Bilateral optic perineuritis secondary to giant cell arteritis

Giant cell arteritis is a systemic vasculitis affecting large and medium-sized arteries. It can produce a variety of ocular manifestations including ischemic optic neuropathy and central retinal artery occlusion. We report a patient who developed a progressive bilateral optic perineurits due to giant cell arteritis.

Poster 68 Bilateral optic perineuritis secondary to giant cell arteritis Eun Hye Oh1, Jae-Hwan Choi1, Kwang-Dong Choi2, Seung-Han Lee3, Sang Ho Kim4 Pusan National University Yangsan Hospital, Yangsan, Korea (Republic of), 2Pusan National University Hospital, Pusan, Korea (Republic of), 3Chonnam National University Hospital, Gwangju, Korea (Republic of), 4Dong-A University Hospital, Pusan, Korea (Republic of) 1 Introduction: Giant cell arteritis is a systemic vasculitis affecting large and medium-sized arteries. It can produce a variety of ocular manifestations including ischemic optic neuropathy and central retinal artery occlusion. We report a patient who developed a progressive bilateral optic perineurits due to giant cell arteritis. Description of Case(s): An 81-year-old woman presented with progressive bilateral visual loss for 1 month. She also had jaw claudication and sharp pain in the left temporoparietal region of the scalp. Neurological examination showed bilateral mydriasis and absence of the pupillary reflexes. Visual acuity was no light perception in both eyes. Ophthalmoscopy demonstrated bilateral swelling of the optic disc, cherry red spot, and cotton-wool spots in the posterior pole. The erythrocyte sedimentation rate was 55mm/hr, but other laboratory and CSF analysis were unremarkable. MRI scans of the orbit showed an enhancement along the bilateral optic nerve sheath. She underwent a biopsy of the left temporal artery and histopathology revealed a fragmentation of the elastic membranes together with multinucleated giant cells within the wall and organized thrombus occluding the lumen, consistent with giant cell arteritis. She received high dose pulses of systemic corticosteroids, followed by tapering doses of oral prednisolone, but failed to recover her visions. Conclusions, including unique features of the case(s): This case illustrates that optic perineuritis may represent the manifestation of giant cell arteritis. References: None. Keywords: Neuro-ophth & systyemic disease (eg. MS, MG, thyroid), Optic neuropathy Financial Disclosures: The authors had no disclosures. Grant Support: None. 2019 Annual Meeting Syllabus | 123