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A sphenoid sinus mucocele simulating as retro bulbar optic neuritis.

Gupta AK, Menon V, Sharma P, Saxena R, Kumaran S - Indian J Ophthalmol (2012 May-Jun)

Bottom Line: A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis.Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field.A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.

View Article: PubMed Central - PubMed

Affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.

ABSTRACT
A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis. However, magnetic resonance imaging (MRI) showed lesion consistent with sphenoid sinus mucocele. Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field. A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.

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Sagittal image showing T1 hyperintense lesion filling and expanding the sphenoid sinus
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Figure 6: Sagittal image showing T1 hyperintense lesion filling and expanding the sphenoid sinus

Mentions: The patient was asked to follow up after one week, at that time he complained of increase in ocular pain even at rest and his vision had dropped to 20/200. So to exclude any demyelinating disease magnetic resonance imaging (MRI) of the brain was advised. The MRI showed a large lobulated lesion, 41 × 66 × 64 mm along the floor of the sella displacing the pituitary superiorly with a suprasellar extension (no post-contrast enhancement). A diagnosis of sphenoid sinus mucocele was made [Fig. 3a and b]. The mass was large enough to be causing indentation of the cavernous sinus. The entire hormonal profile was done and all hormone levels in the blood were normal, including the serum prolactin level.


A sphenoid sinus mucocele simulating as retro bulbar optic neuritis.

Gupta AK, Menon V, Sharma P, Saxena R, Kumaran S - Indian J Ophthalmol (2012 May-Jun)

Sagittal image showing T1 hyperintense lesion filling and expanding the sphenoid sinus
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361819&req=5

Figure 6: Sagittal image showing T1 hyperintense lesion filling and expanding the sphenoid sinus
Mentions: The patient was asked to follow up after one week, at that time he complained of increase in ocular pain even at rest and his vision had dropped to 20/200. So to exclude any demyelinating disease magnetic resonance imaging (MRI) of the brain was advised. The MRI showed a large lobulated lesion, 41 × 66 × 64 mm along the floor of the sella displacing the pituitary superiorly with a suprasellar extension (no post-contrast enhancement). A diagnosis of sphenoid sinus mucocele was made [Fig. 3a and b]. The mass was large enough to be causing indentation of the cavernous sinus. The entire hormonal profile was done and all hormone levels in the blood were normal, including the serum prolactin level.

Bottom Line: A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis.Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field.A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.

View Article: PubMed Central - PubMed

Affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.

ABSTRACT
A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis. However, magnetic resonance imaging (MRI) showed lesion consistent with sphenoid sinus mucocele. Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field. A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.

Show MeSH
Related in: MedlinePlus