Adult nasal glioma presenting with visual loss

2010 ◽  
Vol 124 (12) ◽  
pp. 1309-1313 ◽  
Author(s):  
A Majithia ◽  
S H Liyanage ◽  
R Hewitt ◽  
W E Grant
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Loss ◽  
English Language ◽  
Incidental Finding ◽  
Relevant Literature ◽  
Nasal Glioma ◽  
Cranial Fossa ◽  
Skull Base Defect

AbstractObjectives:We report a rare case of a nasal glioma found incidentally in an adult, presenting with visual loss, optic nerve oedema and proptosis.Case report:A 41-year-old woman presented with bilateral proptosis, impairment in visual acuity (6/60 bilaterally) and loss of colour vision. Computed tomography and magnetic resonance imaging showed proptosis, bilateral optic nerve swelling and a heterogeneous mass occupying the left nasal cavity and extending through a skull base defect into the anterior cranial fossa. Biopsy confirmed a nasal glioma. Treatment with intravenous dexamethasone resolved the proptosis, and the patient's visual acuity recovered to 6/9 bilaterally. At the multidisciplinary team meeting, it was felt that the nasal glioma probably represented an incidental finding and was not directly responsible for the patient's proptosis and transient visual loss.Conclusion:To our knowledge, this is the first report in the English language literature of adult nasal glioma presenting with visual loss. The management of nasal gliomas in adults is contentious and the relevant literature is reviewed. This case was managed conservatively with regular follow up.

Endoscopic Approach to Traumatic Visual Loss

1997 ◽  
Vol 116 (6) ◽  
pp. 652-655 ◽  
Author(s):  
Stilianos E. Kountakis ◽  
Alberto A. J. Maillard ◽  
Richard Urso ◽  
Charles M. Stiernberg
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Loss ◽  
Endoscopic Approach ◽  
Light Perception ◽  
Hand Motion ◽  
Postoperative Visual Acuity ◽  
Level I ◽  
Total Blindness

OBJECTIVE: To review our experience with the use of endoscopic optic nerve decompression in traumatic blindness. METHOD: We did a retrospective analysis of patients with traumatic blindness that underwent endoscopic decompression of the optic canal to determine postoperative visual acuity and correlate if to preoperative visual loss and intraoperative findings. The setting was a Level I university trauma center. We identified 8 patients treated with both surgery and steroids over a 10-month period beginning in 1993 (Seven males, one female). RESULTS: Four of six patients with total blindness (no light perception) had improvements in visual acuity. In three patients, visual acuity returned to preinjury levels. One patients with total blindness was operated on 6 weeks after injury and had a visual acuity of 20/800 at 1-year follow-up. Two patients with hand motion preoperatively had improvement in visual acuity. In one patient, vision returned to normal (20/20), and in the other it improved to 20/200). Five patients were operated on after megadose steroid treatment for at least 48 hours failed; four of five noted dramatic improvements in visual acuity. CONCLUSION: The endoscopic approach may be used to successfully decompress the optic nerve in traumatic blindness.

scholarly journals Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Salvatore Di Lauro ◽  
Melissa Castrejón ◽  
Itziar Fernández ◽  
Jimena Rojas ◽  
Rosa M. Coco ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Loss ◽  
Vision Loss ◽  
Multicentric Study ◽  
Prospective Multicentre Study ◽  
Snellen Chart ◽  
Pars Plana ◽  
Phakic Eyes

