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báo cáo khoa học: " High-dose steroid therapy for idiopathic optic perineuritis: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: High-dose steroid therapy for idiopathic optic perineuritis: a case series | Tatsugawa et al. Journal of Medical Case Reports 2010 4 404 http www.jmedicalcasereports.eom content 4 1 404 JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access High-dose steroid therapy for idiopathic optic perineuritis a case series Maria Tatsugawa1 Hidetaka Noma2 Tatsuya Mimura3 Hideharu Funatsu2 Abstract Introduction It has been reported that the prognosis of optic perineuritis may be poor when initiation of treatment is delayed. Here we report the successful treatment of three patients with idiopathic optic perineuritis including two in whom initiation of therapy was delayed. Case presentation Three Japanese patients two women aged 73 and 66 years and one man aged 27 years presented with loss of vision for five months several months and two months respectively and pain on eye movement in the third case only and were diagnosed as having idiopathic optic perineuritis. Fat-suppressed T2-weighted magnetic resonance images showed high signal intensity areas around the affected optic nerves suggesting the presence of optic perineuritis. Two patients received steroid pulse therapy and the third was given high-dose steroid therapy. The visual acuity improved in all three cases. Conclusion High-dose steroid therapy may be effective for idiopathic perineuritis in patients without optic nerve atrophy even if initial treatment including moderate-dose steroids has failed. Introduction Idiopathic optic perineuritis has been reported as a type of orbital inflammatory pseudotumor 1-3 . Currently the diagnosis of optic perineuritis is most commonly based on magnetic resonance image MRI findings along with the clinical characteristics. Although some reported cases have been diagnosed by pathologic examinations the distinction between optic neuritis and optic perineuritis is generally radiographic 4 . The characteristic differences between idiopathic optic perineuritis and idiopathic optic neuritis are as follows 5 The age distribution of the former is wide and it .