A middle-aged woman presents with blurred vision and a relative afferent pupillary defect (RAPD). Why?

Neuro Coach #2

Here is the visual field:

Neuro Coach #2 Analysis

Analysis

In the right eye there is evidence of disc swelling as compared to the left eye. The visual fields also show significant reduction in the field from the right eye. The patient’s OCT showed thinning of the macular ganglion cell layer and thickening of the peripapillary rNFL (video). MRI with contrast showed optic nerve enhancement at the optic canal (video).

The patient was diagnosed with an optic sheath meningioma.

In the accompanying 14 min. video featuring Dr. Paul Freund, Assistant Professor at Dalhousie University in Halifax, you will learn:

  • How to interepret the rNFL on OCT
  • How optic nerve sheath meningioma can present
  • How optic nerve meningioma is managed
 

Neuro Coach Tip

In a middle-aged woman with optic swelling or atrophy, consider an optic nerve meningoma.

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