PMC9452792_01
Gazes positions showing bilateral limited abduction in the left and right photos.
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Limited abduction was more severe in her left eye than in her right eye (Figure 1).
Optic disc photo of both the eyes showing optic disc edema with peripapillary hemorrhage and cotton wool spots. Macular edema is noted on the left eyeground examination.
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Eyeground examination showed severe bilateral disc edema, peripapillary hemorrhage, cotton wool spots, and subretinal fluid in the macular area of the left eye (Figure 2).
Magnetic resonance imaging of the brain and orbit with gadolinium contrast showing faint enhancement of both optic nerves (top photo showing axial view, and the bottom photo showing coronal view).
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Magnetic resonance imaging (MRI) revealed no mass-like lesion, but signs indicative of an increased intracranial pressure were detected (Figure 3). Brain parenchyma was normal without any non-specific white matter changes (Figure 3).
Optical coherence tomography angiography of both the eyes showing a normal foveal avascular zone (top photo representing the right eye and bottom photo representing the left eye). A hyporeflective space underneath the submacular area of the left eye is noted.
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Optical coherence tomography angiography of the macula revealed a normal foveal avascular zone (Figure 4).
Flash visual evoked potential (VEP) showing delayed P2 in both eyes with more prominence on the right. Top photo showing the VEP graph and bottom photo showing its results.
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Visual evoked potential (VEP) showed a significantly delayed P2 without decreased amplitude in the right optic nerve compared with that in the left optic nerve (Figure 5).