Clinical features
| Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | Case 6 | Case 7 | Case 8 | Case 9 | Case 10 | |
|---|---|---|---|---|---|---|---|---|---|---|
| AF, atrial fibrillation; ARMD, age related macular degeneration; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; CRAO, central retinal artery occlusion; HTN, hypertension; MRI, magnetic resonance imaging; NA, not available; NAION, non-arteritic ischaemic optic neuropathy; OD, right eye; OS, left eye; OU, both eyes; TIA, transient ischaemic attack; VA, visual acuity. | ||||||||||
| Age/sex | 73/F | 81/F | 68/F | 48/M | 88/F | 59/M | 68/F | 79/F | 66/F | 76/M |
| Diagnosis | Optic neuropathy, right>left | Right optic neuropathy, left NAION | Left optic neuropathy | Left optic neuropathy | Right optic neuropathy | Left junctional scotoma, left Horner’s syndrome | Right optic neuropathy and mild chiasmal syndrome, mild ARMD, OU | Chiasmal compression | Left optic tract compression | Left optic tract compression |
| Duration of symptoms | Many years | Uncertain OD, sudden OS | 5 Years | Uncertain | 3 Years | 2 Months | 5 Years | 1 Year | Uncertain (asymptomatic) | 1 Year |
| Medical history | HTN | HTN, diabetes, CAD | COPD, ARMD | Hypothyroid | HTN, CAD, AF, TIAs, ARMD OS | HTN, diabetes | CAD, HTN, diabetes, AF | HTN, CAD, stroke | HTN, smoking | HTN, CAD, aortic aneurysm, hypercholesterolaemia |
| Visual acuity at presentation | ||||||||||
| OD | 20/30 | 20/40 | 20/50 | 20/20 | 20/20 | 20/20 | 20/70 | 20/40 | 20/20 | 20/25 |
| OS | 20/50 | CF | 20/80 | Hand motion | Count fingers | 20/40 | 20/40 | 20/25 | 20/15 | 20/25 |
| Visual fields at presentation | ||||||||||
| OD | Inferior nasal defect | Inferior nasal defect | Mild depression | Normal | Temporal hemianopia | Superior temporal defect | Nasal and temporal loss | Bitemporal hemianopia | Left homonymous hemianopia | Left homonymous hemianopia |
| OS | Central depression | Cecocentral scotoma | Marked nasal loss | Severe loss | Central scotoma | Central scotoma | Mild temporal loss | |||
| MRI | Ectatic carotid arteries; elevation of optic nerves (OD>OS) | Ectatic right carotid artery elevating chiasm and right optic nerve | Ectatic left carotid compressing left optic nerve | Ectatic carotid severely compressing left optic nerve | Ectatic right carotid distorting optic nerve and right side of chiasm | Left carotid ectasia elevating chiasm and left optic nerve | Ectatic right carotid compressing right prechiasmal optic nerve and right side of chiasm | Ectatic basilar artery compressing chiasm | Ectatic basilar artery compressing right optic tract | Ectatic basilar artery compressing right optic tract |
| Clinical course | Stable until CRAO OS 5 years later | Improved to 20/25 OD following cataract surgery 3 years later | Subjectively stable 4 years later | Decreased VA to no light perception | Stable right optic neuropathy | Initial progression then improved optic neuropathy (20/25 OS) following craniotomy | Some progression of right optic neuropathy (20/200 OD) stable OS | Progressive ataxia | Stable exam at 7 month follow-up died of stroke 2 years later | Stable |
| Follow up interval (last examination) | 5 Years | 6 Years | 2 Years | 1 Year | 3 Years | 3 Years | 2 Years | NA | 7 Months | 2 Years |