Myelin Oligodendrocyte Glycoprotein Optic Neuritis in Children

Abstract

Introduction: Optic neuritis is a common presenting feature of paediatric central nervous system demyelinating disease. Pediatric optic neuritis (PON) can present as a unilateral or bilateral acute onset visual loss in children. It occurs in isolation or can be associated with systemic diseases. It has an incidence of two per million children per year and is considered as a different clinical entity compared to adult optic neuritis (AON). This article highlights myelin oligodendrocyte glycoprotein optic neuritis in children and the differences in the course of these two cases. Method: Case report. Results: The first case is a 14-year-old girl who presented to us at the age of 10 with left subacute painless blurring of vision. Funduscopic examination revealed left swollen optic disc with no macula star and right eye optic disc pallor. MRI scans showed demyelinating lesions. The second case was a nine-year-old boy who presented with right painless loss of vision for 1 week with a visual acuity of perception loss. Funduscopic examination showed a blurred margin of the right optic disc with no macula star. MRI brain and spinal cord were suggestive of demyelinating disease. Both cases received high dose intravenous corticosteroid and had good visual recovery. Conclusion: PON often leads to significant visual impairment but typically shows good recovery. An abnormal MRI brain scan at onset or recurring episodes of optic neuritis should prompt clinicians to consider a diagnosis of multiple sclerosis (MS) or neuromyelitis optica (NMO).