Optic nerve sheath meningioma - Retina Club : Retina Club

Retinography (FF450 IR plus Zeiss)

Color and green filter: Papilla edema, chorioretinal folds and vascular tortuosity

AGF: Papillary oozing (papilla edema) stands out.

Right optic nerve sheath meningioma with diffuse tubular thickening, compression and deformity of the eyeball. The tumor enhances with intravenous contrast injection.

Dr. Pablo Gili Manzanaro

Description

Optic nerve sheath meningioma is a rare benign neoplasm that arises from the meningoendothelial cells surrounding the optic nerve. It is the second most common primary tumor of the optic nerve, accounting for 1-2% of all meningiomas. The incidence is highest in adult women in their 4th-5th decade. Although considered benign tumors, primary meningiomas cause slow, progressive vision loss secondary to compression of the optic nerve and its blood supply.

The diagnosis is confirmed with MRI, which allows confirming the characteristic pattern and assessing the degree of extension.

Comments

The first signs are fundus lesions. MRI is essential to confirm the diagnosis and assess the extent.

Indication

A 54-year-old male presented with progressive vision loss in the right eye. The fundus showed papilledema with vascular tortuosity and chorioretinal folds. MRI confirmed the diagnosis of primary meningioma of the optic nerve sheath in the right eye without intracranial extension. During the follow-up of more than 10 years, the condition progressed to complete visual loss in the right eye, without involvement or extension to the left eye.