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Clinically isolated syndrome in optic neuritis: a case report

Poster Details

First Author: A. Kougou Ntoutoume MOROCCO

Co Author(s):    S. Mekyna   A. Amazouzi   O. Cherkaoui              

Abstract Details


Clinically isolated syndrome is a term that describes a first clinical episode with features suggestive of multiple sclerosis. It usually occurs in young adults and affects optic nerves, the brainstem, or the spinal cord. Through a clinical case, we specify the clinical, radiological and biological characteristics which define the clinically isolated syndrome during optic neuritis and the risk of conversion to multiple sclerosis.


Ophtalmology A, Specialty hospital Mohammed V University, Faculty of Medicine and Pharmacy Rabat, Morroco.


A 25-year-old man with toxic habits (regularly taking cocaine), consulted for a decline in visual acuity in the right eye which had progressed for 7 days, without pain when the globe was mobilized and without any other associated sign. We performed a neuro-ophthalmologic clinical examination, visual field examination, color vision, orbital-brain MRI, lumbar puncture, and laboratory tests.


Far visual acuity is rated at the right finger near and 10/10 on the left. Examination of the right eye revealed dyschromatopsia, relative afferent pupillary deficit, and papillitis. The neurological exam is normal. Orbitoencephalic and medullary MRI shows demyelinating periventricular, cortical and medullary lesions. Analysis of the CSF does not find oligoclonal bands. Toxic urine test is positive for cannabinoids. In this patient the diagnosis of clinically isolated syndrome was made. He received an IV bolus of 1g of MP per day for 5 days and visual acuity gradually improved to 7/10 after this initial treatment.


It is important to know the characteristics of the clinically isolated syndrome during optic neuritis. The patient's history, clinical presentation, MRI and CSF analysis are used to make the diagnosis, assess the risk of converting to multiple sclerosis and rule out other causes of optic neuritis. This will guide the therapeutic management.

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