Bilateral vision loss responsive to corticosteroids

Abstract A 48-year-old woman presented with painless bilateral vision loss that began in the left eye and responded to steroids, followed by vision loss in the right eye one day after completing her steroid taper. Diagnosis was complicated by a positive screening test for Leber hereditary optic neur...

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Bibliographic Details
Published in:Survey of ophthalmology 2013-11, Vol.58 (6), p.634-639
Main Authors: Lee, Michele D., BA, Song, Brian J., MD, Odel, Jeffrey G., MD, Sadun, Alfredo A., MD, PhD
Format: Article
Language:English
Subjects:
Autoimmune optic neuropathy
Blindness - diagnosis
Blindness - drug therapy
chronic relapsing inflammatory optic neuropathy (CRION)
Diagnosis, Differential
DNA Mutational Analysis
DNA, Mitochondrial - genetics
Female
Glucocorticoids - therapeutic use
Humans
Leber hereditary optic neuropathy (LHON)
Magnetic Resonance Imaging
Methylprednisolone - therapeutic use
Middle Aged
multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - drug therapy
Ophthalmology
Optic Atrophy, Hereditary, Leber - diagnosis
Optic Atrophy, Hereditary, Leber - genetics
optic neuritis
Optic Neuritis - diagnosis
Optic Neuritis - drug therapy
Spinal Cord Diseases - diagnosis
Spinal Cord Diseases - drug therapy
steroid complications
steroid responsive optic neuropathy
Visual Acuity
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Summary:Abstract A 48-year-old woman presented with painless bilateral vision loss that began in the left eye and responded to steroids, followed by vision loss in the right eye one day after completing her steroid taper. Diagnosis was complicated by a positive screening test for Leber hereditary optic neuropathy and a negative workup for demyelinating disease. Steroid-dependent optic neuropathies such as autoimmune optic neuropathy and chronic relapsing inflammatory optic neuropathy were considered in the differential. Seven months after initial presentation, the patient developed a new periventricular white matter lesion, lesions on her cervical and thoracic spinal cord, bilateral leg weakness, and sensory loss consistent with multiple sclerosis.
ISSN:0039-6257
1879-3304
DOI:10.1016/j.survophthal.2012.05.006