S19 

A Case of Chronic Relapsing Inflammatory Optic Neuropathy 
 

Steven Toh1, Chean Chung Shen2 

 

 

Abstract 

 

Chronic relapsing inflammatory optic neuropathy (CRION) is a recently described form of 

recurrent isolated subacute optic neuropathy, with accumulating evidence that it is a 

nosological distinct entity. The condition is highly responsive to systemic steroid treatment and 

prone to relapse on steroid withdrawal. Diagnosis and management of this condition is often 

challenging. This 33-year-old lady with family history of multiple sclerosis (MS), with 

uniocular visual loss of her right eye since 2 years old without apparent cause, presented with 

reduction of vision and loss of colour vision in the left eye, associated with painful eye 

movement. There was internuclear ophthalmoplegia but slit lamp examination were 

unremarkable. She had no other related sensory or motor symptoms. Magnetic resonance 

imaging (MRI) did not reveal any features of MS. Aquaporin-4 antibody, anti-MOG and gene 

testing for Leber’s hereditary optic neuropathy were all negative. Metabolic, infective, and 

other autoimmune causes were also excluded. Visual evoked potential studies of left eye 

showed a mild reduction in amplitude with no prolongation of latency. Her multiple optic 

neuritis recurrences were treated with intravenous steroids followed by tapering regime of oral 

prednisolone with good effect. Knowledge of this rare condition as part of the differential 

diagnoses of possible aetiologies of optic neuropathy is important among Ophthalmologists, as 

prompt diagnosis and steroid treatment helped reduce the associated risk of blindness. Multiple 

relapses after initial successful treatment of inflammatory optic neuropathy should raise the 

suspicion of CRION. 

Keywords: ophthalmology, optic neuropathy, chronic relapsing inflammatory optic 

neuropathy, vision loss, steroid-responsiveness 

 

1. School of Medicine, University of Liverpool, Liverpool, UK 

2. Department of Ophthalmology, Lincoln County Hospital, Lincoln, UK 

  

DOI: http://dx.doi.org/10.31344/ijhhs.v5i0-2.337  
 

http://dx.doi.org/10.31344/ijhhs.v5i0-2.337