J Korean Ophthalmol Soc.  2012 Jul;53(7):1016-1022. 10.3341/jkos.2012.53.7.1016.

Clinical Manifestations of Idiopathic Optic Perineuritis in Korea

• Kang HM
• Kim HY

• KMID: 2215862
• DOI: http://doi.org/10.3341/jkos.2012.53.7.1016

Abstract

PURPOSE
To describe the clinical manifestations and magnetic resonance imaging (MRI) characteristics of idiopathic optic perineuritis patients in Korea.
METHODS
A retrospective chart review of 5 patients (6 eyes) with idiopathic optic perineuritis and 7 patients (7 eyes) with optic neuritis was performed.
RESULTS
The mean age of the 5 patients with idiopathic optic perineuritis was 59 years, and the mean age of the 7 patients with optic neuritis was 31.1 years. A relative afferent papillary defect (RAPD) was present in 4 eyes with idiopathic optic perineuritis, and in all 7 eyes with optic neuritis. All six eyes with idiopathic optic perineuritis showed relatively severe optic disc swelling, and 6 eyes with optic neuritis showed mild optic disc swelling. MRI demonstrated optic nerve sheath enhancement in all patients with idiopathic optic perineuritis and optic nerve enhancement in six patients with optic neuritis.
CONCLUSIONS
On MRI, compared with optic neuritis, idiopathic optic perineuritis had a higher onset age, relatively severe optic disc swelling, and optic nerve sheath enhancement. Because idiopathic optic perineuritis is known to have different treatment strategies and prognosis compared with optic neuritis, differential diagnosis is crucial. The clinical manifestations and MRI characteristics of idiopathic optic perineuritis in the present study will help in the diagnosis of Korean patients.

Keyword

Idiopathic optic perineuritis; Optic neuritis

MeSH Terms

Age of Onset
Diagnosis, Differential
Eye
Humans
Korea
Magnetic Resonance Imaging
Optic Nerve
Optic Neuritis
Prognosis
Retrospective Studies

Figure

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  Figure 1 (A) Fundus photography of 66-year-old male patient (Case 4) with idiopathic optic perineuritis shows grade IV optic disc edema in his right eye. He presented with known optic disc edema of 7 weeks in the right eye. (B) Fundus photography after oral steroid treatment.

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  Figure 2 Magnetic resonance imaging scan of the orbit with contrast infusion and fat suppression in case 4 with idiopathic optic perineuritis. Axial and coronal view show enhancement of the right optic nerve sheath and streakiness of the surrounding orbital fat.

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