ACUTE, BILATERAL AMAUROSIS IN EMPYEMA OF THE SPHENOID SINUS

Patient A 14-year-old boy suffered from an acute bilateral blindness w hich occurred in 24-h time. accompanied by headache and raised tempera ture, with inconspicuous optic nerve head and fundus. After diagnosis of empyema with magnet resonance tomography (MRT) the sphenoid sinus w as fenestrated and streptococcus pneumoniae isolated. Liquor and serol ogy being inconspicuous, there was no evidence of leucaemic or autoimm une disease, intoxication or intracranial tumor.Clinical Course The co ndition of the patient improved under systemic antibiotic therapy. The bilateral amaurosis remained and opticus atrophy developed. Conclusio n A bilateral amaurosis with descending opticus atrophy as a consequen ce of a sphenoiditis and spreading inflammation to the meninges and th e optic nerve in the area of the chiasm is a rare event. The imaging t echnique of the MRT offers new opportunities for an early and more poi nted diagnosis and therapy.