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Year : 2023  |  Volume : 3  |  Issue : 2  |  Page : 455-457

Widespread retinal hemorrhages in a patient with atypical optic neuritis: A case report

1 Neuro-Ophthalmology Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
2 Department of Imaging Sciences and Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India

Correspondence Address:
Virna M Shah
Consultant and Head of the Department, Neuro-Ophthalmology Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Avinashi Road, Coimbatore - 641 014, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJO.IJO_2880_22

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Retinal hemorrhages are rare in optic neuritis. We report a case of atypical optic neuritis with widespread retinal hemorrhages. A 30-year-old Indian woman presented with sudden painful and severe visual loss in the left eye for 3 days. Fundus examination showed minimal optic disk edema associated with intraretinal hemorrhages extending to the periphery in the left eye. On neuroimaging, long segment thickening of the intraorbital segment of the left optic nerve was appreciated with T2 hyperintensity. Serum myelin oligodendrocyte (MOG) antibodies and neuromyelitis optica (NMO) antibodies were negative. Visual acuity improved rapidly after the administration of intravenous high-dose steroids, and fundus abnormalities resolved rapidly. Retinal hemorrhages can also be present in atypical optic neuritis in the absence of severe optic disk edema. Clinicians should be mindful of the variable presentations of optic neuritis to initiate proper and timely treatment.

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