Purpose. To quantify the frequency of visual loss after successful retinal detachment (RD) surgery in macula-on patients in a multicentric, prospective series of RD.Methods. Clinical variables from consecutive macula-on RD patients were collected in a prospective multicentric study. Visual loss was defined as at least a reduction in one line in best corrected visual acuity (VA) with Snellen chart. The series were divided into 4 subgroups: (1) all macula-on eyes (n=357); (2) macula-on patients with visual loss at the third month of follow-up (n=53) which were further subdivided in (3) phakic eyes (n=39); and (4) pseudophakic eyes (n=14).Results. Fifty-three eyes (14.9%) had visual loss three months after surgery (n=39phakic eyes;n=14pseudophakic eyes). There were no statistically significant differences between them regarding their clinical characteristics. Pars plana vitrectomy (PPV) was used in 67.2% of cases, scleral buckle in 57.7%, and scleral explant in 11.9% (36.1% were combined procedures).Conclusions. Around 15% of macula-on RD eyes lose VA after successful surgery. Development of cataracts may be one cause in phakic eyes, but vision loss in pseudophakic eyes could have other explanations such as the effect of released factors produced by retinal ischemia on the macula area. Further investigations are necessary to elucidate this hypothesis.

scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

Visual Loss from Pituitary Tumor Masked by Optic Nerve Drusen

Neurosurgery ◽  
1981 ◽  
Vol 8 (4) ◽  
pp. 473-476 ◽  
Author(s):  
Careen Y. Lowder ◽  
Robert L. Tomsak ◽  
Nicholas Z. Zakov ◽  
Joseph Hahn
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Pituitary Tumor ◽  
Visual Loss ◽  
Strong Indication ◽  
Progressive Loss ◽  
Optic Nerve Drusen

Abstract A case of optic nerve drusen and progressive loss of central visual acuity is reported. Despite the presence of optic nerve drusen. the loss of central visual acuity that cannot be explained by a retinal abnormality is a strong indication for further neuro-ophthalmological evaluation.

Long-term efficacy of fractionated conformal radiotherapy for the management of primary optic nerve sheath meningioma

2018 ◽  
Vol 103 (10) ◽  
pp. 1436-1440 ◽  
Author(s):  
Ravi Pandit ◽  
Liliana Paris ◽  
Danielle S Rudich ◽  
Robert L Lesser ◽  
Mark J Kupersmith ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Symptom Onset ◽  
Conformal Radiotherapy ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma ◽  
The Mean

Background/AimFractionated conformal radiotherapy (FCRT) is now used to treat vision-threatening optic nerve sheath meningioma (ONSM), but long-term efficacy and safety data are lacking; the purpose of this study was to assess these key data.MethodsThis is a retrospective chart review with prospective follow-up of adult patients treated with FCRT for primary ONSM at four academic medical centres between 1995 and 2007 with ≥10 years of follow-up after treatment.Results16 patients were identified with a mean post-treatment follow-up of 14.6 years (range: 10.5–20.7 years). The mean age at symptom onset was 47.6 years (range: 36–60 years). FCRT was performed at a mean of 2.3 years after symptom onset (range: 0.2–14.0 years). At last follow-up, visual acuity had improved or stabilised in 14 of the 16 (88%) patients, and 11 (69%) had retained or achieved ≥20/40. The mean deviation on automated perimetry remained stable (−14.5 dB pretreatment vs −12.2 dB at last follow-up; p=0.68, n=10). Two (11%) patients had persistent pain, proptosis or diplopia, compared with six (38%) pretreatment (p=0.11). Two (13%) patients developed radiation retinopathy more than 6 months after completion of therapy, one (50%) of whom had worse visual acuity compared with pretreatment. No patient developed tumour involvement or radiation damage in the fellow eye.ConclusionFCRT stabilises or improves visual function in patients with primary ONSM and is associated with a low risk of significant ocular sequelae. This treatment should be considered instead of surgery in patients with primary ONSM who require intervention due to loss of visual sensory and/or ocular motor function.

scholarly journals Navigation-assisted endonasal endoscopic optic nerve decompression in fibrous dysplasia

2019 ◽  
Vol 12 (12) ◽  
pp. e230621 ◽  
Author(s):  
Ramya Thota ◽  
Rakesh Kumar ◽  
Rajeev Kumar ◽  
Bhinyaram Jat
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Fibrous Dysplasia ◽  
Nerve Decompression ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
Optic Nerve Decompression ◽  
Stable Vision ◽  
Best Corrected Visual Acuity

