Bilateral optic neuritis in HIV patient

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Orbital pain with reduced visual acuity and papilledema in an HIV-positive patient.

Patient Data

Age: 35 years
Gender: Female

High T2 fat sat and DWI with enhancement of the intraorbital and intracranial prechiasmatic segments of both optic nerves mainly the left best seen on postcontrast axial FLAIR fat sat and coronal T1 fat sat with enhancement of the optic nerve sheath and inflammatory changes of the intraconal fat.

Normal appearance of the optic chiasma.

Case Discussion

The clinical presentation and the MRI features are most consistent with bilateral optic neuritis in an HIV patient.

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