RETROBULBAR NEURITIS - THE MOST FREQUENT MANIFESTATION OF MULTIPLE SCLEROSIS

Abstract

In order to determine the representation of retrobulbar neuritis in the neuroophthalmological pathology and their possible connection with retrobulbar neuritis, hospitalized patients with the diagnosis multiple sclerosis were treated within the period of 5 years (1990-1994). From the total number of neuroophthalmological disorders treated at the Clinic within the studied period, retrobulbar neuritis was found in 30 patients (34,3%). The retrobulbar neuritis is an inflammation of the optic nerve which process starts in the back of lamina cribrosa. In most cases it attacks the population between 20 - 40: years of age. The clinical picture is characterized by a large decrease of visual acuity, the existence of central scotoma within the visual field, whereas the finding at the fundus remains unchanged. Visual acuity, visual field and the condition of the visual evoked potentials have been followed. On the basis of the following parameters and the positive neurologic findings, 15 cases (50%) were suspected of having multiple sclerosis. Multiple sclerosis was confirmed in 3 of the cases (10%) with retrobulbar re lapse. Тhe pathological findings of VEP was presented in 15 cases (50%) whereas the characteristically findings of the visual field was found in 13 cases (43,3%). The fact that the retrobulbar neuritis appear as a monosymptom of multiple sclerosis has been suggested by the last several years, following the patients with this disorder.