Unilateral anterior neuritis - Retina Club : Retina Club

Color retinography: Hyperemic papilla with blurring of papilla in the upper sector

Radial OCT: Thickening of the upper left RNFL (vertical slice)

OCT Optic disc cube: Thickening of RNFL in upper half of LE. Normal OD

Visual field (Humphrey 24-2, Zeiss). Arc-shaped defect in the lower hemifield of the left eye.

Dr. Pablo Gili Manzanaro

Description

Unilateral anterior neuritis

Optic neuritis is most common between the ages of 18 and 45, and usually presents with unilateral vision loss, color vision impairment, and visual field defects. In adults, the optic disc is usually normal (retrobulbar optic neuritis); in children and young adults, the presence of an edematous optic disc is more common (papillitis or anterior neuritis). The presence of multiple sclerosis should always be ruled out.

Comments

Although the immunological origin of neuritis has not been determined, the good response to corticosteroid bolus continues to suggest this etiology.

Indication

A 34-year-old woman with decreased VA in the left eye (0.5) and eye pain on movement, after a fever with intense headache in the previous days. Diagnosed with lymphocytic meningitis in the context of a probable viral infection, with left anterior optic neuritis. Cranial and cervical MRI were normal, and anti-MOG antibodies were negative. Six months later, the patient presented a new anterior neuritis, with all imaging and immunological tests negative.