Tuberculum meningioma with recovery of glaucomatous visual field defects after chiasmal decompression: a case report

Abstract

Abstract Background: To report a case of tuberculum meningioma with recovery of glaucomatous visual field defects after chiasmal decompression. Case presentation: A 39-year-old woman presenting with headache was found to have a suprasellar tumor compressing the anterior chiasm upwards on magnetic resonance imaging of the brain. The patient had bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT). The visual fields showed arcuate scotomas compatible with RNFL loss, suggesting glaucomatous change. But after resection of the mass, which was pathologically diagnosed as meningothelial meningioma, the glaucomatous visual field defects resolved despite the RNFL thinning on the OCT showing no improvement. Conclusions: Chiasmal compression in this case is extremely rare in the way that it produced arcuate scotoma such as glaucoma 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.