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Bilateral optic neuritis

Mark D Willis, Trevor P Pickersgill, Neil P Robertson, Richard W J Lee, Andrew D Dick, Ester Carreño
PURPOSE: The purpose of the study was to report a case of multiple sclerosis (MS)-associated uveitis refractory to conventional immunosuppressants, with subsequent remission following treatment with alemtuzumab. METHODS: Case report Patient was treated with intravenous alemtuzumab, a lymphocyte depleting anti-CD52 monoclonal antibody that has recently been approved for use in relapsing MS. RESULTS: A 17-year-old female presented with bilateral optic neuritis and subsequently bilateral intermediate uveitis and secondary macular oedema...
October 11, 2016: International Ophthalmology
Yonguk Kim, Seung-Young Yu, Hyung Woo Kwak
PURPOSE: To describe the clinical manifestations and treatment outcomes of ocular syphilis in patients without human immunodeficiency virus (HIV) infection. METHODS: A total of 45 eyes from 39 patients with ocular syphilis confirmed by serologic tests were reviewed retrospectively. The included cases were all non-HIV-infected patients presenting with intraocular inflammation from 2002 to 2014 at Kyung Hee University Hospital. Medical records of 45 eyes were analyzed and included best-corrected visual acuity and ophthalmologic examination findings of the anterior and posterior segments to determine the focus of inflammation...
October 2016: Korean Journal of Ophthalmology: KJO
Huanfen Zhou, Wei Wang, Quangang Xu, Shaoying Tan, Shuo Zhao, Mo Yang, Chunxia Peng, Shihui Wei
Purpose. Although optic neuritis (ON) in children is relatively common, visual outcomes and factors associated with the condition have not been well documented. The aim of this study was to evaluate the clinical features and visual outcomes of ON in Chinese children. Methods. Patients with a first episode of ON at a tertiary neuroophthalmic centre in China were assessed and followed up for at least three months. Visual outcomes and clinical, laboratory, and neuroimaging findings were reviewed. In patients with bilateral ON, only the eyes with worse visual acuity (VA) at presentation were used for statistical analysis...
2016: Journal of Ophthalmology
Sithara Ramdas, Danny Morrison, Michael Absoud, Ming Lim
Optic neuritis (ON) is an acquired disorder of the optic nerve due to inflammation, demyelination or degeneration. We report a child who presented with acute onset bilateral visual loss who, following a diagnosis of ON, was treated and had excellent visual recovery. Paediatric ON is considered to be different clinical entity to adult ON. Although in children ON is usually parainfectious or postinfectious, it can be the first presenting feature of multiple sclerosis or neuromyelitis optica spectrum disease. In this paper, we discuss the literature on treatment of ON and prediction of risk of recurrence...
October 4, 2016: BMJ Case Reports
Kyung Min Kim, Ungsoo Samuel Kim
PURPOSE: To evaluate the prevalence of aquaporin 4 antibody (AQP4-Ab) in new-onset optic neuritis patients and investigate the characteristics of seropositive patients. METHODS: Thirty-six women and six men with new-onset isolated optic neuritis were included in this study between January 2013 and December 2014. AQP4-Ab was detected and all blood samples were obtained prior to treatment and within one week from attack. The patients were sub-grouped into either a seropositive group or a seronegative group according to AQP4-Ab...
September 26, 2016: Seminars in Ophthalmology
Tanawat Tengsirikomol, Sasitorn Siritho, Naraporn Prayoonwiwat
BACKGROUND AND PURPOSE: A few reports studied the time use to diagnose patient with neuromyelitis optica (NMO). The Aim of the study is to evaluate the interval from disease onset to the time when patients fulfilled the NMO diagnostic criteria 2006 in Thai. METHOD: A retrospective study of the NMO patients visiting the MS clinic and related disorders at Siriraj hospital was reviewed. RESULTS: There were 42 definite NMO. All were female. The most common first presentations were optic neuritis (ON) (45...
