A 32-year-old woman presents with sudden-onset blurred vision and pain in her right eye, worsened by eye movement. She describes a central dark spot and decreased color perception. On exam, there is an afferent pupillary defect and decreased visual acuity. Fundoscopy is normal. MRI of the brain reveals multiple periventricular white matter lesions. What is the most likely diagnosis, and what is the significance of this episode in the broader context of her neurological health? What are the conservative and invasive techniques used ?
It suggests a case of multiple sclerosis, and the symptom and presentation is of optic neuritis..
The peri ventricular white matter lesions is Dawson’s sign- Its the classic MS indicator..
Afferent defect is marcus gunn pupil i think.
Some conservative methods are- High dose corticosteroids, DMT like interferons, etc…
Invasive method is plasma exchange,( plasmapharesis)
Now significance is that the optic neuritis is the first demyelination event she is experiencing.. so it isnt a isolated situation, she will need quick diagnosis and immediate treatment internvention.