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Compressive Optic Neuropathy Due to Dolichoectatic Ophthalmic Artery
Sylvia E Villarreal Navarro1, Andrea Naranjo1, Robert Dodd2,3
1Department of Ophthalmology, Stanford University, Palo Alto, California, USA.
Abstract:
A 63-year-old man experienced progressive vision loss in his right eye over five years. Ophthalmologic examination showed right optic neuropathy with optic nerve pallor. Prior MRI findings of gadolinium enhancement near the prechiasmatic optic nerve had suggested acute optic neuritis. A repeat MRI revealed a dilated vascular structure compressing the optic nerve, confirmed by Time-of-Flight MRA as dolichoectatic ophthalmic artery. Compression-related optic neuropathy caused by a dolichoectatic ophthalmic artery can have similar appearance to acute optic neuritis on MRI. When the clinical history or course does not align with the initial diagnosis, it is important to reconsider the diagnosis.
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