Sequential NAION presenting as pseudo Foster Kennedy syndrome.

PURPOSE: To review recurrent NAION as a cause for PFK syndrome.

METHODS: In an observational study patients presenting with sudden loss of vision were evaluated. We reviewed patients presenting with disc edema on one side and optic atrophy in contralateral eye on fundus examination. Their visual field defects and fundus fluorescein angiography was assessed.

RESULTS: Of the 7 patients evaluated 4 (57.1%) were females. Mean age at presentation was 53.7±11.9years. Mean duration between the two episodes was 12.7months (range: 2-30). The visual acuity of presenting eye ranged from 6/9 to worse counting fingers close to face.

CONCLUSIONS: The diagnosis in a PFK presentation is essentially one of exclusion. Patients with NAION are at risk for recurrence in fellow eye, thereby presenting as PFK syndrome. NAION should be considered as a differential especially when imaging and other laboratory investigations are not suggestive of any compressive lesion.