Tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression: a case report

BMC Ophthalmol. 2024 Feb 14;24(1):68. doi: 10.1186/s12886-024-03332-w.

Abstract

Background: To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression.

Case presentation: A 39-year-old woman presenting with headache was found to have bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT) with a corresponding arcuate scotomas consistent with glaucomatous change. However a suprasellar tumor compressing the anterior chiasm from below was found on magnetic resonance imaging of the brain. After resection of the mass, which was diagnosed as meningothelial meningioma by the pathological examination, the glaucoma-like visual field defects resolved despite the RNFL thinning on the OCT showing no improvement.

Conclusions: Chiasmal compression may mimic glaucoma and produce arcuate scotoma 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.

Keywords: Chiasmal compression; Optical coherence tomography (OCT); Preperimetric glaucoma; Suprasellar tumor.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Decompression
  • Female
  • Glaucoma* / diagnosis
  • Glaucoma* / etiology
  • Glaucoma* / surgery
  • Humans
  • Meningeal Neoplasms* / complications
  • Meningeal Neoplasms* / diagnosis
  • Meningeal Neoplasms* / surgery
  • Meningioma* / complications
  • Meningioma* / diagnosis
  • Meningioma* / surgery
  • Nerve Fibers / pathology
  • Retinal Ganglion Cells / pathology
  • Scotoma / diagnosis
  • Scotoma / etiology
  • Tomography, Optical Coherence / methods
  • Vision Disorders / diagnosis
  • Vision Disorders / etiology
  • Vision Disorders / pathology
  • Visual Field Tests
  • Visual Fields