Atypical Optic Nerve Sheath Menengioma Mimics Like Optic Neuritis; A case report

Year 2019, Volume: 46 Issue: 3, 593 - 596, 16.09.2019

Umay Güvenç Gözde Orman , Gülten Sungur Selma Uzman

https://doi.org/10.5798/dicletip.620653

Abstract

A 40-years old female patient applied with complaining of a progressive vision loss for 3 months. Systemic symptoms were; headache, tingling in her hands and feet and pain during eye movements. Visual acuity was hand motion on the right eye, 20/20 on the Snellen chart on the left. There was relative afferent pupillary defect on the right eye. In fundoscopic examination, disc edema was met on the right eye and left eye’s fundus examination was normal.

A prolongation of p100 wave latency in the Visual Evoked Potentials examination and total visual field defect on automated perimetry test were seen on the right eye. The patient was hospitalized with a pre-diagnosis of optic neuritis. Orbita Magnetic Rezonans was reported the optic nerve sheath menengioma (ONSM). Atypical clinical presentation of an ONSM case that mimiced as optic neuritis, extended to the optic chiasm and lead to a progressive visual loss in a period of 3 months is presented. It is crucial to recognize atypical ONSM cases by the guidence of imaging techniques.

Keywords

Optic nerve sheath meningioma, MRI

Project Number

Our case report was presented at 52. Turkish Ophthalmology Society National Congress between November 13-18, 2018 in Antalya.

References

• 1. Wright J, McNab A, McDonald W. Primary optic nerve sheath meningioma. Br Ophthalmol1989; 73: 7.
• 2. Saeed P, Rootman J, Nugent RA, et all. Optic nerve sheath meningiomas. Ophthalmology 2003; 110: 2019–30.
• 3. Wilson WB. Meningiomas of the anterior visual system. Survey of Ophthalmology 1981; 26: 109–27.
• 4. Miller NR. Primary tumours of the optic nerve and its sheath. Eye 2004; 18: 1026–37.
• 5. Shapey J, Sabin HI, Danesh-Meyer HV, Kaye AH. Diagnosis and management of optic nerve sheath meningiomas. J ClinNeurosci 2013; 20: 1045-56.
• 6. Mack EE, Wilson CB. Meningiomas induced by high-dose cranial irradiation. Neurosurg1993; 79: 28–31.
• 7. Arar ZV, Vatavuk Z, Miskic B, et all. Optic Nerve Sheath Meningioma: A Case Report with 15-Year Follow-Up. Seminars in Ophthalmology 2013; 29: 52-55.
• 8. Schick U, Jung C, Hassler WE. Primary optic nerve sheath meningiomas: a follow-up study. CenEurNeurosurg2010; 71: 126-33.
• 9. Mao JF, Xia XB, Tang XB, Zhang XY, Wen D. Analyses on the misdiagnoses of 25 patients with unilateral optic nerve sheath meningioma. International Journal of Ophthalmology 2016; 9: 1315-9.
• 10. Deftereos SP, Karagiannakis GK, Spanoudaki A, Foutzitzi SN, Prassopoulos P. Optic nerve sheath meningioma: a case report. Cases Journal 2008; 1: 423.