Clinical case: A ten year-old girl, after a Yersinia
gastroenteritis, developed an optic neuritis in the
left eye. She was not treated and resulted ultimately
in optic atrophy on the affected side. Six months
later a similar episode occurred in the contralateral
eye. On this occasion corticosteroid therapy was
given. During this therapy the neuritis diminished;
however the patient had three relapses, so it was
decided to give her immunosuppressive treatment
with azathioprine and continue this indefinitely.
Discussion: After considering the differential diagnoses
of bilateral recurrent optical neuritis in childhood,
we concluded that it was most likely to have
an autoimmune basis. After considering the benefits
and risks of the long-term treatment, we believe
immunosuppressive therapy is most useful in controlling
the disease allowing corticosteroid therapy
to be reduced (Arch Soc Esp Oftalmol 2006; 81:
607-610)
