case_images: PMC10506880_01
case_images: Colour photography, optical coherence tomography, and fluorescein angiography of case 1 at the first visit. (a) Margin of optic nerve in the right eye is enlarged and blurred. There are cotton-wool spots around the disc in the left eye (white arrowheads). Superior temporal macula area in the left eye shows a cherry red spot due to whitening of the retina. (b) Horizontal optical coherence tomography scan of the optic nerve in the right eye (above) shows thickening of the nerve fibre layer (blue arrowheads). Vertical scan of the macula in the left eye (below) shows high reflectivity of the ganglion cell layer and inner nuclear layer (blue arrows). (c) Optic nerve hyperfluorescence in the right eye (8'58'') and retinal artery filling transition in the left eye (8'32'') by fluorescein angiography. Arm to retina time in the left eye time (38'').
case_images: CRIOPM2023-8845850.001.jpg
case_images: PMC10506880_01_CRIOPM2023-8845850.001.jpg
case_images: fig1
case_images: Fundus examination revealed optic nerve swelling in the right eye and central retinal artery occlusion in the left eye (Figure 1(a)). Optical coherence tomography (OCT) revealed optic nerve swelling in the right eye and inner retinal hyperreflectivity and oedema in the left eye (Figure 1(b)). Fluorescein angiography (FA) revealed hyperfluorescence of the optic nerve in the right eye and filling transition of the retinal arteries in the left eye (Figure 1(c)).
case_images: PMC10506880_02
case_images: Colour photography, optical coherence tomography, and temporal artery biopsy of case 2. (a) The tilted disc in the high myopic right eye seems to be difficult in evaluation with or without swelling. Dense nuclear cataracts obscure disc swelling in the left eye. (b) Vertical scan optical coherence tomography image in the right eye (above) is unclear due to poor fixation and tilted disc. Vertical scan in the left eye (below) shows optic nerve swelling (blue arrowheads). (c) Haematoxylin and eosin stain (left) shows neutrophil/lymphocyte infiltration in the tunica media (red circle). Elastica van Gieson stain (right) shows thickening of the outer membrane (blue arrow) and separation/torn of the inner elastic plate (white arrow).
case_images: CRIOPM2023-8845850.002.jpg
case_images: PMC10506880_02_CRIOPM2023-8845850.002.jpg
case_images: fig2
case_images: Fundus examination revealed a swelling of the optic nerve in the left eye (Figure 2(a)). OCT revealed optic nerve swelling in the left eye (Figure 2(b)). Elastica van Gieson staining showed that the outer membrane was thickened fibrously and the inner elastic plate was partially separated and torn (Figure 2(c)).
case_images: PMC10506880_03
case_images: Colour photography, optical coherence tomography, and fluorescein angiography of case 3 before treatment. (a) Retinal haemorrhage predominantly around the optic disc was seen in both eyes. The inferior disc margin in the right eye is blurred. The superior temporal disc margin in the left eye is enlarged and blurred. (b) Vertical optical coherence tomography scan in the right eye and horizontal scan in the left eye show thickening of the retinal nerve fibre at disc. (c) Fluorescein angiography reveals vigorous leakage at the disc in the left eye (6'55'') and mild staining of the disc in the right eye (6'39''). Arm-to-retina time in the left eye (21''). (d) Auricular cartilage biopsy shows fibrosis between cartilage tissues, mild inflammatory infiltration, and haemosiderin deposition around blood vessels (red circle).
case_images: CRIOPM2023-8845850.003.jpg
case_images: PMC10506880_03_CRIOPM2023-8845850.003.jpg
case_images: fig3
case_images: Fundus examination revealed optic nerve swelling and retinal haemorrhage in both eyes (Figure 3(a)). OCT revealed optic nerve swelling in both eyes (Figure 3(b)). FA revealed optic nerve hyperfluorescence in both eyes (Figure 3(c)), which was more pronounced in the left eye. Auricular cartilage biopsy showed fibrosis between the cartilage tissues, mild inflammatory infiltration, and hemosiderin deposition around the blood vessels, and a diagnosis of recurrent polychondritis was made (Figure 3(d)).
case_images: Goldmann perimeter tests before (a) and after (b) treatment. A partial recovery of the right eye is seen.
case_images: CRIOPM2023-8845850.004.jpg
case_images: PMC10506880_03_CRIOPM2023-8845850.004.jpg
case_images: fig4
case_images: Goldmann perimeter tests revealed that the temporal visual field was preserved in the right eye (Figure 4(a)). Goldmann perimeter tests revealed partial recovery from the previous visual field defect (Figure 4(b)).