scholarly journals Improvement of optic nerve pial blood supply visualized through indocyanine green videoangiography after resection of a tuberculum sellae meningioma: 2-dimensional operative video

2022 ◽  
Vol 6 (1) ◽  
pp. V13
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Indocyanine Green ◽  
Blood Supply ◽  
Visual Disturbance ◽  
Prognostic Information ◽  
Indocyanine Green Videoangiography ◽  
Tuberculum Sellae ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Ischemia of the optic nerve (ON) is an important cause of visual field deficit provoked by tuberculum sellae (TS) meningiomas. Indocyanine green (ICG) videoangiography could provide prognostic information. Moreover, it allows new insight into the pathophysiology of visual disturbance. The authors present the case of a 48-year-old woman with visual field impairment. Magnetic resonance imaging (MRI) depicted a lesion highly suggestive of a TS meningioma. Following microsurgical resection, ICG videoangiography demonstrated improvement of right ON pial blood supply. In this case, there was one lesion causing visual impairment through both direct compression over the left ON and ischemia to the right nerve. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21155

scholarly journals Vogt-Koyanagi-Harada Disease Following COVID-19 Infection

2021 ◽  
pp. 804-808
Author(s):  
Juan B. Yepez ◽  
Felipe A. Murati ◽  
Michele Petitto ◽  
Jazmin De Yepez ◽  
Jose M. Galue ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Plexiform Layer ◽  
Visual Disturbance ◽  
Ocular Pain ◽  
Ocular Movements ◽  
Interdigitation Zone ◽  
The Right ◽  
Retinal Folds

A 29-year-old female presented to the emergency clinic with gradual visual disturbance in both eyes for 15 days duration, accompanied by bilateral tinnitus, and ocular pain that increased with ocular movements. One month prior to presentation, the patient had tested positive for severe acute respiratory syndrome coronavirus-2 but without complications. Visual acuity was 20/100 in the right eye and 20/300 in the left eye. Funduscopy demonstrated optic nerve swelling, radial nerve fiber striation disruption, and bilateral retinal folds. Optical coherence tomography showed serous (bacillary) retinal detachment and multifocal areas of hyper-reflective changes in the inner and outer plexiform layer with inner nuclear layer thickening and disruption of the interdigitation zone bilaterally. We present a case of incomplete Vogt-Koyanagi-Harada disease following COVID-19 infection.

scholarly journals Optic Nerve Vascular Compression in a Patient with a Tuberculum Sellae Meningioma

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Cezar José Mizrahi ◽  
Samuel Moscovici ◽  
Shlomo Dotan ◽  
Sergey Spektor
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Vascular Compression ◽  
Case Description ◽  
Tuberculum Sellae Meningioma ◽  
Documented Case ◽  
Suprasellar Tumor ◽  
Tuberculum Sellae

Background. Optic nerve vascular compression in patients with suprasellar tumor is a known entity but is rarely described in the literature.Case Description. We present a unique, well-documented case of optic nerve strangulation by the A1 segment of the anterior cerebral artery in a patient with a tuberculum sellae meningioma. The patient presented with pronounced progressive visual deterioration. Following surgery, there was immediate resolution of her visual deficit.Conclusion. Vascular strangulation of the optic nerve should be considered when facing progressive and/or severe visual field deterioration in patients with tumors proximal to the optic apparatus.

Microsurgical Resection of a Chiasmatic Cavernoma: 3-Dimensional Operative Video

2021 ◽  
Author(s):  
Alvaro Campero ◽  
Ignacio Casas-Parera ◽  
Juan F Villalonga ◽  
Matías Baldoncini
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Visual Loss ◽  
Brain Mri ◽  
Optic Tract ◽  
Nerve Fibers ◽  
Visual Field Defects ◽  
Cavernous Malformations ◽  
Transsylvian Approach ◽  
The Right

