Optic Neuropathy and Sinus Disease

Gallagher, David J.; Quigley, Clare; Lyons, Conor; McElnea, Elizabeth; Fulcher, Tim

doi:10.14740/jmc2926w

Cited by 4 publications

(5 citation statements)

References 17 publications

(27 reference statements)

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“…The most common is demyelination secondary to multiple sclerosis or neuromyelitis optica spectrum disorders [ 5 , 6 ]. However, optic neuritis has also been reported in association with hypertension and hyperthyroidism [ 7 ], infectious diseases such as rubella, mumps, measles and mononucleosis [ 8 ], systemic neoplasia [ 9 ], lead, arsenic, and methanol poisoning [ 7 , 10 ], and paranasal sinus diseases [ 1 , 2 , 11 , 12 ]. Because of the anatomical proximity of the optic canal to the sphenoid sinus, the optic nerve is vulnerable to the direct spread of infection or inflammation from the latter [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

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Optic Neuritis Related to Chronic Sphenoid Sinusitis as an Uncommon Cause of Vision Loss: A Case Report and Literature Review

Nowacka

Lubiński

2023

Am J Case Rep

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Objective:Rare disease Background:Optic neuritis is a rare but possible complication of sphenoid sinusitis. Case Report:We present a case of a young woman with recurrent optic neuritis associated with chronic sphenoid sinusitis.A 29-year-old woman with visual impairment of the left eye to Snellen distance best-corrected visual acuity (DBCVA) of 0.5 and migraine headaches accompanied by vomiting and dizziness reported to the ophthalmic emergency room. The preliminary diagnosis was demyelinating optic neuritis. On head computed tomography, a polypoid lesion of the sphenoid sinus was found and qualified for elective endoscopic treatment. During a 4-year follow-up, evaluation of DBCVA, fundus appearance, visual field, ganglion cells layer (GCL), peripapillary retinal nerve fiber layer (RNFL) thickness, and ganglion cells and visual pathway function (pattern electroretinogram -PERG, pattern visual evoked potentials -PVEPs) were performed. Four years after the occurrence of the initial symptoms, surgical drainage of the sphenoid sinus was performed, which revealed a chronic inflammatory infiltrate and a sinus wall defect on the left side around the entrance to the visual canal. After surgery, headaches and other neurological symptoms resolved, but DBCVA deteriorated in the left eye to finger counting/hand motion, partial atrophy of the optic nerve developed, the visual field defect progressed to 20 central degrees, GCL and RNFL atrophy appeared, and deterioration of ganglion cells and visual pathway function were observed. Conclusions:In patients with optic neuritis and atypical headaches, sphenoid sinusitis should be considered in the differential diagnosis. Delayed laryngological intervention can cause irreversible damage to the optic nerve.

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Section: Discussionmentioning

confidence: 99%

“…These findings suggest the importance of initiating treatment when sinus walls are still intact to preserve vision. Gallagher et al [ 11 ] described 2 cases of optic neuropathy related to sinus disease. In the first, a 36-year-old man had a 3-day history of worsening vision and headache.…”

Section: Discussionmentioning

confidence: 99%

Optic Neuritis Related to Chronic Sphenoid Sinusitis as an Uncommon Cause of Vision Loss: A Case Report and Literature Review

Nowacka

Lubiński

2023

Am J Case Rep

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“…Невропатія зорового нерва може бути пов'язана з поширенням цитокінів і/або імунних медіаторів із синусів до орбітальної апікальної частини зорового нерва через місцеву венозну циркуляцію з місцевими вазомоторними змінами. Вторинний запальний оклюзійний васкуліт також спричиняє неврит зорового нерва [40].…”

Section: орбітопатіяunclassified

Disorders of aqueous humor flow in the posterior part of the eye in the mechanisms of optic nerve damage development (literature review)

