Female, 81 years old, with optic nerve pallor, right more than left. Assess for causes other than glaucoma. The optic nerves and the optic chiasm are small bilaterally. However, no evidence of pathologic signal abnormality or enhancement is seen along the course of the optic apparatus. The optic nerve sheaths are not dilated. The globes are round and symmetric. Lenses are normally positioned. The extraocular muscles demonstrate normal caliber and pattern of enhancement. The intraconal soft tissues are unremarkable. On limited visualization of the brain, prominence of the ventricles and sulci is seen compatible with underlying parenchymal volume loss. The septum pellucidum is present. There is likely a mild degree of periventricular T2 hyperintensity which is a nonspecific finding.
The optic nerves and optic chiasm are of small caliber bilaterally with no other significant orbital abnormalities detected. The etiology for this finding is uncertain but it could reflect either atrophy or congenital hypoplasia.