A 12-year-old girl presented with left-sided decreased vision of 2-month duration. Clinical evaluation and imaging revealed fibrous dysplasia compressing the left optic nerve with no underlying endocrinological abnormalities. Best-corrected visual acuity showed progressive deterioration of vision over 2-month follow-up. She underwent navigation-assisted endonasal endoscopic optic nerve decompression. Post-surgery there was improvement in vision and it became normal (6/6). Six-month follow-up showed stable vision with no further complications.

scholarly journals Ocular imaging findings of bilateral optic disc pit in a child

2013 ◽  
Vol 5 (2) ◽  
pp. 258-261 ◽  
Author(s):  
Abdullah Ozkaya ◽  
Z Alkin ◽  
AT Taylan ◽  
A Demirok
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Anterior Segment ◽  
Rare Condition ◽  
Optic Disc Pit ◽  
Fiber Layer ◽  
Retinal Nerve Fiber

Background: To report a rare condition of bilateral optic disc pit in a child. Case description: A ten-year-old female was admitted with a complaint of headache. Visual acuity was 20/20 in both eyes (OU). Anterior segment examination was normal in OU. Fundus examination revealed optic disc pit (ODP) located temporally with a diameter of 1/5 disc diameter in OU. Intraocular pressure was within normal limits in both eyes. Macular optical coherence tomography (OCT) showed a loss of retinal tissue at the site corresponding to the ODP in both eyes. Retinal nerve fiber OCT revealed decreased RNFL thickness at the temporal side of the optic nerve, corresponding to the ODP in both eyes. The patient and patient’s parents were informed about the disease and called for follow-up examinations every 6 months. In addition, the family was informed about optic pit maculopathy (OPM) and, they were told to return immediately if the patient ever complained of decreased vision in either of her eyes. After a follow-up period of 12 months, visual acuity remained stable, and no complications secondary to ODP were detected. Conclusion: Optic disc pit is diagnosed incidentally unless it is complicated with OPM. The retinal nerve fiber layer thickness is decreased at the side of the optic nerve corresponding to the ODP. Nepal J Ophthalmol 2013; 5(10): 258-261 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8739

scholarly journals Bilateral Syphilitic Optic Neuropathy with Secondary Autoimmune Optic Neuropathy and Poor Visual Outcome

2019 ◽  
Vol 10 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Tanya Kowalski ◽  
Dujon  Fuzzard ◽  
Isla Williams ◽  
Jonathan Darby ◽  
Heather Gwen Mack
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Nerve Palsy ◽  
Visual Loss ◽  
Visual Outcome ◽  
High Dose ◽  
Optic Nerve Atrophy ◽  
Poor Visual Outcome ◽  
Appropriate Treatment

We describe the case of a 65-year-old man who suffered progressive visual loss despite appropriate treatment of ocular syphilis. Our patient initially presented with a unilateral 6th nerve palsy and associated double vision, which self-resolved over 6 months. His ophthalmic examination was otherwise normal. 12 months after the initial complaint, he represented with dyschromatopsia, reduced visual acuity, tonic pupils, and optic nerve atrophy. He tested positive for syphilis and was admitted for treatment of neurosyphilis with high-dose benzylpenicillin. Despite treatment, at a 4-month review his visual acuity remained poor and progression of optic nerve atrophy was noted alongside the development of bilateral central scotomas. Further testing was congruent with a diagnosis of autoimmune optic retinopathy. We propose this to be secondary to his syphilitic infection. Syphilis is known as the “great mimicker,” and despite being quite treatable, this case highlights ongoing complexity in the diagnosis and management of syphilis, unfortunately with a poor visual outcome.

