DR.PRIYANKA MANDRAHA

PROF. PANKAJ CHOUDHARY, Dr.Anamika Dwivedi, Dr. SHASHI AGARWAL

Abstract

Purpose: To report an usual case of optic neuritis.Case: A male presented with pain & progressive DOV in LE for 10 days. LE examination shows V/A CF2,RAPD,disc edema & splinter hemorrhage.OCT suggestive of serous macular detachment .Previous CT orbit shows thickened LE optic nerve(ON) in retrobulbar(RB) & canalicular(C) part likely ON glioma.CE MRI orbit reveals enhanced nodular thickened left ON with increased signal & optic sheath effacement in RB & C part,likely inflammatory/infective etiology ,probably sarcoidosis.Test for Tb,syphilis were negative & prominent hilar shadow on chest X-ray.Result:A diagnosis of inflammatory optic neuropathy,possible sarcoidosis was made & treated with methylprednisolone pulse therapy followed by slow tapering oral steroid.V/A improved 6/12 in a week.Disc edema & macular detachment resolved.Conclusion: A high degree suspicion is needed for differentials of optic neuritis besides demyelinating diseases & neuroimaging is essential in their evaluation.