Optic Neuropathy, Autoimmune Diseases, Cupped Optic Nerve, MRI, Visual Field
History
A 74 year-old man with a chief complaint of difficulty with night time driving for several years as well as difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism, GERD, glottic squamous cell cancer without recurrence, and a prior history of alcoholism. POHx: cataract extraction right eye and AMD. Medications include Multivitamin, Aspirin, Synthroid, Tamsulosin, Omeprazole, Crestor. Drinks wine intermittently and stopped drinking after possible DT's. He owns a bar. His initial exam VA: 20/25 OU, normal IHCP, CFVF: OD constricted, OS normal. Pupils with no APD but were sluggish. IOP's 13 mm Hg OU. Motility showed some slight decreased abduction OU: 5ET primary, 10ET left, 5ET right gazes. SLE: PCIOL OD, NS cataract OS. Optic nerves had 0.7 cups with difficulty in appreciating any pallor. He had a few RPE macular changes OU. The HVF appeared reliable with severe constriction OD>OS (MD -29 and -17 respectively). RNFL OCT showed a mean thickness of 69 and 61 microns respectively. Testing was later done.
Disease/Diagnosis
Idiopathic Hypertrophic Pachymeningitis mimicking Normal Tension Glaucoma Visual Field loss
Date
2015-02
References
None.
Language
eng
Format
video/mp4
Type
Image/MovingImage
Source
47th Annual Frank Walsh Society Meeting
Relation is Part of
NANOS Annual Meeting Frank B. Walsh Sessions; 2015