BILATERAL SIMULTANEOUS ACUTE AMAUROSIS AS PRIMARY MANIFESTATION OF ENCEPHALOMYELITIS DISSEMINATA

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.