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Optic perineuritis in polyarthritis nodosa.
Sijgje Maria Droger1, Jan-Hein Hensen2, Lucas Cornelis van Rooij3
1Neurology, Maasstad Hospital, Rotterdam, Zuid-Holland, The Netherlands DrogerS@maasstadziekenhuis.nl.
BMJ Case Reports
|July 22, 2021
Summary
Polyarteritis nodosa (PAN) can cause optic perineuritis (OPN), a condition leading to vision loss. Early diagnosis and immunosuppressant treatment of OPN are crucial for a positive patient outcome.
Area of Science:
- Ophthalmology
- Neurology
- Rheumatology
Background:
- Polyarteritis nodosa (PAN) is a systemic vasculitis that can affect various organs, including the optic nerves.
- Optic perineuritis (OPN) is an inflammatory condition involving the optic nerve sheath, often presenting with visual disturbances.
Observation:
- A 52-year-old male with PAN presented with paroxysmal alternating bilateral blindness and retro-orbital pain.
- Standard neurological examination and laboratory tests were unremarkable.
- MRI of the orbits revealed characteristic perineural thickening and enhancement of the optic nerve sheaths.
Findings:
- The MRI findings were pathognomonic for optic perineuritis (OPN).
- The central optic nerve was spared, distinguishing OPN from other optic neuropathies.
Implications:
- Prompt diagnosis of OPN is essential for effective management.
- High-dose immunosuppressant therapy led to a good clinical outcome in this patient.
- Early intervention in OPN improves visual prognosis and reduces the risk of permanent vision loss.
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