Korean J Otolaryngol-Head Neck Surg.  2000 Dec;43(12):1355-1358.

A Case of Optic Nerve Decompression in a Patient with Retrobulbar Neuritis Secondary to Paranasal Sinusitis

• Baek BJ
• Kim HJ
• Choi JH
• Oh CH

Abstract

Optic neuritis (ON) is an acute or subacute inflammatory or demyelination process affecting the optic nerve. ON can be classified ophthalmologically as retrobulbar neuritis, papillitis, neuroretinitis. Retrobulbar neuritis, in which the optic disc appearance is normal, is the most common type of ON in adults. Multiple sclerosis is the most common cause of ON, but in many cases no apparent etiology is found. Paranasal sinusitis as a cause of ON is rare. Management of retrobulbar neuritis which is combined with paranasal sinusitis is controversial. Recently, we experienced a case of retrobulbar neuritis which was combined with paranasal sinusitis without orbital complication. It was treated by endoscopic sinus surgery and endoscopic optic nerve decompression in addition to intravenous antibiotics and corticosteroids. Visual acuity was improved nearly to a normal state after the treatment. The most possible pathophysiologic mechanism of retrobulbar neuritis may be the direct spread of infection of the sphenoid sinus to the optic nerve.

Keyword

Optic neuritis; Sinusitis; Optic nerve; Decompression

MeSH Terms

Adrenal Cortex Hormones
Adult
Anti-Bacterial Agents
Decompression*
Demyelinating Diseases
Humans
Multiple Sclerosis
Optic Nerve*
Optic Neuritis*
Orbit
Papilledema
Retinitis
Sinusitis*
Sphenoid Sinus
Visual Acuity
Adrenal Cortex Hormones
Anti-Bacterial Agents