorescein Angiography; Fundus Oculi; Giant Cell Arteritis / complications; Giant Cell Arteritis / diagnosis; Humans; Pupil Disorders / diagnosis; Pupil Disorders / etiology; Retinal Artery Occlusion / complications; Retinal Artery Occlusion / diagnosis; Retinal Artery Occlusion / physiopathology; Visual Acuity
OCR Text Show
Date 2020-12
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, December 2020, Volume 40, Issue 4
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6z48pkr
Setname ehsl_novel_jno
ID 1741112
Reference URL https://collections.lib.utah.edu/ark:/87278/s6z48pkr
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