By Guy V. Jirawuthiworavong, MD
    Subspecialty Day 2011: Neuro-Ophthalmology

    In this case discussion from Neuro-Ophthalmology Subspecialty Day 2011, a woman presents with significant central vision loss over the course of 24 hours. Her past ocular history was significant for visible optic disc drusen OD, chronic fatigue syndrome, and headaches. Dilated fundus exam showed visible disc drusen of the right optic nerve while the left optic nerve appeared pink with sharp borders and no peripapillary atrophy. The macula and periphery seemed unremarkable; however, red-free photos hinted to subtle petaloid lesions parafoveally, and OCT showed abnormal thinning along the same areas OU. Analysis of the visual fields showed a defect that did not respect the vertical meridian, suggesting a pseudobitemporal hemianopia. Acute macular neuroretinopathy, a rare idiopathic inflammatory condition, was diagnosed in both eyes.