case_images: PMC11101248_01
case_images: Photographs of right and left optic nerves at presentation, respectively. Cup/disc ratios: (a) 0.6 OD and (b) 0.75 OS.
case_images: CRIOPM2024-3878152.001.jpg
case_images: PMC11101248_01_CRIOPM2024-3878152.001.jpg
case_images: fig1
case_images: Slit-lamp biomicroscopy revealed a stable cup-to-disc ratio of 0.6 OD but an increase to 0.75 OS in comparison to 4 months prior (Figure 1).
case_images: (a) Visual field testing of the right eye showing relative stability over a 12-month period. (b) Visual field testing of the left eye showing significant progressive temporal and paracentral loss over the same 12-month period.
case_images: CRIOPM2024-3878152.002.jpg
case_images: PMC11101248_01_CRIOPM2024-3878152.002.jpg
case_images: fig2
case_images: Visual field (VF) findings were relatively stable OD (Figure 2(a)), but OS showed extensive superior more than inferior progressive loss temporally and pericentrally over a 12-month period (Figure 2(b)).
case_images: (a) MRI head without contrast showing a giant aneurysm (arrow) near the optic chiasm. (b) 3D CT angiogram confirming the presence of a giant aneurysm measuring 16 mm diameter with an 8 mm neck (arrow) arising from the internal carotid artery.
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case_images: PMC11101248_01_CRIOPM2024-3878152.003.jpg
case_images: fig3
case_images: On neurological examination, a noncontrast MRI of the head revealed an unruptured giant left internal carotid aneurysm (Figure 3(a)). A 3D CT cerebral angiogram confirmed a 16 mm x 8 mm left carotid ophthalmic artery aneurysm with associated mass effect on the left optic nerve (Figure 3(b)).
case_images: Visual field testing following the successful left internal carotid ophthalmic artery aneurysm coiling and occlusion. (a) Visual field testing of the right eye showing mild nonspecific worsening. (b) Visual field testing of the left eye showing further constriction of the field.
case_images: CRIOPM2024-3878152.004.jpg
case_images: PMC11101248_01_CRIOPM2024-3878152.004.jpg
case_images: fig4
case_images: OS for the first time, and a repeat VF testing demonstrated mild nonspecific worsening OD and possible worsening constriction OS (Figure 4). OCT analysis showed further significant progressive thinning superiorly and inferiorly OS (Figure 5(b)).
case_images: (a) RNFL and ONH summary parameters of the right eye demonstrating thinning inferiorly following neurosurgical intervention. (b) RNFL and ONH summary parameters of the left eye demonstrating progressive thinning of the RNFL despite neurosurgical intervention prior to the last reported RNFL measurement.
case_images: CRIOPM2024-3878152.005.jpg
case_images: PMC11101248_01_CRIOPM2024-3878152.005.jpg
case_images: fig5
case_images: OS for the first time, and a repeat VF testing demonstrated mild nonspecific worsening OD and possible worsening constriction OS (Figure 4). OCT analysis showed further significant progressive thinning superiorly and inferiorly OS (Figure 5(b)). In addition, inferior RNFL thinning OD was noted for the first time (Figure 5(a)).