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Case Reports
. 2021 Jun;118(6):593-596.
doi: 10.1007/s00347-020-01165-8.

[Atypical optic neuritis: the importance of a comprehensive diagnostic work-up]

[Article in German]
R Yaïci  1 , A Carzoli  2 , F Bétis  2 , G Geerling  3 , R Guthoff  3 , T Guthoff  3
Affiliations
Case Reports

[Atypical optic neuritis: the importance of a comprehensive diagnostic work-up]

[Article in German]
R Yaïci et al. Ophthalmologe. 2021 Jun.

Abstract
in English, German

A 65-year-old woman was referred for sudden bilateral loss of vision. She was vaccinated a few days earlier. The ophthalmological examination showed a massive optic disc swelling on both eyes. Magnetic resonance imaging (MRI) revealed suspected bilateral optic neuritis without cerebral involvement or transverse myelitis. After serological detection of anti-MOG (myelin oligodendrocyte glycoprotein) antibodies, the patient was treated with high-dose corticosteroid pulse therapy until vision recovered. Discussion: an atypical optic neuritis may indicate a neuromyelitis optica spectrum disorder (NMOSD), which should be further characterized by determination of Aquaporin 4(AQP4)-IgG and MOG-IgG.

Eine 65-jährige Frau wurde wegen plötzlicher beidseitiger Sehminderung überwiesen, nachdem sie kurz zuvor geimpft wurde. Augenärztlich zeigte sich beidseits eine ausgeprägte Papillenschwellung. In der Magnetresonanztomografie (MRT) fand sich keine zerebrale Beteiligung oder transverse Myelitis. Serologisch konnten wir Myelin-Oligodendrozyten-Glykoprotein(MOG)-IgG nachweisen, sodass wir mit Hochdosiskortikosteroidpulstherapie behandelten. Diskussion: Bei atypischer Optikusneuritis muss an eine Neuromyelitis-optica-Spektrum-Erkrankung (NMOSD) gedacht werden, die durch die Bestimmung von Aquaporin 4(AQP4)- und MOG-IgG weiter charakterisiert werden sollte.

Keywords: Anti-MOG antibodies; Bilateral papilledema; NMSOD; Neuromyelitis optica; Postvaccination.

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References

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