Optical coherence tomography as a useful adjunct in the early detection of meningioma with optic nerve compression

A 48-year-old woman presented with persistent clouding vision in her lower field in the right eye for 5 months. A small retinal hemorrhage was initially reported. Her visual acuity was 20/30 in the right eye and 20/20 in the left, with normal color vision and pupil response. Fundus examination did not reveal any retinal hemorrhage. Although optical coherence tomography (OCT) showed normal macula and retinal nerve fiber layers in both eyes, asymmetric thinning of the ganglion cell inner plexiform layer was found in the superior macula of the right eye in ganglion cell analysis (GCA). Visual field examination revealed a subtle inferonasal scotoma. Compressive optic neuropathy (CON) was suspected. The visual evoked potential test revealed delayed P100 latency. A tuberculum sellae meningioma was found with right medial optic canal extension. The visual acuity of the right eye returned to 20/25 after decompression surgery. OCT can be used to differentiate between retinopathy and optic neuropathy. GCA can help in the early detection of CON and achieve a good visual outcome after surgery.