Bilateral optic neuritis related to chronic inflammatory demyelinating polyneuropathy
Kui-Yueh Lin1, I-Hua Wang1, Jieh-Ren Jou2, Hai-Jui Chu3, William Wei1, Shwu-Huey Lee1, Szu-Yuan Lin1
1 Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan, ROC
2 Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Changhua County 500; Department of Ophthalmology, National Taiwan University Hospital, Number 1, Taipei City 10048, Taiwan, ROC
3 Department of Neurology, National Taiwan University Hospital, Number 1, Taipei City 10048, Taiwan, ROC
Department of Ophthalmology, Changhua Christian Hospital, 135 Nanxiao Street, Changhua City, Changhua County 500, Taiwan
Source of Support: None, Conflict of Interest: None
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a condition that mainly affects the peripheral nervous system; however, the central nervous system has also been involved in rare cases. Herein, we describe the case of a 33-year-old man with CIDP who presented with progressively blurred vision and pain with eye movement in both eyes for 1 month. Ocular examination revealed reduced visual acuities of 0.15 (oculus unitas or OU) and unremarkable fundi (OU). Furthermore, bitemporal visual field defects and prolonged visually evoked potentials were evident. Brain magnetic resonance imaging revealed nothing remarkable along the optic nerve and chiasm. These findings were compatible with the diagnosis of bilateral optic neuritis. The patient’s symptoms and visual acuity improved after 5 days of intravenous (IV) corticosteroid pulse therapy, which was subsequently replaced by oral prednisolone therapy with a tapering schedule. The patient’s visual acuity returned to 1.0 (OU) 6 months after treatment. However, bilateral optic neuritis recurred in 7 months while the patient was on oral pred-nisolone and azathioprine. IV corticosteroid pulse therapy was subsequently reinitiated and the patient’s visual acuity returned gradually to 1.0 (OU). Bilateral optic neuritis is a rare manifestation of CIDP. It responded well to IV corticosteroid therapy in our case.