Optic-nerve compression by the internal carotid artery as a cause of “unexplained: optic atrophy

Abstract

Objective: To present a case of bilateral optic neuropathy secondary to optic-nerve compression by the internal carotid artery (ICA).

Methods: Observational case report; single patient seen in private practice.

Results: Compression of the optic nerves by the ICAs as the etiology of unexplained progressive optic neuropathy is reported. The patient refused further invasive procedures after diagnosis.

Conclusion: Compressive optic neuropathy due to direct pressure by the adjacent ICA should be considered as a possible etiology of occult, progressive visual loss in an otherwise healthy patient. Although rare, the clinical picture of progressive optic neuropathy backed by evidence of magnetic resonance imaging (MRI) should clinch the diagnosis early and spare the patient from further unnecessary ancillary work-up.