A Case of Optic Neuritis Concomitant with Pituitary Tumor During Pregnancy

World Neurosurg. 2016 Sep:93:488.e1-4. doi: 10.1016/j.wneu.2016.06.103. Epub 2016 Jun 30.

Abstract

Background: Optic neuritis (ON) is unilateral painful optic nerve inflammation in a young healthy female diagnosed by excluding glaucoma. ON onset during pregnancy is rare, with only 2 cases reported to date.

Case description: A 35-year-old previously healthy parous woman who was pregnant with her second child suffered rapidly progressive visual acuity loss. Magnetic resonance imaging (MRI) revealed a pituitary tumor. Emergency surgery was performed for optic nerve compression; however, her visual impairment worsened. Postoperative diffusion-weighted MRI showed high intensity in the bilateral optic nerves, and ON was diagnosed. Administration of methylprednisolone was effective, and her visual acuity recovered over 6 months.

Conclusions: Associated pituitary macroadenoma complicated the true diagnosis of ON, because contrast medium cannot be used in pregnant women. The diffusion-weighted MRI findings were useful for diagnosing this complex clinical condition.

Keywords: Optic neuritis; Pituitary tumor; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Humans
  • Nerve Compression Syndromes / diagnostic imaging
  • Nerve Compression Syndromes / etiology*
  • Nerve Compression Syndromes / prevention & control*
  • Optic Neuritis / diagnostic imaging
  • Optic Neuritis / etiology*
  • Optic Neuritis / prevention & control*
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / surgery*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnostic imaging
  • Pregnancy Complications, Neoplastic / therapy*
  • Treatment Outcome