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Bilateral Optic Nerve Sheath Meningoceles in an Asymptomatic Patient

To identify the key insights or developments described in this article
1 Credit CME

An 82-year-old man with newly diagnosed asymptomatic bilateral choroidal folds (Figure, A) had stable visual acuity (20/30 OU), normal intraocular pressures, no relative afferent pupillary defect, normal automated perimetry, and no papilledema bilaterally. Magnetic resonance imaging showed no orbital tumor or inflammation but demonstrated bilateral optic nerve sheath meningoceles (ONSMs) (Figure, B).

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Article Information

Corresponding Author: Sally S. Ong, MD, Department of Ophthalmology, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist, 1 Medical Center Blvd, Winston-Salem, NC 27157 (song@wakehealth.edu).

Conflict of Interest Disclosures: Dr Ong reported receiving advisory board fees from EyePoint Pharmaceutical outside the submitted work. No other disclosures were reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

References
1.
Garrity  JA , Trautmann  JC , Bartley  GB ,  et al.  Optic nerve sheath meningoceles—clinical and radiographic features in 13 cases with a review of the literature.   Ophthalmology. 1990;97(11):1519-1531. doi:10.1016/S0161-6420(90)32382-5PubMedGoogle ScholarCrossref
2.
Mesa-Gutiérrez  JC , Quiñones  SM , Ginebreda  JA .  Optic nerve sheath meningocele.   Clin Ophthalmol. 2008;2(3):661-668. doi:10.2147/OPTH.S2689PubMedGoogle ScholarCrossref
3.
Shanmuganathan  V , Leatherbarrow  B , Ansons  A , Laitt  R .  Bilateral idiopathic optic nerve sheath meningocele associated with unilateral transient cystoid macular oedema.   Eye (Lond). 2002;16(6):800-802. doi:10.1038/sj.eye.6700212PubMedGoogle ScholarCrossref
4.
Algarni  M , Maralani  PJ , Sundaram  AN .  Optic nerve sheath meningocele.   Int Med Case Rep J. 2018;11:213-215. doi:10.2147/IMCRJ.S166655PubMedGoogle ScholarCrossref
5.
Halimi  E , Wavreille  O , Rosenberg  R , Bouacha  I , Lejeune  JP , Defoort-Dhellemmes  S .  Optic nerve sheath meningocele: a case report.   Neuroophthalmology. 2013;37(2):78-81. doi:10.3109/01658107.2013.766219PubMedGoogle ScholarCrossref
6.
Lunardi  P , Farah  JO , Ruggeri  A , Nardacci  B , Ferrante  L , Puzzilli  F .  Surgically verified case of optic sheath nerve meningocele: case report with review of the literature.   Neurosurg Rev. 1997;20(3):201-205. doi:10.1007/BF01105565PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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