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허혈시신경병증 및 시신경교종과 유사한 소견을 보인 시신경염

Other Titles
 Optic Neuritis Mimicking Ischemic Optic Neuropathy and Optic Glioma 
Authors
 강은민  ;  권계윤  ;  최문정  ;  김찬윤  ;  성공제  ;  홍사민 
Citation
 JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY, Vol.55(11) : 1721-1725, 2014 
Journal Title
 JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 
ISSN
 0378-6471 
Issue Date
2014
Keywords
Ischemic optic neuropathy ; Optic nerve glioma ; Optic neuritis
Abstract
Purpose : To report a case of optic neuritis difficult to differentiate from ischemic optic neuropathy and optic nerve glioma. Case summary : A 63-year-old male visited our clinic because of a sudden painless decrease in visual acuity in his right eye. He had a relative afferent pupillary defect and inferior altitudinal scotoma with disc pallor in his right eye. Ischemic optic neuropathy was suspected based on these clinical observations. However, a focal enhancing lesion was found in the intracranial portion of the right optic nerve on gadolinium-enhanced T1-weighted MRI. The radiologist's report revealed right intracranial optic glioma. Optic neurectomy was planned in accordance with the suspicion for optic glioma. However, a systemic mega-dose methylprednisolone therapy which is relatively less invasive was performed first based on the decision that optic neuritis should be distinguished from optic nerve glioma. The patient was hospitalized and 1 gram of methylprednisolone was injected intravenously daily for 3 days. The patient's visual acuity in the right eye improved from 0.1 before treatment to 0.3 after treatment. MRI scans at 8 months after steroid treatment showed disappearance of the previously enhanced lesion suspicious for optic glioma with developed atrophic change. The patient was finally diagnosed with optic neuritis based on these results. Conclusions : Careful differential diagnoses and therapeutic approaches to possible diseases are necessary because optic neuritis can manifest as a variety of clinical entities and imaging findings.
Files in This Item:
T201405824.pdf Download
DOI
10.3341/jkos.2014.55.11.1721
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Min(강은민)
Kim, Chan Yun(김찬윤) ORCID logo https://orcid.org/0000-0002-8373-9999
Seong, Gong Je(성공제) ORCID logo https://orcid.org/0000-0002-5456-4296
Hong, Sa Min(홍사민)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138936
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