Yen Nee See Wendy, Sumugam Kala, Subrayan Visvaraja
Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Allergy Rhinol (Providence). 2016 Jan 1;7(4):223-226. doi: 10.2500/ar.2016.7.0178.
To report an unusual case of compressive optic neuropathy secondary to a large onodi air cell.
Case report.
A 50 year-old gentlemen presented to the eye clinic with left eye painless loss of vision for one day. Visual acuity was counting finger in the left eye with a positive relative afferent pupillary defect (RAPD). Dilated left fundus examination revealed a pale optic disc. A computed tomography of orbit and brain showed a large left sphenoid sinus with onodi-cell-like projection on the left superior margin of left optic canal impinging on the left optic nerve. He was referred to the otorhinolaryngology team and subsequently underwent left optic nerve decompression. Post-operatively, his left visual acuity improved to 6/60 with reversal of RAPD.
There are many causes of optic neuropathy and compressive optic neuropathy due to large onodi air cell is uncommon. Acute unilateral loss of vision heralds from a multitude of sinister causes and junior residents should be vigilant that onodi air cell pneumotisation could be one of them.
报告一例罕见的因大的蝶筛隐窝气房导致的压迫性视神经病变。
病例报告。
一名50岁男性因左眼无痛性视力丧失一天就诊于眼科门诊。左眼视力为眼前指数，伴有相对传入性瞳孔障碍（RAPD）阳性。左眼散瞳眼底检查显示视盘苍白。眼眶和脑部计算机断层扫描显示左侧蝶窦大，左侧视神经管上缘有类似蝶筛隐窝气房的突起，压迫左侧视神经。他被转诊至耳鼻喉科团队，随后接受了左侧视神经减压术。术后，他的左眼视力提高到6/60，RAPD消失。
视神经病变有多种原因，因大的蝶筛隐窝气房导致的压迫性视神经病变并不常见。急性单侧视力丧失有多种严重原因，初级住院医师应警惕蝶筛隐窝气房气化可能是其中之一。
