PMC10225563_01
Physical examination showed an eschar on the left leg (A), and B-type ultrasound showed enlarged lymph nodes in the left groin (B).
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At presentation, physical examination confirmed the skin eschar on the left leg (Figure 1A), and B-type ultrasound revealed enlarged lymph nodes in both groins (Figure 1B).
Fundus photographs showed swollen optic disc in the right eye (A), and normal fundus in the left eye (B) at presentation. Fundus photograph showed pale optic disc (C), and visual field test showed tunnel field (D) in the right eye at 11 weeks follow-up.
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Ophthalmic examination revealed his right eye had a visual acuity of light perception, clear cornea, quiet anterior chamber, dilated pupils of 6 mm with sluggish light reflex, clear lens, and swollen optic disc (Figure 2A), and his left eye was normal (Figure 2B). Another one month later (11 weeks after the onset of ON), his right eye vision was gradually improved to 20/80, ophthalmic examination showed a pale optic disc (Figure 2C), and visual field test showed a tunnel field (Figure 2D) in the right eye.
Tissue-based indirect immunofluorescence assay showed granular intracytoplasmic and circular perinuclear immunofluorescence staining in Purkinje cells (arrow) of monkey cerebellum tissues incubated with the serum samples (diluted as 1:100) of the patient.
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TBA revealed granular intracytoplasmic and circular perinuclear immunofluorescence staining in Purkinje cells (Figure 3, arrow) of monkey cerebellum tissues when they were incubated with the serum samples (diluted as 1:100) of the patient.
Orbital MRI showed normal optic nerves (A) with no enhancement (B).
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Orbital MRI showed normal optic nerves with no enhancement (Figures 4A, B).