[A case of retrobulbar optic neuritis associated with Sjögren syndrome which remitted spontaneously]

A 21-year-old woman came to the department of ophthalmology because of decreased visual acuity detected at the driving license center. MRI revealed T 1 iso-, T 2 hyper-intense, and Gd-enhanced lesion in the left optic nerve adjacent to the optic chiasma. No autoantibodies indicating systemic lupus erythematosus, Sjögren syndrome, or anti-phospholipid syndrome were elevated except for antinuclear antibody. There were no cerebral and spinal lesions on MRI. Neither oligoclonal IgG band nor myelin basic protein was found in the cerebrospinal fluid. Although she did not complain of dry mouth, secretion of the saliva was decreased. Biopsy of the minor salivary gland showed sialadenitis with infiltration of mononuclear cells, suggesting subclinical Sjögren syndrome. Visual acuity and MRI findings were remitted spontaneously. This case is distinguished from multiple sclerosis and vasculitis or ischemic mechanism(s) associated with autoantibodies might play a role in the development of the disease.