Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of optic perineuritis\A literature review of Japanese cases and clinical problems

Makoto Takemaru, M.D.1), Keisuke Tachiyama, M.D.1)2), Yuji Shiga, M.D.1), Yuhei Kanaya, M.D.1)3), Yutaka Shimoe, M.D., Ph.D.1) and Masaru Kuriyama, M.D., Ph.D.1)

1)Department of Neurology, Brain Attack Center, Ota Memorial Hospital
2)Present address: Department of Neurology, Hiroshima City Hiroshima Citizens Hospital
3)Present address: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences

A 64-year-old woman was admitted to our hospital owing to decreased visual acuity and visual field defect. She had a similar history of decreased visual acuity and received steroid therapy 10 years ago. Brain MRI revealed gadolinium-enhancement in the sheath of the optic nerve, called "tram-track" and "doughnut" signs. Optic perineuritis (OPN) was diagnosed on the basis of her clinical manifestations, which improved on treatment with high-dose methylprednisolone (mPSL). However, clinical manifestations relapsed 10 days post-discharge; hence, she was re-admitted. She was re-administered high-dose mPSL and subsequent oral administration of prednisolone. She had no relapse or recurrence for the last 2 years. We reviewed studies involving Japanese patients with OPN, including 17 idiopathic and 14 secondary cases and found that 43% of patients had recurrences and 30% of patients had poor outcome including severe residuals of visual acuity. Secondary OPN occurred owing to various diseases manifesting generalized systematic inflammation. Timely and suitable treatment was very important for clinical favorable outcomes in OPN.
Full Text of this Article in Japanese PDF (623K)

(CLINICA NEUROL, 57: 716|722, 2017)
key words: optic perineuritis, idiopathic case, relapse and recurrence, outcome, steroid therapy

(Received: 1-Jun-17)