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Although local transmission of malaria has been eliminated, the disease is frequently imported to China by Chinese travelers returning from Africa. Optic neuritis (ON) is occasionally reported in malarial cases and usually shows good visual recovery and prognosis. Herein, we report severe visual loss with poor recovery due to bilateral ON in a malarial patient who traveled from Nigeria. While he was still in Nigeria, his visual acuity dropped to no light perception in both eyes after the third episode of malaria, which was confirmed by a positive blood smear for malarial parasites. His general condition gradually improved after a 6-day course of artesunate therapy. However, visual acuity in both eyes remained unchanged after artesunate therapy alone, with gradual improvement subsequently shown after pulse steroid therapy. Our case indicates that early antimalarial drugs combined with pulse steroid therapy may be of great importance for good visual recovery in ON cases after malarial infection.
Authors’ addresses: Chuan-bin Sun, Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China, E-mail: firstname.lastname@example.org. Zhiqiong Ma, Department of Ophthalmology, Xiaoshan Hospital, Hangzhou, China, E-mail: email@example.com. Zhe Liu, Department of Ophthalmology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China, E-mail: firstname.lastname@example.org.