Foster Kennedy sign and bilateral central visual failure in drusen of the optic disc

Abstract

A 70-year-old man with pseudopapilloedema due to bilateral drusen of the optic discs presented with real papilledema due to anterior ischaemic optic neuropathy affecting first the left eye and then, after an interval of six months, the right eye. During the attack of the second eye he presented with a classical Foster Kennedy sign, characterized by right optic disc oedema and left optic atrophy. The results of complete medical and neuro-radiologic examinations were entirely normal. Secondary optic atrophy of both optic discs resulted in bilateral loss of central vision and an apparent binasal hemianopia. Summarized evidence clearly indicated that optic disc drusen interfered with the vascular supply of the optic discs and in this way caused both the Foster Kennedy sign and the bilateral loss of central vision.

Key Words:

• Foster Kennedy sign
• optic disc drusen
• visual loss
• ischaemic optic neuropathy
• papilledema
• pseudopapilloedema
• optic atrophy