[Left eye optic neuropathy and right eye retinopathy after embolization of middle cerebral artery aneurysm: a case report].

A 45 year old patient presented with left upper visual field defect and decreased vision on the first postoperative day following "stent-assisted endovascular embolization for a ruptured left middle cerebral artery aneurysm with subarachnoid hemorrhage" performed in the neurology department. Lumbar puncture showed normal cerebrospinal fluid pressure initially, but repeated follow-up measurements during hospitalization indicated elevated intracranial pressure. The patient exhibited unequal pupil size, with a positive relative afferent pupillary defect (RAPD) in the left eye and slight pallor of the left optic disc. Half a month later, the patient developed decreased vision in the right eye. Fundus examination revealed optic disc hyperemia, edema with blurred margins, multiple peripapillary cotton-wool spots accompanied by small patchy hemorrhages, and scattered microaneurysms in the macular area. Based on the medical history, the diagnosis was confirmed as: left eye surgery-associated posterior ischemic optic neuropathy, and right eye Purtscher retinopathy. After treatment with mecobalamin tablets, citicoline sodium capsules, and compound vitamin B tablets, the ocular symptoms in the right eye showed some improvement.