Recurrent Retrobulbar Optic Neuritis in Seronegative  Rheumatoid Arthritis

Mohammad Hudzaifah Nordin; Abdul Hadi Rosli; Muhd Syafi Abd Bari; Nurul &lsquo; Ain Masnon; Wan Hazabbah Wan Hitam

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Recurrent Retrobulbar Optic Neuritis in Seronegative Rheumatoid Arthritis

Author: Mohammad Hudzaifah Nordin ¹ ; Abdul Hadi Rosli ² ; Muhd Syafi Abd Bari ² ; Nurul ‘Ain Masnon ³ ; Wan Hazabbah Wan Hitam ⁴
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1. Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Medical Campus, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu Darul Iman, Malaysia
2. Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Department of Ophthalmology, Kuliyyah of Medicine, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia
3. Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Department of Ophthalmology, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
4. Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia&
Publication Type:Case Reports
Keywords: Optic Neuritis, Arthritis, Rheumatoid
From:Malaysian Journal of Medicine and Health Sciences 2022;18(No.2):185-187
CountryMalaysia
Language:English
Abstract: Rheumatoid arthritis (RA) is a multisystemic autoimmune disease which can be associated with visual threatening ocular manifestations. Common ocular associations with RA include necrotising scleritis and peripheral ulcerative keratitis (PUK). Optic nerve involvement otherwise is uncommon, especially as a presenting feature of RA. We report a rare case of recurrent bilateral retrobulbar optic neuritis (ON) with progressive visual deterioration as an early manifestation of seronegative RA. This case posed diagnostic and management challenges due to its unusual presentation and initially inconclusive investigations. The patient was diagnosed with seronegative RA three years after the first eye presentation. Her RA disease activity score (DAS-28) improved after treatment with a disease-modifying anti-rheumatic drugs (DMARDs), and her ON attacks have been controlled since then. However, her visual acuity, visual field and colour vision remained poor after multiple ON attacks. Multidisciplinary care is key to managing such a patient’s condition and its potential disease complications.
Full text:11.2022my1256.pdf