Bilateral simultaneous optic neuritis following envenomations by Indian cobra and common krait

Senthilkumaran, S., Miller, S. W., Williams, H. F., Thirumalaikolundusubramanian, P., Patel, K. and Vaiyapuri, S. ORCID: https://orcid.org/0000-0002-6006-6517 (2022) Bilateral simultaneous optic neuritis following envenomations by Indian cobra and common krait. Toxins, 14 (11). 805. ISSN 2072-6651 doi: 10.3390/toxins14110805

Abstract/Summary

In India, most snakebite envenomation (SBE) incidents are caused by the “Big Four” snakes which include Russell’s viper, common krait, Indian cobra, and saw-scaled viper. Their common en-venomation effects include neurotoxicity, myotoxicity, and coagulopathy. However, they also in-duce rare complications such as priapism, pseudoaneurysm and sialolithiasis. Ocular manifesta-tions such as optic neuritis develop rarely following envenomations by non-spitting snakes and they may cause temporary vision changes and blindness if untreated. While optic neuritis fol-lowing Indian cobra envenomation has been reported previously, this was not encountered in vic-tims of common kraits. Hence, for the first time, we report optic neuritis developed in a victim following envenomation by a common krait and compare its clinical features, and diagnostic and therapeutic methods used with another case of optic neuritis in a victim of an Indian cobra. Both patients received antivenom treatment and made an initial recovery, however, optic neuritis de-veloped several days later. The condition was diagnosed using ophthalmic examination together with computed tomography and/or magnetic resonance imaging methods. Due to very similar clinical features, both patients received intravenous corticosteroids which restored their vision and successfully treated optic neuritis. This case report suggests that the optic neuritis developed in a common krait envenomation is comparable to the one developed following a cobra bite, and therefore, the same diagnostic and therapeutic approaches can be used. This study also raises awareness of this rare complication and provides guidance for the diagnosis and treatment of SBE-induced optic neuritis.

Item Type	Article
URI	https://reading-clone.eprints-hosting.org/id/eprint/108977
Item Type	Article
Refereed	Yes
Divisions	Life Sciences > School of Biological Sciences > Biomedical Sciences Life Sciences > School of Chemistry, Food and Pharmacy > School of Pharmacy > Division of Pharmacology
Publisher	MDPI
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