Abstract According to reports from the literature,1,2 depending on the location where cavernomas appear, range from the very common locations to unusual. Cavernous malformations arising from the optic nerve and chiasm are rare, with only few cases reported to date.3-5  We present a case of a 28-yr-old man who suddenly started with sever visual loss in the right eye and homonymous lateral hemianopia in the left eye. Because of the acute symptomatology, a brain MRI was immediately performed in order to diagnose the etiology. The MRI showed a chiasmatic mass with right extension, heterogeneous on T1 and T2 sequences, without enhancement after gadolinium. The surgery was carried out a week after the diagnosis. A right pterional transsylvian approach was performed and the cavernoma was resected with microsurgical maneuvers, preserving the optic nerve fibers, chiasm, and optic tract.  The patient evolved favorably, improving the visual deficit in the postoperative period as can be observed in the postoperative visual field study 7 mo after the surgery.  The patient signed an informed consent for the procedure and agreed with the use of his images and surgical video for research and academic purposes.  Our surgical case emphasizes the importance of a prompt diagnosis and surgery for chiasmatic cavernomas3 associated to visual loss, providing early decompression of the optic apparatus and improvement of the visual field defects after surgery.

scholarly journals Spontaneous improvement of secondary empty sella syndrome due to re-expansion of an intrasellar cyst: A case report

2020 ◽  
Vol 11 ◽  
pp. 282
Author(s):  
Shodai Yamada ◽  
Kenji Yagi ◽  
Kazuhiro Hirano ◽  
Masaaki Uno
Keyword(s):  
Optic Nerve ◽  
Mr Imaging ◽  
Sella Turcica ◽  
Visual Disturbance ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
First Case ◽  
Spontaneous Improvement ◽  
The Right ◽  
Gyrus Rectus

Background: In patients with secondary empty sella syndrome (ESS), optic nerve herniation into the sella turcica is caused by shrinkage of the mass lesion at the sella turcica, resulting in visual disturbance. ESS is often surgically treated using chiasmapexy. Here, we report the first case of spontaneous improvement in a patient with ESS. Case Description: A 69-year-old woman presented with a month-long history of visual disturbance in the right eye, poor visual acuity, and quadrantanopia in her upper temporal visual field. Magnetic resonance (MR) imaging showed herniation of her right optic nerve and gyrus rectus into the sella turcica. The visual disturbance gradually improved, and the patient’s vision became almost normal after a month without any treatment. On repeated MR imaging, it was observed that the herniation of the right optic nerve and gyrus rectus disappeared due to an intrasellar cyst re-expansion. The secondary ESS caused by the shrinkage of the intrasellar cyst resulted in the visual disturbance and re-expansion of the cyst resulted in spontaneous improvement of symptoms. The visual disturbance did not recur for a year. Conclusion: Patients with secondary ESS without severe symptoms may be followed up conservatively. However, surgical treatment should be applied if symptoms deteriorate or do not improve.

Optic Nerve Sheath Meningiomas: Visual Improvement after Stereotactic Radiotherapy

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 950-957 ◽  
Author(s):  
James K. Liu ◽  
Scott Forman ◽  
Gerard L. Hershewe ◽  
Chitti R. Moorthy ◽  
Deborah L. Benzil
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Color Vision ◽  
Stereotactic Radiotherapy ◽  
Optic Nerve Sheath ◽  
Dramatic Improvement ◽  
Visual Deterioration ◽  
Nerve Sheath ◽  
The Right

Abstract OBJECTIVE: The management of primary optic nerve sheath meningioma (ONSM) is controversial. Surgery often results in postoperative blindness in the affected eye and thus has been abandoned as a treatment option for most patients. When these tumors are left untreated, however, progressive visual impairment ensues, which also leads to blindness. Recently, radiation therapy has gained wider acceptance in the treatment of these lesions. Experience with stereotactic radiotherapy (SRT) in the treatment of ONSMs is limited because of the rare incidence of this tumor. We present a series of patients with ONSM who were treated with SRT. METHODS: Five patients (three women, two men), ranging in age from 40 to 73 years, presented with progressive visual loss with decreased visual field, visual acuity, and color vision affecting six eyes (one patient had tumor involving both optic nerves). One patient also presented with proptosis and diplopia. Five eyes had functional residual vision (range, 20/20 to 20/40), and one eye was completely blind. All five patients were diagnosed clinically and radiographically to have an ONSM. Three were intraorbital, one was intracanalicular as well as intraorbital, and one was a left ONSM extending through the optic foramen into the intracranial space and involving the right optic nerve. The five functional eyes were treated with SRT by use of 1.8-Gy fractions to a cumulative dose of 45 to 54 Gy. RESULTS: Follow-up ranged from 1 to 7 years, and serial magnetic resonance imaging revealed no changes in the size of the tumor in all five patients. Four patients experienced dramatic improvement in visual acuity, visual field, and color vision within 3 months after SRT. One patient remained stable without evidence of visual deterioration or disease progression. None had radiation-induced optic neuropathy. CONCLUSION: SRT may be a viable option for treatment of primary ONSM in patients with documented progressive visual deterioration, and it may be effective in improving or stabilizing remaining functional vision.

