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Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
Patient Presentation: A 54-year-old female was seen in the emergency department for a new-onset severe headache and visual field deficit OU. The patient noted that she believes she cannot see in her periphery as well as normal. The patient’s vision was 20/40 OD and 20/25 OS. Colour vision was 9/14 OD, 12/14 OS on Ishihara plates. No RAPD was noted. Dilated eye examination was normal. The OCT RNFL and GCC are shown below:
Question: What pathology is found in the above RNFL/GCIPL OCT images?
Question: What is the next best step in evaluating this this patient in the eye clinic?
Question: Based on visual field results and the patient presentation, what is the most likely cause of her symptoms?
1. Describe the findings on visual field and OCT with acute pituitary apoplexy
2. Time is necessary for OCT to thin compared to visual field deficit in compressive lesions
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