Parts A, C reprinted from Arnold AC. Optic nerve meningioma. Focal Points: Clinical Modules for Ophthalmologists. San Francisco: American Academy of Ophthalmology; 2004, module 7. Part B courtesy of Steven A. Newman, MD.
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Neuro-Ophthalmology/Orbit
A, Fundus photograph shows optic disc atrophy, with optociliary shunt vessels (retinochoroidal collaterals, arrow) visible at the 8 and 12 o’clock positions. B, CT scan reveals “tram track sign”; diffuse enlargement of the right intraorbital optic nerve extending anteriorlyto the globe, with enhancement of the optic nerve sheath. C, “Ring sign” in meningioma. Coronal orbital MRI scan shows similar optic nerve sheath enhancement surrounding relatively normal, darker optic nerve on the right.