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Case 14-3 continued

Clinical Summary

Following fenestration, examination of the patient's left eye (E) revealed a 2+afferent pupillary defect and papilledema, which was reduced compared to the preoperative evaluation. Mild blurring of the disc margin was noted; however, no hemorrhage was observed. Visual acuity was 20/30. A Humphrey (G) visual field showed a dense inferior arcuate scotoma and superior quadrant loss.

Optical Coherence Tomography

A linear OCT section (F) taken vertically through the center of the left optic disc again showed significant disc edema. À circular tomogram (H), acquired at a diameter of 3.4 mm surrouaiding the optic disc, showed generalized thinning of the nerve fiber layer The thinning was greater superotemporally (2:00 to 3:00), than inferotem-porally (4:00 to 5:00) consistent with the relative preservation of the superior compared to the inferior visual field. The overall nerve fiber layer thickness was thinner in the left eye compared to the right throughout all clock hours, corresponding to the clinical observation of asymmetric visual field loss and afferent pupillary defect in the left eye.

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