Abstract

Background: Optic neuritis is an acute inflammatory disorder of the optic nerve that is clinically manifested by a temporary but severe unilateral visual loss. In a typical case, impaired color vision, visual field defects and a relative afferent pupillary defect can also be observed in the affected eye. Optic neuritis may be a complication of many diseases. The most common is demyelination secondary to multiple sclerosis or neuromyelitis optica spectrum disorders. However, optic neuritis has also been reported in association with hypertension and hyperthyroidism, infectious diseases such as rubella, mumps, measles and mononucleosis, systemic neoplasia, lead, arsenic, and methanol poisoning and paranasal sinus diseases. Materials and methods: Data were collected from eighty-eight eyes of 46 chronic sinusitis patients and 93 eyes of 57 normal controls. Visual sensitivity using standard automated perimetry (SAP) and inner retinal thickness using optical coherence tomography (OCT) were measured. The LundMackay system was used to quantify radiographic findings on the ostiomeatal unit CT scan with a numerical score representing the severity of sinusitis. Result: There was a significant positive correlation between the pattern standard deviation (dB) and Lund-Mackay score (P = 0.031). Nasal retinal nerve fiber layer (RNFL) thickness, average, minimum, superotemporal, superior, superonasal, and inferonasal ganglion cell-inner plexiform layer (GCIPL) thickness were negatively correlated significantly with Lund-Mackay score (all, P < 0.05). Eyes with grade 2 opacification of the posterior ethmoid sinus showed a significantly lower mean deviation (dB) and higher pattern standard deviation (dB) than those with clear respective sinuses (P = 0.007 and <0.001, respectively). Conclusion: Though rhinogenic optic neuropathy as a complication of sinusitis is uncommon, this report reaffirms the importance of considering and recognizing sinusitis as a possible cause of visual loss and the need for the prompt initiation of medical and surgical treatment of the underlying disease.

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