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Case #1: Incidental finding of bilateral visual field defects        
Shadi Awwad, MD      

                 56 year old lady known case of Rheumatoid Arthritis on Resorchine 250 mg PO QD since 
2 months is referred by her physician for baseline eye check-up.
On exam:
VOD=20/20 (SC)
VOS=20/20 (SC)
Pupils: equal in size and reactive. No APD
Slit Lamp Exam: normal; no vortex keratopathy
Fundus: Normal macula and periphery OU. 
ONH looked as below

onh_dr.jpg (35804 bytes) OD

onh_dr_os.jpg (44023 bytes) OS

Macular Visual Field that are done routinely at AUBMC to screen for chloroquine maculopathy were 
mistakenly substituted by peripheral visual fields, that looked as follow:

vfod1.jpg (35913 bytes) OD

vfos1.jpg (38358 bytes) OS

Decision was to repeat visual fields in 3 months, but the results were pretty much the same.
Angiography was then performed:

Angiography was considered non-specific.
An ultra-sound B-scan was performed:

OD

OS

Diagnosis:

.

 

Bilateral optic nerve head drusens


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