PMC8189782_01
Fundus photo of the (a) right and (b) left eyes at presentation. Late recirculation phase fluorescein angiogram taken at 3 minutes showing subtle staining of the nerve of the (c) right and (d) left eyes.
CRIOPM2021-6668552.001.jpg
PMC8189782_01_CRIOPM2021-6668552.001.jpg
fig1
Figures 1(a) and 1(b)). Optical coherence tomography (OCT) of the macula showed mild macular thickening OS (shown in Figures 2(a) and 2(b)). OCT retinal nerve fiber layer (RNFL) analysis showed RNFL thickening OD > OS. Fluorescein angiography (FA) studies showed no overt signs of retinal vascular leakage, but subtle staining of retinal vessels and subtle hyperfluorescence of the disc were present.
Optical coherence tomography with associated topographical map at presentation showing normal foveal contour with mild macular thickening of the (a) right eye and (b) left eye.
CRIOPM2021-6668552.002.jpg
PMC8189782_01_CRIOPM2021-6668552.002.jpg
fig2
Figures 1(a) and 1(b)). Optical coherence tomography (OCT) of the macula showed mild macular thickening OS (shown in Figures 2(a) and 2(b)). OCT retinal nerve fiber layer (RNFL) analysis showed RNFL thickening OD > OS. Fluorescein angiography (FA) studies showed no overt signs of retinal vascular leakage, but subtle staining of retinal vessels and subtle hyperfluorescence of the disc were present.
Octopus 30-2 visual field at presentation showing diffuse nonspecific suppression in the right eye (OD) and left eye (OS).
CRIOPM2021-6668552.003.jpg
PMC8189782_01_CRIOPM2021-6668552.003.jpg
fig3
The Octopus 30-2 visual field showed diffuse suppression OU (shown in Figure 3).
Electrooculogram (EOG) showing suppression in the right eye (OD) and borderline suppression in the left eye (OS) with Arden ratio of 1.41 (OD) and 1.85 (OS).
CRIOPM2021-6668552.004.jpg
PMC8189782_01_CRIOPM2021-6668552.004.jpg
fig4
At a subsequent visit, ancillary tests confirmed retinal and optic nerve dysfunction including an electrooculogram (EOG) which showed suppression OD and borderline suppression OS with an Arden ratio of 1.41 (OD) and 1.85 (OS) (shown in Figure 4).
Visual evoked potential/response (VEP/VER) demonstrated mild suppression in the right and left eyes (OD and OS, respectively).
CRIOPM2021-6668552.005.jpg
PMC8189782_01_CRIOPM2021-6668552.005.jpg
fig5
Visual evoked potential (VEP) demonstrated mild suppression (shown in Figure 5).
Handheld flash full field electroretinogram (ERG) showing mild to moderate delayed implicit time with reduced photopic negative response OU.
CRIOPM2021-6668552.006.jpg
PMC8189782_01_CRIOPM2021-6668552.006.jpg
fig6
Handheld flash electroretinogram (ERG) showed mild to moderate delayed implicit time with reduced photopic negative response OU (shown in Figure 6).
Magnetic resonance imaging (MRI) of head and orbits without evidence of optic nerve abnormality on (a) T2 image and without perineural enhancement of the optic nerve on (b) T1 with contrast and fat suppression.
CRIOPM2021-6668552.007.jpg
PMC8189782_01_CRIOPM2021-6668552.007.jpg
fig7
Orbits were unremarkable, and optic nerve was negative for perineural contrast enhancement (shown in Figure 7).