Sharanya R, Habeeba C, Kumar Karthik, Shah Virna M
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India.
Indian J Ophthalmol. 2025 May 1;73(5):691-694. doi: 10.4103/IJO.IJO_672_24. Epub 2025 Apr 24.
The purpose is to analyze the clinical and radiological presentation of meningiomas in an Indian population in a tertiary eye care institute in South India.
A total of 15 patients with intraorbital and intracranial meningioma presented to our neuro-ophthalmology clinic over 4 months. These cases of meningioma presented primarily to us with ophthalmic features and were diagnosed by us. Complete neuro-ophthalmic evaluation, including ocular examination, fundus, color vision, visual field, cranial nerve examination, was performed for each case and neuroimaging in the form of MRI brain with orbit with contrast. Clinical presentation of each case and site and extension of meningioma in neuroimaging was analyzed.
Among 15 patients, age range was from 26-72 years, with mean age of 56 years. A total of 27% of patients were male, and 73% were female. A total of nine out of 15 cases were histologically proven. Chiasmal compression was observed on neuroimaging in 53% of patients. A total of 10 patients (66.67%) presented with complaints of defective vision, and five patients (33.33%) had double vision as their presenting symptom. Clinical examination revealed signs of sixth cranial nerve involvement in 20%, multiple cranial nerve paresis in 20%, and third cranial nerve palsy in 13%. A total of 47% of patients did not have any cranial nerve involvement. Visual field examination revealed homonymous hemianopia in 13% of patients. On fundus examination, 40% had bilateral optic atrophy, and 7% presented with papilledema. Visual field defects were documented and corelated with location of meningioma.
Our study emphasizes the role of ophthalmologists in early detection of meningioma as many patients present first with subtle ophthalmological signs and symptoms before developing neurological symptoms.
分析印度南部一家三级眼科护理机构中印度人群脑膜瘤的临床和影像学表现。
在4个月内，共有15例眶内和颅内脑膜瘤患者到我们的神经眼科诊所就诊。这些脑膜瘤病例主要因眼科症状前来就诊并由我们进行诊断。对每个病例进行了全面的神经眼科评估，包括眼部检查、眼底、色觉、视野、颅神经检查，并进行了眼眶MRI增强扫描形式的神经影像学检查。分析了每个病例的临床表现以及脑膜瘤在神经影像学中的位置和范围。
15例患者年龄在26至72岁之间，平均年龄为56岁。男性患者占27%，女性患者占73%。15例中有9例经组织学证实。神经影像学检查发现53%的患者存在视交叉受压。共有10例患者（66.67%）主诉视力缺陷，5例患者（33.33%）以复视为首发症状。临床检查发现20%的患者有第六颅神经受累体征，20%的患者有多发性颅神经麻痹，13%的患者有第三颅神经麻痹。共有47%的患者没有任何颅神经受累。视野检查发现13%的患者有同向性偏盲。眼底检查发现40%的患者有双侧视神经萎缩，7%的患者有视乳头水肿。记录了视野缺损情况并与脑膜瘤的位置相关联。
我们的研究强调了眼科医生在脑膜瘤早期检测中的作用，因为许多患者在出现神经症状之前首先表现出细微的眼科体征和症状。
