Monocular Blindness as Presentation Manifestation of Neuroblastoma

摘要

A previously healthy 4-year-old patient was admitted with a 2-week history of extreme irritability with no apparent etiology on initial examination. Coincidentally, the child was noted to have intermittent strabismus involving the right eye. His visual acuity was 20/200 on the affected side with an afferent pupillary defect. On dilated direct ophthalmoscopy, a swollen optic disc was noted. There was no restriction of ocular movements. Magnetic resonance imaging of the brain and the orbits revealed a large, lobulated, contrast-enhancing mass in the region of the sphenoid bone (Figure 1 A). The right optic nerve appeared to be completely surrounded by the mass (accounting for the edema of the optic disc on examination).