Complete remission of Retrobulbar Optic Neuritis caused by Ethmoidal sinusitis in a pediatric patient.

Abstract

Background: retrobulbar optic neuritis (on) in pediatric patients is a rare entity that causes visual disturbances and blindness and may be involved with an ethmoid and sphenoid rhinosinusitis. Although that inflammatory of the paranasal sinuses disease in children is a very common disorder and its extra-nasosinusal complications are infrequent, on may be related to the presence of an anatomical variation of the ethmoid and sphenoid sinuses architecture. Case report: we present a 6-year-old patient with recurrent rhinosinusitis of torpid evolution, who manifested progressive blurry vision and visual impairment on the left side. Imaging studies revealed a homolateral ethmoidal mucocele, associated with a highly pneumatized spheno-ethmoidal cell (onodi cell). The patient showed slow improvement with the suitable medical treatment and was able to satisfactorily recover his sinonasal process and his visual function without evidence of aftermaths. Conclusions: visual disturbances associated with rhinosinusal manifestations in children should arouse suspicion of this complication, so the timely diagnosis and management of this problem can improve visual disturbances and prevent consequences that can be serious and permanent.