Zhao FF, Yao SQ, Wang Y, Li TP, Yang JF, Pang CP, Cen LP. Bilateral retinal nerve fiber layer thickness reduction in a 9-year-old myopic boy suffering from unilateral optic neuritis: A case report. World J Clin Cases 2023; 11(28): 6806-6811 [PMID: 37900998 DOI: 10.12998/wjcc.v11.i28.6806]
Corresponding Author of This Article
Ling-Ping Cen, PhD, Chief Physician, Professor, Department of Medical Retina and Neuro-ophthalmology, Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou 515041, Guangdong Province, China. cenlp@hotmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Fang-Fang Zhao, Shi-Qi Yao, Yun Wang, Tai-Ping Li, Jian-Feng Yang, Ling-Ping Cen, Department of Medical Retina and Neuro-ophthalmology, Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
Chi-Pui Pang, Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
Author contributions: Cen LP and Zhao FF contributed to conceptualization; Zhao FF contributed to data curation; Yao SQ and Wang Y contributed to data analysis and figure preparation; Zhao FF contributed to original draft preparation; Cen LP, Wang Y, and Pang CP contributed to manuscript review and editing; Cen LP contributed to supervision; all authors have read and agreed to the published version of the manuscript.
Supported byOverseas Famous Teachers Project 2021, Guangdong Province, China, No. 21-294L.-P.C; Academic Committee of Joint Shantou International Eye Center (JSIEC). Analysis of the Gut Microbiota Composition in Patients with Optic Neuritis Guangdong Province, China, No. 21-007L.-P.C.
Informed consent statement: Informed written consent was obtained from the patient’s parents for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Ping Cen, PhD, Chief Physician, Professor, Department of Medical Retina and Neuro-ophthalmology, Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou 515041, Guangdong Province, China. cenlp@hotmail.com
Received: May 16, 2023 Peer-review started: May 16, 2023 First decision: August 4, 2023 Revised: August 17, 2023 Accepted: September 4, 2023 Article in press: September 4, 2023 Published online: October 6, 2023 Processing time: 131 Days and 23.8 Hours
Abstract
BACKGROUND
In this paper, we present a 9-year-old boy who demonstrates a complex interplay between myopia progression, axial length (AL) extension, and retinal nerve fiber layer (RNFL) thickness loss in both eyes. Additionally, concurrent optic neuritis has directly impacted RNFL thickness in his right eye, and its potential indirect influence on RNFL and macular ganglion cell layer (mGCL) thickness in his left eye is also noteworthy.
CASE SUMMARY
A 9-year-old boy with bilateral myopia presented with diminished vision and pain in his right eye due to optic neuritis, while his left eye showed pseudopapilledema. Steroid therapy improved his vision in the right eye, and 16-mo follow-up revealed recovery without recurrence despite myopia progression. Follow-up optical coherence tomography conducted 16 mo later revealed a notable thinning of the RNFL in both eyes, especially along with a reduction in mGCL thickness in the left eye. This intricate interaction between optic neuritis, myopia, and retinal changes underscores the need for comprehensive management, highlighting potential long-term visual implications in young patients.
CONCLUSION
The progression of myopia and AL extension led to the loss of RNFL thickness in both eyes in a 9-year-old boy. Concurrently, optic neuritis directly affected RNFL thickness in his right eye and may indirectly play a role in the thickness of RNFL and mGCL in his left eye.
Core Tip: When evaluating retinal nerve fiber layer (RNFL) thickness in patients with optic neuritis and myopia, it is essential to consider both direct and indirect effects on the RNFL. Additionally, it is important to closely monitor changes in RNFL thickness over time, as it may be influenced by both myopia and optic neuritis. Further research is needed to better understand the relationship between these conditions and their impact on RNFL thickness.
