Unilateral optic disc swelling as a first sign of optic nerve sheath meningioma — a case report

Abstract

Optic nerve sheath meningiomas (ONSM) are rare, slow-growing, benign tumours, which constitute approximately 2% of all orbital tumours of the anterior visual pathway (or orbital or anterior visual pathway) and 1–2% of all meningiomas. Middle-aged females are primarily affected. Untreated ONSMs usually lead to progressive visual decline, colour blindness, and finally complete loss of vision. Surgical excision may result in blindness in the affected eye. Stereotactic fractionated radiotherapy has recently shown effectiveness in improving or stabilising remaining visual function with minimal procedural morbidity in patients with ONSM. We present a case of a 59-year-old female with unilateral optic nerve sheath meningioma treated with stereotactic fractionated radiotherapy. During eight months of follow-up we observed persistent oedema of the right optic disc and full visual acuity. Optical coherence tomography showed decreased peripapillary nerve fibre layer.