Peripheral scotoma associated with chronic ethmoidal sinusitis. A case report and review of the literature

Diseases of the paranasal sinuses may cause visual disturbances, especially diminished visual acuity and visual field defects, by affecting the optic nerve. We report the unusual case of a female patient with unilateral peripheral, quadrantic scotoma and concomitant chronic ethmoidal sinusitis. Visu...

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Bibliographic Details
Published inRhinology Vol. 36; no. 2; p. 86
Main Authors Rödel, R, Meyer-Riemann, W, Hommerich, C, Vogel, M
Format Journal Article
LanguageEnglish
Published Netherlands 01.06.1998
Subjects
Adult
Chronic Disease
Ethmoid Sinusitis - complications
Ethmoid Sinusitis - pathology
Ethmoid Sinusitis - surgery
Female
Humans
Paranasal Sinuses - pathology
Paranasal Sinuses - surgery
Scotoma - etiology
Scotoma - physiopathology
Visual Fields
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Summary:Diseases of the paranasal sinuses may cause visual disturbances, especially diminished visual acuity and visual field defects, by affecting the optic nerve. We report the unusual case of a female patient with unilateral peripheral, quadrantic scotoma and concomitant chronic ethmoidal sinusitis. Visual acuity was not diminished. Despite extensive diagnostic examinations no other cause of the scotoma could be evaluated. As conservative therapy had been unsuccessful, endonasal pansinus operation was performed. Upon surgery, nearly all ethmoidal cells appeared to be filled with polypous mucosa. The sphenoid sinuses, however, contained air. In contrast, pre-operative CT scans had shown only a slight opacity of the ethmoid bone. Already two weeks after surgery a reduction in size of the scotoma could be noted. In addition to this case report, possible causes of visual field defects due to inflammatory diseases of the paranasal sinuses are discussed. In cases of unilateral visual field reduction associated with symptoms of chronic paranasal sinusitis, early operative exploration of the paranasal sinuses should be considered after exclusion of other possible causes, even if radiological findings do not warrant such a procedure.
ISSN:0300-0729