Bailey Lucy A, Riascos Roy F, Adesina Ore-Ofe O
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.
Robert Cizik Eye Clinic, Houston, Texas, USA.
Ocul Immunol Inflamm. 2025 Jul;33(5):879-881. doi: 10.1080/09273948.2022.2075762. Epub 2025 Jan 30.
A 45-year-old healthy African-American man experienced 2 months of right-eye soreness followed by acute onset of right painful vision loss with binocular, oblique diplopia. Visual acuity was count fingers OD and 20/20 OS. He had a partial, right, pupil-involving cranial nerve III palsy with a right relative afferent pupillary defect and optic disc edema with tortuous vessels. Magnetic resonance imaging showed increased T2 signal with tortuosity and thickening of the retrobulbar right optic nerve with associated restricted diffusion and enhancement, enhancement of orbital fat adjacent to the optic nerve sheath, and relative right proptosis. Workup was positive for aquaporin-4 antibody (AQP4-IgG) consistent with neuromyelitis optica spectrum disease (NMOSD). Our patient presented with signs and symptoms of orbital inflammation with optic neuritis and, to our knowledge, this is the first reported case of AQP4-IgG NMOSD presenting with orbital inflammatory syndrome.
一名45岁健康的非裔美国男性，右眼疼痛2个月，随后急性发作右眼疼痛性视力丧失，并伴有双眼斜向复视。右眼视力为眼前指数，左眼视力为20/20。他患有部分性、右侧、累及瞳孔的动眼神经麻痹，伴有右侧相对性传入性瞳孔障碍以及视盘水肿和血管迂曲。磁共振成像显示右侧球后视神经T2信号增强，伴有迂曲和增粗，相关区域弥散受限且有强化，视神经鞘相邻的眶脂肪强化，以及右侧眼球相对突出。水通道蛋白4抗体（AQP4-IgG）检测呈阳性，符合视神经脊髓炎谱系疾病（NMOSD）。我们的患者表现出眼眶炎症合并视神经炎的体征和症状，据我们所知，这是首例报道的以眼眶炎症综合征为表现的AQP4-IgG NMOSD病例。
