A 48-year-old man presented with gradual loss of vision of the right eye since 1 year and headache since 4 years. On examination, visual acuity in the right eye was finger counting at a distance of two feet. Humphrey-automated perimetry showed right inferior temporal quadrantanopia. Fundoscopy revealed right optic atrophy. Blood biochemistry was normal. Magnetic resonance imaging (MRI) of the brain and orbit showed a hyperintense expanded sphenoid sinus on Tl-weighted image (T1WI) [Figure la]. This was isointense to grey matter on the T2-weighted image (T2WI) and Fluid-Attenuated Inversion Recovery (FLAIR) sequence, with few hypointense areas [Figures lb and cj. The right optic nerve was compressed by the expanded sinus [Figure la].
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