Parafita-Fernández Alberto, Sampil Marta, Cores Carlos, Cores Francisco Javier, Viso Eloy
*MD †MD, PhD Ophthalmology Department, Complejo Hospitalario de Pontevedra, Pontevedra, Spain (AP-F, MS, FJC, EV); and School of Medicine, University of Santiago de Compostela, Spain (CC).
Optom Vis Sci. 2015 Dec;92(12):e425-30. doi: 10.1097/OPX.0000000000000731.
To describe an unusual presentation of Foster Kennedy syndrome (FKS; unilateral optic nerve atrophy with optic nerve edema in the other eye) with optic nerve atrophy and retinal vein occlusion. It is an example of how common clinical features can hide a rare condition or presentation of a disease. Foster Kennedy syndrome is uncommon. Therefore, a space-occupying lesion should be suspected when there is optic atrophy associated with acute pathology of the other eye.
A 56-year-old man presented with hemiretinal retinal vein occlusion in his right eye. He had previous optic nerve atrophy in his left eye attributed to nonarteritic anterior ischemic optic neuropathy. He lacked cardiovascular or prothrombotic risk factors. Consideration was given whether the presence of contralateral optic atrophy was associated with the retinal vein occlusion. A computed tomographic scan revealed a suprasellar mass. The tumor was excised and identified as meningioma.
Although typical FKS would present with optic nerve atrophy and contralateral optic nerve edema secondary to an intracranial mass, in this case, edema was replaced by a hemiretinal vein occlusion. In optic atrophy that does not show characteristic visual field alterations, typical symptoms, or the classic evolution of a given disease, diagnostic imaging may reveal the etiology. As FKS is uncommon, when there is optic atrophy associated with acute pathology of the other eye, a space-occupying lesion should be suspected.
描述福斯特·肯尼迪综合征（FKS；一侧视神经萎缩伴对侧视神经水肿）合并视神经萎缩和视网膜静脉阻塞的一种不寻常表现。这是一个常见临床特征如何掩盖罕见疾病或疾病表现的例子。福斯特·肯尼迪综合征并不常见。因此，当存在与另一只眼的急性病变相关的视神经萎缩时，应怀疑有占位性病变。
一名56岁男性，右眼出现半侧视网膜静脉阻塞。他左眼先前存在视神经萎缩，归因于非动脉性前部缺血性视神经病变。他没有心血管或血栓形成前危险因素。考虑对侧视神经萎缩的存在是否与视网膜静脉阻塞有关。计算机断层扫描显示鞍上有一肿块。肿瘤被切除，病理诊断为脑膜瘤。
虽然典型的FKS表现为继发于颅内肿块的视神经萎缩和对侧视神经水肿，但在本病例中，水肿被半侧视网膜静脉阻塞所取代。在未表现出特征性视野改变、典型症状或特定疾病经典演变过程的视神经萎缩中，诊断性影像学检查可能揭示病因。由于FKS不常见，当存在与另一只眼的急性病变相关的视神经萎缩时，应怀疑有占位性病变。
