A 56-year-old woman diagnosed 11 years ago with primary NOM of the right eye (OD).
The examination revealed unilateral proptosis with blushing conjunctive-bral edema, sclerotic engorgement due to venous drainage involvement, restriction of normal intraocular pressure and intraocular pressure in both eyes, and bcular diplop
Initial visual acuity (VA) was unit.
In funduscopy (FO) the papilla of the RE appeared hyperemic and slightly elevated.
Imaging tests identified a lesion compatible with intraconal NOM that was confirmed by biopsy.
Given the benignity and VA, we opted for observation, together with magnetic resonance imaging (MRI) and visual field (CV) every 6 months.
1.
After 4 years of follow-up there was a lower peripheral scotoma in the RE, VA deterioration and IOP elevation up to 24-25 mm Hg, controlled with topical beta-blockers and latanoprost.
One year later, VA RE was 0.3, IOP 20 mm Hg (with treatment) and VC and FO had significantly worsened.
Given the progression, treatment with RFE (total dose of 50 Gy in 30 meshes of 1.67 Gy) was decided, ending with a VA OD of 0.1.
1.
VC, FO, and VA gradually became evident (AV OD 1, 38 months after treatment); however, edematous polyposis, proptosis, and engorgement have not changed,
