Tevaraj Jessica Mani Penny, Tai Li Min Evelyn, Mohd-Noor Raja-Azmi, Thavaratnam Lakana Kumar, Salmah Win Mar, Wan Hitam Wan Hazabbah
Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
Case Rep Ophthalmol Med. 2016;2016:6741925. doi: 10.1155/2016/6741925. Epub 2016 Dec 18.
A previously healthy 27-year-old Malay male presented with acute onset of painless, severe blurring of vision in his right eye. It was associated with headache and vomiting for the past week. Relative afferent pupillary defect was present in the right eye, with reduced optic nerve function. Patient also had bilateral generalised optic disc swelling, splinter haemorrhages, and tortuous vessels. Initial examination was suggestive of either optic neuritis or raised intracranial pressure. Typical features of bilateral optic perineuritis (OPN) such as tram track and doughnut sign were observed on magnetic resonance imaging. Connective tissue and infective screening were negative. He was diagnosed with bilateral optic perineuritis and treated with high dose intravenous corticosteroids followed by a three-month course of oral steroids. His vision and optic nerve function recovered to baseline levels.
一名此前健康的27岁马来男性，右眼突然出现无痛性严重视力模糊。在过去一周里，还伴有头痛和呕吐。右眼存在相对传入性瞳孔障碍，视神经功能减退。患者还出现双侧视神经乳头普遍肿胀、片状出血和血管迂曲。初步检查提示可能为视神经炎或颅内压升高。磁共振成像观察到双侧视神经周围炎（OPN）的典型特征，如轨道征和甜甜圈征。结缔组织和感染筛查均为阴性。他被诊断为双侧视神经周围炎，并接受了大剂量静脉注射皮质类固醇治疗，随后进行了为期三个月的口服类固醇疗程。他的视力和视神经功能恢复到了基线水平。
