G. Haring et al., BILATERAL SIMULTANEOUS ACUTE AMAUROSIS AS PRIMARY MANIFESTATION OF ENCEPHALOMYELITIS DISSEMINATA, Der Ophthalmologe, 95(5), 1998, pp. 344-347
Background: Bilateral simultaneous acute amaurosis as a primary manife
station of demyelinating disease is extremely rare. Patient: The clini
cal course of a 24-year-old patient who initially presented with a bil
ateral complete loss of vision is demonstrated. Morphologically both o
ptic discs appeared slightly blurred and prominent. Otherwise there we
re no anterior and posterior segment abnormalities. Examination of the
cerebrospinal fluid revealed an increased number of cells and protein
without oligoclonal bands. On MRI multiple white matter lesions were
visible, laboratory tests showed no specific abnormalities, especially
with respect to infectious or vasculitic diseases. Under intensive st
eroid therapy (initially 1000 mg prednisolone/day), visual acuity reco
vered almost completely. Nine months after onset of the disease visual
acuity was 1.0 in both eyes. Conclusions: Even in patients with a ful
minant onset of the disease almost complete visual recovery is possibl
e. Differential diagnosis should rule out vasculitic autoimmune optic
neuritis, infections, tumors, processes of the paranasal sinuses, toxi
c, and hereditary causes.