Reversible Optic Neuritis Secondary to Paranasal Sinusitis

Awerbuch, Gavin I.; Labadie, Enrique L.; Dalen, Jeanne

doi:10.1159/000116409

Cited by 25 publications

(12 citation statements)

References 10 publications

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“…Three typical diseases of paranasal sinuses related to optic neuritis are described in the literature: muco and pyoceles of the sphenoid sinus [3,4]; invasive paranasal mycosis [5]; and purulent bacterial sinusitis-especially in posterior ethmoids and the sphenoid sinus [6,7]. Inoue and Oshima [8] reviewed 19 cases of rhinogenic optic neuropathy in which 16 patients had cysts or mucoceles of the paranasal sinuses; 2 had acute sinusitis and 1 had malignant lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Optic neuritis and paranasal sinus diseases

et al. 2010

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AbstractThe relationship of sinusitis and paranasal sinus mucoceles to optic neuritis (ON) remains a challenge for both the otolaryngologist and the ophthalmologist. Currently, ON is assumed to be a rare complication of paranasal sinus diseases. Three new cases of ON associated with paranasal sinus diseases are described. We postulate different pathophysiologic mechanisms of ON in our three patients: compression of optic nerve due to sphenoid mucocele in the first patient; extension of bacterial infection to the optic nerve in the second patient; and invasion of aspergillosis to the orbital apex in the third patient. We assume that the complete recovery of the patient’s vision in the second case resulted from surgery, which had been performed immediately. A timely operation could possibly have prevented permanent blindness in cases 1 and 3 as well. Optic neuritis can occasionally be a complication of bacterial and mycotic sinusitis or paranasal sinus mucoceles, especially if located in the sphenoid sinus and posterior ethmoids. The evaluation of paranasal sinuses using imaging techniques is necessary to diagnose the problem, and immediate surgery can prevent permanent sequelae in indicated cases.

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Section: Discussionmentioning

confidence: 99%

Optic neuritis and paranasal sinus diseases

et al. 2010

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“…However, it is difficult to envision a systemic mechanism targeting the optic nerves so specifically. In the absence of contiguous propagation of infection, ON could be related to the spread of cytokines or immune mediators from the sinuses to the orbital-apical portion of the optic nerve through the local venous circulation, or to local vasomotor changes as suggested by Awerbuch 26 and Rothstein. 19 There are extensive anastomoses in the venous circulation of the paranasal sinuses, the perinasal facial veins, and the maxillary veins, all of which have extensive connections with and drain into the interconnected pterygoid plexus and the cavernous sinuses.…”

Section: Discussionmentioning

confidence: 99%

Acute Optic Neuritis: Association With Paranasal Sinus Inflammatory Changes on Magnetic Resonance Imaging

Ergene¹,

Rupp²,

Qualls³

et al. 2000

Journal of Neuroimaging

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The authors compared the frequency of paranasal sinus inflammatory changes (SIC) on brain magnetic resonance imaging (MRI) obtained from 23 patients with new onset acute optic neuritis (ON) and 48 control patients who underwent outpatient MRI of the brain for reasons other than ON. The authors found a higher frequency of paranasal SIC in patients with ON (83%) than in controls (54%) (p = 0.02). The distribution of paranasal SIC (in ON and in controls) was maxillary (83% and 52%), ethmoid (4% and 2%), frontal (9% and 14%), and sphenoid (4% and 10%). Frequency of the maxillary SIC was significantly higher (p = 0.02) in patients with ON than in controls. Further evaluation of maxillary paranasal SIC with a grading system showed the presence of thickened mucosal lining of the sinuses (grade I) in 17% (ON) and 23% (controls), mucous retention cysts within the sinuses (grade II) in 48% (ON) and 25% (controls), and severe mucosal thickening with complete or near-complete filling of the sinus or an air-fluid level within the sinus (grade III) in 17% (ON) and 4% (controls). Combined frequency of grade II and grade III SIC was significantly higher in the ON group than in controls (p = 0.005), as was the frequency of grade III SIC alone (p = 0.02). Grade I SIC did not significantly differ between the groups. There was a trend (p = 0.09) toward a higher prevalence of bilateral sinus inflammatory changes in patients with bilateral ON. These findings suggest that ON may be associated with sinus inflammatory changes.

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“…Rarely, infection may spread posteriorly to lead to cavernous sinus thrombosis, in which case there would be bilateral orbital swelling in a desperately ill patient. Other unusual causes of visual impairment in sinusitis include optic neuritis and compressive optic neuropathy.8'9 A patient with optic neuritis due to purulent maxillary sinusitis was described by Awerbuch et al 8 The CT scan did not include views of the sinuses and maxillary sinusitis was subsequently identified by a coronal magnetic resonance imaging scan of the head.…”

Section: Discussionmentioning

confidence: 99%

Serious unexpected sinus infection discovered by CT scanning for presumed neurological disease

Swift

Gill

1994

Postgraduate Medical Journal

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Serious infection in the paranasal sinuses may present with symptoms suggestive of neurological disease and thus lead to delay in the diagnosis and subsequent treatment. We present three such cases in whom the initial diagnoses had been acute optic neuritis, a posterior communicating aneurysm and an intracranial space occupying lesion. The fourth patient had meningitis but the paranasal sinuses had not initially been considered as a possible source of infection. The current methods of diagnosing sinusitis are discussed.

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Reversible Optic Neuritis Secondary to Paranasal Sinusitis

Cited by 25 publications

References 10 publications

Optic neuritis and paranasal sinus diseases

Optic neuritis and paranasal sinus diseases

Acute Optic Neuritis: Association With Paranasal Sinus Inflammatory Changes on Magnetic Resonance Imaging

Serious unexpected sinus infection discovered by CT scanning for presumed neurological disease

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