Combined Transcranial-supraorbital and Transconjunctival Approach for Optic Nerve Coloboma with Ophthalmic Dysplasia Associated with Rheumatoid Arthritis

DOI Web Site 12 References
  • Hanada Tomoko
    Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
  • Hanaya Ryosuke
    Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
  • Ummah Fauziah Chaira
    Department of Neurosurgery, Diponegoro University, Semarang, Indonesia
  • Kamisasanuki Taro
    Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
  • Kirishima Mari
    Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
  • Tanimoto Akihide
    Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
  • Arita Kazunori
    Department of Neurosurgery, Izumi Regional Medical Center, Izumi, Kagoshima, Japan
  • Yoshimoto Koji
    Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan

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Abstract

<p>We report a 59-year-old woman with optic nerve coloboma and ophthalmic dysplasia associated with rheumatoid arthritis. She experienced progressive visual dysfunction over the course of several years and presented with headache and pain in the left eye. Since infancy the visual acuity of her left eye had been compromised and her eyesight worsened gradually until she was blind in the left eye. Macroscopic observation showed a reddish lesion on the sclera thought to be due to rheumatoid arthritis (RA). Magnetic resonance imaging and computed tomography disclosed a well-defined cystic lesion at the left retro-bulbar optic nerve within the optic nerve sheath. We selected the combined transcranial-supraorbital and transconjunctival approach to remove the eyeball after detaching the optic nerve. This technique was successful and the placement of an ocular prosthetic was cosmetically acceptable.</p>

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