Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, 060-8570, Sapporo, Japan.
Department of Neurosurgery, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan.
BMC Ophthalmol. 2024 Feb 14;24(1):68. doi: 10.1186/s12886-024-03332-w.
To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression.
A 39-year-old woman presenting with headache was found to have bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT) with a corresponding arcuate scotomas consistent with glaucomatous change. However a suprasellar tumor compressing the anterior chiasm from below was found on magnetic resonance imaging of the brain. After resection of the mass, which was diagnosed as meningothelial meningioma by the pathological examination, the glaucoma-like visual field defects resolved despite the RNFL thinning on the OCT showing no improvement.
Chiasmal compression may mimic glaucoma and produce arcuate scotoma rather than temporal visual field loss. There is a possibility that the development of chiasmal compression somehow converted preperimetric glaucoma into a more advanced form accompanied by visual field defects and that the glaucoma reverted to the preperimetric state after chiasmal decompression.
报告一例颅咽管瘤，对视神经交叉减压后类似青光眼的视野缺损恢复。
一位 39 岁女性因头痛就诊，发现光学相干断层扫描（OCT）显示双侧弧形视网膜神经纤维层（RNFL）变薄，伴有相应的弧形暗点，符合青光眼改变。然而，脑部磁共振成像显示鞍上肿瘤从下方压迫视交叉。切除肿块后，病理检查诊断为脑膜瘤，尽管 OCT 显示 RNFL 变薄无改善，但类似青光眼的视野缺损消失。
视交叉受压可能模拟青光眼并产生弧形暗点，而不是颞侧视野损失。视交叉受压可能会导致某种程度的前期青光眼进展为更晚期的伴有视野缺损的青光眼，并且在视神经交叉减压后青光眼恢复到前期状态。
