Seeing the unseen: A case series of intracranial mass lesions initially presenting with visual disturbances

This study aimed to characterize the clinical presentation, ophthalmologic findings, and final diagnoses of patients with primary intracranial mass lesions who initially presented with visual symptoms. We conducted a retrospective observational case series at the Neuro-ophthalmology Department of Chi Mei Medical Center, Taiwan, analyzing adult patients who presented with visual disturbances between January 2021 and August 2023 and were subsequently diagnosed with intracranial mass lesions. Demographic characteristics, ophthalmologic findings, imaging results, treatment modalities, and visual outcomes were analyzed. Thirteen patients were included (six men; mean age: 45.2 ± 13.1 years). Blurred vision (61.5%) was the most frequent presenting symptom. Visual field defects (76.9%) and optic disc pallor (53.9%) were common findings. Pituitary adenoma was the most predominant tumor type (38.5%). The results indicate that visual symptomatology may represent an early manifestation of primary intracranial mass lesions. Prompt neuroimaging and multidisciplinary management are essential for achieving timely diagnosis and optimal clinical outcomes.