Abstract
16 cases (18 eyes) of rhinogenous optic neuropathy due to muco-pyoceles in the sphenoid sinus and posterior ethmoid cells are reported. The clinical symptomes of this condition are characterized as follows: 1) acute or chronic progressive visual disturbance, 2) ophthalmoscopically normal or oedematous disc in the acute stage and optic atrophy in the chronic stage, 3) central scotoma or inferior hemianopsia in the visual field, 4) good recovery of vision in the cases with mucoceles, occasionally no recovery of vision in the cases with pyoceles, 5) oculomotor as well as abducent palsy and exophthalmos; occasionally, 6) past history of optic neuropathy and nasal operation, 7) few rhinologic complaints, 8) rhinoscopically: swelling, obstruction and/or polyp in the middle meatus, and 9) CT scan showing homogeneous mass in the sphenoid sinus and/or posterior ethmoid cells. The causative factor of the visual disturbance due to pyoceles might be caused not only by compression but also by inflammatory infiltration and vascular disturbance. Recurrence of rhinogenous optic neuropathy is frequent.
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