A Diagnostic Challenge: Optic Nerve Glioma in an Elderly Patient Presenting with Acute Vision Loss
Author: Agni Mokka
Base Hospital / Institution: University Hospitals of Leicester
ePoster presentation
Abstract ID: 25-460
Purpose
Optic nerve glioma is a rare and often underdiagnosed condition in adults. We report a case of an 80-year-old woman who presented with acute vision loss in one eye and reduced color vision in the contralateral eye. This case highlights the diagnostic challenges and the role of orbital biopsy in confirming the diagnosis of optic nerve glioma in elderly patients.
Methods
An 80-year-old woman with a medical history of type 2 diabetes and hypertension presented with sudden vision loss in her right eye (VA 6/60) and decreased color vision in the left eye. Initial CT and MRI imaging raised suspicion for optic perineuritis, and extensive diagnostic workups for inflammatory and neoplastic causes were inconclusive. Despite steroid treatment, the patient’s condition worsened, and an orbital biopsy was performed, which confirmed optic nerve glioma.
Results
Imaging revealed a ring-enhancing lesion at the right optic nerve with perineural involvement, initially suggesting optic neuritis. The patient’s condition progressed with worsening vision loss (NPL in right eye) and perineural enhancement. The biopsy confirmed high-grade glioma, and subsequent treatment options, including surgery and chemotherapy, were discussed.
Conclusion
This case underscores the importance of considering optic nerve glioma in the differential diagnosis of elderly patients with unexplained optic neuropathies. Early biopsy may be crucial in confirming the diagnosis, allowing for better management and outcomes.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Mary | Awad | University Hospitals of Leicester |
| Straton | Tyradellis | University Hospitals of Leicester |
| Raghavan | Sampath | University Hospitals of Leicester |
