J Clin Neurol.  2011 Mar;7(1):50-52. 10.3988/jcn.2011.7.1.50.

Atypical Presentation of Orbital Pseudotumor with Visual Loss as an Initial Manifestation

• Turkoglu R
• Balak N

• KMID: 1452575
• DOI: http://doi.org/10.3988/jcn.2011.7.1.50

Abstract

BACKGROUND
An orbital pseudotumor typically presents with periorbital pain, cranial nerve palsies and proptosis. Although visual deterioration is not unexpected in this pathology, its presentation solely with visual loss is unusual.
CASE REPORT
In this short report, we summarize a case of orbital pseudotumor which presented solely with a decrease in visual acuity, and discuss the clinical and radiological findings.
CONCLUSIONS
This atypical presentation likely resulted from the orbital pseudotumor originating in the optic foramen, leaving the neurovascular structures of the superior orbital fissure untouched initially. In the early clinical period, an orbital pseudotumor may manifest itself solely by visual loss. It should therefore be included in the differential diagnosis of visual pathologies-even in the absence of orbital pain and symptoms related to ocular movements.

Keyword

orbital pseudotumor; pseudotumor orbit; visual loss

MeSH Terms

Diagnosis, Differential
Exophthalmos
Headache
Orbit
Orbital Pseudotumor
Paralysis
Visual Acuity

Figure

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  Fig. 1 Cranial axial FLAIR and sagittal T1-weighted MRI scans show a small mass lesion in the right optic foramen. The lesion is iso-intense. FLAIR: fluid attenuated inversion recovery.

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  Fig. 2 T1-weighted axial and sagittal orbital MRI scans, without and with contrast media respectively, show a significantly large retrobulbar orbital lesion. The lesion is iso-intense and strongly enhanced after contrast injection.

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