Division of Ophthalmology, Laboratory of Investigation in Ophthalmology Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Department of Specialized Medicine, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
Arq Bras Oftalmol. 2024 Sep 23;88(2):e20230185. doi: 10.5935/0004-2749.2023-0185. eCollection 2024.
Optic neuritis is an important cause of unilateral and acute visual loss in young adults, but other differential diagnoses should be considered, especially when the disease has an atypical presentation. This report presents the case of a young woman with reduced visual acuity in her right eye, associated with optic disc edema and a relative afferent pupillary defect, that was initially misdiagnosed as optic neuritis and subsequently found to have paracentral acute middle maculopathy, possibly secondary to subtle impending central retinal vein occlusion. This case emphasizes the need to remember that retinal vascular diseases can occasionally mimic optic neuritis. Detailed anamnesis and ophthalmic examination can avoid unnecessary interventions.
视神经炎是导致年轻人单侧、急性视力丧失的重要原因，但应考虑其他鉴别诊断，尤其是当疾病表现不典型时。本报告介绍了一例年轻女性右眼视力下降的病例，伴有视盘水肿和相对性传入性瞳孔障碍，最初误诊为视神经炎，随后发现为旁中心急性中黄斑病变，可能继发于轻微的中央视网膜静脉阻塞。该病例强调需要记住，视网膜血管疾病偶尔可能类似于视神经炎。详细的病史和眼科检查可以避免不必要的干预。
