Ocular Manifestations of Sphenoid Meningioma : A Case Report Irfan Kurnia Kaban 1 , Muhammad Saiful Ardhi 2 kabanrebel@yahoo.com 1 Neurology Resident, Faculty of Medicine, Airlangga University, Surabaya, Indonesia 2 Departement of Neurology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia Abstract Background: Approximately 46.8% to 88.6% patient with brain tumor experienced ophthalmology manifestations and most patients went to ophthalmologist in the first time with ocular symptoms. Sphenoid meningioma are often asymptomatic in the early stage of the disease. The ocular manifestations mentioned above could appear as the disease progresses, therefore a careful clinical evaluation is needed in order to retain neurological function. Case: A 40 years old female patient was presented with main complaint of headache. This symptom was felt since 6 months ago on the left side of the head accompanied by visual disturbance on the left eye since 3 months ago. Head magnetic resonance imaging (MRI) with contrast showed broad base meningioma on the left sphenoid wing measuring about 3,62 x 3,08 x 2,24 cm. The mass extended to left cavernous sinus and encased left carotid artery as well as pushing the right carotid artery laterally; the mass also extended to left sphenoid sinus and encased left optical nerve; the mass also extended to intrasellar and compressed the hypophysis. Optical coherence tomography (OCT) examination showed retinal nerve fiber layer (RNFL) thinning on the temporal quadrant of the left eye, reduced macular thickness of the left eye, and optic papilla atrophy of the left eye. Conclusion: Ophthalmic examinations and evaluation could assist in early diagnosis of tumor in order to adequately treat the disease. The prognosis is better if the cranial lesion could be recognized early and hence managed well, therefore decreasing morbidity and mortality. Keywords: Meningioma, visual disturbance, optic papilla atrophy Introduction Meningioma is the most common intracranial tumor. The afferent and efferent visual paths are spread all around the central nervous system.(Cappabianca et al. 2020) The afferent visual path counted for 50% of all sensory input to the central nervous system so that it is not uncommon for meningioma to involve the visual system. The involvement of visual afferent paths could manifest as visual disturbance, visual fields defect, or diplopia.(Lee 2009) Approximately 46.8% to 88.6% of patients with cerebral tu mors experienced several ophthalmology manifestations hence neuro-ophthalmology manifestations could assist in diagnosing tumors because 60% of patients went to an ophthalmologist for the first time with ocular symptoms.(Saurabh Deshmukh, Dipankar Das 2018) 187 www.ijrp.org IJRP 2021, 88(1), 187-192; doi:.10.47119/IJRP1008811120212395