Atypical presentation of suprasellar meningioma

Demyelinating optic neuritis is the commonest cause of optic neuropathy in young adults. Retrobulbar optic neuritis is one of the frequent clinical forms of demyelinating optic neuritis. We report a case of a 28-year-old lady who presented with blurring of vision in the right eye for one month and pain on eye movement. Fundi examinations were normal. Initial suspicion was that of retrobulbar optic neuritis. Interestingly, imaging showed a suprasellar mass consistent with a meningioma. The patient underwent surgery but unfortunately the excision was incomplete due to a portion of the tumour adherent to the internal carotid artery. Histology confirmed the diagnosis of suprasellar meningioma. The patient was followed up for one year post-surgery with no visual improvement. This case highlights that although rare, suprasellar meningioma should be included in the differential diagnosis of retrobulbar neuritis in young patients.