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Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome

A 36-year-old man presented with an acute onset of a right eye monocular altitudinal defect associated with pain on eye movement upon waking up from sleep. His right eye subsequently developed outward deviation and a total loss of vision. Clinical examination of the right eye revealed a visual acuit...

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Autores principales: Sulaiman, Farhana Nabila, Kamardin, Nur Farhana, Sultan Abdul Kader, Mohamed Iliyas, Ch'ng, Hannie, Wan Abdul Halim, Wan Haslina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10259875/
https://www.ncbi.nlm.nih.gov/pubmed/37313108
http://dx.doi.org/10.7759/cureus.38975
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author Sulaiman, Farhana Nabila
Kamardin, Nur Farhana
Sultan Abdul Kader, Mohamed Iliyas
Ch'ng, Hannie
Wan Abdul Halim, Wan Haslina
author_facet Sulaiman, Farhana Nabila
Kamardin, Nur Farhana
Sultan Abdul Kader, Mohamed Iliyas
Ch'ng, Hannie
Wan Abdul Halim, Wan Haslina
author_sort Sulaiman, Farhana Nabila
collection PubMed
description A 36-year-old man presented with an acute onset of a right eye monocular altitudinal defect associated with pain on eye movement upon waking up from sleep. His right eye subsequently developed outward deviation and a total loss of vision. Clinical examination of the right eye revealed a visual acuity of no light perception (NLP) with the presence of relative afferent pupillary defect (RAPD) and involvement of cranial nerves II, III, IV, and VI. A marked optic disc swelling and peripapillary hemorrhages were seen in the right fundus. Contrast-enhanced computed tomography of the brain and orbit showed a unilateral enlargement and enhancement of the right intraorbital and intracanalicular segments of the optic nerve with surrounding fat stranding and orbital apex crowding. Magnetic resonance imaging showed T2/fluid-attenuated inversion recovery hyperintensity and enhancement of the optic nerve and the myelin sheath. Serum anti-myelin oligodendrocyte glycoprotein antibodies were detected. He was treated with corticosteroids, plasma exchange, and intravenous immunoglobulin. His vision improved slowly after treatment. This case report shows the diverse manifestations of myelin oligodendrocyte glycoprotein antibody disease, which includes the orbital apex syndrome.
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spelling pubmed-102598752023-06-13 Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome Sulaiman, Farhana Nabila Kamardin, Nur Farhana Sultan Abdul Kader, Mohamed Iliyas Ch'ng, Hannie Wan Abdul Halim, Wan Haslina Cureus Neurology A 36-year-old man presented with an acute onset of a right eye monocular altitudinal defect associated with pain on eye movement upon waking up from sleep. His right eye subsequently developed outward deviation and a total loss of vision. Clinical examination of the right eye revealed a visual acuity of no light perception (NLP) with the presence of relative afferent pupillary defect (RAPD) and involvement of cranial nerves II, III, IV, and VI. A marked optic disc swelling and peripapillary hemorrhages were seen in the right fundus. Contrast-enhanced computed tomography of the brain and orbit showed a unilateral enlargement and enhancement of the right intraorbital and intracanalicular segments of the optic nerve with surrounding fat stranding and orbital apex crowding. Magnetic resonance imaging showed T2/fluid-attenuated inversion recovery hyperintensity and enhancement of the optic nerve and the myelin sheath. Serum anti-myelin oligodendrocyte glycoprotein antibodies were detected. He was treated with corticosteroids, plasma exchange, and intravenous immunoglobulin. His vision improved slowly after treatment. This case report shows the diverse manifestations of myelin oligodendrocyte glycoprotein antibody disease, which includes the orbital apex syndrome. Cureus 2023-05-13 /pmc/articles/PMC10259875/ /pubmed/37313108 http://dx.doi.org/10.7759/cureus.38975 Text en Copyright © 2023, Sulaiman et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Sulaiman, Farhana Nabila
Kamardin, Nur Farhana
Sultan Abdul Kader, Mohamed Iliyas
Ch'ng, Hannie
Wan Abdul Halim, Wan Haslina
Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome
title Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome
title_full Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome
title_fullStr Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome
title_full_unstemmed Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome
title_short Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting With Orbital Apex Syndrome
title_sort myelin oligodendrocyte glycoprotein optic neuritis presenting with orbital apex syndrome
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10259875/
https://www.ncbi.nlm.nih.gov/pubmed/37313108
http://dx.doi.org/10.7759/cureus.38975
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