Neuromyelitis Optica Spectrum Disorder–Related Optic Neuritis Mimicking Idiopathic Orbital Inflammation

Abstract

The authors report a case of neuromyelitis optica spectrum disorder–related optic neuritis. The patient showed rapid vision loss in both eyes, and brain magnetic resonance imaging indicated perineuritis due to idiopathic orbital inflammation. Although minor improvement was noted following corticosteroid pulse therapy, the patient’s vision worsened after 7 days. Further evaluation revealed anti-aquaporin-4 antibody positivity, therefore the authors diagnosed the case as neuromyelitis optica spectrum disorder. This case suggests that patients with severe bilateral visual loss and poor corticosteroid response should be tested for anti-aquaporin-4 antibody and may require further aggressive management.

KEYWORDS::

• Anti-AQP4 antibody
• Idiopathic orbital inflammation
• Neuromyelitis optica
• Neuromyelitis optica spectrum disorder
• Optic neuritis

ACKNOWLEDGMENTS

We thank Ho Jin Kim (National Cancer Center, Korea) for his kind advice concerning the manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.