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P. M. Phillips, S. A. Newman; Cavernomas of the Anterior Visual Pathways. Invest. Ophthalmol. Vis. Sci. 2007;48(13):947.
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Cavernous hemangiomas are the most common benign tumor of the orbit. They also occur intracranially. A few cases have been reported involving the anterior visual pathways. The presentation and neuro-ophthalmic findings are characteristic.
A case series of 3 patients studied retrospectively with involvement of the optic nerve and chiasm is reported from a single institution.
2 men and 1 woman ages 35 through 55 presented with sub acute or acute visual loss in one eye and were found to have superior temporal field involvement in the opposite eye. The classical pattern of junctional syndrome with central scotoma and temporal field involvement the opposite eye were seen in all patients. Surgical intervention confirmed the presence of hemangioma in all 3 with improvement in the temporal field of the opposite eye.
Cavernous hemangiomas may affect the substance of the optic nerve and chiasm producing classical optic nerve and junctional syndromes. Hemorrhage into the tumor may result in acute visual deterioration. MR imaging has characteristic findings. Surgical decompression may improve function at least in the contra lateral optic nerve and possibly in the involved optic nerve.
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