Sudden visual loss in pseudotumor cerebri due to central retinal artery occlusion

A patient with a 16-month history of papilledema from pseudotumor cerebri had sudden loss of vision in one eye because of a central retinal artery occlusion (CRAO). The CRAO was transient and visual acuity improved from light perception to 6/7.5 OS in long-term follow-up. A visual field abnormality and color-vision deficit have persisted. Both eyes demonstrated peripapillary neovascular membranes. The eye with CRAO had extensive chorioretinal folds extending from the disc through the macula. Thorough investigations failed to demonstrate a coagulation abnormality, hyperviscosity, or source of emboli. Although the mechanism remains unclear, we postulate that CRAO may have been caused by a local pathologic condition in the optic nerve.