Papillitis

Papillitis

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Papillitis is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Optic Nerve Papillitis

Disorder Subdivisions

  • None

General Discussion

Papillitis, also known as optic neuritis, is characterized by inflammation and deterioration of the portion of the optic nerve known as the optic disk. Also referred to as the "blind spot," the optic disk (optic papilla) is that portion of the optic nerve that enters the eye and joins with the nerve-rich membrane lining the eye (retina). The optic nerves are the pair of nerves (second cranial nerves) that transmit impulses from the retina to the brain. Individuals with papillitis experience loss of vision in one eye that may occur within several hours of onset. The severity of visual impairment may vary from case to case, ranging from slight visual deficiency to complete loss of light perception. In addition, affected individuals experience a reduction in color perception. In some cases, spontaneous recovery may occur. However, in other cases, permanent visual impairment may result if the underlying cause is not detected or treated. Papillitis may occur for unknown reasons, after a viral illness, or due to or in association with a number of different underlying disorders or other factors.

Symptoms

The symptoms of papillitis include loss of vision, pain in the eye, and interference with accurate color vision (dyschromatopsia).



Individuals with papillitis usually experience unilateral loss of vision. That is, they lose sight in one eye (about 70% of cases), usually within a short time (a few hours) of having become aware of diminished sight. This condition is usually rapidly progressive.



The intensity of vision impairment varies from case to case, ranging from slight visual deficiency to complete loss of light perception. In addition, affected individuals experience a reduction in color perception. In some cases, spontaneous recovery may occur. However, in other cases, permanent visual impairment may result if the underlying cause is not detected or treated. Papillitis may occur for unknown reasons, after a viral illness, or due to or in association with a number of different underlying disorders or other factors.

Causes

There are many possible causes of papillitis. These include diseases that result in damage to the lining of nerves (demyelinating diseases) such as multiple sclerosis and encephalomyelitis; viral or bacterial infections such as polio, measles, pneumonia, or meningitis; nutritional or metabolic disorders such as diabetes, pernicious anemia, and hyperthyroidism; secondary complications of other diseases; reactions to toxic substances such as methanol, quinine, salicylates, and arsenic; and trauma.



In patients over 60 years of age, a common cause of papillitis is temporal arteritis (giant cell arteritis). In such cases, papillitis can spread to the other eye resulting in bilateral blindness.

Affected Populations

Papillitis affects males and females in equal numbers and can occur at any age. A percentage of people with papillitis may eventually be diagnosed with multiple sclerosis. (for more information on this disorder, see the Related Disorders section of this report.)

Standard Therapies

Diagnosis

Diagnostic testing may include testing for visual acuity, testing for color vision, examination of the optic disc by means of ophthalmoscopy and magnetic resonance imaging.



Treatment

If spontaneous remission does not occur in people with papillitis it is usually treated with the corticosteroid drugs prednisone or methylprednisolone. Other treatment is symptomatic and supportive.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.



For information about clinical trials being conducted at the National Institutes of Health (NIH) Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



MidAmerica Neuroscience Institute is currently recruiting patients experiencing a first "demyelinating event" for a clinical trial. For information, go to www.clinicaltrial.gov or contact:



Laurie A. Dressman, RN, BA at 816-753-8800 ext 124, at

MidAmerica Neuroscience Institute

Kansas City, MO 64108

References

TEXTBOOKS

Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:739.



Bennett JC, Plum F., eds. Cecil Textbook of Medicine. 20th ed. W.B. Saunders Co., Philadelphia, PA; 1996:2016-17.



Stein JH, Hutton JJ, Kohler PO, et al., eds. Internal Medicine. 4th ed. Mosby-Yearbook, Inc., St. Louis, MO. 1994:1152-53.



Kanski JJ., ed. Clinical Ophthalmology. 4th ed. Butterworth-Heinemann. Oxford, UK; 1999:590-93.



Newell FW., ed. Ophthalmology: Principles and Concepts. 7th ed. Mosby Year Book, St. Louis, MO; 1991:348-49.



REVIEW ARTICLES

Myers TD, Smith JR, Wertheim MS, et al. Use of corticoid sparing systemic immunosuppression for treatment of corticoid dependent optic neuritis not associated with demyelinating disease. Br J Ophthalmol. 2004;17:3-8.



Margalit E, Sadda SR. Retinal and optic nerve diseases. Artif Organs. 2003;27:963-74.



Parisi V. Correlations between morphological and functional retinal impairment in patients affected by ocular hypertension, glaucoma, demyelinating optic neuritis and Alzheimer's disease. Semin Ophthalmol. 2003;18:50-57.



Kesler A, Pianka P. Toxic optic neuropathy. Curr Neurol Neurosci Rep. 2003;3:410-14.



Chan JW. Optic neuritis in multiple sclerosis. Ocul Immunol Inflamm. 2002;10:161-86.



JOURNAL ARTICLES

Pirko I, Blauwet LK, Lesnick TJ, et al. The natural history of recurrent optic neuritis. Arch Neurol. 2004;61:1401-05



[No authors listed]. Neurologic Impairment 10 Years after Optic Neuritis. Arch Neurol. 2004;61:1386-89.



Hickman SJ, Toosy AT, Miszkiel KA, et al. Visual recovery following acute optic neuritis: A clinical, electrophysiological and magnetic resonance imaging study. J Neurol. 2004;251:996-1005.



Lim ET, Grant D, Pashenkov M, et al. Cerebrospinal fluid levels of brain specific proteins in optic neuritis. Mult Scler. 2004;10:261-65.



Craenen G, Brown SM, Freedman KA, et al. Rapid, painless unilateral vision loss in a 37-year-old healthy woman. Surv Ophthalmol. 2004;49:343-48.



Beck RW, Gal RL, Bhatti MT, et al. Visual function more than 10years after optic neuritis: experience of the optic neuritis treatment trial. Am J Ophthalmol. 2004;137:77-83. Errata in: Am J Ophthalmol. 2004;137:following 793. Am J Ophthalmol. 2004;138:following 321.



Fazzone HE, Lefton DR, Kupersmith MJ. Optic neuritis: Correlation of pain and magnetic resonance imaging. Ophthalmology. 2003;110:1646-49.



FROM THE INTERNET

Swallow C. Optic Neuritis. emedicine. Last Updated: July 20, 2004. 9pp.

www.emedicine.com/radio/topic488.htm



Giovannini J, Chrousos G. Pseudopapilledema. emedicine. Last Updated: August 26, 2002. 6pp.

www.emedicine.com/oph/topic615.htm



Papillitis. The Merck Manual. 2004. 2pp.

www.merck.com/mrkshared/mmanual/section8/chapter101/101b.jsp

Resources

Lighthouse International

111 E 59th St

New York, NY 10022-1202

Tel: (800)829-0500

Email: info@lighthouse.org

Internet: http://www.lighthouse.org



NIH/National Eye Institute

31 Center Dr

MSC 2510

Bethesda, MD 20892-2510

United States

Tel: (301)496-5248

Fax: (301)402-1065

Email: 2020@nei.nih.gov

Internet: http://www.nei.nih.gov/



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.