CRION Patients Often Reveal Their Autoimmunity and Systemic Disease State Years After Their Intial Neuroophthalmic Presentation

Chronic Relapsing Inflammatory Optic Neuritis (CRION) is felt to likely be an immune mediated condition, however the exact cause is still unknown. It causes severe visual loss in one or both eyes. These patients often present with no recognised systemic symptoms other than their visual loss, and often also have no obvious lab abnormality on testing. Data has shown that immunosuppressive therapy early is usually necessary to prevent further visual loss. We have noted that if followed over the years, many of these cases do re-present with their actual autoimmune systemic condition, explaining their initial response and dependence on immunosuppression. We will discuss a few very relevant cases and also demonstrate how autoimmune titers vary significantly throughout a disease course, explaining why labs can often appear normal on presentation.