The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study.
Yumin Huang-LinkGe YangGreta GustafssonHelena GauffinAnne-Marie LandtblomPierfrancesco MirabelliHans LinkPublished in: Journal of clinical medicine (2023)
Background: Optic neuritis (ON) is an inflammatory condition of the optic nerve. ON is associated with development of demyelinating diseases of the central nervous system (CNS). CNS lesions visualized by magnetic resonance imaging (MRI) and the finding of oligoclonal IgG bands (OB) in the cerebrospinal fluid (CSF) are used to stratify the risk of MS after a "first" episode of ON. However, the diagnosis of ON in absence of typical clinical manifestations can be challenging. Methods and Materials: Here we present three cases with changes in the optic nerve and ganglion cell layer in the retina over the disease course. (1) A 34-year-old female with a history of migraine and hypertension had suspect amaurosis fugax (transient vision loss) in the right eye. This patient developed MS four years later. Optical coherence tomography (OCT) showed dynamic changes of the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) over time. (2) A 29-year-old male with spastic hemiparesis and lesions in the spinal cord and brainstem. Six years later he showed bilateral subclinical ON identified using OCT, visual evoked potentials (VEP) and MRI. The patient fulfilled diagnosis criteria of seronegative neuromyelitis optica (NMO). (3) A 23-year-old female with overweight and headache had bilateral optic disc swelling. With OCT and lumbar puncture, idiopathic intracranial hypertension (IIH) was excluded. Further investigation showed positive antibody for myelin oligodendrocyte glycoprotein (MOG). Conclusions: These three cases illustrate the importance of using OCT to facilitate quick, objective and accurate diagnosis of atypical or subclinical ON, and thus proper therapy.
Keyphrases
- optic nerve
- optical coherence tomography
- magnetic resonance imaging
- diabetic retinopathy
- cerebrospinal fluid
- case report
- blood pressure
- spinal cord
- contrast enhanced
- single cell
- mass spectrometry
- multiple sclerosis
- blood brain barrier
- cell therapy
- minimally invasive
- oxidative stress
- stem cells
- magnetic resonance
- physical activity
- computed tomography
- spinal cord injury
- diffusion weighted imaging
- mesenchymal stem cells
- ultrasound guided
- bone marrow
- peripheral nerve