Assessment of optic nerve vascularity in healthy eyes using superb microvascular imaging: a preliminary study

2021 ◽  
pp. 028418512098327
Author(s):  
Abdussamet Batur ◽  
Muhammed Alpaslan ◽  
Sercan Özkaçmaz ◽  
M Sedat Durmaz
Keyword(s):  
Optic Nerve ◽  
Blood Supply ◽  
Power Doppler ◽  
Optic Nerves ◽  
Vascular Flow ◽  
Superb Microvascular Imaging ◽  
Vascular Structures ◽  
The Right ◽  
Ciliary Artery ◽  
Microvascular Imaging

Background Changes in optic nerve vascularity are observed in many diseases. Superb microvascular imaging (SMI) has the potential to become the method of choice for detecting microvasculature in the optic nerves. Purpose To evaluate optic nerve vascularity in healthy individuals through power Doppler sonography (PDUS) and SMI. Material and Methods Twenty-seven healthy patients with 54 eyes were prospectively evaluated. The duration of the examination for optic nerve vascularity lasted until the posterior ciliary artery blood supply was observed in PDUS and SMI. The visibility of vascularity, as well as the ratio of the vascular structures to the optic nerves (vascular index [VI]), was evaluated. Results Fifty-four eyes were evaluated from a total of 27 patients (mean age = 49.0 ± 19.42 years). The VI value for the right optic nerve was 29.58 ± 4.00 while for the left optic nerve, it was 31.21 ± 3.52. Vascularity was clearly observed in both eyes (n = 54) in all 27 cases in the evaluation performed with the SMI technique. However, with the power Doppler examination, vascular flow was not observed in 14 right eyes and in 10 left eyes within the specified timeframe. Conclusion The results indicate that imaging of vascular structures can be done faster and better with SMI than PDUS examination. The normal VI values may provide important information about the blood supply of the optic nerve, which is of relevance in orbital pathologies and many systemic conditions.

scholarly journals Retinoblastoma Extending up to the Optic Chiasma and Presenting as a Suprasellar Mass

2021 ◽  
Vol 18 (4) ◽  
pp. 64-67
Author(s):  
Himanshu Mishra ◽  
Amit Kumar
Keyword(s):  
Optic Nerve ◽  
Complete Evaluation ◽  
Tissue Mass ◽  
Cross Sectional ◽  
Optic Chiasma ◽  
Non Invasive ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Funduscopic Examination ◽  
The Right

Retinoblastoma is the most common ocular malignancy of childhood. It is present in childhood with leukocoria and strabismus. Most patients are diagnosed under 3 years of age. Funduscopic examination can reveal an intraocular mass, but imaging is essential for complete evaluation of the lesion. Although ultrasound is a non-invasive and relatively inexpensive screening tool, cross-sectional imaging is required to assess the involvement of optic nerve and intracranial spread. We report a case of retinoblastoma in a 5 year old male child who presented with headache diminution of vision in both eyes. Contrast enhanced magnetic resonance imaging (MRI) revealed an enhancing soft tissue mass in the right eye with involvement of optic nerve and optic chiasma and contiguous with a large suprasellar mass causing hydrocephalus. Non-contrast computed tomography (CT) showed extensive calcifications in the mass lesion.

scholarly journals Optic neuropathy secondary to probable optic nerve glioma: case report

2021 ◽  
Author(s):  
Mariana Gurgel Carvalho de Souza ◽  
Deibi Solano de Araújo Dantas ◽  
Luciano Gonçalves do Nascimento Júnior ◽  
Paulo Francisco Lucena de Araújo Espínola ◽  
Isabella Wanderley de Queiroga Evangelista
Keyword(s):  
Case Report ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Multidisciplinary Care ◽  
Optic Nerve Glioma ◽  
Patient Reported ◽  
Specialized Care ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Black School

