Monday, June 09, 2008

Optic Perineuritis-Imaging

Optic perineuritis is an uncommon variety of orbital inflammatory disease that is distinct from demyelinating optic neuritis. 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.

MRI usually shows Perineural enhancement and “streaky” fat with or without extraocular muscle enhancement. This patient improved dramatically with steroids.

Dr.Sumer K Sethi, MD
Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

1 comment:

Anonymous said...

I have idiopathic optic perineuritis, and I just wanted to leave a note here for anyone who might find this: a three week delay in steroid treatment for my condition likely caused permanent damage to my vision. It's likely I would have had less scarring and damage if my neurologist had put me back on steroids as soon as my vision deteriorated - within 24 hours of tapering off of a short burst of steroid treatment that had dramatically improved my vision almost to normal. I don't blame him - he was following the treatment guidelines for the optic neuritis treatment trial, and prolonged steroid treatment is not recommended for most cases of optic neuritis. Since he didn't catch the nerve sheath involvement on the MRI and he was ignorant of optic perineuritis, he didn't know what to do. Optic perineuritis is a different condition!

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