Related Experiment Video
Updated: Jun 13, 2026
14:54
Rat Model of Photochemically-Induced Posterior Ischemic Optic Neuropathy
Published on: November 29, 2015
p-ANCA pachymeningitis presenting with isolated "optic neuropathy"
Fabrizio Salvi1, Mario Mascalchi, Elena Pasini
1Centro per le Malattie Rare e Neuroimmuni, Unità Operativa di Neurologia, Dipartimento di Neuroscienze, Ospedale Bellaria, Bologna, Italy.
Summary
Isolated bilateral optic neuropathy, a rare symptom of perinuclear-antineutrophil cytoplasmic autoantibody (p-ANCA) vasculitis, can be caused by pachymeningitis. MRI confirmed this compressive mechanism, and treatment improved vision.
Area of Science:
- Neurology
- Ophthalmology
- Rheumatology
Background:
- Perinuclear-antineutrophil cytoplasmic autoantibody (p-ANCA) vasculitis is a rare autoimmune condition.
- Optic neuropathy, particularly isolated bilateral presentation, is an unusual manifestation of this vasculitis.
Observation:
- A 69-year-old woman experienced progressive bilateral visual failure over six months.
- Cranial MRI revealed diffuse dural enhancement extending to the perioptic sheaths, encasing the optic nerves.
Findings:
- Laboratory tests indicated elevated p-ANCA titres and other autoimmune markers.
- The patient's visual acuity and MRI signs of pachymeningitis improved with corticosteroid treatment.
Implications:
- Bilateral optic neuropathy can be the initial presenting symptom of p-ANCA-associated pachymeningitis.
- MRI is a valuable tool for demonstrating the compressive role of pachymeningitis in optic neuropathy.
- This case highlights the importance of considering autoimmune vasculitis in the differential diagnosis of bilateral optic neuropathy.
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