RATHKE\u27S CLEFT CYST PRESENTING AS BILATERAL OPTIC ATROPHY

PURPOSE: Reporting a case of Rathke\u27s cleft cyst presenting as bilateral Optic atrophy. Optic atrophy could have been prevented with appropriate surgery if the patient would have consulted ophthalmologist earlier. Case report: A 23 year-old male presented with bifrontal headache and diminution of vision over 6 months period. On fundus examination right eye showed partial optic atrophy and left eye total optic atrophy. MRI Brain showed well defined lobulated cystic lesion in the sella with suprasellar extension, peripheral rim calcification causing widening of sella and displacing anterior cerebral artery and optic chiasma superiorly. Histopathology of the biopsied material was suggestive of Rathke\u27s cleft cyst. Endoscopic endonasal transsphenoidal sinus surgery was done and biopsy was sent which suggested Rathke\u27s cyst. Following surgery there was improvement in the field of vision in right eye. Conclusion: Early diagnosis and removal of a Rathke\u27s cleft cyst has a good prognosis in visual acuity and visual field. Patient ended with optic atrophy because of delayed consultation for headache. KEYWORDS: Rathke\u27s cleft cyst; Optic atrophy; Headache