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   Table of Contents      
LETTER TO THE EDITOR
Year : 2015  |  Volume : 63  |  Issue : 7  |  Page : 623

Atypical optic neuritis due to tuberculosis


Department of Neuro-ophthalmology, Clinic and Glaucoma Service, AG Eye Hospital, Trichy, Tamil Nadu, India

Date of Web Publication12-Oct-2015

Correspondence Address:
Dr. Nataraja Pillai Venugopal
No. 19, Mathuram Apartments (Behind YMCA), Officer's Colony, Puthur, Trichy - 620 017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.167110

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How to cite this article:
Venugopal NP. Atypical optic neuritis due to tuberculosis. Indian J Ophthalmol 2015;63:623

How to cite this URL:
Venugopal NP. Atypical optic neuritis due to tuberculosis. Indian J Ophthalmol [serial online] 2015 [cited 2019 Dec 8];63:623. Available from: http://www.ijo.in/text.asp?2015/63/7/623/167110

Sir,

We read with interest the article titled "A case of subretinal tubercular abscess presenting as disc edema" by Shetty et al.[1] Authors have mentioned about the difficulty to decide whether the first episode of defective vision is due to demyelinating optic neuritis (DON) or atypical optic neuritis (AON). Asian race, pain persistent for >2 weeks from the onset of defective vision and worsening of vision for >2 weeks are a feature of AON.[2] In Shetty et al.[1] case report, an Asian patient, had pain persisting for 25 days and gradually progressive loss of vision in left eye since 20 days. The disc swelling of DON is diffuse and the presence of segmental changes, altitudinal swelling, pallor, arterial attenuation, and splinter hemorrhages should bring its diagnosis into question. In Shetty et al. case report the disc edema is pronounced and elevated in the upper temporal quadrant.

In DON, the disc is normal in 65% of patients (retrobulbar neuritis).[3] If disc edema is present in DON, it is mild and diffuse. To conclude, from above-mentioned features the first episode of defective vision may be due to tuberculous AON.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
  References Top

1.
Shetty SB, Bawtag MA, Biswas J. A case of subretinal tubercular abscess presenting as disc edema. Indian J Ophthalmol 2015;63:164-6.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Shams PN, Plant GT. Optic neuritis: A review. Int MS J 2009;16:82-9.  Back to cited text no. 2
    
3.
Behbehani R. Clinical approach to optic neuropathies. Clin Ophthalmol 2007;1:233-46.  Back to cited text no. 3
    




 

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