Хронічна рецидивуюча запальна оптична нейропатія: огляд двох клінічних випадків

Abstract

Aim. To study the features of the clinical course, diagnosis and treatment of chronic relapsing inflammatory optic neuropathy based on clinical cases. Materials and Methods. Clinical cases of chronic relapsing inflammatory optic neuropathy in two men are presented. The patients underwent neurological and ophthalmological examination, laboratory blood tests, testing of cerebrospinal fluid, magnetic resonance imaging of the brain and spinal cord, perimetry, ophtalmoscopy, optical coherence tomography, ultrasound examination of internal organs and of the branches of the aortic arch, and chest radiography. Results and Discussion. Two cases of chronic relapsing inflammatory optic neuropathy were described in two men aged 44 and 22 years. Episodes of recurrent optic neuritis, both unilateral and bilateral, were observed in patients; their vision improved after corticosteroid therapy. No etiological factors or comorbidities capable of causing the condition were identified. The older patient had 8 attacks of recurrent optic neuritis, with complete recovery of vision after therapy in seven cases, and partial recovery after the last relapse . The 22-year-old patient endured 5 episodes without complete recovery of vision after treatment. Based on the diagnostic criteria of chronic recurrent inflammatory optic neuropathy, this diagnosis was suspected in the patients. Conclusions. Chronic relapsing inflammatory optic neuropathy is a rare pathology whose clinical manifestations must meet diagnostic criteria. Patients with recurrent optic neuritis are to be well examined, in order to make a correct diagnosis and prescribe adequate therapy. Clinical manifestations of chronic relapsing inflammatory optic neuropathy tend to regress and stabilize against a background of immunosuppressive therapy. Keywords: chronic relapsing inflammatory optic neuropathy, clinical cases