Khodeiry Mohamed M, Lind John T, Pasol Joshua, Lam Byron L, Lee Richard K
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt.
Am J Ophthalmol Case Rep. 2021 Dec 31;25:101253. doi: 10.1016/j.ajoc.2021.101253. eCollection 2022 Mar.
To report a unique case of metastatic paraganglioma presenting as a junctional scotoma.
A 38-year-old Caucasian man with a history of abdominal paraganglioma presented with minimally blurred vision 20/25 visual acuity in the left eye. The patient was found to have a junctional scotoma upon visual field testing. Cranial MRI revealed a large peri-clival mass compressing the pre-chiasmal optic nerves and other loci of metastatic disease. Intracranial masses, including metastases, can present with a relatively intact central acuity and nonspecific visual symptoms.
To the best of our knowledge, this is the first report of metastatic paraganglioma causing a junctional scotoma. In cases with junctional scotoma, careful neuro-ophthalmic assessment and imaging are of paramount importance, even in patients with excellent visual acuity.
报告一例表现为交界性暗点的转移性副神经节瘤的独特病例。
一名38岁有腹部副神经节瘤病史的白种男性，左眼视力轻度模糊，视力为20/25。视野检查发现该患者有交界性暗点。头颅磁共振成像（MRI）显示一个巨大的斜坡周围肿块压迫视交叉前视神经及其他转移病灶部位。颅内肿块，包括转移瘤，可表现为相对完好的中心视力和非特异性视觉症状。
据我们所知，这是转移性副神经节瘤导致交界性暗点的首例报告。在有交界性暗点的病例中，即使视力良好的患者，仔细的神经眼科评估和影像学检查也至关重要。
