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Journal : Vision Science and Eye Health Journal

Compressive Optic Neuropathy (CON) Secondary to Inflammatory Polyp Mimicking Lymphoma: A Rare Manifestation Danniswara, Fadia Ghaisani; Agustini, Lukisiari
Vision Science and Eye Health Journal Vol. 3 No. 1 (2023): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i1.2023.23-27

Abstract

Introduction: Compressive optic neuropathy (CON) is the impairment of optic nerve function by space-occupying lesions that mechanically compress the optic nerve or optic tract. CON can arise from either intrinsic or extrinsic compression, and determining the underlying cause is important to approach the correct management. The objective of this case report is to present a rare case of CON secondary to an inflammatory polyp that mimicking lymphoma. Case Presentation: A 68-year-old male patient came to the neuro-ophthalmology clinic with a chief complaint of blurry vision in his left eye since three months ago that was getting worse until he lost his vision accompanied by drooping of the upper left eyelid. He also felt pain in his left eye, nausea, vomiting, and headache. Visual acuity of the right eye was 5/5 and the left eye had no light perception. Ocular motility of the left eye was restricted in all gaze. The pupil was 6 mm with no light reflex, and edema in the optic nerve head in the left eye was found from the posterior segment. The patient's MRI showed soft tissue thickening on the left orbital apex – left optic canal – left anterior cavernous sinus and enlargement of left medial rectus muscle with encasement of the left optic nerve, and from post-contrast showed contrast enhancement that suggested a lymphoma. He was diagnosed with CON secondary to lymphoma and was given Methylprednisolone 32 mg three times a day orally. Conclusions: Several differential diagnoses resemble the findings of CON secondary to inflammatory polyp. Some diagnostic examination must be done to exclude the other diagnosis to give a proper treatment for the patient.
Clinical Improvement in a Patient with Methanol-Induced Optic Neuropathy Rusydiana; Aritonang, Christina; Agustini, Lukisiari
Vision Science and Eye Health Journal Vol. 5 No. 1 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v5i1.2025.23-27

Abstract

Introduction: Due to optic nerve and retinal damage, methanol-induced optic neuropathy (Me-ION) may lead to permanent vision loss, including blindness, making it a serious condition. Here, we present a case demonstrating clinical recovery in a patient with Me-ION. Case Presentation: A 20-year-old man came to the emergency unit with a chief complaint of sudden visual loss in both eyes since the day before admission. It was accompanied by shortness of breath, headache, nausea, and vomiting. He reported ingesting methanol three days before presentation and had no history of systemic illness. Visual acuity (VA) was counting fingers at one meter in the right eye and counting fingers at three meters in the left eye. The intraocular pressure (IOP) in both eyes was measured at 12.2 mmHg. Optical Coherence Tomography (OCT) of the retinal nerve fiber layer (RNFL) revealed increased thickness in both superior and inferior quadrants bilaterally. Laboratory tests revealed metabolic acidosis. The patient was diagnosed with Me-ION in both eyes, accompanied by metabolic acidosis. Dialysis was started, and he was treated with a high-dose steroid. Subsequently, VA improved to 5/5 in the right eye and 5/12 in the left eye. Color vision improved in the right eye to 30/38 (Ishihara), while the left eye remained at 20/38. Conclusions: Early diagnosis and prompt treatment of Me-ION can result in significant clinical improvement in visual acuity and color vision, emphasizing the significance of early treatment in managing toxic optic neuropathy.