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[Can optic perineuritis be triggered by Mycobacterium tuberculosis?]
M Jacob1, L Kodjikian, B Ponceau
1Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Lyon, France. maud.jacob@laposte.net
Journal Francais D'Ophtalmologie
|March 25, 2006
Summary
A patient with miliary tuberculosis developed optic disc swelling, diagnosed as optic perineuritis. Treatment adjustment led to recovery, highlighting diagnostic considerations for this condition.
Area of Science:
- Ophthalmology
- Neurology
- Infectious Diseases
Background:
- Miliary tuberculosis can present with diverse neurological complications.
- Optic disc swelling (papilledema) requires careful etiological investigation, especially when visual acuity is preserved.
Observation:
- A 38-year-old woman undergoing treatment for miliary tuberculosis developed isolated swelling of the left optic disc.
- The clinical presentation mimicked papilledema but without associated visual impairment.
Findings:
- Optic perineuritis was diagnosed based on clinical findings and response to treatment.
- Antibiotic regimen was modified, leading to a gradual resolution of optic disc swelling.
Implications:
- This case underscores the importance of considering optic perineuritis in the differential diagnosis of optic disc edema in patients with tuberculosis.
- It highlights the diagnostic challenges and potential etiologies, including infectious, toxic, and dysimmune mechanisms.
- Management involves adapting antimicrobial therapy and considering broader neurological workup.
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