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Meningioma of the optic nerve sheath
Last reviewed: 07.07.2025
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[ Symptoms of Optic Nerve Sheath Meningioma
The disease manifests itself in middle age with a gradual unilateral decrease in vision. Temporary visual impairment may be the first symptom.
The classic triad is: decreased vision, optic nerve atrophy, and opticociliary vascular shunts. However, the simultaneous appearance of all three signs is rare. The sequence of signs is as follows:
- Dysfunction of the optic nerve and chronic stagnation of the disc, followed by atrophy.
- Opticociliary vascular shunts, which are found in approximately 30% of cases, regress with the development of optic nerve atrophy.
- Limited mobility, especially upward, since the tumor can “split”) the optic nerve.
- Exophthalmos appears due to tumor growth within the muscular funnel and develops after a decrease in vision.
The sequence is the opposite of that seen in tumors growing outside the dura mater, where exophthalmos appears long before compression of the optic nerve.
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Treatment of optic nerve sheath meningioma
- Monitoring of middle-aged patients with slow tumor growth, as the prognosis is good.
- Surgical removal in young patients with aggressive tumors, especially in a blind eye.
- Radiation in some cases.