A case report of pediatric-onset MS associated uveitis

Zahra Mahdizad; Mohammad Zarei; Hanieh Fakhredin; Reza Samiee; Hora Heidari; Nazanin Ebrahimiadib

doi:10.1186/s12348-024-00405-1

A case report of pediatric-onset MS associated uveitis

J Ophthalmic Inflamm Infect. 2024 May 29;14(1):21. doi: 10.1186/s12348-024-00405-1.

Authors

Zahra Mahdizad¹, Mohammad Zarei¹, Hanieh Fakhredin^{2

3}, Reza Samiee⁴, Hora Heidari⁵, Nazanin Ebrahimiadib⁶

Affiliations

¹ Ophthalmology Department, Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
² Ophthalmology Department, Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. fakhredin.hanieh@gmail.com.
³ Retina & Vitreous Service, Farabi Comprehensive Center of Excellence in Ophthalmology, Qazvin Square, Tehran, 1336616351, Iran. fakhredin.hanieh@gmail.com.
⁴ Student`S Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Ophthalmology Department, Ocular Immunology and Uveitis Foundation, Waltham, MA, USA.

Abstract

Background: To report a case of Pediatric-onset MS associated uveitis managed with local and systemic medications.

Case presentation: An 11-year-old boy who was diagnosed with Pediatric-onset MS (POMS) with the first presentation of left optic neuritis in another center, was referred to our clinic with the complaint of non-improved vision in the left eye despite receiving IV 5gr methylprednisolone. After the ophthalmologic examinations, the patient was diagnosed as bilateral POMS-associated intermediate uveitis, and local treatment with corticosteroid was administered to both eyes. He was continued on systemic therapy such as Rituximab and five sessions of plasmapheresis. After four months, the patient's vision improved from FC at 50cm to 9/10 in the left eye. The intensity of intraocular inflammation decreased in both eyes. In fluorescein angiography findings, the optic disc, as well as vascular leakage, subsided bilaterally.

Conclusion: Despite its rarity, POMS-associated uveitis presents a considerable challenge that necessitates the collaborative efforts of neurologists and ophthalmologists to achieve the most effective treatment outcomes.

Keywords: Intermediate Uveitis (IU); Pediatric IU; Pediatric-onset MS (POMS); Uveitis.