Optic Neuritis as First Manifestation of Multiple Sclerosis: A Case Report

Abstract

Optic neuritis is one of the most important clinical manifestation associated with multiple sclerosis. We experienced a case of retrobulbar optic neuritis as the first manifestation of multiple sclerosis in young man without specific neurologic symptom or sign. A 18-years-old man suffered from loss of vision in the left eye before a week was visited our hospital. He had relative afferent pupillary defect, color blindness, and non-specific visual field defect without optic disc swelling. On the other hand, the patient didn't present any neurologic symptoms including headache, motor weakness, or paresthesia. On T2-weighted images of the brain magnetic resonance imaging (MRI) scan, multiple lesions with high signal density were found on cerebral hemisphere, pons, and medulla. As a result, the patient was diagnosed as multiple sclerosis, and the treatment with high dose steroid was started. We should keep in mind that multiple sclerosis can be revealed as optic neuritis without other neurologic symptom or sign, and meticulous evaluation is needed for the patients with optic neuritis.