Severe Simultaneous Bilateral Optic Neuritis as a Rare Clinical Manifestation in a Case of Multiple Sclerosis Presented with Acute Bilateral Vision Loss in the Emergency Department

Document Type : Case Report/Series

Authors

1 Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran

2 Innovated Medical Research Center, Faculty of Medicine, Mashhad Islamic Azad University of Medical sciences, Mashhad, Iran

3 Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Ophthalmological emergencies typically present with symptoms such as visual loss, diplopia, ocular motility impairment, or anisocoria. Acute vision loss is a frightening manifestation for both patients and physicians which can occur as one or both eyes involvement. It is a common manifestation in patients with multiple sclerosis (MS) and the most common cause is optic neuritis (ON). ON is almost always unilateral in subjects with MS and simultaneous bilateral ON has been rarely reported.
 
Case Presentation: Here, we report a case of a female patient with a history of MS, who presented with simultaneous bilateral and progressive vision loss. ON in this patient did not respond dramatically to high doses of intravenous methylprednisolone. So, she received intravenous humanized monoclonal anti-CD20 antibody therapy (Ocrelizumab).
 
Conclusion: This report aims to introduce a very rare case, with regard to the key points for evaluating patients with acute visual loss in the emergency department.

Keywords

Acknowledgment: We would like to thank all personnel for their support and cooperation especially those involved in the emergency room.

 

Availability of data and materials: The data supporting the findings of this case report are available from the corresponding author upon reasonable request.

 

Conflicts of interests: The authors declare no conflict of interest regarding the present case report. The authors confirm that neither the manuscript nor its main contents have already been published or submitted for consideration for publication in another journal.

 

Consent for publication: Written informed consent for publication of this case report has been obtained from the patient.

 

Ethics approval and consent to participate: This case report was conducted in accordance with the ethical standards of the ethics committee. Given the nature of a case report and the use of anonymized patient data, formal ethical approval was waived or deemed unnecessary by the relevant ethics committee. Informed consent for participation was obtained from the patient.

Financial disclosure: No financial support was received for this study

 

Author contributions: Each author has made substantial contributions to the final manuscript version have approved the submitted version and have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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