Case reports in ophthalmology · 2025
A Cavernous Sinus Meningioma in a Child with Progressive Bilateral Visual Loss Ultimately Attributed to Unsuspected Optic Nerve Sheath Meningiomas.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Wang Debbie X, Walker Carson S, Ahmedin Yusra A, Ohan Masis A, Vitanza Nicholas A, Ermoian Ralph P, Crotty Erin E, Francis Courtney E, Cabrera Michelle T
Аннотация
INTRODUCTION: Pediatric optic nerve sheath meningiomas (ONSMs) are rare and have an aggressive presentation often resulting in rapid vision decline. Here, we report a case of a right cavernous sinus meningioma (CSM) with a delayed diagnosis of concomitant bilateral ONSMs, ultimately leading to permanent bilateral blindness.
CASE PRESENTATION: A 7-year-old boy with a history of a right trochlear nerve palsy and amblyopia presented with worsening right eye vision. An MRI revealed a right CSM that was resected; however, the patient experienced a progressive visual acuity decline from 20/60 right eye and 20/40 left eye to light perception right eye and 20/400 left eye, along with bilateral optic atrophy appreciated on optical coherence tomography. Repeat evaluation of the brain MRIs revealed bilateral ONSMs characterized by a tram-track appearance. The visual acuity remained unimproved 3 years after optic canal decompression with optic nerve sheath fenestration followed by proton beam radiation.
CONCLUSION: Pediatric ONSM is rare, with a high risk of permanent blindness in children. Intracranial meningioma and unexplained painless vision loss should prompt a careful evaluation of orbital neuroimaging for this condition.
CASE PRESENTATION: A 7-year-old boy with a history of a right trochlear nerve palsy and amblyopia presented with worsening right eye vision. An MRI revealed a right CSM that was resected; however, the patient experienced a progressive visual acuity decline from 20/60 right eye and 20/40 left eye to light perception right eye and 20/400 left eye, along with bilateral optic atrophy appreciated on optical coherence tomography. Repeat evaluation of the brain MRIs revealed bilateral ONSMs characterized by a tram-track appearance. The visual acuity remained unimproved 3 years after optic canal decompression with optic nerve sheath fenestration followed by proton beam radiation.
CONCLUSION: Pediatric ONSM is rare, with a high risk of permanent blindness in children. Intracranial meningioma and unexplained painless vision loss should prompt a careful evaluation of orbital neuroimaging for this condition.