Jornal de Oftalmologia Clínica e Experimental
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Optic Neuropathy Secondary to Multifocal Nerve Compression by Dolichoecatatic Vasculature

Thomas S Bacon, Tariq T Lamki, Mario Ammirati, David K Hirsh and Claudia F Kirsch

Progressive vision loss due to compression of the optic pathways by perichiasmal vasculature is uncommon. Several case reports describe unilateral vision loss due to compression of the optic nerve by the distal portions of the internal carotid artery, or less commonly the anterior cerebral artery. Bilateral vision loss is infrequently reported in the context of vascular compressive optic neuropathy and is either the result of independent compression of both optic nerves or rarely due to vascular compression at the optic chiasm. This paper presents a unique case of progressive bilateral vision loss due to multiple nerve lesions produced by compression of the optic pathways by dolichoectatic perichiasmal vasculature. In this case, both an enlarged right cavernous carotid artery and an ectatic segment of the left anterior cerebral artery compress the optic chiasm, in addition to compression of the left optic nerve by the supraclinoid portion of the left carotid artery.