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Usefulness of B-scan ocular ultrasound image for diagnosis of optic perineuritis

Poster Details

First Author: A.Edo JAPAN

Co Author(s):    Y. Harada   Y. Kiuchi                 

Abstract Details


Optic perineuritis is rare inflammation disorder involving the optic nerve sheath characterized by visual loss. It is often diagnosed by magnetic resonance imaging (MRI). We report the usefulness of B-scan ocular ultrasound image for diagnosis of optic perineuritis.


Uveitis service, Hiroshima University. Hiroshima (Japan)


A 72 year-old woman noticed blurred vision in her left eyes without pain. At the first ophthalmological consultation, she had optic disc swelling and choroidal fold in the both eyes and subretinal fluid in the left eye. Best correct visual acuity (BCVA) was 1.2 in the right eye and 0.7 in the left eye. Critical flicker-fusion frequency (CFF) was decreased to 24 Hz in the right eye and 22 Hz in the left. Differential diagnosis at this point was Vogt-Koyanagi-Harada disease (VKH) and posterior scleritis. Then she was referred to our clinic one month after she developed her symptom.


At the first visit on our clinic, she still complained blurred vision. She was found to have mild vitreous cell in the left eye and optic disc swelling on the both eyes. But choroidal fold was already resolved the both eyes. B-scan ultrasound image showed that optic nerve sheath was revealed as high reflex circle with shadowing around optic disc. It seemed highly plausible that she had bilateral optic perineuritis. Then MRI with intravenous contrast revealed increased signal intensity around the optic nerve called ‘tram track sign’ in her both eyes which consistent with optic perineuritis.


Here we first report that optic perineuritis was suspected by B-scan image and confirmed by MRI. Since B-scan image could not show full optic nerve sheath image, this technic may useful only when inflammation of optic perineuritis involved surrounding the optic nerve disc like this case.

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