EC Ophthalmology

Objective: Presentation of a clinical case of a female patient with meningioma in the sphenoid wing with ophthalmological manifestations. Spheno-orbital meningiomas are rare intracranial tumors that arise in the sphenoid wing. These tumors can invade important neurovascular structures making radical resection difficult, and residual tumors often lead to recurrence.

Summary: 44-year-old female patient referred by a clinician for proptosis of 6 months of evolution. The ophthalmological examination presented proptosis in the right eye, with inferior projection, preserved ocular motility in 9 quadrants, with diplopia in extreme superior and extreme lateral gaze. Visual acuity 10/10 both eyes. Computerized visual field od altered oi normal. Normal eye fundus at the time of examination. Brain MRI is requested where a marked thickening and heterogeneous signal, predominantly hypotensive in T2, are reported. This alteration conditioned compression and displacement of the external rectum. Interconsultation with neurosurgery is performed and diagnostic and therapeutic resection is planned.

Pathology reports meningioma meningotheliomatous intraosseous grade 1 of the sphenoid wing.

On postoperative ophthalmological examination, the patient presented no proptosis, preserved motility in 9 quadrants without diplopia, VA 10/10, normal computerized visual field in both eyes.

At six months post-surgery, there are no imaging or clinical signs of recurrence.

Conclusion: The maximum safe resection with preservation of function continues to be the most important prognostic factor associated with lower recurrence rates and the performance at the right time of surgery reduces permanent ophthalmological alterations.

Keywords: Sphenoid Meningioma; Proptosis; Visual Disability

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