Miller Cara, Vu NgocHanh H, Carozza Richard B
Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Child Neurol. 2025 Nov;40(10):906-909. doi: 10.1177/08830738251341771. Epub 2025 May 25.
Optic perineuritis is an inflammatory disorder of the optic nerve sheath, presenting with visual deficits, dyschromatopsia, and pain with extraocular movement, often confused with optic neuritis. Most cases are believed to be idiopathic but can be associated with autoimmune, infectious, and neoplastic etiologies. Treatment involves corticosteroids, and when administered promptly has been associated with rapid recovery. Delays in treatment have been linked to poor visual outcomes. Few pediatric cases have been described. We report a teenager who presented with 2 months of unilateral visual loss and paracentral scotoma, found to have optic perineuritis. She was treated aggressively with high-dose corticosteroids, therapeutic plasma exchange, and intravenous immunoglobulin, but had limited symptomatic recovery attributable to delays in seeking treatment. Optic perineuritis is rare in children but should be included in the differential for visual deficits, especially as delayed treatment is associated with irreversible visual loss. Further studies are needed for children to better identify underlying causes and establish consistent treatment paradigms.
视神经周围炎是一种视神经鞘的炎症性疾病，表现为视力缺陷、色觉障碍以及眼球运动时疼痛，常与视神经炎混淆。大多数病例被认为是特发性的，但可能与自身免疫、感染和肿瘤病因有关。治疗包括使用皮质类固醇，及时给药与快速恢复相关。治疗延迟与视力预后不良有关。儿科病例报道较少。我们报告一名青少年，其出现2个月的单侧视力丧失和旁中心暗点，被诊断为视神经周围炎。她接受了大剂量皮质类固醇、治疗性血浆置换和静脉注射免疫球蛋白的积极治疗，但由于就诊延迟，症状恢复有限。视神经周围炎在儿童中罕见，但在视力缺陷的鉴别诊断中应予以考虑，尤其是因为治疗延迟与不可逆的视力丧失有关。需要进一步对儿童进行研究，以更好地确定潜在病因并建立一致的治疗模式。
