Bilateral Simultaneous Retrobulbar Neuritis After Swine Flu: A Clinical Case Report

Retrobulbar neuritis is most commonly demyelinating and associated with multiple sclerosis. Rarely, it has been associated with viral and bacterial infections, systemic autoimmune diseases, vaccinations, and certain medications. We present a case of bilateral simultaneous optic neuritis following swine flu. We did a case report on a 56-year-old male patient with retrobulbar neuritis after swine flu, who had been treated in Alexandrovska Hospital, Sofia, Bulgaria. The diagnosis was based on the clinical exam, clinical course and on specialized investigations. The follow-up period was from February 2015 until April 2021. On admission in the hospital the best-corrected visual acuity of both eyes was decreased – VOD=0.6, VOS=PPLC. 30-2 visual field testing demonstrated no light sensitivity in the left eye, and decreased – in the right. Therapy was begun with methylprednisolone, pentoxiphylline, vinpocetine, piracetam, and clopidogrel. On day 19 the visual fields were significantly improved. On discharge, BCVA was 0.6-0.7 of the right eye and 0.7-0.8 – of the left, and improved to 1.0 during the follow-up period. Bilateral simultaneous retrobulbar neuritis is an infrequent immune complication after swine flu. In our case, we achieved recovery of normal visual acuity and a significant improvement in the visual fieds of both eyes. Therapy included systemic corticosteroids, pentoxiphylline, vinpocetine, piracetam, and clopidogrel.