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Retrobulbar optic neuritis in a two-year-old boy.

K Matsubara1, K Suzuki, M Itoh

  • 1Division of Pediatrics, Matsue Red Cross Hospital, Shimane, Japan.

Brain & Development
|January 1, 1990
PubMed
Summary

This study presents a rare case of optic neuritis in a young child, likely caused by autoimmune demyelination. Early diagnosis using cerebrospinal fluid myelin basic protein and anti-myelin antibodies is crucial for managing this condition.

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Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Ophthalmology

Background:

  • Optic neuritis is an inflammatory condition affecting the optic nerve, often associated with demyelination.
  • While common in adults, optic neuritis in young children is rare, presenting diagnostic challenges.
  • Autoimmune processes are frequently implicated in demyelinating optic neuritis.

Observation:

  • A 2-year-4-month-old boy experienced sudden, rapid vision loss progressing to blindness.
  • Normal findings were observed in visual evoked potential (VEP), electroretinogram, CT, and MRI scans of the visual pathway.
  • Elevated cerebrospinal fluid (CSF) myelin basic protein (MBP) and positive serum anti-myelin antibodies were detected.

Findings:

  • The clinical presentation and laboratory results strongly suggest autoimmune-induced retrobulbar demyelination as the cause of optic neuritis.

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  • The patient showed gradual, though incomplete, visual recovery after treatment with oral prednisolone.
  • No recurrence of optic neuritis or other neurological issues were noted during a one-year follow-up.

    • Implications:

    • This case highlights the possibility of autoimmune mechanisms triggering optic neuritis even in early childhood.
    • CSF MBP and serum anti-myelin antibody testing are valuable adjuncts to VEP and MRI for diagnosing and monitoring pediatric optic neuritis.
    • Early diagnosis and intervention may improve visual outcomes in children with demyelinating optic neuritis.