Improved Vision from Severe Compressive Optic Neuropathy by Apical Cavernous Hemangioma

Area of Science:

• Ophthalmology
• Neurology
• Neurosurgery

Background:

• Cavernous hemangiomas are benign vascular tumors that can occur in the orbit.
• Orbital tumors can cause significant visual impairment due to compression of ocular structures.

Observation:

• A 59-year-old woman presented with a year of progressive right vision loss, reduced visual acuity (0.01 OD), and diminished critical flicker frequency (CFF) (8 Hz OD).
• Ophthalmic examination revealed inferior visual field defects, and imaging identified an apical orbital tumor compressing the optic nerve and surrounding muscles.

Findings:

• Histopathology confirmed the orbital tumor as a cavernous hemangioma.
• Complete surgical excision of the tumor was achieved.
• Following surgery and steroid pulse therapy, the patient experienced remarkable visual recovery, with visual acuity improving to 1.0 and CFF to 32 Hz OD within one year.

Implications:

• This case highlights the potential for successful surgical management of orbital cavernous hemangiomas causing optic nerve compression.
• Complete tumor resection can lead to significant and lasting visual functional recovery.
• Early diagnosis and intervention are crucial for optimizing outcomes in patients with orbital tumors affecting vision.