Case Report A unilateral optic perineuritis in a teenager – A case report Ahmad Ameilia a , Ismail Shatriah a,⇑ , Wan Hazabbah Wan-Hitam a , Rohaizan Yunus b a Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia b International Medical University Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia Received 5 August 2014; received in revised form 29 September 2014; accepted 30 September 2014 Abstract Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineu- ritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2 weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits. Ó 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. Keywords: Optic perineuritis; Pediatric patients 1. Introduction Optic perineuritis is an uncommon form of orbital inflammatory disease and typically affects the optic nerve sheath. The majority of cases are isolated and idiopathic [1,2]. Syphilis, Wegener’s granulomatosis, sarcoidosis, Crohn disease and leukemia have been reported as causing optic perineuritis in adult patients [3–8]. Based on a PubMed literature search, limited information is available regarding optic perineuritis in pediatric patients. Recently, Grosso et al. was the first to report a case of optic perineuritis in a pediatric patient [9]. We describe here another case of optic perineuritis in a teenager with unilateral presentation. The clinical signs were fairly similar to optic neuritis. However, the magnetic resonance (MR) images of orbit and brain were consistent with right optic perineuritis, and our patient showed dramatic response to a high dose of systemic corticosteroid. 2. Case report A 15-year-old girl presented with blurred vision over her right eye that had lasted 2 weeks. It was associated with mild discomfort on ocular movement. No eye pain, redness or double vision was noted. She had no history of a similar illness. She denied any recent history of upper respiratory infection, fever, joint pain or recent immunization. Her visual acuity was 1/60 and improved to 4/60 with a pinhole in the right eye and 6/6 in the left eye. A relative afferent pupillary defect was noted in the affected eye. Other anterior segment examination was within normal. Fundoscopy examination revealed a mild swollen optic disk, particularly at the superior and nasal edges. The macula was normal. Examination of the fellow eye revealed no observed abnormality. Humphrey visual field showed inferotemporal field http://dx.doi.org/10.1016/j.braindev.2014.09.011 0387-7604/Ó 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. ⇑ Corresponding author. Tel.: +60 97676354. E-mail address: shatriah@usm.my (I. Shatriah). www.elsevier.com/locate/braindev Brain & Development xxx (2014) xxx–xxx Please cite this article in press as: Ameilia A et al. A unilateral optic perineuritis in a teenager – A case report. Brain Dev (2014), http:// dx.doi.org/10.1016/j.braindev.2014.09.011