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Case report
Parainfectious optic neuritis followed by microcystic macular oedema
  1. Diogo Hipolito-Fernandes1,
  2. Maria Elisa-Luís1,
  3. Miguel Trigo2 and
  4. Joana Tavares-Ferreira1,2,3
  1. 1 Department of Ophthalmology, Centro Hospitalar de Lisboa Central EPE, Lisbon, Portugal
  2. 2 Ophthalmology, Hospital CUF Descobertas, Lisbon, Portugal
  3. 3 Nova Medical School, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal
  1. Correspondence to Dr Diogo Hipolito-Fernandes, cdiogo777{at}gmail.com

Abstract

Parainfectious optic neuritis is a very rare cause of acute vision loss. We present a case of a 51-year-old man with a recent upper respiratory tract infection, presumably of viral aetiology, who showed up with complains of painless right eye vision loss, followed by the same symptoms on the left eye 3 weeks later. Ophthalmological examination revealed optic disc swelling (sequential in severity) which was confirmed by optic disc imaging. The remaining evaluations (lumbar puncture, MRI, laboratory and genetic testing) were completely normal. Considering a postviral aetiology, 5-day intravenous methylprednisolone treatment was performed. Follow-up examinations revealed slight visual acuity and visual fields recovery, with subsequent optic disc atrophy and microcystic macular oedema, bilaterally. This case illustrates how important a correct clinical history is to guide a correct diagnosis and posterior management.

  • neuroopthalmology
  • ophthalmology
  • retina
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Footnotes

  • Contributors DH-F: data acquisition, data analysis and paper conception. MEL: data analysis, paper conception. MT: data acquisition. JT-F: data acquisition, data analysis and paper revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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