Optic perineuritis: A Canadian case series and literature review

Xie, Jim; Donaldson, Laura; Margolin, Edward

doi:10.1016/j.jns.2021.120035

Cited by 10 publications

(9 citation statements)

References 71 publications

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“…Treatment modalities for orbital sarcoidosis include intralesional, oral, and intravenous steroids, methotrexate, cyclosporine, cyclophosphamide, mycophenolate, interferon, azathioprine, hydroxychloroquine, and surgical debulking [1][2][3]6,14]. However, intravenous steroids, which were given in the present case, may be a better option for cases with optic nerve involvement [14].…”

Section: Discussionmentioning

confidence: 76%

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Optic Neuropathy Caused by a Perineural Sarcoid Lesion

Takahashi¹,

Kono²,

Vaidya³

et al. 2022

Cureus

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A 74-year-old woman had a six-month history of decreased vision in the left eye. On the first examination, her left best-corrected visual acuity was 0.02, and Goldmann visual field test revealed a central scotoma in the left eye. Magnetic resonance imaging demonstrated lesions around the optic nerve on both sides and enlargement of the lacrimal gland and superior rectus/levator palpebrae superioris muscles on both sides and the medial and inferior recti muscles on the left side. Systemic computed tomography revealed bilaterally enlarged mediastinal and supraclavicular lymph nodes. The blood test results included an elevated soluble interleukin-2 receptor. Pathological examination of the specimens harvested from the lacrimal gland on both sides, left levator palpebrae superioris muscle, and the lesion around the optic nerve on the left side showed lymphocytic infiltration with noncaseating epithelioid granuloma. After the biopsy, the patient underwent two cycles of steroid pulse therapy, followed by oral prednisolone. Although the lesions were reduced after steroid treatment, the left vision did not recover.

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Section: Discussionmentioning

confidence: 76%

“…Other differential diagnoses include metastatic tumors, leukemia, lymphoma, and other orbital inflammatory diseases [3,14]. However, it may be possible to differentiate these diseases, based on the results of blood tests and systemic imaging studies.…”

Section: Discussionmentioning

confidence: 99%

Optic Neuropathy Caused by a Perineural Sarcoid Lesion

Takahashi¹,

Kono²,

Vaidya³

et al. 2022

Cureus

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“…OPN is a heterogeneous condition causing inflammation of the optic nerve sheath for which standard treatment is anti-inflammatory or immunosuppressive therapy, usually high-dose corticosteroids. The overwhelming majority of OPN cases have been treated with steroids [ 1 , 3 , 15 ] or, somewhat less commonly, with NSAIDS alone [ 2 ]. It has been suggested that prompt treatment of OPN is essential to avoid poor visual outcomes [ 2 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…He received only lubricating eye drops, and pain subsided at 2-month follow-up. Finally, in a recent Canadian case series, 2 patients were identified as untreated, 1 with idiopathic OPN and normal visual function, and the other with OPN secondary to myelin oligodendrocyte glycoprotein antibody disease and a 2-year history of visual symptoms [ 3 ]. No further details of their workup and clinical course were provided.…”

Section: Discussionmentioning

confidence: 99%

“…While many cases of OPN are idiopathic (primary OPN), most are secondary to an identifiable systemic disease [ 3 ], for which OPN is sometimes the initial presenting feature. Systemic associations for secondary OPN include inflammatory conditions such as Crohn's disease [ 4 ], sarcoidosis [ 3 , 5 , 6 ], Behçet disease [ 7 ], granulomatosis with polyangiitis [ 8 ], giant cell arteritis [ 3 , 9 ], and myelin oligodendrocyte glycoprotein antibody disease [ 3 ]. OPN can also occur in association with infections such as syphilis [ 3 , 10 , 11 , 12 ], tuberculosis [ 13 ], or COVID-19 [ 3 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Resolution of Optic Perineuritis in a Patient with Crohn’s Disease

Pickel

Micieli

2022

Case Rep Ophthalmol

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Optic perineuritis (OPN) is a rare condition characterized by inflammation of the optic nerve sheath. The underlying etiologies of OPN are varied and include systemic inflammatory conditions such as Crohn’s disease. It has been asserted that OPN requires prompt treatment in all cases. However, we report a case of OPN in a patient with Crohn’s disease that spontaneously resolved without treatment, underscoring that observation is a reasonable approach in some cases of OPN.

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Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

Huang

et al. 2022

Neurol Sci

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Background Polyneuritis cranialis (PNC) with the disease characteristics of Guillain-Barré syndrome (GBS) in addition to both ocular and bulbar weakness in the absence of limb paralysis or ataxia is defined as an unusual variant of GBS. As evidence of central nervous system (CNS) involvement, visual impairment is an unusual finding complicating with GBS spectrum disorders and has never been reported in patients with PNC. Methods We describe a very rare case who clinically presented with progressive multiple cranial nerve palsy and visual impairment. Furthermore, a literature search of concurrent GBS and optic neuritis (ON) as well as PNC attributed to GBS was conducted. Results A diagnosis of PNC was considered due to the typical clinical characteristics as well as the presence of cerebrospinal fluid cytoalbumin dissociation and serum antibodies against gangliosides. The clinical manifestations and the bilateral optic nerve involvement in brain magnetic resonance imaging further suggested possible optic neuritis (ON). The patient received treatment with intravenous immunoglobulin followed by short-term use of corticosteroids and finally achieved a full recovery. Thirty-two previously reported cases (17 women, mean age 40) of concurrent GBS and ON and 20 cases of PNC (5 women, mean age 40) were analyzed. We further provided a comprehensive discussion on the potential etiologies, clinical features, therapeutic strategies, and prognosis. Conclusions This rare case with the co-occurrence of PNC and visual impairment and the related literature review may help clinicians advance the understanding of GBS spectrum disorders and make appropriate diagnoses and treatment decisions for the rare variants and CNS complications of GBS. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06580-0.

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Optic perineuritis: A Canadian case series and literature review

Cited by 10 publications

References 71 publications

Optic Neuropathy Caused by a Perineural Sarcoid Lesion

Optic Neuropathy Caused by a Perineural Sarcoid Lesion

Spontaneous Resolution of Optic Perineuritis in a Patient with Crohn’s Disease

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

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