Pseudo-Foster Kennedy Syndrome - a case report

Abstract

Objective: To report a case of Pseudo-Foster Kennedy (PFK) syndrome and describe its clinical and paraclinical particularities, as well as the diagnostic difficulties and established treatment. Methods: The case of a 60-year-old male patient with sudden, painless visual impairment in the left eye (LE), and a medical history of old optic nerve atrophy in his right eye (RE) was described. Results: The diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was established based on the medical history, local and general clinical and paraclinical examination, and temporal artery biopsy. Conclusions: Although there is no current generally accepted treatment for NAION, a correct diagnosis and supportive treatment may contribute to the improvement in visual acuity (VA), improvement that in this case remained stable for 6 months after the onset. The patient is still being monitored and no relapses have been noted.

Keywords: Pseudo-Foster Kennedy syndrome; anterior ischemic optic neuropathy; giant cell arteritis; nonarteritic anterior ischemic optic neuropathy.

Fig. 1

Perimetric examination of the LE 2 months prior to presentation (left image) and at presentation (right image), showing a new, severe altitudinal field defect

Fig. 2

Fundus color photography showing atrophy of the right optic disc (left image) and hyperemic swelling of the left optic disc, with a “splinter” hemorrhage (right image)

Fig. 3

OCT examination of RE and LE on presentation

Fig. 4

LE Fundus aspect on presentation (left image) and 1 month later (right image), showing the reduction of optic disc swelling, now with clear optic nerve margins contour and resolution of the “splinter” hemorrhage and hyperemic aspect