[Autoimmune optic neuropathy: case report].

Area of Science:

• Ophthalmology
• Immunology
• Neurology

Background:

• Autoimmune optic neuropathy is a rare condition causing acute visual loss.
• It can mimic idiopathic optic neuritis but has laboratory evidence of autoimmune disorder.
• Systemic disease is typically absent, though a skin biopsy may show vasculitis.

Observation:

• A 9-year-old female experienced bilateral severe visual loss.
• Initial oral corticosteroid treatment led to partial visual improvement in one eye.
• A relapse occurred nine years later in her only seeing eye, with temporary improvement from pulse corticosteroid therapy followed by complete visual loss upon tapering.

Findings:

• Clinical and laboratory investigations ruled out systemic disease.
• The patient tested positive for antinuclear (1/640), anti-Ro, and anti-La antibodies.
• Repeat corticosteroid treatment after relapse was ineffective.

Implications:

• Autoimmune optic neuropathy requires aggressive treatment, including corticosteroids and immunosuppressants.
• Prompt and potent therapy is necessary due to the typically severe visual involvement.
• Early diagnosis and intervention are critical to prevent irreversible vision loss.