BILATERAL TRANSIENT
AMAUROSIS IN AN EIGHT YEAR OLD GIRL WITH OPTIC NEURITIS
Albrecht M.1, Jandeck C.2,
Kewitz G.1, Versmold H.1
1Department of
Paediatrics, Freie Universität Berlin, Universitätsklinikum Benjamin Franklin,
Benin, Germany; 2 Department of Ophthalmology, Freie Universität
Berlin, Universitätsklinikum Benjamin Franklin, Berlin, Germany
BACKGROUND: We report a case of
acute bilateral optic nerve neuritis, which is very rarely seen in childhood.
CASE REPORT: An eight-year-old girl
developed an acute bilateral amaurosis with oedema of the papilla. On admission
she presented tired but compliant. Visual evoked potential (VEP) showed no
response on both eyes. MRI scan showed oedema of both optic nerves. Levels of
Immunoglobulin A were slightly elevated and levels of complement C3 and C4 low.
All other laboratory findings were within the normal range. There were no signs
of Multiple Sclerosis in spinal fluid and MRI. Oncologic, toxic and vascular
cause for the acute amaurosis was excluded. Treatment with Acetazolamid and
Methylprednisolon was started, along with antibiotic treatment with Ceftriaxon.
After 5 days of treatment vision improved and returned to normal over the next
weeks. VEP response resolved completely on the left eye and almost completely
on the right eye.
CONCLUSION: After exclusion of all
possible causes of acute amaurosis we think that the cause of disease is
autoimmune in this case.