Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report
A 60-year-old white woman presented to the emergency department with painless decrease of visual acuity in the left eye (LE). The diagnosis of a non-arteritic anterior ischemic optic neuropathy in the LE was established based on the clinical picture and the results of static perimetry, fluorescein a...
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2023-06-01
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| Series: | Türk Oftalmoloji Dergisi |
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http://www.oftalmoloji.org/archives/archive-detail/article-preview/late-onset-neuromyelitis-optica-spectrum-disorder-/60712
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| _version_ | 1797786904677056512 |
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| author | Lech Sedlak Marta Swierczynska Dorota Wygledowska Promienska |
| author_facet | Lech Sedlak Marta Swierczynska Dorota Wygledowska Promienska |
| author_sort | Lech Sedlak |
| collection | DOAJ |
| description | A 60-year-old white woman presented to the emergency department with painless decrease of visual acuity in the left eye (LE). The diagnosis of a non-arteritic anterior ischemic optic neuropathy in the LE was established based on the clinical picture and the results of static perimetry, fluorescein angiography, visual evoked potential, and magnetic resonance imaging (MRI) of the brain and orbit. Six months later, the patient reported visual impairment in the right eye (RE). Best corrected visual acuity (BCVA) in the RE was 5/10. Gadolinium-enhanced MRI showing inflammation of both optic nerves and the optic chiasm in correlation with positivity for immunglobulin G antibody against aquaporin-4 led to the diagnosis of late-onset neuromyelitis optica spectrum disorder. High-dose intravenous methylprednisolone therapy followed by oral tapering was administered and oral azathioprine was started to reduce the risk of further relapse. At discharge, BCVA was 5/5 in the RE. The patient remains under the care of neurology and ophthalmology clinics, with no recurrences for two years. The possibility of neuromyelitis optica spectrum disorder with optic neuritis in older patients is important in the differential diagnosis of ischemic optic neuropathy. |
| first_indexed | 2024-03-13T01:14:27Z |
| format | Article |
| id | doaj.art-4038649ac0a34d588eec70bdf863c5f0 |
| institution | Directory Open Access Journal |
| issn | 1300-0659 2147-2661 |
| language | English |
| last_indexed | 2024-03-13T01:14:27Z |
| publishDate | 2023-06-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Türk Oftalmoloji Dergisi |
| spelling | doaj.art-4038649ac0a34d588eec70bdf863c5f02023-07-05T11:55:42ZengGalenos YayineviTürk Oftalmoloji Dergisi1300-06592147-26612023-06-0153319219610.4274/tjo.galenos.2023.7276213049054Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case ReportLech Sedlak0Marta Swierczynska1Dorota Wygledowska Promienska2 Silezya Tıp Üniversitesi, Katowice Tıp Bilimleri Fakültesi, Göz Hastalıkları Anabilim Dalı, Katowice, Polonya Silezya Tıp Üniversitesi, Katowice Tıp Bilimleri Fakültesi, Göz Hastalıkları Anabilim Dalı, Katowice, Polonya Silezya Tıp Üniversitesi, Katowice Tıp Bilimleri Fakültesi, Göz Hastalıkları Anabilim Dalı, Katowice, Polonya A 60-year-old white woman presented to the emergency department with painless decrease of visual acuity in the left eye (LE). The diagnosis of a non-arteritic anterior ischemic optic neuropathy in the LE was established based on the clinical picture and the results of static perimetry, fluorescein angiography, visual evoked potential, and magnetic resonance imaging (MRI) of the brain and orbit. Six months later, the patient reported visual impairment in the right eye (RE). Best corrected visual acuity (BCVA) in the RE was 5/10. Gadolinium-enhanced MRI showing inflammation of both optic nerves and the optic chiasm in correlation with positivity for immunglobulin G antibody against aquaporin-4 led to the diagnosis of late-onset neuromyelitis optica spectrum disorder. High-dose intravenous methylprednisolone therapy followed by oral tapering was administered and oral azathioprine was started to reduce the risk of further relapse. At discharge, BCVA was 5/5 in the RE. The patient remains under the care of neurology and ophthalmology clinics, with no recurrences for two years. The possibility of neuromyelitis optica spectrum disorder with optic neuritis in older patients is important in the differential diagnosis of ischemic optic neuropathy. http://www.oftalmoloji.org/archives/archive-detail/article-preview/late-onset-neuromyelitis-optica-spectrum-disorder-/60712 neuromyelitis optica spectrum disorderlate-onset nmosdoptic neuritisanti-aquaporin 4 antibodyaqp4 |
| spellingShingle | Lech Sedlak Marta Swierczynska Dorota Wygledowska Promienska Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report Türk Oftalmoloji Dergisi neuromyelitis optica spectrum disorder late-onset nmosd optic neuritis anti-aquaporin 4 antibody aqp4 |
| title | Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report |
| title_full | Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report |
| title_fullStr | Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report |
| title_full_unstemmed | Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report |
| title_short | Late-Onset Neuromyelitis Optica Spectrum Disorder Mimicking a Non-Arteritic Anterior Ischemic Optic Neuropathy–Case Report |
| title_sort | late onset neuromyelitis optica spectrum disorder mimicking a non arteritic anterior ischemic optic neuropathy case report |
| topic | neuromyelitis optica spectrum disorder late-onset nmosd optic neuritis anti-aquaporin 4 antibody aqp4 |
| url |
http://www.oftalmoloji.org/archives/archive-detail/article-preview/late-onset-neuromyelitis-optica-spectrum-disorder-/60712
|
| work_keys_str_mv | AT lechsedlak lateonsetneuromyelitisopticaspectrumdisordermimickinganonarteriticanteriorischemicopticneuropathycasereport AT martaswierczynska lateonsetneuromyelitisopticaspectrumdisordermimickinganonarteriticanteriorischemicopticneuropathycasereport AT dorotawygledowskapromienska lateonsetneuromyelitisopticaspectrumdisordermimickinganonarteriticanteriorischemicopticneuropathycasereport |