Intracanalicular Optic Nerve Sheath Meningioma

A middle-aged patient with a PMH of breast cancer, migraines, and hyperlipidemia presents to the Bascom Palmer ER with a chief complaint of headache and left eye blurry vision for the past month. Recent work-up outside is remarkable for normal laboratory work-up, normal MRI brain and orbits, but an OCT GCL with diffuse thinning and a HVF 24-2 with superior altitudinal defect OS. Repeat MRI shows a T2 hyperintense lesion medial to the intracanalicular left optic nerve sheath. The patient is treated with high-dose IV steroids for perineuritis without improvement. Repeat imaging and testing confirms no improvement and the patient subsequently receives a second diagnosis. This case presentation will discuss the diagnostic challenges of this entity, as well as the available treatment options.

Presentation Date: 04/01/2021

Issue Date: 04/23/2021