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Background <p>Optic perineuritis (OPN) is a rare inflammatory disorder affecting the optic nerve sheath, often mistaken for optic neuritis. Its occurrence during pregnancy is exceptionally rare and poses diagnostic and therapeutic dilemmas due to limited imaging options and concern for fetal safety.</p> Case Presentation <p>A 26-year-old primigravida, 28 weeks and 6 days pregnant, experienced sudden bilateral vision loss that progressed to complete blindness within 24 hours. Ophthalmic evaluation showed signs of Vogt-Koyanagi-Harada (VKH) syndrome, but MRI confirmed bilateral optic nerve perineuritis. The patient was treated with intravenous methylprednisolone and oral corticosteroids. She partially regained her vision and delivered a healthy term infant. Long-term follow-up revealed permanent vision loss in one eye, with some restoration in the other.</p> Conclusions <p>This case highlights the importance of early recognition and differentiation of optic nerve perineuritis from other causes of vision loss during pregnancy, including VKH syndrome. Prompt diagnosis, multidisciplinary care, and judicious corticosteroid use are crucial for optimizing maternal visual outcomes and fetal safety.</p>

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Unseen Risk: Acute Optic Nerve Perineuritis and Vision Loss During Pregnancy-A Case Report and Literature Review

  • 期刊论文

  • 发表日期：

    2025年7月16日

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  • Dinesh Choudhary,
  • Manisha Jhirwal,
  • Charu Sharma,
  • Manjari Tandon,
  • Sarbesh Tiwari,
  • Shashank Shekhar

摘要

Background

Optic perineuritis (OPN) is a rare inflammatory disorder affecting the optic nerve sheath, often mistaken for optic neuritis. Its occurrence during pregnancy is exceptionally rare and poses diagnostic and therapeutic dilemmas due to limited imaging options and concern for fetal safety.

Case Presentation

A 26-year-old primigravida, 28 weeks and 6 days pregnant, experienced sudden bilateral vision loss that progressed to complete blindness within 24 hours. Ophthalmic evaluation showed signs of Vogt-Koyanagi-Harada (VKH) syndrome, but MRI confirmed bilateral optic nerve perineuritis. The patient was treated with intravenous methylprednisolone and oral corticosteroids. She partially regained her vision and delivered a healthy term infant. Long-term follow-up revealed permanent vision loss in one eye, with some restoration in the other.

Conclusions

This case highlights the importance of early recognition and differentiation of optic nerve perineuritis from other causes of vision loss during pregnancy, including VKH syndrome. Prompt diagnosis, multidisciplinary care, and judicious corticosteroid use are crucial for optimizing maternal visual outcomes and fetal safety.