허혈시신경병증 및 시신경교종과 유사한 소견을 보인 시신경염

• 영문명: Optic Neuritis Mimicking Ischemic Optic Neuropathy and Optic Glioma
• 발행기관: 대한안과학회
• 저자명: 강은민 권계윤 최문정 김찬윤 성공제 홍사민,Eun Min Kang, MD, Kye Yoon Kwon, MD, Moon Jung Choi, MD, Chan Yun Kim, MD, PhD,Gong Je Seong, MD, PhD, Samin Hong, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume55,number11, 1721~1725쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2014.11.15

영문 초록

Purpose: To report a case of optic neuritis difficult to differentiate from ischemic optic neuropathy and optic nerve glioma. Case summary: A 63-year-old male visited our clinic because of a sudden painless decrease in visual acuity in his right eye. He had a relative afferent pupillary defect and inferior altitudinal scotoma with disc pallor in his right eye. Ischemic optic neuropathy was suspected based on these clinical observations. However, a focal enhancing lesion was found in the intracranial portion of the right optic nerve on gadolinium-enhanced T1-weighted MRI. The radiologist’s report revealed right intracranial optic glioma. Optic neurectomy was planned in accordance with the suspicion for optic glioma. However, a systemic mega-dose methylprednisolone therapy which is relatively less invasive was performed first based on the decision that optic neuritis should be distinguished from optic nerve glioma. The patient was hospitalized and 1 gram of methylprednisolone was injected intravenously daily for 3 days. The patient's visual acuity in the right eye improved from 0.1 before treatment to 0.3 after treatment. MRI scans at 8 months after steroid treatment showed disappearance of the previously enhanced lesion suspicious for optic glioma with developed atrophic change. The patient was finally diagnosed with optic neuritis based on these results. Conclusions: Careful differential diagnoses and therapeutic approaches to possible diseases are necessary because optic neuritis can manifest as a variety of clinical entities and imaging findings.J Korean Ophthalmol Soc 2014;55(11):1721-1725

키워드

Ischemic optic neuropathy, Optic nerve glioma, Optic neuritis