Optic Nerve Sheath Meningioma Masquerading as Optic Neuritis

Area of Science:

• Neuro-ophthalmology
• Neuroradiology

Background:

• Optic neuritis, often linked to multiple sclerosis, typically causes acute, painful monocular vision loss.
• Chronic optic neuropathy has diverse causes, including compressive lesions, genetic, toxic, or nutritional factors.

Purpose of the Study:

• To report an unusual case of optic nerve sheath meningioma (ONSM) misdiagnosed as optic neuritis.
• To highlight the importance of accurate diagnostic approaches for visual pathway disorders.

Main Methods:

• Case report detailing clinical presentation, diagnostic imaging, and final diagnosis.
• Review of diagnostic challenges in differentiating optic neuritis from other optic neuropathies.

Main Results:

• The patient's condition, initially presumed to be optic neuritis, was ultimately diagnosed as ONSM.
• Misinterpretation of brain MRI findings and delayed optic nerve imaging contributed to the initial misdiagnosis.

Conclusions:

• Optic nerve sheath meningioma can present atypically, mimicking common conditions like optic neuritis.
• Thorough patient history and appropriate neuroimaging are essential for accurate diagnosis of progressive visual deterioration.