Recurrent optic neuritis
A 52 year old lady from North India came for an opinion here and was referred to me by a neurophysician. In short, she has had two episodes of bilateral simultaneous retrobulbar optic neuritis in the last six months and recovered with complete recovery after having been treated with usual treatment for optic neuritis.
Presently, she has no evidence of any ocular disability, Vision 6/6 & N6 in each eye with corrective glasses.Color vision normal with Isihara(20/20 plates) Pupils are normal, may be a tad not so brisk.Fundus normal. All investigations have been normal except delayed P 100 in both eyes in VEP. ACE inhibitor enzyme is raised but no other of sarcoidosis or any other infection.She is not on any drugs, maening no evidence of toxic amblyopia. MRI is normal with no white matter changes, absolutely no evidence of demyelination.CT chest was also normal. I had opined this as such must be left alone but in case of another recurrence, do all the tests to rule our AON-autoimmune optic neuritis, a skin biosy and a PET scan. It goes without saying she must be followed up for MS conversion
What say you?