This report documents the occurrence in three patients of subretinal choroidal neovascular membranes (CNVM) ipsilateral to meningiomas involving the optic nerve. We propose that the association might not be coincidental.

Case 1

A 31 year old woman developed a central scotoma in the left eye that led to the diagnosis of a left sphenoid wing meningioma involving the optic canal. The tumour was resected and her vision returned to normal. At age 56 a generalised seizure led to recognition of a recurrence. When the recurrent tumour was resected it proved to be a malignant meningioma. She was then treated with photon radiation from a 10 MV source using a three field technique (right lateral, left lateral, and superior). The total dose was 45 Gy administered in 25 fractions. Thereafter, on regular follow up eye examinations she had normal visual function, pupils, and fundi. At the age of 64 she had a single episode in which for several seconds she lost all vision in the left eye except for a nasal island. There were no residua but her ophthalmologist found a new fundus abnormality that prompted referral.

Her medical history included migraine and a cutaneous malignant melanoma. There was no pertinent family history.

The patient’s visual acuities were 20/15 in each eye. Her colour vision (Ishihara) and pupils were normal. The Goldmann visual field of her right eye was full but she had a relative inferior altitudinal defect to the I2e white stimulus in the left eye. There was 3 mm of proptosis of the left eye with normal orbital resiliency. Fundus examination of the left eye revealed a peripapillary superotemporal retinal elevation associated with lipid (fig …