Neuro-Ophthalmology Flashcards

Progressive painless vision loss, optic atrophy, and optociliary shunt vessels in a middle-aged woman with 'tram-track' calcification on CT suggest which diagnosis?

Answer: Optic nerve sheath meningioma

This classic triad with tram-track calcification is characteristic of optic nerve sheath meningioma.

Severe bilateral optic neuritis with longitudinally extensive transverse myelitis is most associated with antibodies against which target?

Answer: Aquaporin-4

Neuromyelitis optica spectrum disorder is mediated by aquaporin-4 IgG on astrocytes.

Which feature favors MOG antibody-associated optic neuritis over MS-related optic neuritis?

Answer: Bilateral involvement with prominent optic disc swelling

MOGAD often causes bilateral, anterior optic neuritis with marked disc edema and long nerve enhancement.

A patient with a right optic tract lesion and left homonymous hemianopia usually has a relative afferent pupillary defect in which eye?

Answer: Left eye

Crossed nasal fibers outnumber uncrossed fibers, so the RAPD appears in the eye with the temporal field loss, contralateral to the tract lesion.

A patient being treated for tuberculosis develops bilateral painless vision loss with centrocecal scotomas and dyschromatopsia. Which drug is most likely responsible?

Answer: Ethambutol

Ethambutol causes dose-related toxic optic neuropathy with centrocecal scotomas and color vision loss.

Ipsilateral Horner syndrome, skew deviation, and ocular lateropulsion toward the lesion are most consistent with occlusion of which artery?

Answer: Vertebral artery or posterior inferior cerebellar artery

Lateral medullary (Wallenberg) syndrome from vertebral/PICA occlusion produces these ocular findings.

Which cranial nerve courses within the body of the cavernous sinus beside the internal carotid artery rather than in the lateral wall?

Answer: Abducens nerve

The abducens nerve lies free in the sinus next to the carotid, making it often the first affected by cavernous lesions.