Odontogenic Optic Neuropathy, Clinic, Treatment Dynamics: A Case Report

Abstract

Optic nerve neuropathy due to dental lesions is rare but causes complex persistent functional disorders that are difficult to diagnose. The aim of this case report is to show odontogenic optic neuropathy through treatment tactics and observation of structural dynamics and functional changes of the optic nerve with the help of a clinical case. The consultation of the patient was done as per the Department of Ophthalmology, Ivano-Frankivsk National University, Ukraine. Tests such as computed perimetry, Optically Coherent Tomography (OCT) of the optic nerve, Magnetic Resonance Imaging (MRI) of the brain, Computed Tomography (CT) of the paranasal sinuses and immunological blood tests were performed. The patient gave informed consent to access personal data and use it for scientific purposes. In the case of patient S., the combination of neuritis with lesions of the anterior part of the vascular tract is attributed to the background of multiple caries and prolapse of the teeth of the upper jaw in the sinus. Treatment includes a regimen by a dentist for caries and pulse therapy with corticosteroids. From the result, it was possible to reduce the swelling in the nerve fibers of the right eye by 35% and the left eye by 19%. The average sensitivity threshold in the right eye increased by 79% and in the left eye by 90%. In conclusion, we confirm that odontogenic optic neuropathy is a rare form of optic nerve damage. Two-stage treatment (dental and corticosteroids) reduces the nerve fibers swelling and increases retinal ganglion cells sensitivity.