Optic perineuritis: clinical and radiographic features.
BACKGROUND
Optic perineuritis is an uncommon variety of orbital inflammatory disease that is distinct from demyelinating optic neuritis.


OBJECTIVE
To describe the clinical and radiographic features of idiopathic optic perineuritis, with particular emphasis on those features that help to distinguish this condition from optic neuritis.


METHODS
We reviewed the medical records of 14 patients with optic perineuritis who were seen in 2 neuro-ophthalmology clinics.


RESULTS
Patients ranged in age from 24 to 60 years; 5 were older than 50 years. All patients had visual loss, eye pain, or both. The visual acuity was 20/20 or better in 8 of the 15 eyes. The results of visual field testing were normal in 2 eyes, and a paracentral scotoma or an arcuate defect was seen in 7. Magnetic resonance imaging scans demonstrated circumferential enhancement around the optic nerve, sometimes with intraorbital extension. Response to corticosteroids was dramatic; however, 4 patients had a relapse with lowering of the dose.


CONCLUSIONS
In contrast to those with optic neuritis, patients with optic perineuritis are often older at onset and are more likely to show sparing of central vision. Magnetic resonance imaging scans demonstrate enhancement around, rather than within, the optic nerve. Response to corticosteroids is more dramatic than in patients with optic neuritis, and patients are more likely to experience recurrence after stopping treatment.
Purvin
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V
Midwest Eye Institute, 201 Pennsylvania Pkwy, Indianapolis, IN 46280, USA. Vpurvin@iupui.edu
Kawasaki
A
A
Jacobson
D M
DM
D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D009902:Optic Neuritis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D010211:Papilledema / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D011859:Radiography; D012307:Risk Factors; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields
D005938:Glucocorticoids