Neither the patient nor the physician could see anything: Atypical Bing–Neel syndrome

Image 1. Panel A: Fluoresceine angiography demonstrating discrete leakage of fluorescein in the left parafoveal region (arrow), increasing at late phase (double arrow), evocative of macular cystoid edema. Panel B: Optical coherence tomography (OCT) demonstrating the presence of cystoid macular edema (arrow) in the macular region of the left eye (right) compared to the right eye which is normal (left). Panel C: Macular retinal ganglion cell (RGC) study (upper part) demonstrating diffuse RGC loss in the left eye (right) and moderate RGC loss in the right eye (left) suggestive of bilateral optic neuropathy. OCT retinal nerve fiber layer analysis disclosing normal thickness of both optic nerves. Panel D: Goldman kinetic visual field demonstrating bilateral large central scotomas at presentation (upper part), improving during chemotherapy (interediate) and after chemotherapy (lower). Panel E: Pattern reversal visual evoked potentials (VEP): in March 2014, no recordable VEP. In April 2015, improvement of the VEP results showing normal amplitude of the P100 wave and slow peak time. Panel F: Cerebral MRI demonstrating minimal enlargement of the left optic nerve on axial T1 (left) and coronal T2 (right) sections.