Myelinated retinal nerve fibers of the optic nerve mimicking elevated ICP on MRI

Pseudotumor cerebri produces a constellation of MR imaging signs that can assist in establishing the diagnosis of elevated intracranial pressure (ICP). The presence of flattening of the posterior sclera is one of several subtle signs of elevated ICP on cranial MRI. Myelinated retinal nerve fibers usually appear continuous with the optic nerve head and in most patients is clinically asymptomatic. We present a case of a man with myelinated retinal nerve fibers OU whose MRI showed flattening of the posterior sclera mimicking a subtle MRI sign of elevated ICP.