Three case reports of optic perineuritis complicated by ocular scleritis and hypertrophic pachymeningitis.
Momoka Yoshida, Kimihiko Kaneko, Genta Kumada et al.
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Case in brief
Three cases of optic perineuritis (OPN) complicated by ocular scleritis and hypertrophic pachymeningitis are presented. A 54-year-old man experienced ocular pain and visual loss, with MRI revealing optic sheath hyperintensity; treatment led to significant visual improvement. A 76-year-old man with ocular scleritis and OPN had partial symptom relief after treatment for pneumonia. A 63-year-old woman with acute visual loss also showed improvement following treatment. No relapses were noted in follow-ups.
What made this case unusual
The concurrent occurrence of optic perineuritis, ocular scleritis, and hypertrophic pachymeningitis in these cases suggests a potential shared autoimmune mechanism, which is atypical.
Diagnostic / clinical pearl
Clinicians should consider the possibility of overlapping autoimmune conditions when encountering cases of optic perineuritis, especially in the presence of ocular scleritis and hypertrophic pachymeningitis.
Why it matters
Recognizing the association between these conditions may lead to more comprehensive management strategies and improve patient outcomes.