Abstract:

Objective To understand the clinical features, diagnosis and treatment of fungal optic neuritis. Design Retrospective cases. Participants Three patients with fungal infected optic neuritis. Methods The symptoms, signs, imaging examination were evaluated in 3 patients of fungal infected optic neuritis, addition with literature review and summary of the clinical characteristics and key points of diagnosis in this disease. Main Outcome Measures Clinical symptoms, signs, imaging examinations, pathologic biopsy. Results Three patients of fungal infected optic neuritis were old aged men, monocular or binocular involved, coexisted with systemic disease. Clinical manifestations included acute severe visual loss, headache, eye pain, eyelid prolapse and eye movement disorders. CT showed soft tissue density and bone resorption in the lateral wall of the orbit. Orbital magnetic resonance (MRI) showed irregular enhancement signal with unclear boundary. Pathological biopsy helped to confirm the fungal hyphae and spores. After surgical lesions removal and long-term systemic anti-fungal treatment, symptoms could be controlled in a stable condition. Conclusion Fungus infected optic neuritis should be considered when suddenly unilateral visual loss with headache or eye pain. Imaging examination can help for diagnosis and pathological biopsy is the gold standard. Early managements were suggested with surgical removal of the lesions and long-term systemic anti-fungal therapy.

Key words: optic neuritis, fungal infected, imaging examinations, pathological biopsy