CASE REPORT article
Front. Ophthalmol.
Sec. Neuro-Ophthalmology Disorders
Volume 5 - 2025 | doi: 10.3389/fopht.2025.1616532
Case Report: Unilateral Optic Perineuritis as the Initial Presentation of Multiple Myeloma
Provisionally accepted
- 1Pusan National University Hospital, Seo-gu, Republic of Korea
- 2Pusan National University Yangsan Hospital, Yangsan, South Gyeongsang, Republic of Korea
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Background: Multiple myeloma (MM) is typically diagnosed based on systemic symptoms such as anemia or fatigue, or through imaging findings of bone lytic lesions. Neurologic manifestations as the initial presentation are rare. In this case, we report a patient diagnosed with MM after presenting with severe, unilateral vision loss. Methods: A 67-year-old woman presented with a five-day history of painless vision loss in her left eye. Her visual acuity was severely reduced to light perception, yet both the optic disc and retinal vessels appeared normal upon examination. Blood tests revealed no significant abnormalities except for anemia. MRI revealed enhancement of the left optic nerve sheath, and bone marrow biopsy confirmed MM. High-dose steroid and subsequent chemotherapy led to significant visual improvement. Conclusions: Unilateral optic perineuritis can be the first manifestation of multiple myeloma, potentially caused by immune-mediated mechanisms or direct tumor cell infiltration near the optic nerve. Steroid not only contributed to symptom improvement but also may have played a role in partial remission of MM.
Keywords: Multiple Myeloma, Optic Neuritis, Optic perineuritis, Visual loss, Optic Nerve
Received: 08 May 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Jung, Choi, Choi and Choi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Seo-Young Choi, csy035@hanmail.net
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