title: "Optic neuritis" that is neither.
abstract: A 28-year-old African American woman developed periocular pain worsening with eye movement and decreased vision in her left eye. A diagnosis of left optic neuropathy was made based on the findings of decreased vision in the left eye, a left relative afferent pupillary defect, and mild optic disc hyperemia in the left eye (figure 1), with normal retinae and maculae bilaterally. Automated perimetry showed a small central scotoma in the left eye. The pain with eye movements suggested an inflammatory mechanism (i.e., optic neuritis). Her neurologic examination was normal. MRI of the brain showed 2 small T2 hyperintense lesions in the right inferior frontal lobe and left periatrial white matter. The lesions did not enhance. Angiotensin converting enzyme level was slightly elevated. A chest CT was negative for pulmonary sarcoidosis. She did not receive steroids, and her visual function improved spontaneously over a few weeks. She had no neurologic symptoms and the diagnosis of clinically isolated syndrome was made. The patient declined treatment with an immunomodulatory agent.
authors.affiliation: Departments of Ophthalmology (OYB, NJN, BBB, VB), Neurology (NJN, BBB, VB), and Neurological Surgery (NJN), and Department of Epidemiology, Rollins School of Public Health and Laney Graduate School (BBB), Emory University, Atlanta, GA.
authors.forename: Omer Y
authors.initials: OY
authors.lastname: Bialer
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Newman
authors.forename: Beau B
authors.initials: BB
authors.lastname: Bruce
authors.forename: Valérie
authors.initials: V
authors.lastname: Biousse
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