The Clinical Spectrum of Schwannomas Presenting With Visual Dysfunction

Cockerham, Kimberly P.; Cockerham, Glenn C.; Stutzman, Ray E.; Hidayat, Ahmed A.; Depper, Mark H.; Turbin, Roger E.; Kennerdell, John S.

doi:10.1016/s0039-6257(99)00100-9

Cited by 26 publications

(19 citation statements)

References 9 publications

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“…Less commonly, they occur in the orbital apex and may mimic the appearance of a cavernous hemangioma. In contrast to orbital schwannomas, intracranial tumors typically arise from cranial nerve VIII or, less commonly, cranial nerves V, IX, and X [8].…”

Section: Discussionmentioning

confidence: 99%

A patient with swelling of the eyelid: ancient schwannoma of the supraorbital nerve (2010:6b)

et al. 2010

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Section: Discussionmentioning

confidence: 99%

A patient with swelling of the eyelid: ancient schwannoma of the supraorbital nerve (2010:6b)

et al. 2010

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“…5,7,22 The presenting VA is significantly affected by the presence of disc changes on fundus whereas choroidal folds did not hamper it. The postoperative visual outcome also followed suit.…”

Section: Discussionmentioning

confidence: 99%

Visual function alterations in orbital tumors and factors predicting visual outcome after surgery

Singh

Pushker

Bajaj

et al. 2011

Eye

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Purpose To study the effect of orbital tumors on visual functions and highlight the factors predictive of visual outcome after surgery. Methods A prospective interventional study compared visual function parameters and fundus changes, before and after surgery, in eyes having well-defined orbital tumors with the normal fellow eye. These included visual acuity (VA), refractive error, keratometry changes, color vision, Goldmann visual field (GVF), and visual evoked response (VER). Results In total 28 cases (age range 7-56 years), of which the majority of tumors were vascular (46%) and lacrimal (18%) in origin, had a mean VA of 0.54±0.33 in the affected eye, which improved postoperatively to 0.66 ± 0.31 (P ¼ 0.002). The affected eye had a median refractive error of þ 0.00 DS (À2.00 to 5.13), which was significantly more hyperopic than the normal eye (median þ 0.00 DS; range À1.25 to þ 1.63 DS) and normalized postoperatively. Keratometry showed higher astigmatism in the involved eye (P ¼ 0.004). The fundus showed disc pallor, edema, and/or choroidal folds, of which disc edema resolved in all cases after surgery. In all, 40% of the affected eyes had a deficient color vision and this partially improved postoperatively (P ¼ 0.25). GVF had abnormalities in 10 cases, half of which normalized postoperatively (P ¼ 0.04). The VER of affected eyes had a mean amplitude of 8.91 ± 4.59 lv and latency of 116.3 ± 14.7 ms, with improvement after surgery (P ¼ 0.005 and 0.001, respectively). Conclusion Orbital tumors adversely affected visual functions. The presenting acuity depended on disc changes, color vision abnormalities, and prolonged VER latency. The postoperative VA depended on VA at presentation, amount of proptosis, degree of hyperopia, and clinically significant VER abnormalities.

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“…Surgical friability can complicate tumour excision and, although not common, has been described. 1,5,11 In this case, the previous biopsy, which disrupted the capsule, may have resulted in operative friability of the tumour. Local recurrences may occur many years later, but malignant transformation is extremely rare.…”

Section: Commentmentioning

confidence: 92%

“…1,2 Immunohistochemical examination, for example, with S-100 and vimentin gives additional supportive data when classical histology is not present. 1,2,11 Surgical excision is the treatment of choice in symptomatic patients. Surgical friability can complicate tumour excision and, although not common, has been described.…”

Section: Commentmentioning

confidence: 99%