A Case of Sphenoidal Mucocele with Optic Neuropathy

Kim, Sung-In; Lee, Kyung-Wook; Choi, Jin-Seok

Case Report

Korean Journal of Optometry and Vision Science 2010;9(2):48-52.
Published online December 20, 2010.

접형동 점액낭종으로 인한 시신경병증의 치험 1예

김성인, 이경욱, 최진석

Saevit Eye Hospital, Goyang, Korea

A Case of Sphenoidal Mucocele with Optic Neuropathy

Sung-In Kim, Kyung-Wook Lee, Jin-Seok Choi

Abstract

Purpose
To report of a case of optic neuropathy due to sphenoidal mucocele that was treated with drainage under nasal endoscopy successfully. Methods: A 57-year-old male visited our ophthalmologic clinic complaining of decreased visual acuity with no ocular pain in his left eye for a year. The best corrected visual acuity was initially 1.0 in the right eye and 0.2 in the left eye. Light reflex was intact and no relative afferent papillary defect was found, but his pupil was slightly dilated. Fundus examination revealed no remarkable findings. No exophthalmos, ptosis, extraocular muscle movement limitation were found. Results: A notch-like focal contraction was found in Goldmann perimeter, and the decreased amplitude in visual evoked potential. Orbital MRI showed a 26.9×27.1×33.1 mm sized well-demarcated cystic mass involving left sphenoid sinus and skull base. The orbital apex and optic nerve was contiguous with the cystic mass. Adjacent skull base was remodeled and brain parenchyma was compressed. Incisional drainage of the cystic mass was performed by nasal endoscopy. Next day, his visual acuity became 1.0 with no significant complications such as retrobulbar hemorrhage, ptosis, or extraocular muscle movement limitation. Conclusions: Conventional incisional drainage through nasal endoscopy can be effective treatment of the mucocle of sphenoid sinus causing chronic visual disturbance. (Korean J Optom Vis Sci 2010;9(2):48-52)

Key Words: Mucocele, Optic neuropathy, Sphenoid sinus