Optic Perineuritis as the Presenting Feature of Crohn Disease

McClelland, Collin M.; Zaveri, Maulik; Walsh, Ryan D.; Fleisher, Jori; Galetta, Steven

doi:10.1097/wno.0b013e31825e8e2e

Cited by 36 publications

(21 citation statements)

References 17 publications

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“…Most reports are from patients suffering from Crohn disease (Gupta et al, 2005;Felekis et al, 2009b). Very occasionally a diagnosis of optic perineuritis is made (McClelland et al, 2012;Tung et al, 2013). Optic neuritis may be a complication of inflammatory bowel disease treatment, with several cases reported in association with treatment with tumor necrosis factor inhibitors (Chan and Castellanos, 2010;Tristano, 2010), and may require discontinuation of treatment and/or change to a different immunosuppressive drug (Felekis et al, 2009a).…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Autoimmunity in visual loss

Petzold¹,

Wong

Plant

2016

Handbook of Clinical Neurology

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There are a number of autoimmune disorders which can affect visual function. There are a very large number of mechanisms in the visual pathway which could potentially be the targets of autoimmune attack. In practice it is the retina and the anterior visual pathway (optic nerve and chiasm) that are recognised as being affected in autoimmune disorders. Multiple Sclerosis is one of the commonest causes of visual loss in young adults because of the frequency of attacks of optic neuritis in that condition, however the basis of the inflammation in Multiple Sclerosis and the confirmation of autoimmunity is lacking. The immune process is known to be highly unusual in that it is not systemic and confined to the CNS compartment. Previously an enigmatic partner to Multiple Sclerosis, Neuromyelitis Optica is now established to be autoimmune and two antibodies - to Aquaporin4 and to Myelin Oligodendrocyte Glycoprotein - have been implicated in the pathogenesis. The term Chronic Relapsing Inflammatory Optic Neuropathy is applied to those cases of optic neuritis which require long term immunosuppression and hence are presumed to be autoimmune but where no autoimmune pathogenesis has been confirmed. Optic neuritis occurring post-infection and post vaccination and conditions such as Systemic Lupus Erythematosus and various vasculitides may cause direct autoimmune attack to visual structures or indirect damage through occlusive vasculopathy. Chronic granulomatous disorders such as Sarcoidosis affect vision commonly by a variety of mechanisms, whether and how these are placed in the autoimmune panoply is unknown. As far as the retina is concerned Cancer Associated Retinopathy and Melanoma Associated Retinopathy are well characterised clinically but a candidate autoantibody (recoverin) is only described in the former disorder. Other, usually monophasic, focal retinal inflammatory disorders (Idiopathic Big Blind Spot Syndrome, Acute Zonal Occult Outer Retinopathy and Acute Macular Neuroretinitis) are of obscure pathogenesis but an autoimmune disorder of the post-infectious type is plausible. Visual loss in autoimmunity is an expanding field: the most significant advances in research have resulted from taking a well characterised phenotype and making educated guesses at the possible molecular targets of autoimmune attack.

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Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Autoimmunity in visual loss

Petzold¹,

Wong

Plant

2016

Handbook of Clinical Neurology

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“…It is a great mimicker of typical ON. OPN has been reported mostly as idiopathic and isolated cases [1] although associations with other diseases such as Wegener granulomatosis [2], giant cell arteritis [3], Crohn’s disease [4], Behcet disease [5], leukemia [6] and acute retinal necrosis [7] have been reported. To the best of our knowledge, there are limited reports of OPN in patients with NMO or NMOSD.…”

Section: Discussionmentioning

confidence: 99%

Optic Perineuritis in Neuromyelitis Optica Spectrum Disorder

Kamaluddin

Tai

Hitam

et al. 2019

Cureus

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Optic perineuritis (OPN) involvement in demyelinating disease is rarely encountered. To our knowledge, this is the first reported case of bilateral OPN associated with neuromyelitis optica spectrum disorder (NMOSD). We present a case of a healthy young gentleman who presented with OPN, initially presumed to have a young stroke but later diagnosed to be NMOSD. Early neuroimaging is essential to help distinguish optic neuritis (ON), and prolonged treatment of systemic immunosuppression is the mainstay of treatment.

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“…Although many cases of OPN are understood to be isolated and idiopathic,1–4 patients with OPN secondary to inflammatory or infectious disorders, including syphilis,5,6 sarcoidosis,7,8 Crohn disease,9 and Wegener’s granulomatosis,3 have also been reported. Given the various underlying disorders associated with the disorder, OPN is conceivably several separate disorders that share the feature of optic nerve sheath inflammation.…”

Section: Introductionmentioning

confidence: 99%

Optic perineuritis: a retrospective case series

Bergman¹,

Andersson²,

Zetterberg³

2017

IMCRJ

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Optic perineuritis (OPN) is a rare inflammatory disorder involving the optic nerve sheath characterized by visual loss. OPN may be isolated and idiopathic or part of an underlying disorder. This case series aimed to help clinicians investigate and manage this disorder. Presentation, clinical findings, and treatment of OPN are discussed. After review of medical records at the ophthalmology clinic at Sahlgrenska University hospital in Gothenburg, Sweden, seven OPN patients (three men and four women) were identified and included in the present case series. These included idiopathic cases and patients with underlying disorders. Age at OPN diagnosis ranged from 26 to 64 years (mean age 55 years, median age 58 years). Five of the patients were treated with corticosteroids. This study suggests that a high-dose course of corticosteroids is important in the treatment of OPN in severely affected patients.

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Optic Perineuritis as the Presenting Feature of Crohn Disease

Cited by 36 publications

References 17 publications

Autoimmunity in visual loss

Autoimmunity in visual loss

Optic Perineuritis in Neuromyelitis Optica Spectrum Disorder

Optic perineuritis: a retrospective case series

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