DWI Findings of Optic Nerve Ischemia in the Setting of Central Retinal Artery Occlusion

Abstract

A 67-year-old African-American male with untreated hypertension, hyperlipidemia, and diabetes mellitus presented with sudden, staggering, progressive loss of vision in his left eye over the course of 8 days. Ophthalmologic and fluorescein angiography exams confirmed central retinal artery conclusion, but revealed no embolus. Magnetic resonance imaging of the brain serendipitously revealed restricted diffusion within the distal left optic nerve, illustrating a more proximal occlusion, which matched the fluorescein angiographic findings. Extensive workup revealed no embolic source, postulating primary hypertension as the underlying etiology.