UNILATERAL CHILDHOOD OPTIC NEURITIS – CASE REPORT
Muhammad Nabil Afif H., Nur Fazlie S., Siti Hajar M.A. & Ropilah A.R.
abstract
Optic neuritis in childhood may be a clinically isolated and self-limiting event or may present in the context of underlying neurologic, infective, or systemic disease, tend to affect both eyes and frequently be associated with swollen discs and good visual outcomes. We report 2 cases of childhood unilateral Optic Neuritis (ON). Case 1 is a 15-year-old Malay school girl who presented with a 3-day history of blurring of right vision associated with pain with eye movements. Right best corrected visual acuity (BCVA) at presentation was 3/60, markedly reduced to Counting Finger at 1 foot within one day of admission. Fundoscopy revealed a swollen optic disc with adjacent inferior cotton wool spots and retinal haemorrhages. Case 2 is a 12-year-old Indian school girl who presented with acute loss of right vision of 2 days duration following upper respiratory tract infection 1 week prior. For both patients, comprehensive workups to identify infectious, autoimmune, and neoplastic etiologies were negative. Brain MRI in each case showed isolated enhancement of the intraocular portion of the affected optic disc with no other focal lesions in the central nervous system. Both patients were managed with high-dose corticosteroids to reduce inflammation and support visual recovery, as per standard protocols for acute optic neuritis and resulted in favourable visual outcomes. Prognosis is generally good for isolated cases of childhood optic neuritis without underlying systemic disease or infection.
references
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2. Shams P.N., Plant G.T. Optic neuritis: a review. Int MS J. 2009;16:82–89.
3. Waldman AT, Stull LB, Galetta SL, Balcer LJ,Liu GT. Pediatric optic neuritis and risk of multiple sclerosis: Meta analysis of observational studies.J AAPOS 2011 Oct; 15(5):441-6 doi: 10.1016/j jaapos.2011.05.020 :22108356 PMD.22108356.
4. Bonhomme GR, Mitchell EB. Treatment of Pediatric Optic Neuritis. Curr Treat option Neurol 14,93-102(2012) Doi.org/10.1007/s11940-011-0159- 0, PMD 22190178.
5. Kowsalya A, Ramalingam U, Chaudhary S, Kumar M. Clinical features and visual outcomes of pediatric optic neuritis in Indian population: A prospective study Indian J Ophthalmol 2023 Feb2; 71(2):637-642 doi: 10.4103/ijo.IJO 1407 22.
6. Morales D.S., Siatkowski R.M., Howard C.W., Warman R. Optic neuritis in children. J Pediatric Ophthalmol Strabismus. 2000;37:254-259.
7. Optic Neuritis Study Group. High-dose corticosteroids in acute optic neuritis. N Engl J Med. 1992;326(9):581-588.
8. Rho BK, Lee SC, Park DW, Lee KH, Jin YJ. Clinical profiles and prognostic factors of pediatric optic neuritis. J Child Neurol. 2011;26(4):460–5.
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