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Case Reports in Ophthalmological Medicine
Volume 2016 (2016), Article ID 6741925, 4 pages
http://dx.doi.org/10.1155/2016/6741925
Case Report

Atypical Presentation of Idiopathic Bilateral Optic Perineuritis in a Young Patient

1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
2Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
3Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia

Received 2 July 2016; Revised 4 November 2016; Accepted 23 November 2016

Academic Editor: Hsin-Yi Chen

Copyright © 2016 Jessica Mani Penny Tevaraj et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A previously healthy 27-year-old Malay male presented with acute onset of painless, severe blurring of vision in his right eye. It was associated with headache and vomiting for the past week. Relative afferent pupillary defect was present in the right eye, with reduced optic nerve function. Patient also had bilateral generalised optic disc swelling, splinter haemorrhages, and tortuous vessels. Initial examination was suggestive of either optic neuritis or raised intracranial pressure. Typical features of bilateral optic perineuritis (OPN) such as tram track and doughnut sign were observed on magnetic resonance imaging. Connective tissue and infective screening were negative. He was diagnosed with bilateral optic perineuritis and treated with high dose intravenous corticosteroids followed by a three-month course of oral steroids. His vision and optic nerve function recovered to baseline levels.