Perineuritis or infiltration of optic nerve sheath? A presentation of diffuse large B cell Gastric lymphoma

Perineuritis or infiltration of optic nerve sheath? A presentation of diffuse large B cell Gastric lymphoma

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Optic perineuritis is an inflammatory disorder involving the optic nerve sheath.It is currently considered as a part of idiopathic orbital inflammatory disease which also includes dacryoadenitis, orbital myositis, superior orbital fissure, and cavernous sinus syndrome (Tolosa hunt syndrome).As Woks it is idiopathic, it is considered a diagnosis of exclusion.

Another important differential is optic nerve lymphoma.Isolated optic nerve lymphoma associated with systemic involvement has been described in literature.We report a case that presented as third nerve palsy but later on developed central retinal Snap Caps vein occlusion and was ultimately diagnosed as primary gastric lymphoma of diffuse large B cell type.