Recurrent Neuroretinitis in an Adolescent with Ulcerative Colitis

Shoari, Mohammad; Katz, Bradley J.

doi:10.1097/01.wno.0000189827.69634.7d

Cited by 20 publications

(7 citation statements)

References 12 publications

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“…For idiopathic cases, a viral etiology has been assumed, but this has never been proven. In addition, there have been 3 reported cases of NR associated with inflammatory bowel disease (33,79,80). Occasional cases of NR are due to noninfectious forms of uveitis, such as sarcoidosis (78) and periarteritis nodosa (81).…”

Section: Etiologymentioning

confidence: 99%

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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Section: Etiologymentioning

confidence: 99%

Neuroretinitis: Review of the Literature and New Observations

Purvin¹,

Sundaram²,

Kawasaki³

2011

Journal of Neuro-Ophthalmology

124

146

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“…Attacks are rarely accompanied by eye pain and are not usually preceded by a flu‐like illness or other systemic symptoms. Although recurrent NR has been reported in a patient with inflammatory bowel disease, 11 a history of this disorder was found in only one patient in this series, the diagnosis made many years after onset of NR.…”

Section: Discussionmentioning

confidence: 54%

Recurrent idiopathic neuroretinitis: natural history and effect of treatment

Sundaram

Purvin

Kawasaki

2010

Clinical Exper Ophthalmology

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“…The non-infectious causes include idiopathic retinal vasculitis aneurysm and neuroretinitis (IRVAN), polyarteritis nodosa, inflammatory bowel disease and Behçet's disease. [1][2][3] Infectious causes were excluded appropriately as discussed above. IRVAN was excluded by the absence of aneurysmal dilatations on angiography.…”

Section: Descriptionmentioning

confidence: 99%