Analyses on the misdiagnoses of 25 patients with unilateral optic nerve sheath meningioma.
OBJECTIVE
To investigate clinical features of optic nerve sheath meningioma (ONSM) that was misdiagnosed, and to find methods to reduce the misdiagnoses.


METHODS
Retrospective series study. Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan. 2008 to Jan. 2015 and the clinical records reviewed.


RESULTS
Patients were misdiagnosed with acute papillitis most frequently (n=17), immediately followed by optic atrophy (n=8), ischemic optic neuropathy (n=5), acute retrobulbar optic neuritis (n=5), optic disc vasculitis (n=3). For each patient, the minimum frequency of misdiagnoses was once and the maximum was 4 times. As for the lasting time of being misdiagnosed, the shortest was 1.5mo and the longest was 45mo. Twenty-one cases (84%) were once treated with glucocorticoids, and its side effects was found in seventeen patients. Twenty patients (80%) complained with varying degree of vision loss. When a definite diagnosis was made, sixteen cases (64%) showed slight exophthalmos and eighteen cases (72%) had the tubular ONSM.


CONCLUSIONS
ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic, and for most of these ONSMs are tubular.
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Jun-Feng
JF
Mao
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Xiao-Bo
XB
Xia
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Xiang-Bo
XB
Tang
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Xue-Yong
XY
Zhang
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Dan
D
Wen
clinical feature; misdiagnosis; optic nerve sheath meningioma
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