Neuroretinitis With Retrobulbar Involvement

Vaphiades, Michael S.; Wigton, Eric H; Ameri, Hossein; Lee, Andrew G.

doi:10.1097/wno.0b013e3181e7e4c8

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…We evaluated an immunosuppressed patient who developed bilateral EBV neuroretinitis, with subacute swelling of the optic discs, accumulation of intraretinal and subretinal fluid originating from the disc leakage, and finally precipitation of lipid within the neurosensory retina once the fluid resorbed several weeks later (9). The thickening and enhancement of the left retrobulbar optic nerve seen on MRI here has been previously reported in the setting of neuroretinitis (10, 11). The absence of right optic nerve enhancement on repeat MRI could be explained by the course of high-dose steroids that the patient had just received, or a more localized involvement of the optic nerve head on the right compared to the left side.…”

Section: Discussionsupporting

confidence: 77%

Epstein–Barr Virus Neuroretinitis in a Lung Transplant Patient

Hsia

Chin‐Hong²,

Levin³

2017

Journal of Neuro-Ophthalmology

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Section: Discussionsupporting

confidence: 77%

Epstein–Barr Virus Neuroretinitis in a Lung Transplant Patient

Hsia

Chin‐Hong²,

Levin³

2017

Journal of Neuro-Ophthalmology

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“…The consistent absence of these changes and the failure to develop clinical MS on long-term follow-up (87) have put this issue to rest. Two additional cases with similar findings have been reported (46,102). Schmalfuss et al (101) evaluated the MRI findings in 82 patients with various optic neuropathies, including 9 with CSD.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 88%

“…Schmalfuss et al (101) evaluated the MRI findings in 82 patients with various optic neuropathies, including 9 with CSD. A combination of optic nerve and sheath enhancement was seen on CT in 1 case of idiopathic NR (104) and on MRI in 1 patient with recurrent idiopathic NR (46). The authors suggested that this ''short segment enhancement'' is highly specific for CSD-NR.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 98%

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Neuroretinitis: Review of the Literature and New Observations

Purvin¹,

Sundaram²,

Kawasaki³

2011

Journal of Neuro-Ophthalmology

124

146

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Neuroretinitis (NR) is an inflammatory disorder characterized by optic disc edema and subsequent formation of a macular star figure. The underlying pathophysiology involves increased permeability of disc vasculature, but the etiology is not fully defined. In some cases, NR is probably due to an infectious process involving the disc; in others, a postviral or autoimmune mechanism is more likely. Cases can be divided into those in which a specific infectious agent has been identified, those considered idiopathic, and those with recurrent attacks. Some reports have not distinguished among these subgroups, and it is unclear if their clinical features vary. We reviewed the literature and our own patients looking particularly at features that might better distinguish these subtypes. Features common to all 3 groups included age, absence of pain, and fundus appearance. Preceding systemic symptoms were more common in patients with cat scratch disease (CSD) and uncommon in those with recurrence. The pattern and magnitude of visual field loss differed, more commonly confined to the central field in CSD cases and more severe in recurrent cases. Recovery of visual acuity and field was less substantial in recurrent cases even after the initial episode. MRI was usually normal in all 3 groups. Enhancement confined to the optic disc was found in all 3 groups, but enhancement of the retrobulbar optic nerve was seen only in recurrent cases. Findings that are strongly suggestive of CSD include very young age, preceding systemic symptoms, and poor visual acuity but with a small or absent relative afferent pupil defect (RAPD). In contrast, the following are suggestive of idiopathic NR with a high risk of recurrence: absence of systemic symptoms, visual field defect outside the central field, preserved visual acuity with a large RAPD, and poor recovery of vision. Decisions regarding evaluation and treatment should be made with these features in mind.

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“…Fat suppression of the orbital soft tissue further supported the diagnosis of optic perineuritis. Vaphiades et al 8 reported two patients with neuroretinitis in which a contrast enhanced fat-suppressed orbital MRI revealed diffuse enhancement of the optic nerve and sheath on both patients.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Inflammatory Neuroretinitis Simulating Optic Nerve Sheath Dural Ectasia

İlker¹,

Seymenoğlu²,

Tarhan³

et al. 2013

Neuro-Ophthalmology

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We report a case of a 32-year-old female patient who presented with decreased vision on both eyes and headache. In fundus examination, both eyes had elevation of the optic disc and star shaped hard exudates in the macula. Magnetic resonance imaging was completely normal except the saccular dilatation of bilateral optic nerve sheath. The patient was treated with oral steroids following high-dose intravenous methylprednisolone. She displayed good anatomical and functional results during the follow-up. This case raises the possibility that optic nerve sheath enlargement, probably induced by an idiopathic inflammatory optic neuritis, may simulate dural ectasia of the optic nerve sheath.

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Neuroretinitis With Retrobulbar Involvement

Abstract: Two patients with neuroretinitis are presented, both having MRI abnormalities of the orbital portion of the optic nerve. We review previous reports of CT and MRI findings in patients with neuroretinitis and propose a spectrum of neuroimaging abnormalities in these patients.

Cited by 9 publications

References 5 publications

Epstein–Barr Virus Neuroretinitis in a Lung Transplant Patient

Epstein–Barr Virus Neuroretinitis in a Lung Transplant Patient

Neuroretinitis: Review of the Literature and New Observations

Idiopathic Inflammatory Neuroretinitis Simulating Optic Nerve Sheath Dural Ectasia

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