Pellegrini Francesco, Lee Andrew G, Cercato Cristina
Neuro-Ophthalmology Service, Department of Ophthalmology, De Gironcoli Hospital, Conegliano, Italy.
Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA.
Neuroophthalmology. 2017 Aug 2;42(2):112-116. doi: 10.1080/01658107.2017.1350194. eCollection 2018 Apr.
A 49-year-old previously healthy woman presented with acute painless visual loss in the right eye, a right relative afferent pupillary defect, and a normal fundus examination. She was diagnosed with retrobulbar "optic neuritis" and given a course of intravenous steroids. Despite treatment, however, she continued to lose vision and serial visual field testing confirmed a junctional scotoma in the fellow eye. Cranial magnetic resonance imaging (MRI) showed a mass at the junction between the right optic nerve and the anterior aspect of the chiasm and a right frontal lesion that proved to be multicentric glioblastoma multiforme. Clinicians should be aware of the possibility of aggressive neoplasm in the differential diagnosis of retrobulbar optic neuritis.
一名49岁既往健康的女性,出现右眼急性无痛性视力丧失、右相对性传入性瞳孔障碍,眼底检查正常。她被诊断为球后视神经炎,并接受了一个疗程的静脉类固醇治疗。然而,尽管进行了治疗,她仍继续视力下降,系列视野检查证实对侧眼有交界性暗点。头颅磁共振成像(MRI)显示右侧视神经与视交叉前部交界处有一肿块,右侧额叶病变经证实为多中心多形性胶质母细胞瘤。临床医生在球后视神经炎的鉴别诊断中应意识到侵袭性肿瘤的可能性。