September 2016: Multiple Sclerosis and related Disorders
E Ann Yeh, Jennifer S Graves, Leslie A Benson, Evangeline Wassmer, Amy Waldman
Optic neuritis (ON) is a common presenting symptom in pediatric CNS demyelinating disorders and may be associated with dramatic visual loss. Knowledge regarding clinical presentation, associated diseases, therapy, and outcomes in ON in children has grown over the past decade. These studies have shown that younger children (<10 years of age) are more likely to present with bilateral ON and older children with unilateral ON. Furthermore, studies focusing on visual recovery have shown excellent recovery of high-contrast visual acuity in the majority of children, but functional and structural studies have shown evidence of irreversible injury and functional decline after ON in children...
August 30, 2016: Neurology
Desmond P Kidd, Ben J Burton, Elizabeth M Graham, Gordon T Plant
OBJECTIVE: To identify and follow a series of 52 patients with optic neuropathy related to sarcoidosis. METHODS: Prospective observational cohort study. RESULTS: The disorder was more common in women and affected a wide age range. It was proportionately more common in African and Caribbean ethnic groups. Two clinical subtypes were identified: the more common was a subacute optic neuropathy resembling optic neuritis; a more slowly progressive optic neuropathy arose in the remaining 17%...
October 2016: Neurology® Neuroimmunology & Neuroinflammation
Claudia Bruè, Cesare Mariotti, Ilaria Rossiello, Andrea Saitta, Alfonso Giovannini
PURPOSE: Demyelinizing neurological disease is a rare complication after treatment with tumor necrosis factor (TNF)α antagonists. We report on a case of multiple sclerosis after TNFα antagonist treatment and discuss its differential diagnosis. METHODS: This is an observational case study. RESULTS: A 48-year-old male was referred to Ophthalmology in January 2015 for an absolute scotoma in the superior quadrant of the visual field in his right eye...
May 2016: Case Reports in Ophthalmology
D Lopez-Martin, J Martinez-Anton
INTRODUCTION: In children, the most common form of optic neuritis usually occurs after an infectious disease with papilledema, usually bilateral and has a good prognosis. Conversion to multiple sclerosis is low. AIM: To present clinical and laboratory case of optic neuritis in pediatrics features. PATIENTS AND METHODS: Seventeen clinical cases of optic neuritis in children and young people aged 4-14 years, referred from 2000 to 2015 were analyzed...
August 1, 2016: Revista de Neurologia
Teresa M Crout, Laura P Parks, Vikas Majithia
Neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD), previously known as Devic's syndrome, are a group of inflammatory disorders of the central nervous system (CNS) characterized by severe, immune-mediated demyelination and axonal damage, predominantly targeting optic nerves and the spinal cord typically associated with a disease-specific serum NMO-IgG antibody that selectively binds aquaporin-4 (AQP4). The classic and best-defined features of NMOSD include acute attacks of bilateral or rapidly sequential optic neuritis (leading to visual loss) or transverse myelitis (often causing limb weakness and bladder dysfunction) or both with a typically relapsing course...
August 2016: Current Rheumatology Reports
Rei Yamaguchi, Hideaki Kohga, Masahiko Tosaka, Akiko Sekine, Kazuyuki Mizushima, Yasuo Harigaya, Yuhei Yoshimoto
BACKGROUND: Optic neuritis (ON) is unilateral painful optic nerve inflammation in a young healthy female diagnosed by excluding glaucoma. ON onset during pregnancy is rare, with only 2 cases reported to date. CASE DESCRIPTION: A 35-year-old previously healthy parous woman who was pregnant with her second child suffered rapidly progressive visual acuity loss. Magnetic resonance imaging (MRI) revealed a pituitary tumor. Emergency surgery was performed for optic nerve compression; however, her visual impairment worsened...
September 2016: World Neurosurgery
Azusa Oshiro, Sadao Nakamura, Kunihito Tamashiro, Kazuo Fujihara
A 10-year-old boy developed bilateral optic neuritis and myelitis after a suspected viral infection and appendicitis. Magnetic resonance imaging (MRI) showed multiple lesions in both optic nerves, the optic chiasm, and the spinal cord. Several small lesions were also observed in the cerebellum and cerebral white matter. The serum tested negative for anti-aquaporin (AQP)-4 antibody and positive for anti-myelin oligodendrocyte glycoprotein (MOG) antibody. The diagnosis was neuromyelitis optica spectrum disorder (NMOSD)...
