Systemic Disorders With Optic Nerve and Retinal Findings

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Identifier 96_50
Title Systemic Disorders With Optic Nerve and Retinal Findings
Creator Larry P. Frohman, MD
Affiliation UMDNJ-New Jersey Medical School
Contributing Institution AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology Society
Subject Syphilis
Description A 42-year old woman presented with a history of severe brow pain and 4 days of progressive visual loss OD. There was no increased pain on ocular rotation. Aside from heavy menses, she denied any significant past medical history. Her examination revealed acuity NLP OD, 20/25 OS; color vision 9/10 OS; pupils amaurotic OD, RRL OS, +3 APD OD; motility normal, slit-lamp examination and IOP normal OU; visual field mild generalized constriction and nasal step OS. Neurologic examination normal; funduscopic examination bilateral hyperemic disc edema, OD>>OS. The MRI of the head was normal. That night, she underwent a spinal tap that showed an opening pressure of 300, 5 white cells, protein = 30, and serology, cultures, and gram stain all negative. MRI of the orbits with fat suppression revealed enhancement of the right optic nerve and streaky enhancement of the orbital fat, consistent with optic neuritis/perineuritis. Her RPR returned later that day, and was +1:32, with a positive FTA-ABS. Her hemoglobin was 6.5, with a platelet count of 701,000. She had hypochromic -microcytic indices and was felt by the hematology specialist to have severe iron deficiency anemia. She was treated with 2 grams IV penicillin q4h for 14 days with concomitant Solu-Medrol 250 mg IV q6h for 3 days. Her pain resolved within 6 to 12 hours, and her vision recovered to 20/20 OU. She refused HIV testing and any subsequent blood work. Disease/Diagnosis: Syphilitic optic neuritis/perineuritis, fundus, OD - post treatment.
Date 1999
Date Digital 2005
References Frohman LP, Wolanski L: Magnetic resonance Imaging of Syphilitic Optic Neuritis/Perineuritis. J Neuro-Ophthalmol 1997;17:57-59
Language eng
Format image/jpeg
Type Image
Source AAO/NANOS Clinical neuro-ophthalmology : image collection for ophthalmic practitioners. American Academy of Ophthalmology [electronic resource], [San Francisco, Calif.] : AAO, c1999.
Relation is Part of Case 51
Collection Neuro-Ophthalmology Virtual Education Library: AAO-NANOS Neuro-Ophthalmology Clinical Collection: https://NOVEL.utah.edu/AAO
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 1999. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6g76d9j
Setname ehsl_novel_aao_nanos
ID 177025
Reference URL https://collections.lib.utah.edu/ark:/87278/s6g76d9j
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