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Jae Ho Jung, Jong Heon Lee, Kyong Ho Kim, Ik Soo Byon, Je Hyun Seo, Ji Eun E Lee, Hee-Young Choi; Evaluation of Retinal Nerve Fiber Layer in patients with idiopathic Optic Perineuritis using Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5778.
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Optic perineuritis (OPN) is an uncommon inflammatory disorder of the optic nerve sheath. It has been reported that the prognosis of OPN may be poor when initiation of treatment is delayed. The aim of this study is to assess the effect of optic nerve sheath inflammation on retinal nerve fiber layer (RNFL), and the ability of optical coherence tomography(OCT) to evaluate the retinal nerve fiber loss after idiopathic optic perineuritis (OPN)
The diagnosis of OPN was made in patients who had an acute optic neuropathy and radiographic demonstration of enhancement of the optic nerve sheath in fat suppression and contrast enhancement orbital magnetic resonance imaging (MRI). All patients underwent laboratory testing to exclude specific systemic inflammatory diseases: the complete blood cell count, the erythrocyte sedimentation rate, and the levels of antinuclear antibodies and angiotensin-converting enzyme were determined; a syphilis serologic test was performed; and a chest x-ray film was obtained. We excluded patients who were diagnosed intraocular disease, systemic disorder associated with orbital inflammation, systemic infectious disease and neoplastic condition. We analyzed 4 OPN patients; symptoms, visual acuity, color vision, automated visual field, optic disc appearance, and OCT. Subjects were underwent by Cirrus Spectral Domain-OCT (Carl Zeiss Meditec, Inc.,Dublin, CA) and the OCT parameters, optic nerve head and RNFL thickness, was calculated automatically by the equipment’s software at initial visit and 12 months follow-up.
All patient showed decreased visual acuity, abnormal color vision, visual field defect. Average and temporal sector RNFL thickness of affected eye was 86.75 um, 85.25 um at initial visit and was 76.75 um, 53 um after 12months, which means especially temporal sector RNFL (Papillomacular bundle) was significant thinner in affected eye when compared to normal value and the other sound eye at 12 months after acute OPN.
Our study suggests that retinal nerve fiber loss was observed in idiopathic optic nerve sheath inflammation and OCT was good technique for axonal loss and disease severity indicator in OPN
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