RT Journal Article
SR Electronic
T1 Catastrophic vision loss from radiation-induced optic neuropathy
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e233706
DO 10.1136/bcr-2019-233706
VO 13
IS 2
A1 Sultan Aldrees
A1 Jonathan A Micieli
YR 2020
UL http://casereports.bmj.com/content/13/2/e233706.abstract
AB A 68-year-old woman presented with profound vision loss of 2-month duration in the right eye and 1-week duration in her left eye. This occurred in the context of craniopharyngioma that was twice resected and irradiated (54 Gy in 30 fractions) 9 months before her presentation. Ophthalmological examination revealed hand motion vision in the right eye and light perception vision in the left eye with poorly reactive pupils and bilateral optic disc pallor. A non-contrast MRI of the brain and sella showed significant reduction of the sellar mass. A repeat MRI of the brain and orbits with gadolinium showed pre-chiasmatic enhancement of both optic nerves. The diagnosis of radiation-induced optic neuropathy was made. Despite treatment with high-dose intravenous corticosteroids, 19 sessions of hyperbaric oxygen therapy, and 3 doses of intravenous bevacizumab, her vision worsened to no light perception in both eyes.