COVID-19 감염 후 발생한 구후시신경염 1예
Retrobulbar Optic Neuritis after COVID-19 Infection
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목적: COVID-19 감염 후 발생한 급성 구후시신경염의 증례를 보고하고자 한다. 증례요약: 특이 병력 없는 20세 남자가 COVID-19 감염 6일 후 좌안이 갑자기 흐려지는 증상을 보였다. 초진 시 좌안 최대교정시력 안전수지 30 cm로 측정되었고, 동공 검사 상 상대구심동공운동장애 2단계로 관찰되었다. 안저 검사 상 양안 정상 소견, 시유발전위도검사상 좌안 P100 진폭 저하 소견 및 지연 소견이 관찰되었다. 안와 자기공명영상검사 상 좌측 시신경 구후부에 조영 증강 및 두꺼워진 소견이 관찰되었고, 시신경 주변을 압박하고 있는 다른 병변은 관찰되지 않았다. 좌안 구후시신경염 진단 하에 고용량 정주 스테로이드 치료를 시작하였으며, 1개월 후, 좌안 시력 1.0으로 향상되었고, 상대구심동공운동장애 및 시야 결손이 호전되었으며, 시유발전위도 검사상 P100 진폭이 회복되고, 지연 소견이 사라졌다. 결론: 구후시신경염은 COVID-19 감염 후 발생 가능한 신경 안과적 합병증으로, 이 경우 다른 시신경염 치료와 마찬가지로 고용량정주 스테로이드 치료가 도움이 될 수 있다.
Abstract
Purpose: To report a case of retrobulbar optic neuritis after COVID-19 infection. Case summary: A 20-year-old Korean man, without any previous relevant medical history, presented with sudden blurred vision in the left eye that began 6 days after a COVID-19 infection. At his initial visit, the best-corrected visual acuity in the left eye was counting fingers at 30 cm. The pupil showed a grade 2 relative afferent pupillary defect. The fundus exam was normal in both eyes. In the visual evoked potential (VEP) exam, the P100 amplitude of the left eye was decreased and delayed. Orbit magnetic resonance imaging showed asymmetric enlargement and mild enhancement in the left optic nerve. No other lesions were observed around the optic nerve. Steroid pulse therapy was started after a diagnosis of retrobulbar optic neuritis. After 1 month, the patient’s visual acuity had improved to 1.0 in the left eye. The relative afferent pupillary defect and visual field defect disappeared. On VEP, the P100 amplitude recovered, and the delay disappeared. Conclusions: Retrobulbar optic neuritis is a possible neuro-ophthalmological complication of COVID-19 infection. In such cases, high-dose steroid pulse therapy may be helpful, as in the treatment of other forms of optic neuritis.
참고문헌 (33)
- Jiang F, "Review of the clinical characteristics of coronavirus disease 2019(COVID-19)", J Gen Intern Med, 35, pp.1545~1549 (2020)
- Sen M, "COVID-19 and eye : a review of ophthalmic manifestations of COVID-19", Indian J Ophthalmol, 69, pp.488~509 (2021)
- Alomari SO, "COVID-19 and the central nervous system", Clin Neurol Neurosurg, 198, pp.106116~ (2020)
- Shams PN, "Optic neuritis : a review", Int MS J, 16, pp.82~89 (2009)
- Toosy AT, "Optic neuritis", Lancet Neurol, 13, pp.83~99 (2014)
- Son CN, "Interpretation of anti-nuclear antibody tests", Korean J Med, 96, pp.337~340 (2021)
- Frigui M, "Optic neuropathy as a presenting feature of systemic lupus erythematosus : two case reports and literature review", Lupus, 20, pp.1214~1218 (2011)
- Houtman JJ, "Pathogenesis of mouse hepatitis virusinduced demyelination", J Neurovirol, 2, pp.361~376 (1996)
- Deane K, "Unilateral optic neuritis associated with SARS-CoV-2 infection : a rare complication", Am J Case Rep, 22, pp.e931665~ (2021)
- Sawalha K, "COVID-19-induced acute bilateral optic neuritis", J Investig Med High Impact Case Rep, 8, pp.2324709620976018~ (2020)
- Rodríguez-Rodríguez MS, "Optic neuritis following SARS-CoV-2 infection", J Neurovirol, 27, pp.359~363 (2021)