Мойсеєнко

2023

Oftalmol Zh

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The study based on the literature search revealed that the peculiarities of fluid circulation in the posterior part of the eye have been studied insufficiently compared to the anterior part. It is suggested that the retina and optic nerve have their own cleansing system, which functions independently or in interaction with the brain's cleansing system. Of interest is the theory of the glymphatic system of the eye, which probably functions similarly to the glymphatic system of the brain, has four segments and ensures the exchange between intraocular, intracranial and interstitial fluids and the removal of metabolic waste products in the posterior part of the eye. Purpose. To determine the disorders of fluid circulation in the posterior part of the eye in the mechanisms of optic nerve damage development according to the literature. Methods: literature search of 48 sources. It is important to understand that the optic nerve under normal conditions passes a large amount of fluid from the eye to the brain and vice versa. The balance of perfusion (and, presumably, reperfusion in case of pathology) is ensured by the lamina cribrosa, the location of subarachnoid spaces in different parts of the nerve, and the AQP4 channels that support them. The question is whether the optic nerve has its own separate glymphatic system, or whether it interacts with the glymphatic system of the brain. It also remains unclear how the circulation of intraocular fluid, interstitial fluid of the retina and brain, and cerebrospinal fluid in the optic nerve is coordinated with blood, as well as with fluctuations in atmospheric pressure. Although this theory has not yet been recognized, it nevertheless has many supporters who explain optic nerve damage as a result of fluid circulation disturbances. The slowing of fluid flow, as well as the slowing of axonal transport, can be considered as the moment when neuropathy transforms into optic atrophy. That is why the study of the peculiarities of fluid flow and exchange in the posterior part of the eye is important when studying diseases of the optic nerve, whereas the correction of such circulation disorders could be used for therapeutic purposes. Conclusion. Impaired fluid circulation in the posterior part of the eye can occur in mechanisms of optic nerve damage. Improved diagnostics with the ability to assess hydrodynamics will help to understand the role of individual components, while their correction will likely contribute to the optic nerve recovery.

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“…Damage to the visual nerve due to sinusitis or neuralgia is a rare clinical occurrence, and there is ongoing debate in the scienti c literature about the relationship between sinus disease and visual nerve damage. Some researchers argue that sinusitis does not cause damage to the visual nerve [1], while others believe that it can cause damage through various mechanisms, such as compression or demyelination [2[. There are reports of sinus disease causing a condition that mimics demyelinating optic neuritis, with sudden vision loss and eye pain, or progressive neurodegeneration and atrophy of the visual nerve due to compression [3]. However, these cases are di cult to diagnose and treat due to their varied clinical presentations and the lack of standardized diagnostic criteria.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Secondary Neuritis on the Optic Nerve in Patients with Chronic Rhinosinusitis

Moyseyenko

2023

Preprint

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Background: Chronic rhinosinusitis (CRS) is a common condition that affects millions of people worldwide. Despite its prevalence, the pathophysiology of CRS is not fully understood, and there is a lack of consensus on the definition and diagnosis of this condition. Methods: 8 patients (16 eyes) aged 18-32 were examined at the Ivano-Frankivsk National Medical University with progressive optic nerve atrophy caused by secondary neuritis combined with sinusitis. We conducted a cross-sectional study of patients with CRS who underwent a comprehensive otolaryngological evaluation, including nasal endoscopy, computed tomography (CT) scan, and allergy testing. Patients were classified into two groups: those with and without secondary neuritis. Result. Eight patients with optic nerve atrophy caused by secondary neuritis combined with sinusitis examined by OCT. The optic nerve damage in the early period (up to half a year) characterized by the appearance retinal neural fibers layer (RNFL)’s white sectors combined with red-yellow sectors on the side of the lesion. It could be evidence of edematous -degenerative processes. Later, after more than a year, RNFL’s yellow-red sectors appeared on the side of the lesion and white on the opposite side. The finding characterizes the development of atrophy of the optic nerve and involvement of the opposite side. Conclusion Our study suggests that secondary neuritis is a common complication of CRS and is associated with more severe symptoms and CT scan abnormalities. Early recognition and treatment of secondary neuritis may help to prevent or slow down the progression of the disease.

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Optic Neuropathy and Sinus Disease

Cited by 4 publications

References 17 publications

Optic Neuritis Related to Chronic Sphenoid Sinusitis as an Uncommon Cause of Vision Loss: A Case Report and Literature Review

Optic Neuritis Related to Chronic Sphenoid Sinusitis as an Uncommon Cause of Vision Loss: A Case Report and Literature Review

Disorders of aqueous humor flow in the posterior part of the eye in the mechanisms of optic nerve damage development (literature review)

The Effect of Secondary Neuritis on the Optic Nerve in Patients with Chronic Rhinosinusitis

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