Arachnoid cyst of the optic nerve: therapeutic management and progress

  • Irene Temblador-Barba Ophthalmologist
  • Carlos Gálvez-Prieto-Moreno
  • María Martínez-Jiménez
Keywords: arachnoid cyst, drain, incision, magnetic resonance imaging, transconjunctival approach

Abstract

Purpose: To describe the management of a case of an arachnoid cyst of the optic nerve.

Methods: Here, we report a 27-year-old female patient who was diagnosed with arachnoid cyst of the left sheath optic nerve, drained in several occasions, and came to our service because of progressive blurring in the left eye.

Outcomes: Due to the location of the lesion, excision could not be performed; so we performed a microsurgical incision with drain by nasal superior transconjunctival approach. After that, the visual acuity (VA) was 0.7, and we could observe that the size of the cyst was smaller than previous examinations with magnetic resonance imaging (MRI). Nowadays, the patient keeps the same asymptomatic VA. So medical appointments are planned to closely follow-up, and periodically, we perform new scan images and visual fields.

Conclusions: Arachnoid cysts of the optic nerve are rare, benign, slowly progressive conditions. They can be asymptomatic lesions, especially smaller ones, or may result in proptosis and loss of vision because of the compression. The best imaging examination for their follow-up is MRI. They should be differentiated from optic nerve sheath meningioma and other conditions.

References

Akor C, Wojno TH, Newman NJ, Grossniklaus HE. Arachnoid cyst of the optic nerve. Report of two cases and review of the literature. Ophthalmic Plast Reconstr Surg. 2013;19(6):466-469.

Moschos MM, Lymberopoulos C, Moschos M. Arachnoid cyst of the optic nerve. A case report. Klin Monbl Augenheilkd. 2004 May;221(5):408-409.

Holt H. Cysts of the intracranial portion of the optic nerve. Am J Ophthalmol. 1966;61:1166-1170.

Al-Holou WN, Terman S, Kilburg C, et al. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg. 2013;118(2):222-231.

Kural C, Kullmann M, Weichselbaum A, Schuhmann MU. Congenital left temporal large arachnoid cist causing intraorbital optic nerve damage in the second decade of life. Child Nerv Syst. 2016;32:575-578.

Wester K, Moen G. Documented growth of a temporal arachnoid cyst. J Neurol Neurosurg Psychiatry. 2000;69:699-700.

Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus. 2007;22(2):E7.

Miller NR, Green WR. Arachnoid cysts involving a portion of the intraorbital optic nerve. Arch Ophthalmol. 1975 Nov;93(11):1117-1121.

Published
2020-04-30
How to Cite
Temblador-Barba, I., Gálvez-Prieto-Moreno, C., & Martínez-JiménezM. (2020). Arachnoid cyst of the optic nerve: therapeutic management and progress. Asian Journal of Ophthalmology, 17(2), 137-141. https://doi.org/10.35119/asjoo.v17i2.531
Section
Case Reports/Case Series