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Masquerading optic neuritis.

Katherine McVeigh1, Georgios Vakros2, Rafik Girgis1

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Summary
This summary is machine-generated.

This case highlights how optic neuritis (ON), often associated with multiple sclerosis (MS), can present with unusual visual field defects, mimicking stroke. Prompt visual field testing and appropriate treatment led to significant recovery.

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Area of Science:

  • Ophthalmology
  • Neurology

Background:

  • Optic neuritis (ON) is an inflammatory condition affecting the optic nerve, frequently associated with multiple sclerosis (MS).
  • Visual field (VF) defects are common in ON, but presentation can vary.

Observation:

  • A 54-year-old woman with a history of MS presented with blurred vision and reduced visual acuity.
  • Initial examination revealed bilateral reduced visual acuity and a left relative afferent pupillary defect.

Findings:

  • Visual field testing unexpectedly showed an incongruous left homonymous hemianopia, initially prompting investigation for stroke.
  • Pulsed methylprednisolone treatment resulted in near-complete resolution of the hemianopia.

Implications:

  • This case underscores the critical role of comprehensive visual field testing in diagnosing optic neuritis.
  • Optic neuritis can present with diverse visual field defects, potentially mimicking cerebrovascular events like stroke.
  • Ophthalmologists and medical professionals should consider optic neuritis in the differential diagnosis of unexplained hemianopia.