Abstract:
Abstract
Aim of the research was to outline etiological triggers, clinical
presentation, diagnostic approaches, treatment strategies, visual as well as
neurological outcomes.
Methods: Twenty-three patients with persisting visual symptoms after
viral infections have been examined. A series of tests have been undergone
in order to establish visual pathways alteration.
Results: A probable post-infectious immune-mediated etiology was
identified in the majority of cases, accounting for approximately 65% (n≈15)
of patients. These children typically developed visual symptoms within 1–4
weeks after resolution of a self-limited viral illness and demonstrated clinical
and paraclinical features consistent with optic nerve inflammation. In
approximately 13% of cases, visual pathway impairment was attributed to
direct or para-infectious viral involvement of the optic nerve. These cases
were characterized by an acute or subacute onset of visual symptoms
occurring during or shortly after the viral illness, in the absence of
radiological features of demyelination. The etiological agents most
frequently implicated included varicella-zoster virus (post-varicella and postherpetic
forms), measles virus, and other common neurotropic viruses, based
on clinical history, serological evidence, and temporal association with
infection.
Conclusions: Post-infectious optic neuritis in children is most commonly
immune-mediated, with a smaller proportion associated with post-viral
demyelinating processes or direct viral effects on the optic nerve. Accurate
diagnosis relies on a combination of clinical history, neuroimaging, and
immunological markers to guide appropriate management. Early recognition
and treatment are associated with generally favorable visual outcomes in the
pediatric population.
