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Leber's hereditary optic neuropathy misdiagnosed as optic neuritis and Lyme disease in a patient with multiple sclerosis.

A 28-year-old Caucasian man developed sudden painless vision loss in the right eye. He was diagnosed with optic neuritis. MRI showed white matter lesions consistent with multiple sclerosis (MS), but no optic nerve enhancement. Eight months later, the left eye was affected in the same manner. Examination showed right optic atrophy and apparent left optic disc swelling. Workup revealed positive Lyme IgG. Differential diagnosis included optic neuritis and Lyme optic neuropathy, and he was treated with intravenous steroids, intravenous immunoglobulin, plasmapheresis and intravenous ceftriaxone wit…

Diffusion-Weighted Imaging and Post-contrast Enhancement in Differentiating Optic Neuritis and Non-arteritic Anterior Optic Neuropathy.

Non-arteritic anterior ischaemic optic neuropathy (NAION) and optic neuritis (ON) may be difficult to distinguish early in their disease courses. Our goal was to determine if specific magnetic resonance imaging characteristics differentiate acute NAION from ON. Neuroradiologists, masked to diagnosis, reviewed the diffusion-weighted imaging (DWI) and post-contrast enhancement (PCE) characteristics of the optic nerve in 140 eyes. PCE and DWI signals of the optic disc alone did not discriminate between NAION and ON. After taking age and sex into consideration, only DWI and PCE of the intraorbital…

Effects of high-dose prednisolone on optic nerve head blood flow in patients with acute optic neuritis.

BACKGROUND: In this study, patients with optic neuritis were treated with high-dose prednisolone. Little information is available about the effects of this treatment on ocular blood flow. We set out to investigate the effects of high-dose prednisolone on optic nerve head (ONH) blood flow in patients with acute optic neuritis. METHODS: Thirteen patients with acute optic neuritis were included in the study. 1000 mg of prednisolone was infused intravenously over 30 minutes on 3 consecutive days. On each study day, ONH blood flow was measured using laser Doppler flowmetry. The ocular hemodynamic …

Optic nerve demyelination induced by human serum: patients with multiple sclerosis or optic neuritis and normal subjects.

We injected guinea pig optic nerves with serum from patients with MS or acute optic neuritis (ON), or normal subjects. Serum from 12 of 17 MS patients, 3 of 3 patients with ON, and 5 of 11 normal age- and sex-matched controls produced myelin vesiculation and demyelination 24 hours after injection. Nerves injected with demyelinating serum contained oligodendrocytes with pyknotic nuclei and edematous, rarefied cytoplasm. Nerves injected with serum that did not cause demyelination did not have these oligodendrocyte changes. Serum from normal subjects or patients with MS may induce in vivo demyeli…

MOGAD optic neuritis after mild head/orbital trauma in six children.

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a potential cause of optic neuritis (ON). Its triggers and etiologies are not completely understood. We describe a novel clinical observation in six young patients with MOGAD-ON in the setting of strikingly parallel histories of mild head/orbital trauma. This is a single-center retrospective case series of six young patients and age-matched isolated MOGAD-ON controls. We present data both individually (de-identified, only the six trauma-associated cases) and in aggregate. Averages are presented as the arithmetic mean +/…

Severe Bilateral Optic Neuritis and a Tumefactive Demyelinating Lesion in Pregnancy.

A 40-year-old pregnant woman developed severe bilateral optic neuritis and a tumefactive demyelinating lesion (TDL) in the first trimester. Although her bilateral optic neuritis improved with intravenous methylprednisolone, plasma exchange, and intravenous immunoglobulin, the TDL lesion expanded, and the accompanying symptoms worsened. Following a shared decision-making process, the patient received ofatumumab after repeated steroid pulse therapy. Subsequently, the lesion enlargement stopped and there was no exacerbation of the symptoms. This case demonstrates the challenges and management of …

Case Report: Fundus findings in myelin oligodendrocyte glycoprotein-associated optic neuritis.

Myelin oligodendrocyte glycoprotein-associated optic neuritis (MOG-ON) is a sight-threatening demyelinating disorder that can present with various ocular manifestations. Here, we describe a unique case of bilateral MOG-ON with unilateral retinal hemorrhages and Roth spots. We present the case of a 48-year-old man with acute-onset painful, severe vision loss in both eyes. Initial fundoscopic examination revealed bilateral optic nerve edema with unilateral retinal hemorrhages and Roth spots. Imaging was notable for perineural enhancement along both optic nerves. Serological testing revealed elev…

Оптический неурит, как необычные проявления гипопаратироидизма: редкий случай.

