Suparmaniam Sruban, Wan Hitam Wan-Hazabbah, Thilagaraj Saritrasaraswathy
Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, MYS.
Department of Ophthalmology, Hospital Sultanah Bahiyah, Kedah, MYS.
Cureus. 2022 Sep 16;14(9):e29220. doi: 10.7759/cureus.29220. eCollection 2022 Sep.
Parainfectious optic neuritis arises from infectious aetiology either from pathogen direct invasion or after an infectious disease which can be immunologically mediated demyelination of optic nerve or, from inflammation of optic disc vasculature. We report a case of bilateral optic neuritis in a young patient. A 13-year-old boy presented with painless profound vision loss in both eyes preceded by an episode of fever two weeks prior. Visual acuity in both eyes was a perception of light. Fundoscopy showed a bilateral hyperemic swollen disc. Blood investigations were normal except for C-reactive protein and ESR was elevated. CSF analysis was also normal with no growth of micro-organisms. Both CT scans and MRIs of the brain and orbit showed normal findings. The patient was diagnosed to have parainfectious optic neuritis. He was started on intravenous methylprednisolone for five days followed by a tapering dose of oral prednisolone for a total of one month. His final visual acuity improved to 6/6 in both eyes with a normal optic disc appearance.
感染后性视神经炎源于感染性病因，要么是病原体直接侵袭，要么是在一种可导致视神经免疫介导性脱髓鞘的传染病之后，或者是由于视盘血管系统的炎症。我们报告一例年轻患者的双侧视神经炎病例。一名13岁男孩在两周前发热发作后出现双眼无痛性严重视力丧失。双眼视力仅为光感。眼底检查显示双侧视盘充血肿胀。血液检查除C反应蛋白和血沉升高外均正常。脑脊液分析也正常，未发现微生物生长。脑部和眼眶的CT扫描及MRI检查均显示正常结果。该患者被诊断为感染后性视神经炎。开始静脉注射甲基强的松龙5天，随后逐渐减量口服强的松龙，共1个月。他的最终视力双眼提高到6/6，视盘外观正常。
