Introduction: Optic neuropathies are a group of pathologies that course with potentially irreversible visual dysfunction. Among compressive causes, optic nerve glioma (GNO) is one of the main ones. Case report: A 12-year-old black school-age female patient seen in February 2020, reported progressive low visual acuity on the right eye (RE) for 6 years. Ectoscopy revealed café au lait spots all over body and hyperchromic nodular lesion in left axilla. Ophthalmologic examination showed acuity of 20/400 in RE and 20/20 in the left eye (LE), relative afferent pupillary defect in RE. At biomicroscopy, irian Lisch nodules. Magnetic resonance imaging (MRI) showed fusiform thickening of intraorbital portion of right optic nerve (ON) with mild enhancement upon gadolinium infusion. Optic neuropathy was secondary to probable GNO. Ophthalmology and neurology management was expectant. Upon return, patient reported intermittent headache and functional and aesthetic discomfort due to axillary lesion, and presented a new MRI with findings similar to the first. Simple retinography showed global pallor in right ON and temporal pallor of left ON. Conclusion: The case presented, in which delay in access to specialized care resulted in blindness, highlights the importance of ophthalmologic screening in NF1. Manifestations resulting from the syndrome, with biopsychosocial repercussions, emphasize importance of multidisciplinary care.
Introduction: Arteritic anterior ischemic optic neuropathy (AAION) is infarction in anterior segment of optic nerve in which there is thrombotic occlusion of short posterior ciliary arteries due to granulomatous inflammation of giant cell arteritis (ACG). Case report: Male patient, 66 years old, complaining of loss of vision in left eye (LE) for 28 days, and in right eye (RE) for 8 days, accompanied by left hemicranial headache, pulsatile, irradiation from frontal to cervical region, of strong intensity, prevalent at night. Report of pain on chewing, chills, night sweats, neck pain and headache for 2 months. On examination, there was no light perception and bilateral non-reactive pupils. At simple retinography, LE with pale optical disc (OD), attenuation of retinal vascularization, atrophic and whitish areas; RE with OD with undefined borders, peripapillary hemorrhages and areas of retinal pallor. At fluorescent retinography; LE without arterial filling; CBC, discrete anisocytosis, thrombocytosis and microcytosis; ESR, 71mm/h in first hour; CRP, 113.6 mg/L. At, doppler USG of temporal arteries, significant increase in thickness of the myointimal layer, causing hemodynamic repercussions, with monophasic flow. Conclusion: Meeting 4 of 5 criteria of American College of Rheumatology, diagnosis of AAION was made. The condition was already irreversible at the time of examination.
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