Optic neuritis after ocular trauma in anti‐aquaporin‐4 antibody‐positive neuromyelitis optica spectrum disorder

• Main Authors: Tetsuya Akaishi, Noriko Himori, Takayuki Takeshita, Kazuo Fujihara, Tatsuro Misu, Toshiyuki Takahashi, Juichi Fujimori, Tadashi Ishii, Masashi Aoki, Toru Nakazawa, Ichiro Nakashima
• Format: Article
• Language: English
• Published: Wiley 2021-05-01
• Series: Brain and Behavior
• Subjects: anti‐aquaporin‐4 antibodies; neuromyelitis optica spectrum disorders; ocular trauma; optic neuritis
• Online Access: https://doi.org/10.1002/brb3.2083

Abstract Objective The aim of this study was to report the possible association between minor trauma to the eyes and the subsequent occurrence of optic neuritis in patients with serum anti‐aquaporin‐4 (AQP4) antibody‐positive neuromyelitis optica spectrum disorder (NMOSD). Methods Herein, we present three patients who developed acute optic neuritis with visual disturbances after accidental minor trauma to their eyes, without any fundus abnormality or orbital floor fractures present. Results Two of the three patients had a preceding history of neurological disturbances compatible with NMOSD (e.g., myelitis, area postrema syndrome) before the occurrence of trauma. One patient was rapidly treated with steroid pulse therapy and plasmapheresis, and he fully recovered visual acuity. The other two, who were left untreated in the acute phase, had sequelae of severe visual disturbances in the affected eyes. Conclusions These cases suggest possible association between minor trauma to the eyes and the subsequent occurrence of optic neuritis in patients with serum anti‐AQP4 antibodies. Avoiding ocular trauma and early administration of steroid pulse therapy in response to optic neuritis after trauma are desired in such cases.