Suprasellar arachnoid cyst causing reversible junctional sco
A 44-year-old woman presented with a sudden awareness of painless vision loss in the left eye while driving. Physical examination revealed visual acuity of 20/20 in the right eye and 20/60 in the left eye, and there was a left relative afferent pupillary defect. The fundus exam was notable for bilateral temporal optic disc pallor, left greater than right. Automated static perimetry (Humphrey 24-2) revealed a left junctional scotoma. The patient subsequently underwent magnetic resonance imaging, which showed a 2.7 X 1.7 × 1.7 cm suprasellar arachnoid cyst compressing the left posterior optic nerve and anterior optic chiasm. The patient underwent uncomplicated endoscopic trans-sphenoidal fenestration of the arachnoid cyst with the recovery of her visual acuity to 20/20 in each eye and substantial improvement of her visual field defect.

The patient had severe visual field defects consistent with the pattern of junctional scotoma in the setting of a suprasellar arachnoid cyst. She underwent a successful fenestration of the arachnoid cyst resulting in complete recovery of her central visual acuity and near-complete resolution of her visual field defect. Here present a case of reversible junctional scotoma caused by the suprasellar arachnoid cyst and it serves as an example of how prompt diagnosis and surgical treatment of symptomatic suprasellar arachnoid cyst can afford substantial visual recovery.