case_images: PMC10583717_01
case_images: The fundus examination.
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case_images: fig1
case_images: The fundus examination revealed significant optic disc edema and blurred disc margins in the left eye (Figure 1).
case_images: Visual field maps at 3 and 16 months after onset. (A,B) The visual field map 3 months after onset showed (A) an infratemporal insular visual field in the right eye, (B) central scotoma connected to the physiological scotoma in the left eye, and arcuate scotoma on the nasal side. (C,D) The visual field map at 16 months after onset showed (D) a smaller insular visual field in the inferotemporal region of the right eye, (C) central scotoma connected to the physiological scotoma in the left eye, and arcuate scotoma on the nasal side.
case_images: fneur-14-1258043-g002.jpg
case_images: PMC10583717_01_fneur-14-1258043-g002.jpg
case_images: fig2
case_images: The visual field examination showed an insular visual field, referring to severe concentric narrowing with only a remaining visual field within a range of 5 to 10 degrees around the center, in the inferotemporal region of the right eye (Figures 2A,D), a central scotoma connected to the physiological scotoma in the left eye (Figures 2B,C), and an arcuate scotoma on the nasal side.
case_images: MRI images of the orbit, cervical spine, and brain. (A) Orbital MRI, (B) Cervical spine MRI, and (C-F) Brain MRI.
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case_images: PMC10583717_01_fneur-14-1258043-g003.jpg
case_images: fig3
case_images: No abnormal enhanced lesion was observed in the enhanced scan of the brain (Figures 3A,C-F). The cervical spine MRI and the enhanced scan revealed mild posterior median protrusion of the cervical intervertebral disc 3-4, 4-5, 5-6, and 6-7, cervical intervertebral disc degeneration, and mild hyperosteogeny of the cervical vertebral body 3-7 (Figure 3B).
case_images: Treatment course.
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case_images: PMC10583717_01_fneur-14-1258043-g004.jpg
case_images: fig4
case_images: When corticosteroid treatment started, penicillin sodium treatment was replaced by intramuscular administration of benzathine penicillin, which lasted for 2 weeks (Figure 4).