Lin Muh-Chiou, Bee Youn-Shen, Sheu Shwu-Jiuan
Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2003 Nov;66(11):689-92.
A 39-year-old female came with the chief complaint of acute decrease of left eye vision for the past 2 weeks. No history of systemic diseases or headache was complained. The visual acuity of the left eye was "hand motion", and rapidly responded to methylprednisolone therapy in 3 days. On tapering oral prednisolone, the visual acuity decreased again from 20/20 to light perception in the left eye. The magnetic resonance image (MRI) study showed a large suprasellar mass. The patient underwent craniotomy and removal of the tumor successfully, and the pathological report turned out to be a meningioma. The visual acuity of the left eye remained poor after the surgery. In conclusion, neuroimaging study is necessary in every case of presumed retrobulbar optic neuritis which shows atypical course. Early detection of a brain tumor may save the vision of the patient.
一名39岁女性因过去两周左眼视力急剧下降前来就诊。无全身性疾病史或头痛主诉。左眼视力为“手动”，在3天内对甲基强的松龙治疗反应迅速。在逐渐减少口服泼尼松龙剂量时，左眼视力再次从20/20降至光感。磁共振成像（MRI）检查显示鞍上有一个大肿块。患者成功接受了开颅手术并切除肿瘤，病理报告显示为脑膜瘤。术后左眼视力仍很差。总之，对于每一例表现为非典型病程的疑似球后视神经炎患者，神经影像学检查都是必要的。早期发现脑肿瘤可能挽救患者的视力。
