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Published on: May 12, 2011
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Bilateral paediatric optic nerve sheath meningioma
Daire John Hurley1, Shane Whitlow2, Declan O'Rourke3
1Ophthalmology, Children's Health Ireland at Temple Street, Dublin, Ireland dairehurley@gmail.com.
BMJ Case Reports
|February 4, 2025
Summary
This case study details a rare presentation of bilateral meningiomas causing vision loss. The tumors led to enophthalmos and optic nerve issues, requiring proton beam therapy for vision preservation.
Area of Science:
- Ophthalmology
- Neurology
- Oncology
Background:
- Bilateral meningiomas are rare tumors that can affect vision.
- Optic nerve involvement can lead to progressive vision loss and other ocular complications.
Purpose of the Study:
- To report a unique case of meningioma presenting with enophthalmos due to retrobulbar optic nerve contraction.
- To highlight the diagnostic challenges and treatment outcomes in such rare cases.
Main Methods:
- Case report detailing clinical presentation, neuroimaging, lumbar puncture, and visual evoked potential.
- Histopathological confirmation of bilateral meningiomas via biopsy.
- Treatment with proton beam therapy for vision salvage.
Main Results:
- The patient presented with microphthalmia and optic atrophy in one eye, followed by disc swelling and vision deterioration in the contralateral eye.
- Neuroimaging revealed bilateral meningiomas, confirmed by biopsy.
- Proton beam therapy was administered to preserve vision in the affected eye.
Conclusions:
- Meningiomas can present with unusual ocular manifestations, including enophthalmos secondary to optic nerve changes.
- Multidisciplinary management is crucial for optimizing outcomes in patients with complex meningioma presentations.
- This case underscores the importance of considering rare diagnoses in the evaluation of progressive vision loss.
