A 47-year old female with a 4-month history of self-reported shadowy vision and poor depth perception OD. Previous history significant for rheumatoid arthritis, diabetes mellitus and hypothyroidism. Contributory: A 10-year history of smoking and exposure to anti-rheumatic agents.
Pathology
Lymphocytic infiltration of dura from right optic nerve; Inflammation and fibrotic changes of right optic nerve
Disease/Diagnosis
Rheumatoid arthritis-related pachymeningitis
Clinical
VA: 20/100, improving to 20/60 with pinholeand subsequent decline to 20/200 OD, 20/25 OS; Color plates: 2/8 OD, 7/8 OS; RAPD OD
Presenting Symptom
Poor depth perception and vision OD
Neuroimaging
MRI
Treatment
IV steroids; Corticosteroids; Surgery
Date
2006-02-26
References
Attached
Language
eng
Format
video/mp4
Type
Image/MovingImage
Source
32nd Annual North American Neuro-Ophthalmology Society Meeting, 2006 Frank B. Walsh Session
