J Korean Ophthalmol Soc.  2012 Jun;53(6):901-905.

A Case of Bilateral Optic Neuritis in Tsutsugamushi Infection

• Lee JJ
• Park JY
• Seo WM

Abstract

PURPOSE
To report a case of bilateral optic neuritis in a child after tsutsugamushi infection.
CASE SUMMARY
An eight-year-old boy diagnosed with tsutsugamushi infection was referred to the ophthalmology clinic at our institution. A typical eschar was detected on his right clavicle. The patient complained of severely decreased visual acuity. The initial best corrected visual acuity (BCVA) in his right eye was 0.08, and in his left eye was negative light perception. Fundus exam showed bilateral optic disc swelling and hyperemia. Optic neuritis was diagnosed after tsutsugamushi infection, and high-dose intravenous steroid therapy was initiated according to the ONTT study protocol. Twelve months after treatment, the right eye BCVA improved to 1.0, but the left eye BCVA was only 0.06.
CONCLUSIONS
The authors of the present study experienced a case of bilateral optic neuritis after tsutsugamushi infection with a relatively positive response to the steroid therapy.

Keyword

Optic neuritis; Tsutsugamushi infection

MeSH Terms

Child
Clavicle
Eye
Humans
Hyperemia
Light
Ophthalmology
Optic Neuritis
Visual Acuity

Figure

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  Figure 1 Photograph shows eschar on his clavicle area.

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  Figure 2 At presention, fundus photograph showed optic disc swelling and hyperemia with vascular engorgement.

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  Figure 3 Magnetic resonance images. (A) Axial fat suppressed T2 weighted image shows thickening of bilateral intraorbital optic nerve and slightly hyperintense adjacent fat (arrow). (B) Axial contrast-enhanced T1 weighted image shows mild enhancement of the bilateral intraorbital optic nerve and adjacent lesion (arrow head).

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  Figure 4 One month after treatment, optic disc swelling subsided, but optic pallor remained.

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