May 2016: No to Hattatsu. Brain and Development
M A Loh, P C Alex Khoo, M F Chong
Neuromyelitis optica (NMO) is a rare disorder in children with variable presentation. We report a 7-year-old boy who presented with bilateral retrobulbar optic neuritis and responded very well to treatment. He was also positive for aquaporin 4 (AQP4) antibodies, which is part of an emerging endophenotype within autoimmune neurological disorders in childhood.
April 2016: Medical Journal of Malaysia
John P Mitchell, Lynn L Huang, Daniel F Rosberger
As Acquired Immunodeficiency Disease (AIDS) turns thirty-years old, much progress has been made. 56,000 new cases of the Human Immunodeficiency Virus (HIV) infection are expected in Americans this year. At least half or more will be in African Americans. Reports of the association between syphilis and HIV infection are well documented. We present a case of bilateral optic neuritis and panuveitis as the initial presentation in a previously undiagnosed patient with human immunodeficiency virus (HIV) and syphilis...
June 2015: Journal of the National Medical Association
Chiara De Giacinto, Elvira Guaglione, Pia E Leon, Rossella D'Aloisio, Odilla Vattovani, Giuseppe Ravalico, Daniele Tognetto
Purpose. To report a case of unilateral optic neuritis following Measles-Mumps-Rubella (MMR) vaccination. Methods. A 30-year-old female developed unilateral optic neuritis five days after a Measles-Mumps-Rubella (MMR) booster vaccination. The patient displayed unilateral involvement, with severe visual loss. However, visual acuity improved significantly after four days of intravenous steroid therapy with 500 mg/day of methylprednisolone. Conclusions. Optic neuritis is one of the rare complications associated with the mumps, measles, and rubella vaccine...
2016: Case Reports in Ophthalmological Medicine
Tadashi Adachi, Kenichi Yasui, Toshiyuki Takahashi, Kazuo Fujihara, Yasuhiro Watanabe, Kenji Nakashima
We herein report a case of recurrent optic neuritis involving the cerebral white matter and brainstem in a patient positive for anti-myelin oligodendrocyte glycoprotein (MOG) antibodies. The patient had an initial attack at 24 years of age. Optic neuritis recurred over 14 years, and she was admitted to our neurology unit at 38 years of age. She showed bilateral optic neuritis, high-intensity lesions in the cerebral white matter and brainstem on T2 MRI with contrast enhancement, and elevated serum anti-MOG antibodies...
2016: Internal Medicine
Huanfen Zhou, Shuo Zhao, Dongfang Yin, Xiaofei Chen, Quangang Xu, Tingjun Chen, Xiaoyan Li, Junqing Wang, Hongyang Li, Chunxia Peng, Dahe Lin, Shihui Wei
Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4 % of whom were female...
July 2016: Journal of Neurology
Tingting Lu, Jian Bao, Dongfang Lin, Hongbing Chen, Wei Qiu, Zhengqi Lu
AIM: Granulomatosis with polyangiitis (GPA), extremely rare in children, is a disease characterized by granulomatous inflammation and necrotizing vasculitis that involves medium and small vessels. Central nervous system (CNS) involvement in GPA is not common and often appears at a later stage of the disease. The CNS manifestation of pediatric GPA was fragmentally discussed. Herein, we reported a case of relapsing-remitting pediatric GPA with prominent CNS involvement as initial symptoms...
August 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Stephanie Lescher, Valerie Wickmann, Peter Hofstetter, Luciana Porto
PURPOSE: Sudden visual impairment in children occurs sporadically but, when present, needs urgent attention. Optimal management strategies and timely recognition are required. Often psychogenic disorders are the cause in school-age children; however, this is a diagnosis of exclusion. Therefore, MRI plays an important role in ruling out pathology along the optic pathways or helping with the diagnosis of underlying life threatening diseases, such as hydrocephalus or intracranial mass. The purpose of this study was first to evaluate non-traumatic (tumoural and non-tumoural) causes of acute vision impairment; and, second, to assess whether conventional cerebral and orbital MR imaging is helpful for children with sudden visual impairment...
July 2016: European Journal of Paediatric Neurology: EJPN
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