Abstract The identifying characteristics of the monocular syndrome of incipient prechiasmal optic nerve compression are slowly progressive dimming of vision with near normal acuity, poor color perception, positive Marcus Gunn pupillary sign, and normal appearance of the optic disc. Associated visual field defects are subtle and nondescript, but progressive. Even the smallest prechiasmal tumors causing this syndrome can now be detected and defined anatomically with modern neuroradiologic techniques, the most informative of which are serial polytomography of the optic canals and pneumotomography of the prechiasmatic cisterns. Microsurgical resection of the compressive lesion greatly reduces operative trauma and ensures the chance for prompt restoration of vision. Problems in diagnostic and surgical management of patients with incipient optic nerve compression are exemplified in reports of six cases. References 1. Jane JA, McKissock W: Importance of failing vision in the early diagnosis of suprasellar meningioma . Brit Med J 2:5-7, 1962.Crossref 2. Little HL, Chambers JW, Walsh FB: Unilateral intracranial optic nerve involvement: Neurosurgical significance . Arch Ophthal 73:331-337, 1965.Crossref 3. Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology . Baltimore. Williams & Wilkins Co, 1969. 4. Thompson HS: Afferent pupillary defects: Pupillary findings associated with defects of the afferent arm of the pupillary light reflex arc . Amer J Ophthal 62:860-873, 1966. 5. Sloan LL: The use of pseudo-isochromatic charts in detecting central scotomas due to lesions in the conducting pathways . Amer J Ophthal 25:1352-1356, 1942. 6. Cushing H, Eisenhardt L: Meningiomas: Their Classification, Regional Behaviour, Life History, and Surgical End Results . Springfield, Ill, Charles C Thomas Publisher, 1938. 7. Potter GD, Trokel SL: Anatomic and radiographic analysis of the optic canal and orbital apex . Arch Ophthal 83:584-587, 1970.Crossref
Archives of Ophthalmology – American Medical Association
Published: Jan 1, 1972
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