Bilateral Neuroretinitis, A Benign Phenomenon or An Alarming Sign for a Life-threatening Disorder?

To report a case of bilateral neuroretinitis as the first sign of underlying pheochromocytoma.

A 14-year-old girl was referred to our clinic with the complaint of progressive visual loss in her left eye 2 weeks ago. She was under systemic steroid therapy and one injection of periocular triamcinolone was done for her. Dilated funduscopy revealed bilateral disc swelling, cotton-wool spots, arterial narrowing, venous dilation and engorgement, macular exudates in star-shaped formation; all symptoms were more prominent in the left eye with no significant finding in the anterior segment examination. Examination of the anterior segment was not particularly significant. By impression of bilateral neuroretinitis, blood pressure was checked urgentlyو which was 200/120 mmHg. Finally, pheochromocytoma was diagnosed for her during a complete systemic workup.

Bilateral neuroretinitis mandates thorough systemic workup, including blood pressure control as this ocular finding, may be the first sign of an underlying life-threatening disorder.