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Foster Kennedy Syndrome: An Atypical Presentation.

Alberto Parafita-Fernández¹, Marta Sampil, Carlos Cores

¹*MD †MD, PhD Ophthalmology Department, Complejo Hospitalario de Pontevedra, Pontevedra, Spain (AP-F, MS, FJC, EV); and School of Medicine, University of Santiago de Compostela, Spain (CC).

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|November 6, 2015

Summary

Foster Kennedy syndrome (FKS) typically presents with optic nerve atrophy and edema. This case highlights FKS with optic nerve atrophy and retinal vein occlusion, suggesting a space-occupying lesion.

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Area of Science:

Neuro-ophthalmology
Neurology
Ophthalmology

Background:

Foster Kennedy syndrome (FKS) is a rare condition characterized by unilateral optic nerve atrophy and contralateral optic nerve edema.
It is typically caused by an intracranial mass compressing the optic nerves and chiasm.

Observation:

A 56-year-old man presented with hemiretinal retinal vein occlusion in his right eye and prior optic nerve atrophy in his left eye.
The patient had no cardiovascular or prothrombotic risk factors, prompting investigation into the cause of contralateral optic atrophy.
Imaging revealed a suprasellar mass, later identified as a meningioma.

Findings:

This case presented an atypical manifestation of FKS, where retinal vein occlusion replaced the typical optic nerve edema.
The findings underscore the importance of considering space-occupying lesions in cases of optic atrophy associated with acute ocular pathology.

Implications:

Diagnostic imaging is crucial for identifying the etiology of optic atrophy when classic symptoms or disease progression are absent.
Unusual presentations of FKS can be masked by common clinical features, necessitating a high index of suspicion for rare conditions.