Parainfectious Optic Neuritis

Selbst, Richard G.

doi:10.1001/archneur.1983.04050060047007

Cited by 70 publications

(18 citation statements)

References 26 publications

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“…Previous reported cases of optic neuritis following chickenpox in immunocompetent adults had a similar course [3–5]. The decrease of visual acuity usually occurs between 2 to 38 days after the onset of the rash and is usually bilateral.…”

Section: Discussionmentioning

confidence: 76%

“…Considering this, some authors suggest the use of systemic corticosteroids in immunocompetent adults to accelerate recovery [3, 4]. Nevertheless, corticotherapy remains controversial since improvement of visual acuity not only occurs in its absence [4, 5, 8], but also despite its use, some patients maintain severe visual loss during follow up [3, 4]. Additionally, it may, theoretically, exacerbate the direct infection by the virus by diminishing the immune response, a phenomenon that is reported in HIV positive patients [9].…”

Section: Discussionmentioning

confidence: 99%

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Optic Neuritis in an Adult Patient with Chickenpox

Azevedo

Simões²,

Silva³

et al. 2012

Case Reports in Ophthalmological Medicine

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Central nervous system involvement in a patient with primary infection with Varicella zoster virus is rare, especially in the immunocompetent adult. In particular, isolated optic neuritis has been described in a small number of cases. The authors present a case of optic neuritis in an immunocompetent patient. A 28-year-old woman presented to the emergency room with a history of headaches during the previous week, without visual symptoms. The examination was unremarkable, except for a rash suggestive of chickenpox and hyperemic and edematous optic disc, bilaterally. Visual acuity and neurological examination were normal. Two days later, she complained of pain on eye movement and decreased visual acuity, which was 20/32 in her right eye and 20/60 in her left eye. Four days after admission, her visual acuity started to improve, and two months later, she had 20/20 visual acuity in both eyes. To our knowledge, this is the first reported case of an immunocompetent adult in which a Varicella zoster virus associated optic neuritis presented with fundoscopic changes before decreased visual acuity. This suggests that this condition may be underdiagnosed in asymptomatic patients.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Optic Neuritis in an Adult Patient with Chickenpox

Azevedo

Simões²,

Silva³

et al. 2012

Case Reports in Ophthalmological Medicine

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“…Alternate pathophysiologic explanations have been proposed based on the parainfectious ON associated with the childhood viral exanthems [18]. In that entity, a systemic autoimmune demyelination rather than direct viral invasion of the optic nerve has been proposed as a likely mechanism.…”

Section: Discussionmentioning

confidence: 99%

Reversible Optic Neuritis Secondary to Paranasal Sinusitis

Awerbuch¹,

Labadie²,

Dalen

1989

Eur Neurol

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Three patients are described in whom optic neuritis was presumably caused by concurrent sinus infection. Aggressive treatment of the underlying sinus condition led to prompt visual improvement. Although underre-cognized in clinical neurology, paranasal sinusitis is an uncommon but treatable cause of optic neuritis. Shortcomings of conventional radiological investigations and inappropriate use of corticosteroids may contribute to initial misdiagnosis.

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“…Optic neuritis after zoster occurs in adults (Miller et al, 1986) and in children and may be bilateral (Selbst et al, 1983). Reports of visual loss in association with pain on eye movement and clinical findings of papillitis and central scotomata or optic atrophy weeks after VZV infection suggest an immunologic pathogenesis in some cases (Carroll and Mastaglia, 1979).…”

Section: Reactivation Of Vzvmentioning

confidence: 99%