Visual function recovery post decompression surgery in meningioma: a case report

Abstract

Background: Meningiomas represent about 20% of intracranial tumors. Due to these tumors' proximity to the optic nerve, typically progressive unilateral vision loss, over several months to years, is the classic clinical presentation.Case Presentation: A 23 y.o. male presented with a progressive monocular visual loss of the right eye since 4 months. Visual acuity on the right eye was 1/300 and 6/6 on the left eye. Color vision and contrast sensitivity of the left eye was excellent. Fundus examination showed papilledema on right eye and left eye was within normal limit. MRI reveals a strong enhancing mass along the right and left sphenoid wing, measuring approximately 3.9 x 5.5 x 3.3 cm, extending into the parasellar region, compressing optic chiasm and encasing right and left N.III, N.IV and N.V. Patient were diagnosed with compressive optic neuropathy on the right eye due to meningioma. Following the decompression surgery, visual acuity on the right eye improved to 6/24, color vision 25/38 and contrast sensitivity was 5%. The patient was discharged 4 days after surgery and scheduled for routine follow-up at the polyclinic.Conclusion: Vision loss due to the compressive effect of meningioma may be reversible. The severity and the duration of vision loss due to compression may affect the final visual recovery. Early detection and prompt multidisciplinary approach are necessary to obtain a better outcome.