Lestak Jan, Haninec Pavel, Kyncl Martin, Tintera Jaroslav
JL Clinic, Prague 15800, Czech Republic.
Czech Technical University of Prague, Faculty of Biomedical Engineering, Kladno 27201, Czech Republic.
Mol Clin Oncol. 2020 May;12(5):411-414. doi: 10.3892/mco.2020.2012. Epub 2020 Mar 5.
The aim of the present study was to observe visual pathway changes on the contralateral side in optic nerve sheath meningioma (ONSM). The authors present a case report of a 43-year-old patient with OfNSM on the right side. A complex ophthalmic examination was performed, including an assessment of visual functions, an electrophysiology examination and functional and structural MRI examinations. Visual acuity of the right eye after ONSM remained with no light perception, while that of the left side was normal. The visual field of the left eye was normal as was colour perception. An electrophysiology examination using a pattern electroretinogram revealed low amplitude values in the right eye. In the left eye, the finding was at the lower limit of normal results. The pattern visual evoked potential exhibited a bilateral lesion with a larger decrease in response after stimulation of the right eye. The structural MRI revealed intraorbital atrophy of the optic nerve on the right side throughout the whole course, which was accompanied by atrophy of the right half of the optic chiasm. Functional magnetic resonance imaging revealed zero activity after stimulation of the right eye and decreased activity in the visual centre after stimulation of the left eye. The present study demonstrated that unilateral damage to the optic nerve in ONSM is accompanied by significant changes on the contralateral side of the optic pathway.
本研究的目的是观察视神经鞘膜瘤(ONSM)对侧视觉通路的变化。作者报告了一例43岁右侧ONSM患者的病例。进行了全面的眼科检查,包括视觉功能评估、电生理检查以及功能和结构磁共振成像检查。右侧ONSM术后右眼视力无光感,而左侧视力正常。左眼视野和色觉正常。使用图形视网膜电图进行的电生理检查显示右眼振幅值较低。左眼的检查结果处于正常范围下限。图形视觉诱发电位显示双侧病变,右眼刺激后反应下降幅度更大。结构磁共振成像显示右侧视神经全程眶内萎缩,并伴有视交叉右半部分萎缩。功能磁共振成像显示右眼刺激后无活动,左眼刺激后视觉中枢活动减少。本研究表明,ONSM中视神经的单侧损伤伴有视通路对侧的显著变化。