Bilateral Optic Neuritis in Children Due to Multiple Sclerosis
ABSTRACT: A rare case of
bilateral optic neuritis in 10 years old boy due to Multiple Sclerosis. A 10
years old boy suffered from sudden blurred vision on both eyes since 3 days
before hospitalized. He also complained of acute periodically headache and pain
on eye movement to all gaze. Visual acuity was one meter finger counting on
both eyes. The eyes also have nystagmus. Pupillary examination showed bilateral
midriatic pupil, decrease of direct light reflex, negative consensual light
reflex, and negative RAPD. Fundal examination revealed bilateral optic disc
swelling with splinter haemorrhage. Humphrey examination showed central scotoma
on both eyes due to optic neuritis. MRI showed an active plaque lies below left
thalamus suggest to Multiple Sclerosis lesion and thickening of both optic nerves
which suggest to retrobulbar optic neuritis. Intravenous high dose methyl
prednisolone was given immediately after consulting to neurologic and pediatric
department. After one day of therapy, the patient's headache and pain on eye
movement dissapeared. There was improvement on visual acuity. After 7 days of
therapy, intravenous corticosteroid was stopped. Visual acuity became 6/6 on
the right eye and 6/30 on the left eye. There was also decreasing of optic disc
swelling. After 2 weeks, left eye visual acuity became 6/6. Bilateral optic
neuritis could be one of Multiple Sclerosis signs especially in children. Treatment
with intravenous methyl prednisolone should be considered in patient with acute
optic neuritis because this treatment can lead to rapid recovery of visual
function and other complaint. Further ophthalmology and neurology observation
need to evaluate clinical relapsing-remitting Multiple Sclerosis.
Penulis: Delfitri Lutfi, Heru
Prasetiyono, Rozalina Loebis, Gatot Suhartono, Diany Yogiantoro
Kode Jurnal: jpkedokterandd100037