WED 143 Chronic relapsing inflammatory optic neuritis (CRION) in the neuroinflammatory clinic

2018 ◽  
Vol 89 (10) ◽  
pp. A16.4-A17
Author(s):  
Cousins Oliver ◽  
Khan Hina ◽  
Harikrishnan Sreedharan
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Correct Diagnosis ◽  
Corticosteroid Treatment ◽  
Oligoclonal Bands ◽  
Short Course

CRION is a rare cause of optic neuritis. It is usually bilateral, painful and associated with profound visual loss. Significant response to corticosteroid treatment is typical but relapse is common when treatment is withdrawn. We present 2 cases of possible CRION and discuss the diagnostic and management considerations.Case 1: 50-year-old woman presented with right optic neuritis which spontaneous recovered. A year later she had left painful visual loss which improved with a short course of corticosteroids. MRI neuroaxis revealed left optic nerve enhancement. Non-specific, faint unmatched OCBs were detected. AQP4-IgG was negative. Nine months later she had further visual loss in her left eye. Prednisolone and azathioprine were commenced.Case 2: 55-year-old woman with bilateral, painless visual acuity deterioration over two weeks. Investigations revealed negative anti-aquaporin 4 antibodies (AQP4-IgG), normal MRI of the neuroaxis, negative oligoclonal bands (OCBs) and visual evoked potentials showed bilateral delay. Serum ACE was slightly elevated. She was started on a tapering course of steroids and had significant visual acuity improvement.The diagnosis of CRION involves the exclusion of other causes of optic neuritis, particularly multiple sclerosis (MS), Neuromyelitis Optica (NMO) and sarcoidosis. Correct diagnosis is important as aggressive and long-term immunosuppression is required.

Visual Loss

2013 ◽  
Author(s):  
Jess T. Whitson
Keyword(s):  
Visual Acuity ◽  
Visual Loss ◽  
Vision Loss ◽  
Neovascular Glaucoma ◽  
Shunt Surgery ◽  
Shunt Implantation ◽  
Shunt Group ◽  
Long Term Follow Up ◽  
Tube Shunt

Tube shunt surgery use has increased significantly in recent years. Once reserved as a treatment option for more refractory types of disease, such as uveitic or neovascular glaucoma, or for eyes that had failed one or more trabeculectomies, tube shunts are now being used by some surgeons in place of trabeculectomy as a first-line surgical alternative in eyes with other less aggressive or less difficult to control forms of glaucoma. Visual loss can occur following tube shunt implantation as a result of complications during the postoperative period or from the progression of underlying disease (see Table 40.1). Although tube shunt implantation is associated with similar postoperative complications as trabeculectomy surgery, such as hypotony, hemorrhage, and failure to control IOP, there are several unique complications that may develop with the use of tube shunts, many of which may result in vision loss. Visual loss following tube shunt surgery is not uncommon. A large, systematic literature review of tube shunts by Hong and coworkers reported rates of vision loss following tube shunt surgery (defined as loss of 2 or more lines of visual acuity at last follow-up) ranging from (mean [SD]) 24 (7)% with the Ahmed™ Glaucoma Valve (New World Medical, Inc., Rancho Cucamonga, California) to 33 (18)% with the Molteno® implant (Molteno Ophthalmic Ltd., Dunedin, New Zealand). In the Tube Versus Trabeculectomy (TVT) Study, an ongoing, prospective, randomized clinical trial that is comparing the Baerveldt® 350 mm tube shunt (Abbott Medical Optics, Inc., Santa Ana, California) to trabeculectomy with mitomycin-C (MMC) in eyes with previous trabeculectomy and/or cataract surgery, vision loss (defined as loss of 2 or more lines of Snellen visual acuity) occurred in 31 of the 107 patients (29%) in the tube shunt group. The occurrence of any postoperative complication significantly increased the risk of vision loss (p < 0.001), and this risk correlated to the number of complications. Corneal decompensation has been reported to occur in up to 30% of patients during long-term follow-up after tube shunt surgery.

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