A case of optic neuropathy: Concurrent internal carotid artery aneurysm and optic nerve sheath meningioma

Abstract

In the examination of fourty-five years old female patient with a sudden decrease in her visual acuity (VA) in the right eye, relative afferent pupillary defect with the VA of 0.3, optic disc edema, concentric visual field (VF) defect, decreased color vision and contrast sensitivity in the same eye were determined. Systemic steroid therapy was initiated to the patient with the diagnosis of papillitis with no additional pathology. Following treatment, total recovery was observed. However, the patient was continued to be followed up without treatment because of chronic optic disc edema. After a 2 years follow-up period, VA in the same eye was slightly decreased (right VA:0.8) and accompanied with a newly developed VF defect. Repeated cranial MRI displayed ICA aneurysm and stent+coil embolization was applied with the prescription of antiplatelet therapy. However, due to ongoing clinic progression, cranio-orbital MRI (surface coil) was performed for the third time and right optic nerve sheath meningioma was detected. The patient is closely followed up by neurosurgery and neurology departments. In case of chronic optic disc edema, additional accompanying pathologies should always be kept in mind and detailed investigation could be necessary.