Ann Clin Neurophysiol.  2023;25(1):50-53. 10.14253/acn.2023.25.1.50.

Optic nerve sheath meningioma mimicking optic perineuritis

• Kim S
• Kang M
• Park JS
• Seok HY

• KMID: 2541824
• DOI: http://doi.org/10.14253/acn.2023.25.1.50

Abstract

Tram-track and doughnut-shaped enhancements of the optic nerve sheath in axial and coronal magnetic resonance imaging (MRI) views, respectively, play crucial roles in the diagnosis of optic nerve sheath meningioma (ONSM). However, this finding is not specific to ONSM since it can also be observed in optic perineuritis (OPN). Here we report a 42-year-old female with ONSM who presented with clinical and MRI findings similar to those of OPN.

Keyword

Optic nerve sheath meningioma; Optic perineuritis; Magnetic resonance imaging

Figure

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  Fig. 1. Fundus examination revealing normal findings in the right eye (A) and a swollen optic disc in the left eye (B). Optociliary shunt vessels were not detected in the left eye (B). The Humphrey visual test of perimetry produced normal findings in the right eye (C) and slightly enlarged blind spots in the left eye (D).

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  Fig. 2. Gadolinium-enhanced T1-weighted MRI images reveal diffuse circumferential thickening and enhancement in the left optic nerve sheath with tram-track (arrow) and doughnut-shaped (arrowhead) appearance in axial (A) and coronal (B) MRI views, respectively. Calcification was not observed around the left optic nerve in noncontrast computed tomography (C). Follow-up MRI images at 10 months after the initial investigation reveal persistent thickening and enhancement of the left optic nerve sheath (arrow, D; arrowhead, E). MRI, magnetic resonance imaging.

Reference

1. Gala F. Magnetic resonance imaging of optic nerve. Indian J Radiol Imaging. 2015; 25:421–438.

2. Parrotta E, Kister I. The expanding clinical spectrum of myelin oligodendrocyte glycoprotein (MOG) antibody associated disease in children and adults. Front Neurol. 2020; 11:960.

3. Gupta S, Sethi P, Duvesh R, Sethi HS, Naik M, Rai HK. Optic perineuritis. BMJ Open Ophthalmol. 2021; 6:e000745.

4. Douglas VP, Douglas KAA, Cestari DM. Optic nerve sheath meningioma. Curr Opin Ophthalmol. 2020; 31:455–461.

5. Chen JJ, Flanagan EP, Jitprapaikulsan J, López-Chiriboga ASS, Fryer JP, Leavitt JA, et al. Myelin oligodendrocyte glycoprotein antibody-positive optic neuritis: clinical characteristics, radiologic clues, and outcome. Am J Ophthalmol. 2018; 195:8–15.