Ocular Manifestations of Sphenoid Meningioma : A Case Report

Abstract

Background: Approximately 46.8% to 88.6% patient with brain tumor experienced ophthalmology manifestations and most patients went to ophthalmologist in the first time with ocular symptoms. Sphenoid meningioma are often asymptomatic in the early stage of the disease. The ocular manifestations mentioned above could appear as the disease progresses, therefore a careful clinical evaluation is needed in order to retain neurological function. Case: A 40 years old female patient was presented with main complaint of headache. This symptom was felt since 6 months ago on the left side of the head accompanied by visual disturbance on the left eye since 3 months ago. Head magnetic resonance imaging (MRI) with contrast showed broad base meningioma on the left sphenoid wing measuring about 3,62 x 3,08 x 2,24 cm. The mass extended to left cavernous sinus and encased left carotid artery as well as pushing the right carotid artery laterally; the mass also extended to left sphenoid sinus and encased left optical nerve; the mass also extended to intrasellar and compressed the hypophysis. Optical coherence tomography (OCT) examination showed retinal nerve fiber layer (RNFL) thinning on the temporal quadrant of the left eye, reduced macular thickness of the left eye, and optic papilla atrophy of the left eye. Conclusion: Ophthalmic examinations and evaluation could assist in early diagnosis of tumor in order to adequately treat the disease. The prognosis is better if the cranial lesion could be recognized early and hence managed well, therefore decreasing morbidity and mortality.