Introduction: Optic neuropathies are a group of pathologies that course with potentially irreversible visual dysfunction. Among compressive causes, optic nerve glioma (GNO) is one of the main ones. Case report: A 12-year-old black school-age female patient seen in February 2020, reported progressive low visual acuity on the right eye (RE) for 6 years. Ectoscopy revealed café au lait spots all over body and hyperchromic nodular lesion in left axilla. Ophthalmologic examination showed acuity of 20/400 in RE and 20/20 in the left eye (LE), relative afferent pupillary defect in RE. At biomicroscopy, irian Lisch nodules. Magnetic resonance imaging (MRI) showed fusiform thickening of intraorbital portion of right optic nerve (ON) with mild enhancement upon gadolinium infusion. Optic neuropathy was secondary to probable GNO. Ophthalmology and neurology management was expectant. Upon return, patient reported intermittent headache and functional and aesthetic discomfort due to axillary lesion, and presented a new MRI with findings similar to the first. Simple retinography showed global pallor in right ON and temporal pallor of left ON. Conclusion: The case presented, in which delay in access to specialized care resulted in blindness, highlights the importance of ophthalmologic screening in NF1. Manifestations resulting from the syndrome, with biopsychosocial repercussions, emphasize importance of multidisciplinary care.

scholarly journals Craniopharyngioma and arteriovenous malformation operated using the same craniotomy

2020 ◽  
pp. 437-440
Author(s):  
Burak Eren ◽  
Feyza Karagoz Guzey ◽  
Ilker Gulec
Keyword(s):  
Visual Field ◽  
Histopathological Examination ◽  
Visual Field Examination ◽  
First Case ◽  
Contrast Enhanced ◽  
Suprasellar Region ◽  
Epithelial Tumours ◽  
Magnetic Resonance Imaging Mri ◽  
Papillary Type ◽  
The Right

Craniopharyngiomas (CPs) are rare benign epithelial tumours. Brain arteriovenous malformations (AVMs) are also rare lesions occurring in young adults. The appearance of both these lesions in the same patient is rare. A 42-year-old patient presented with headaches for 3 months and a progressive decrease in his visual acuity. Bitemporal hemianopsia was detected in the visual field. Magnetic resonance imaging (MRI) revealed a tumour with cystic and solid components located in the suprasellar region and AVM in the right temporal lobe. AVM (Martin–Spetzler grade III) was visualised using digital subtract angiography (DSA), which was fed from the right middle cerebral artery and drained through the sigmoid sinus via the inferior petrosal sinus. The patient was operated with enlarged right frontotemporal craniotomy. AVM nidus was totally removed at the first operation. Embolisation was not preferred before the AVM surgery. After 3 days, sylvian dissection was performed using the same craniotomy. The tumour was completely removed via the carotid cistern by making sharp dissection from the infundibulum. Post-operatively, the patient showed normal neurological examination and significant improvement in his visual field examination. There was no residual/recurrent tumour or AVM on contrast-enhanced MRI and DSA at post-operative 6 months. Histopathological examination revealed AVM in the first operative material and papillary-type CP in the second.  The coexistence of these two rare pathologies has previously been reported in only one patient. This is the first case of surgical resection of CP and AVM using the same craniotomy.

scholarly journals Optociliary Shunt Vessel: An Ancillary Ophthalmic Sign Harbingering Optic Nerve Sheath Meningioma

2019 ◽  
Vol 16 (3) ◽  
pp. 62-64
Author(s):  
Bikram Bahadur Thapa ◽  
Sweta Singh ◽  
Rakshya Basnet ◽  
Saurav Piya
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Visual Field ◽  
Optic Nerve Sheath ◽  
Relative Afferent Pupillary Defect ◽  
Resonance Imaging ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma ◽  
The Right

A 61-year-old male presented with gradual loss of vision in his right eye for one year at neuro ophthalmology clinic. On clinical examination, his visual acuity was perception of light and intraocular pressure was 12 mm of Hg in right eye. Also, there was relative afferent pupillary defect in the right eye. Fund us examination showed per papillary atrophy, temporal pallor in optic disc with dilated and tortuous optociliary shunt vessels in right eye. Presence of optociliary shunt, visual loss, relative afferent pupillary defect and optic atrophyopt us for further evaluation by visual field and magnetic resonance imaging. Visual field showed unilateral blindness suggesting lesion of optic nerve. Magnetic resonance imaging brain revealed optic nerve sheath meningioma.

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