Metastatic paraganglioma presenting as ajunctional scotoma

Mohamed M Khodeiry; John T Lind; Joshua Pasol; Byron L Lam; Richard K Lee

doi:10.1016/j.ajoc.2021.101253

Metastatic paraganglioma presenting as ajunctional scotoma

Am J Ophthalmol Case Rep. 2021 Dec 31:25:101253. doi: 10.1016/j.ajoc.2021.101253. eCollection 2022 Mar.

Authors

Mohamed M Khodeiry^{1

2}, John T Lind³, Joshua Pasol¹, Byron L Lam¹, Richard K Lee¹

Affiliations

¹ Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
² Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt.
³ Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA.

Abstract

Purpose: To report a unique case of metastatic paraganglioma presenting as a junctional scotoma.

Observations: A 38-year-old Caucasian man with a history of abdominal paraganglioma presented with minimally blurred vision 20/25 visual acuity in the left eye. The patient was found to have a junctional scotoma upon visual field testing. Cranial MRI revealed a large peri-clival mass compressing the pre-chiasmal optic nerves and other loci of metastatic disease. Intracranial masses, including metastases, can present with a relatively intact central acuity and nonspecific visual symptoms.

Conclusions and importance: To the best of our knowledge, this is the first report of metastatic paraganglioma causing a junctional scotoma. In cases with junctional scotoma, careful neuro-ophthalmic assessment and imaging are of paramount importance, even in patients with excellent visual acuity.

Keywords: Junctional scotoma; Optic chiasm; Paraganglioma; Visual field defect.

Publication types

Case Reports