Question: I had an mri scan two weeks ago to diagnose a visual disturbance (blurring of my right eye) I’ve experienced for five weeks now. The report indicated that there was no evidence of abnormal enhancement of my optic nerves, however, it found a large lobulated cyst in the pineal region (1.8 cm sagittal oblique length and 1.5 cm transverse. It also says that there is a slight flattening of the superior colliculus, but no edema was related to this mass. So here’s my question, is this cyst what is causing the visual disturbance I am experiencing? If so, what is the most likely course of treatment for this type of cyst?

Dr. Joshua’s Answer:

It’s hard to determine the significance of the cyst without actually seeing the pictures, but pineal cysts may cause visual disturbances by compressing the superior colliculus and other tectal regions. Usually these disturbances are motor (inpairment of eye movements), but difficulty in focusing can also occur. Based on the above information, I cannot say whether this cyst is causing your symptoms, but I cannot exclude that possibility either.

Treatment of pineal cysts that cause symptoms in primarily surgical. In the hands of an expert, pineal region neurosurgical procedures are generally well tolerated and succesful, however as always there are risks involved in brain surgery.

Examination by a neuro-ophthalmologist is recommended, and, ideally, a multidisciplinary team consisting of a neurosurgeon, neurologist, and a neuro-ophthalmologist should evaluate your case.