ОПТИЧЕСКИЙ неурит, обычно связанный с множественным склерозом (MS), может также происходить в контексте гипокальцемии в качестве редкого интригующего клинического сценария. В самых последних статьях сообщалось об ассоциации папилледемы и гипопаратироидизма, однако очень редко сообщения о случаях свидетельствовали о наличии оптического неврата, вызванного гипокальцемией, а также о нашем случае. КИСЛОТА: Мы сообщаем 43-летнюю женщину с гипокальцемией с оптическим невратом, для которой характерны внезапная потеря зрения, болезненные движения глаз и головная боль пульсатиля. Несмотря на нормализац

Совпадение в аннотации оригинала
BACKGROUND: Optic neuritis, commonly associated with multiple sclerosis (MS), can also occur in the context of hypocalcemia as a rare intriguing clinical scenario. Most recent articles have reported the association of papilledema and hypoparathyroidism, However, very rarely, case reports revealed hypocalcemia-induced optic neuritis as well as our case. CASE…

A Comparison between Demyelinating and Omicron Variant Infection-Associated Optic Neuritis.

BACKGROUND: The connection between viral infection and the onset of demyelination has garnered considerable attention. Omicron, the most recent prevalent strain of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised concerns. Optic neuritis (ON) associated with Omicron infection and spontaneous demyelinating ON may manifest distinct disease progressions. This study aims to contrast the features of these two distinct etiologies of ON. METHODS: This case-control study comprised fifteen patients (21 eyes) diagnosed with Omicron infection-related ON and fifteen patients (…

Vestibular Rehabilitation Considerations in an Uncommon Optic Neuritis: A Case Report.

Optic neuritis is an inflammatory condition that leads to inflammation and damage to the optic nerve, causing visual disturbances and pain. It is commonly associated with disorders such as multiple sclerosis and often manifests as sudden, unilateral loss of vision or blurred vision. This disorder can affect individuals of any age and may lead to decreased binocular vision, potentially resulting in difficulties with depth perception and visual coordination. Physiotherapy plays a crucial role in treating optic neuritis by addressing various aspects of the illness. We report the case of a 14-year…

Subclinical optic neuritis in pediatric myelin oligodendrocyte glycoprotein antibody-associated disease.

BACKGROUND AND OBJECTIVES: The clinical spectrum of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is heterogenous and has evolved over time since the commercial availability of the anti-MOG antibody assay. Subclinical disease activity has been previously reported in the visual pathway, but prevalence data remains limited. We investigated subclinical optic neuritis (ON) based on changes on retinal nerve fiber layer (RNFL) thickness on optic coherence tomography (OCT) in pediatric patients who tested positive for the anti-MOG antibody. METHODS: In this retrospect…

Infliximab-induced retrobulbar optic neuritis in a patient with ankylosing spondylitis.

OBJECTIVE: To present a case with infliximab-induced retrobulbar optic neuritis. CASE DESCRIPTION: A 58-year-old woman presented to our clinic with a two-day history of blurred vision in her right eye. She had numerous uveitis attacks previously, and she was on infliximab treatment for ankylosing spondylitis. Her best-corrected visual acuity was counting fingers and 20/25 in the right and left eye, respectively. Optic discs seemed healthy in fundoscopic examination. The right optic nerve showed high signal intensity on magnetic resonance imaging (MRI). Infliximab treatment was discontinued an…

Vision-Related Quality of Life in Patients With Atypical Optic Neuritis.

AIM: To evaluate the vision-related quality of life (QOL) in patients with atypical optic neuritis through the 39-item National Eye Institute Visual Function Questionnaire (NEI VFQ-39). METHODS: Fifty-seven patients with atypical optic neuritis were scheduled in the research unit from June 1 to December 31, 2019. Besides collecting the clinical data, NEI VFQ-39, the Chinese version, was applied to all subjects. The NEI VFQ-39 subscale item scores were compared among subgroups divided by different classifications, and a correlation analysis of the NEI VFQ-39 scores and best-corrected visual ac…

Early predictors of visual and axonal outcomes after acute optic neuritis.

BACKGROUND: Predicting long-term visual outcomes and axonal loss following acute optic neuritis (ON) is critical for choosing treatment. Predictive models including all clinical and paraclinical measures of optic nerve dysfunction following ON are lacking. OBJECTIVES: Using a prospective study method, to identify 1 and 3 months predictors of 6 and 12 months visual outcome (low contrast letter acuity 2.5%) and axonal loss [retinal nerve fiber layer thickness and multifocal evoked potential (mfVEP) amplitude] following acute ON. METHODS: In total, 37 patients of acute ON onset were evaluated w…

Time to steroids impacts visual outcome of optic neuritis in MOGAD.

BACKGROUND: To characterise the response to treatment of inaugural optic neuritis (ON) in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). METHODS: We searched the French MOGAD database for adults with inaugural ON with a detailed report of acute treatment modalities and measures of high-contrast best-corrected visual acuity (BCVA) at nadir and after 3 months. Predictors of visual outcomes were assessed by multivariable analysis. RESULTS: Among 245 patients with at least one episode of ON, 82 fulfilled all criteria, and data on the peripapillary retinal …