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.
Keywords: meningiomaoptic nerveoptic nerve sheath meningiomasorbital tumour
References
- Dutton JJ. Optic nerve sheath meningiomas. Surv Ophthalmol. 1992; 37(3): 167–183.
- Imes RK, Schatz H, Hoyt WF, et al. Evolution of optociliary veins in optic nerve sheath meningioma. Evolution. Arch Ophthalmol. 1985; 103(1): 59–60.
- Saeed P, Blank L, Selva D, et al. Optic nerve sheath meningiomas. Ophthalmology. 2003; 110(10): 2019–2030.
- Miller NR. Primary tumours of the optic nerve and its sheath. Eye (Lond). 2004; 18(11): 1026–1037.
- Kim JW, Rizzo JF, Lessell S. Controversies in the management of optic nerve sheath meningiomas. Int Ophthalmol Clin. 2005; 45(4): 15–23.
- Eddleman CS, Liu JK. Optic nerve sheath meningioma: current diagnosis and treatment. Neurosurg Focus. 2007; 23(5): E4.
- Mafee MF, Goodwin J, Dorodi S. Optic nerve sheath meningiomas. Role of MR imaging. Radiol Clin North Am. 1999; 37(1): 37–58, ix.
- Berman D, Miller NR. New concepts in the management of optic nerve sheath meningiomas. Ann Acad Med Singapore. 2006; 35(3): 168–174.
- Alper MG. Management of primary optic nerve meningiomas. Current status--therapy in controversy. J Clin Neuroophthalmol. 1981; 1(2): 101–117.
- Carrasco JR, Penne RB. Optic nerve sheath meningiomas and advanced treatment options. Curr Opin Ophthalmol. 2004; 15(5): 406–410.
- Miller NR. New concepts in the diagnosis and management of optic nerve sheath meningioma. J Neuroophthalmol. 2006; 26(3): 200–208.
- Liu JK, Forman S, Moorthy CR, et al. Update on treatment modalities for optic nerve sheath meningiomas. Neurosurg Focus. 2003; 14(5): e7.
- Sibony PA, Krauss HR, Kennerdell JS, et al. Optic nerve sheath meningiomas. Clinical manifestations. Ophthalmology. 1984; 91(11): 1313–1326.
- Wright JE. Primary optic nerve meningiomas: clinical presentation and management. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977; 83(4 Pt 1): 617–625.
- Cameron EW. Transient ischaemic attacks due to meningioma--report of 4 cases. Clin Radiol. 1994; 49(6): 416–418.
- Knight CL, Hoyt WF, Wilson CB. Syndrome of incipient prechiasmal optic nerve compression. Progress toward early diagnosis and surgical management. Arch Ophthalmol. 1972; 87(1): 1–11.
- Kennerdell JS, Maroon JC. Intracanalicular meningioma with chronic optic disc edema. Ann Ophthalmol. 1975; 7(4): 507–512.
- Lindblom B, Truwit CL, Hoyt WF. Optic nerve sheath meningioma. Definition of intraorbital, intracanalicular, and intracranial components with magnetic resonance imaging. Ophthalmology. 1992; 99(4): 560–566.
- Turbin RE, Pokorny K. Diagnosis and treatment of orbital optic nerve sheath meningioma. Cancer Control. 2004; 11(5): 334–341.
- Andrews DW, Faroozan R, Yang BP, et al. Fractionated stereotactic radiotherapy for the treatment of optic nerve sheath meningiomas: preliminary observations of 33 optic nerves in 30 patients with historical comparison to observation with or without prior surgery. Neurosurgery. 2002; 51(4): 890–902; discussion 903.
- Baumert BG, Villà S, Studer G, et al. Early improvements in vision after fractionated stereotactic radiotherapy for primary optic nerve sheath meningioma. Radiother Oncol. 2004; 72(2): 169–174.
- Becker G, Jeremic B, Pitz S, et al. Stereotactic fractionated radiotherapy in patients with optic nerve sheath meningioma. Int J Radiat Oncol Biol Phys. 2002; 54(5): 1422–1429.
- Capo H, Kupersmith MJ. Efficacy and complications of radiotherapy of anterior visual pathway tumors. Neurol Clin. 1991; 9(1): 179–203.
- Eng TY, Albright NW, Kuwahara G, et al. Precision radiation therapy for optic nerve sheath meningiomas. Int J Radiat Oncol Biol Phys. 1992; 22(5): 1093–1098.
- Jeremic B, Pitz S. Primary optic nerve sheath meningioma: stereotactic fractionated radiation therapy as an emerging treatment of choice. Cancer. 2007; 110(4): 714–722.
- Klink DF, Miller NR, Williams J. Preservation of residual vision 2 years after stereotactic radiosurgery for a presumed optic nerve sheath meningioma. J Neuroophthalmol. 1998; 18(2): 117–120.
- Landert M, Baumert BG, Bosch MM, et al. The visual impact of fractionated stereotactic conformal radiotherapy on seven eyes with optic nerve sheath meningiomas. J Neuroophthalmol. 2005; 25(2): 86–91.
- Lee AG, Woo SY, Miller NR, et al. Improvement in visual function in an eye with a presumed optic nerve sheath meningioma after treatment with three-dimensional conformal radiation therapy. J Neuroophthalmol. 1996; 16(4): 247–251.
- Liu JK, Forman S, Hershewe GL, et al. Optic nerve sheath meningiomas: visual improvement after stereotactic radiotherapy. Neurosurgery. 2002; 50(5): 950–957.
- Moyer PD, Golnik KC, Breneman J. Treatment of optic nerve sheath meningioma with three-dimensional conformal radiation. Am J Ophthalmol. 2000; 129(5): 694–696.
- Pitz S, Becker G, Schiefer U, et al. Stereotactic fractionated irradiation of optic nerve sheath meningioma: a new treatment alternative. Br J Ophthalmol. 2002; 86(11): 1265–1268.
- Richards JC, Roden D, Harper CS. Management of sight-threatening optic nerve sheath meningioma with fractionated stereotactic radiotherapy. Clin Exp Ophthalmol. 2005; 33(2): 137–141.
- Shrieve DC, Tarbell NJ, Alexander E, et al. Stereotactic radiotherapy: a technique for dose optimization and escalation for intracranial tumors. Acta Neurochir Suppl. 1994; 62: 118–123.
- Sitathanee C, Dhanachai M, Poonyathalang A, et al. Stereotactic radiation therapy for optic nerve sheath meningioma; an experience at Ramathibodi Hospital. J Med Assoc Thai. 2006; 89(10): 1665–1669.
- Smith JL, Vuksanovic MM, Yates BM, et al. Radiation therapy for primary optic nerve meningiomas. J Clin Neuroophthalmol. 1981; 1(2): 85–99.
- Turbin RE, Thompson CR, Kennerdell JS, et al. A long-term visual outcome comparison in patients with optic nerve sheath meningioma managed with observation, surgery, radiotherapy, or surgery and radiotherapy. Ophthalmology. 2002; 109(5): 890–9; discussion 899.