case_images: PMC11788512_01
case_images: Fundus findings at the initial presentation.. (A) and (B) In both eyes, redness and swelling of the optic disc and peripapillary telangiectasia were observed.
case_images: cureus-0017-00000076883-i01.jpg
case_images: PMC11788512_01_cureus-0017-00000076883-i01.jpg
case_images: FIG1
case_images: Fundus examination revealed a reddish optic disc with peripapillary telangiectasia in both eyes (Figures 1A-1B).
case_images: Brain MRI findings at the initial presentation and at 1.5 years after onset.. At the initial presentation, T2-weighted/Fluid-Attenuated Inversion Recovery (FLAIR) images showed bilateral symmetric high signal intensity in the substantia nigra of the midbrain (A: arrows). (B, arrows) The diffusion-weighted images (DWIs) and (C, arrows) the apparent diffusion coefficient (ADC) map also showed symmetric high signal intensity in the same region. There were no abnormal findings in other areas, such as the mammillary bodies. At 1.5 years after onset, the high signal intensity in the substantia nigra of the midbrain had disappeared on (D) T2-weighted/FLAIR images, (E) DWI, and (F) ADC map.
case_images: cureus-0017-00000076883-i02.jpg
case_images: PMC11788512_01_cureus-0017-00000076883-i02.jpg
case_images: FIG2
case_images: Although brain MRI showed no abnormalities in the optic nerves, symmetric high-intensity lesions were observed in the substantia nigra of the midbrain on T2-weighted/FLAIR, diffusion-weighted images (DWIs), and apparent diffusion coefficient (ADC) map (Figures 2A-2C). The brain MRI revealed that the high-signal-intensity lesions on FLAIR/T2-weighted images, DWI, and ADC map in the substantia nigra of the midbrain had disappeared (Figures 2D-2F).