Magnetic resonance imaging showed t2 hyperintensity in the optic nerves affected in 5 patients. The study of cerebrospinal fluid was normal and oligoclonal bands in all cases. Acute disseminated encephalomyelitis ead is a demyelinating disease affecting the optic nerve. Eighteen patients were 7 years of age or older at presentation. Neuromyelitis optica presenting with bilateral optic. In neuromyelitis optica, the autoimmune attack causes inflammation of the nerves, and the resulting damage leads to the signs. Optic neuritis and acute anterior uveitis associated with. In 10 patients 37% an infection had occurred within two weeks before the onset of optic neuritis.
The cases treated with intravenous methylprednisolone had good reco very. Pdf bilateral optic neuritis in pediatric systemic lupus. If a patient with common variable immunodeficiency experiences loss of vision, the possibility of bilateral optic neuritis should be considered as rapid initiation of highdose corticosteroids may improve visual recovery. Optic neuritis, anterior ischemic optic neuropathy, severe vitreous hemorrhage, and retinal detachment with macular involvement. If the patient has a truly isolated bilateral optic neuritis as are the cases in the current series, then, after several weeks, one expects to see improvement. Optic neuritis usually occurs in children after an infectious process. Bilateral optic neuritis in a boy more than the eyes.
Bilateral optic neuritis in a 26yearold man with common. Clinical profile of simultaneous bilateral optic neuritis. The spectrum of neuromyelitis optica dean m wingerchuk, vanda a lennon, claudia f lucchinetti, sean j pittock, brian g weinshenker neuromyelitis optica also known as devics disease is an idiopathic, severe, demyelinating disease of the central nervous system. The aim of this paper is to present the clinical and laboratory characteristics of cases of optic neuritis in children. Bilateral optic neuritis in pediatric systemic lupus erythematosus with antiphospholipid antibody syndrome article pdf available in the indian journal of pediatrics 782. A serum autoantibody marker of neuromyelitis optica. Autoimmune disorders occur when the immune system malfunctions and attacks the bodys own tissues and organs.
Optic neuritis, its differential diagnosis and management. A few reports have described ocular complications of influenza a infection, such as. Recebeu apos os surtos, pulsoterapia com metilprednisolona ev, obtendo. It is most often associated with multiple sclerosis, and it.
Roemer sf, parisi je, lennon va, benarroch ee, lassmann h, bruck w et al. Neuromyelitis optica is an autoimmune disorder that affects the nerves of the eyes and the central nervous system, which includes the brain and spinal cord. Optic neuritis is a demyelinating inflammation of the optic nerve. Six of 7 85% had bilateral disease, and 12 of 92% affected eyes recovered 2040 visual acuity or better. We present three cases with diagnose of bilateral pseudopapilledema secondary to optic disk. The ganglion cells synapse mostly in the lateral geniculate nucleus, and to a lesser extent in the pretectum and superior colliculus of the midbrain and the suprachiasmic nuclei of the hypothalamus. Neuromyelitis optica spectrum disorders nmosd can present in pediatric patients as isolated optic neuritis. These studies have shown that younger children bilateral on and. Descargue como pdf, txt o lea en linea desde scribd. Early treatment can reverse the natural history of neuromyelitis optica as shown in this case.
This is a case of bilateral optic neuritis secondary to demyelination. In pediatric optic neuritis usually occurs after an infectious event, with papilledema, bilateral and with good prognosis, with a low incidence of conversion to. It is also known as optic papillitis when the head of the optic nerve is involved, neuroretinitis when there is a combined involvement of optic disc and surrounding retina in the macular area and retrobulbar neuritis when the posterior part of the nerve is involved. Case reports a 22 year male patient presented to the medicine outpatient department with. In pediatric optic neuritis usually occurs after an infectious event, with papilledema, bilateral and with good prognosis, with a low incidence of conversion to multiple sclerosis. Abstract inflammatory optic neuritis on is the most frequent cause of acute visual loss in young adults. Bilateral optic neuritis should be added to the list of autoimmune disorders related to common variable immunodeficiency. The ganglion cells synapse mostly in the lateral geniculate nucleus figure 1, and to a lesser extent in pretectum and superior colliculus of the midbrain and the suprachiasmic nuclei of the hypothalamus. Optic neuritis on is a common presenting symptom in pediatric cns demyelinating disorders and may be associated with dramatic visual loss. These results are consistent with the presence of a neuromyelitis optica spectrum disorder nmosd.
Generally, what one can do at this point is to carefully follow the clinical course. The term optic neuritis on refers to inflammation of the optic nerve due to many causes, indicated by subacute unilateral painful visual loss mostly in a young healthy female and by excluding glaucoma, on is the most common optic neuropathy in persons under 50 years coming to general ophthalmic practice. The intraorbital portion of the optic nerve is surrounded by dura. Nmoigg has a sensitivity and specificity of 4877% and 97100% respectively for nmosd waters et al. Inflammatory optic neuritis on is the most frequent cause of acute visual loss in young adults. Optic neuritis in neuromyelitis optica sciencedirect. Although the visual prognosis is excellent in the majority of cases, many patients develop pathology, such as multiple sclerosis, in its subsequent evolution. Bilateral optic neuritis is usually thought to affect children, often follows a viral syndrome, and is not typically associated with subsequent multiple sclerosis. Optic neuritis and acute anterior uveitis associated with influenza a infection.