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Cystic Optic Chiasm Lesion: Atypical Magnetic Resonance Imaging Findings
Sameen Haque1, Kate Reid2,3, Ross O'Neil4,3
1Department of Neurology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
Neuro-Ophthalmology (Aeolus Press)
|January 19, 2018
Summary
Intrinsic cystic lesions of the optic chiasm are a rare cause of bitemporal hemianopia. This case highlights an unusual cystic appearance potentially from prior inflammation, emphasizing cautious management due to visual loss risks.
Area of Science:
- Ophthalmology
- Neurology
- Radiology
Background:
- Bitemporal hemianopia is typically caused by extrinsic compressive lesions of the optic chiasm.
- Intrinsic cystic lesions of the optic chiasm are uncommon but present a diagnostic challenge.
Observation:
- A 40-year-old man presented with visual field deficits consistent with bitemporal hemianopia.
- Magnetic resonance imaging revealed an unusual cystic lesion within the optic chiasm.
Findings:
- The cystic appearance was suspected to be sequelae of prior infective or inflammatory processes.
- Differential diagnoses for intrinsic optic chiasm lesions include neoplasms, cysts, and inflammatory conditions.
Implications:
- This case underscores the importance of considering intrinsic cystic lesions in the differential diagnosis of optic chiasm abnormalities.
- Management requires careful consideration of risks, particularly the potential for iatrogenic visual deterioration, as biopsy was avoided in this instance.
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