|Year : 2023 | Volume
| Issue : 1 | Page : 225-226
Compressive optic neuropathy secondary to hypertrophy of Onodi cells
Sania Rajesh Gulwani, Neeharika Shah, Jignasa Makwana
Department of Squint, M and J Institute of Ophthalmology, Ahmedabad, Gujarat, India
|Date of Submission||30-Jun-2022|
|Date of Acceptance||29-Sep-2022|
|Date of Web Publication||20-Jan-2023|
Sania Rajesh Gulwani
Phase 1 D-301 PG Hostel, Civil Hospital Opposite Sahyog MRI, Asarwa, Ahmedabad 380 016, Gujarat
Source of Support: None, Conflict of Interest: None
Keywords: Air cell, compressive optic neuropathy, endoscopic optic nerve decompression, Onodi, optic neuropathy, pneumatized Onodi
|How to cite this article:|
Gulwani SR, Shah N, Makwana J. Compressive optic neuropathy secondary to hypertrophy of Onodi cells. Indian J Ophthalmol Case Rep 2023;3:225-6
|How to cite this URL:|
Gulwani SR, Shah N, Makwana J. Compressive optic neuropathy secondary to hypertrophy of Onodi cells. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Feb 1];3:225-6. Available from: https://www.ijoreports.in/text.asp?2023/3/1/225/368146
A 23-Year-Old Man Presented To The Ophthalmology Clinic With 45 Days Of Gradual Visual Loss And Blurred Right Eye Vision, Preceded By Viral Fever Associated With Cough And Cold, with No Treatment Taken For The Same. His Medical history And Social History Were Unremarkable.Visual Acuity Test Revealed a Right-Sided Best Corrected Visual Acuity (BCVA) Of Counting Fingers Near Face, With A Positive Relative Afferent Pupillary Defect (RAPD) And Normal Anterior Segment. Although Ocular Motility And Main Cranial Nerve Functions Were Undisturbed, Fundoscopy Revealed the Right-Sided Temporal Disc Palor With a Well-Defined Disc Margin. The Cup Margin Was Obscured, And Tortous Blood Vessels were Present [Figure 1]a. The Fellow Left Eye Fundus Was Normal [Figure 1]b, With a BCVA Of 6/6 And a Normal Anterior Segment. T2 magnetic resonance imaging (MRI) (BRAIN + ORBIT) Demonstrated Well-Defined Right-Sided Enlarged Onodi Cells, Measuring 10 × 8 Mm Near Optic Foramen, Causing Narrowing Of Optic Canal And Optic Nerve Compression, and Reducing Its Calliber To Approx 4 mm [Figure 2] and [Figure 3]. No Other Ocular Mass Lesion was Seen, and Extra-ocular Muscles Appeared Normal With Rest Normal MR Study Of Brain. His Sudden Visual Loss Was Caused By An Enlarged Onodi Cell Causing Secondary Optic Neuropathy. He Subsequently Underwent Right Optic Nerve Decompression Surgery (Functional Endoscopic Sinus Surgery) Within 48 Hrs. On Follow-Up Ophthalmic Examination After A Week, the Patient's Right Eye BCVA Improved To Counting Finger 2 Meter With Reversal Of RAPD, And On the third week, It Improved To Cf 6 Meter.
|Figure 2: Non-Contrast Coronal T2. SS: Spenoidal Sinus; TC: Temporal Cortex; OC: Onodi cells|
Click here to view
|Figure 3: Non-Contrast Axial T2. Large right-sided Onodi cell-like projection on. The right optic canal impinging on the right. Optic Nerve. ICA: Internal Carotid Artery; OC: Onodi Cell; ON: Optic Nerve|
Click here to view
| Discussion|| |
An Onodi Air Cell Is Essentially An Anatomical Variant Of A Posterior Ethmoidal Air Cell, And the Optic Nerve Runs Close To It. Its Lateral Or Superior Pneumatization Into The Sphenoid Sinus May Directly Run About The Optic Nerve. MRI Is the Best For the Diagnosis Of Any Compressive Pathology. Therefore, Our Case Could Potentially Be One Of The First Few Timely Managed Cases Of A Large-Sized Onodi Air Cell Itself, Resulting In Compressive Optic Neuropathy, Evidenced By The Absence Of Other Brain, Sinus, Or Orbital Pathologies On Neuro-imaging.
Declaration of patients consent
The authors certify that they have obtained all appropriate patient consent forms. In the forms patient has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patient understand that their names and initials will not be published and due efforts will be made to conceal their identity but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ahmad SS, Kanukollu VM. Optic Atrophy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. [Updated 2022 Feb 17].
DeLano MC, Fun FY, Zinreich SJ. Relationship of the optic nerve to the posterior paranasal sinuses: A CT anatomic study. Am J Neuroradiol 1996;17:669-75.
[Figure 1], [Figure 2], [Figure 3]