Revista de Ciencias Médicas de Pinar del Río (Sep 2018)
Meningioma of the optic nerve sheaths
Abstract
Introduction: meningiomas of the optic nerve sheath are meningothelial tumors originating from arachnoid cells that produce decrease of vision and proptosis with variable ocular involvement. Case report: a 65-year-old female patient with a history of hypertension who was admitted due to proptosis, decrease of vision and conjunctival chemosis of the right eye; fundus of the eye examination revealed the presence of a small optic disc of defined edges of normal coloration, without compromise of the thickness of the layer of nervous fibers of the retina with moderate vascular dilatation to venous predominance without evidence of macular alterations, hemorrhages or exudates. The campimetric studies showed the presence of altitudinal scotoma with lower temporal quadrant capture, and the study of the visual evoked potentials showed fall of its amplitude. Through the study of nuclear magnetic resonance (NMR, the existence of a homogeneous isointense image of well-defined edges was observed, which did not compromise the axonal structure of the optic nerve and which respects the intracanalicular and intracranial portion that confirmed the diagnosis of meningioma of the optic nerve sheaths. Discussion: the diagnosis of meningioma of the optic nerve sheaths on the right eye was confirmed in a patient with unilateral proptosis and conjunctival chemosis, which constitutes an unusual presentation with ophthalmological manifestations.