- Žorić L, "Optic neuritis in a patient with seropositive myelin oligodendrocyte glycoprotein antibody during the post-COVID-19 period", Int Med Case Rep J, 14, pp.349~355 (2021)
- Jossy A, "COVID-19-associated optic neuritis-a case series and review of literature", Indian J Ophthalmol, 70, pp.310~316 (2022)
- Sarwar S, "Multiple sclerosis following SARS-CoV-2 infection : a case report and literature review", Cureus, 13, pp.e19036~ (2021)
- Azab MA, "Optic neuritis post-COVID-19 infection. A case report with meta-analysis", Interdiscip Neurosurg, 26, pp.101320~ (2021)
- Benito-Pascual B, "Panuveitis and optic neuritis as a possible initial presentation of the novel coronavirus disease 2019(COVID-19)", Ocul Immunol Inflamm, 28, pp.922~925 (2020)
- Assavapongpaiboon B, "Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis with COVID-19 infection : a case report and literature review", Am J Ophthalmol Case Rep, 26, pp.101491~ (2022)
- Sainath D, "Acute bilateral retrobulbar optic neuritis-an atypical sequela of COVID-19", Indian J Ophthalmol, 69, pp.3761~3764 (2021)
- Mahfuzullah MA, "Neuro-ophthalmologic manifestations of corona virus disease(COVID-19) : a case series", Bangabandhu Sheikh Mujib Med Univ J, 14(COVID-19 Supplement), pp.42~44 (2021)
- Zhou S, "Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis and myelitis in COVID-19", J Neuroophthalmol, 40, pp.398~402 (2020)
- Parvez Y, "Optic neuritis in a child with COVID-19 : a rare association", Cureus, 13, pp.e14094~ (2021)
- Catharino A, "COVID‑19 related optic neuritis : case report", J Clin Neurol Neurosci, 1, pp.10~ (2020)
- Kogure C, "Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis in a COVID-19 patient : A case report", Medicine(Baltimore), 100, pp.e25865~ (2021)
- Sardar S, "The diagnostic dilemma of bilateral optic neuritis and idiopathic intracranial hypertension coexistence in a patient with recent COVID-19 infection", Clin Case Rep, 9, pp.e04347~ (2021)
- de Ruijter NS, "Neuromyelitis optica spectrum disorder after presumed coronavirus(COVID-19)infection : a case report", Mult Scler Relat Disord, 46, pp.102474~ (2020)
- Al-Salihi MM, "Optic neuritis concomitant with pituitary macroadenoma in a patient with active COVID-19 infection : a case report", Int J Surg Open, 35, pp.100390~ (2021)
- Sinha A, "Optic neuritis as a presenting symptom of post-COVID-19 multisystem inflammatory syndrome in children(MIS-C)", Indian J Pediatr, 88, pp.1269~ (2021)
- Rojas-Correa DX, "Post COVID-19 myelin oligodendrocyte glycoprotein antibody-associated optic neuritis", Neuroophthalmology, 46, pp.115~121 (2021)
- Woodhall M, "Case report : myelin oligodendrocyte glycoprotein antibody-associated relapse with COVID-19", Front Neurol, 11, pp.598531~ (2020)
- Palao M, "Multiple sclerosis following SARS-CoV-2 infection", Mult Scler Relat Disord, 45, pp.102377~ (2020)
- Kivanany PB, "Antiaquaporin 4-related optic neuritis and myelitis post-COVID-19 infection", J Neuroophthalmol, 42, pp.e571~e573 (2022)
- Behera G, "Bilateral optic neuritis and facial palsy following COVID-19 infection", Cureus, 14, pp.e28735~ (2022)
- Kim KH, "Onset of various CNS inflammatory demyelination diseases following COVID-19 vaccinations", Mult Scler Relat Disord, 68, pp.104141~ (2022)