Optic Neuropathy, Secondary to Ethmoiditis, and Onodi Cell Inflammation during Childhood: A Case Report and Review of the Literature

Abstract

Optic neuropathy consists of several etiological events. The primary etiologies of its acute form include optic neuritis, ischemic optic neuropathy, inflammatory (nondemyelinating) disorders, and trauma. Its subacute and chronic forms are most often linked to compressive, toxic, nutritional, or hereditary-genetic causes. Visual loss, dyschromatopsia, and visual field defects are the presenting symptoms. The Onodi cell (sphenoethmoidal air cell) is an anatomic variant located laterally and superior to the sphenoid sinus; it is closely related to the optic nerve. Onodi cell disorders are rare and may be unnoticed in differential diagnoses of patients with ocular and neurological manifestations. Here, we present the case of a 12-year-old boy with headache and acute loss of sight characterized by hemianopsia in the left eye and retrobulbar optic neuropathy caused by left sphenoethmoidal sinusitis with the presence of Onodi cell inflammation. The diagnosis was confirmed by multilayered paranasal computed tomography and cerebral magnetic resonance imaging. Therapeutic treatment resulted in gradual improvement: at the 2-week follow-up, the patient no longer had headaches and his visual acuity returned to normal. Inflammation of Onodi cells should be considered in children with headache and abnormal vision.

Keywords

optic neuropathy - ethmoiditis - Onodi cell - optic neuritis

Financial Support and Sponsorship

None.

Authors' Contribution

P.P and S.C.: Preparation of the draft of the article and review of the literature.

A.F. and P.S.: Critical review of the article for important intellectual content and final approval of the version to be published.

M.M. and F.G.: Contribution to the draft of the article, critical review of the article for important intellectual content, and approval of the version to be published.

M.D.L. P.D.M.: Analysis of the radiologic data, critical review of the article, and final approval of the version to be published.

M.D.L. and E.P.: Edited the article, clinical care, contributed to intellectual content, and final approval of the version to be published.

P.S. and .E.P.: Edited the article, clinical care, contributed to intellectual content, and final approval of the version to be published.

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