Optic Nerve Compression by an Intracanalicular Meningioma

Sanders, Michael; Falconer, Murray A.

doi:10.1136/bjo.48.1.13

Cited by 12 publications

(4 citation statements)

References 10 publications

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“…8,14 Local pressure of ICSOL has significant effect on visual fields. 12 Constriction of visual fields was found in significant number of cases. Hemianopia (Bitemporal/homonymous) is commonly found in pituitary and frontal lobe tumours due to local pressure effects.…”

Section: -Year-old Male Showing Proptosis Left Eye He Had Nasopharmentioning

confidence: 98%

“…This is similar to other studies. 3,8,11,12 Incidence of Headache and Vomiting is significantly higher than other systemic manifestations. 4,12 It may be due to raised intracranial pressure in ICSOL.…”

Section: -Year-old Male Showing Proptosis Left Eye He Had Nasopharmentioning

confidence: 99%

“…Ocular manifestations increased as the level of consciousness deteriorated. Cranial nerve palsies 3,11,13 and papilloedema, 3,12 may be due to raised intracranial pressure. As the intracranial pressure increases, level of consciousness decreases.…”

Section: -Year-old Male Showing Proptosis Left Eye He Had Nasopharmentioning

confidence: 99%

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Clinical Study of Ocular Manifestations of Intracranial Space Occupying Lesions

Nalawade¹,

Javadekar²

2017

jemds

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BACKGROUND The aim of this study is to find out various extraocular and intraocular manifestations of Intracranial Space Occupying Lesions (ICSOL), so as to reach an early diagnosis of ICSOL. MATERIALS AND METHODS Study was carried out in Prakash Hospital and Research Centre over a period of two years attending OPD (Ophthalmology as well as other clinical departments), so also IPD patients from Medicine, Paediatrics and other relevant Departments. Detailed clinical history was taken and detailed clinical, slit lamp, funduscopic examination was done in each case. Visual fields were tested by automated perimetry in all cooperative patients. Radiological investigations were done in all cases. Relevant laboratory investigations were done in all cases. All ocular manifestations were noted in tabular form and were co-related with clinical diagnosis. RESULTS The incidence of intracranial space occupying lesions and ocular manifestations was high in adult age groups (11 yrs. to 40 yrs.). Males (48%) and females (52%) were almost equally affected in intracranial space occupying lesions and ocular manifestations were also almost equal in both males (46%) and females (44%). Most common ICSOL was Brain Tumour (50%) followed by Brain Abscess (20%), Intracranial Haematomas (14%), Metastatic Deposits in brain (2%) and others (14%). There was no case of Intracranial Aneurysm. Ocular manifestations increased as the level of consciousness deteriorated. The most common symptom was Diplopia (26%) and most common signs were of cranial nerve palsies (22%) followed by Ptosis (12%), Cataract (8%), Black Eye (4%), Subconjunctival Haemorrhage, Exposure Keratitis, Proptosis, Nystagmus (1%) each. The most common fundus finding was Established Papilloedema (28%) followed by Early Papilloedema (14%), Retinal Haemorrhages (14%), Optic Atrophy (12%), and Optic Neuritis (4%). The most commonly affected cranial nerve was Abducent, i.e. 6 th nerve (6 cases) due to its long intracranial course. The other nerves were 3 rd oculomotor (5 cases), 4 th Trochlear (2 cases). Visual acuity changes were most common in Brain tumours followed by Brain abscess and others. Fundus changes were more common (37 cases) than extraocular signs (23 cases). The incidence of visual field defects was more common in brain tumours (75%) followed by brain abscess (16%). CONCLUSION ICSOLs are more common in adult age group. Ocular manifestations in ICSOLs indicate severity of the disease. Prognosis of ICSOLs is poor if ocular manifestations are present.

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Section: -Year-old Male Showing Proptosis Left Eye He Had Nasopharmentioning

confidence: 98%

Section: -Year-old Male Showing Proptosis Left Eye He Had Nasopharmentioning

confidence: 99%

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Clinical Study of Ocular Manifestations of Intracranial Space Occupying Lesions

Nalawade¹,

Javadekar²

2017

jemds

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“…Indirect decompression may also be appropriate: endoscopic transethmoidal decompression of the posterior intraorbital and intracanicular segments can usefully be achieved for otherwise inoperable sphenoid meningiomas impinging on the optic nerve from the superolateral aspect (Figure 4). [47][48][49][50] In conclusion, the optic canal may be decompressed as part of the treatment of an extrinsic compressing tumour ( Table 2). In the case of fibrous dysplasia, surgery is usually most appropriate for secondary mass lesions and in traumatic optic neuropathy for delayed secondary visual loss in an otherwise fit patient.…”

Section: Neoplastic and Other Compressive Lesionsmentioning

confidence: 99%

Optic nerve disorders: role of canal and nerve sheath decompression surgery

Acheson

2004

Eye

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Optic nerve sheath decompression (ONSD) maintains a role in the management of visual loss complicating papilloedema in selected patients primarily with idiopathic intracranial hypertension. The evidence base for this intervention is reviewed and audit data on visual outcomes for patients with acute, chronic, and atrophic forms of papilloedema are contrasted. Optic canal decompression has a role in the management of compressive optic neuropathies complicating mass lesions arising from paranasal sinuses and intracranially and can be achieved by transethmoidal, transbasal, and open craniotomy routes. The evidence base supporting this intervention in traumatic optic neuropathy and in primary bone disease causing canal stenosis (in particular fibrous dysplasia) is reviewed where the indications are more controversial.

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