Optic Neuritis：Clinical Analysis of 27 Cases

視神經炎－27例臨床表徵與治療經驗

畢勇賢(Youn-Shen Bee) ； 林睦秋(Muh-Chiou Lin) ； 王振強(Cheng-Chiang Wang) ； 許淑娟(Shwu-Jiuan Sheu)

《The Kaohsiung Journal of Medical Sciences》 19卷3期 (2003/03) Pp. 105-112

https://doi.org/10.6452/KJMS.200303.0105

摘要

自發性視神經炎之臨床表徵與治療預後在中國人族群的研究並不多。本研究收集 1992-2001年間診斷為自發性視神經炎之患者共27例，其中22例為單側發作，5例雙側發作。患者年齡分佈13-54歲，平均年齡35.8-11.3歲。其中44.4%患者可見視神經盤水腫。44.4%患者主述眼窩部疼痛。27例患者中接受視覺誘發電位檢查者均顯示異常；有23例接受放射影像檢查，包括電腦斷層17例及核磁共振6例，其中有10例顯示視神經部位影像異常，在追蹤期間共有4位患者診斷為多發性硬化症。與ONTT研究比較，本研究之患者視神經盤水腫比例較高。但在眼窩疼痛表現，影像診斷顯示腦部白質變化比例與多發性硬化症之發生率則較低。此外，本研究也顯示單眼發作患者視力預後較雙眼發作者好。

關鍵字

視神經炎；多發性硬化症

並列摘要

We retrospectively reviewed 27 cases diagnosed as idiopathic optic neuritis between 1992 and 2001 at Kaohsiung Veterans General Hospital to assess the clinical features, visual prognosis, neuroimaging , laboratory studies, and development of multiple sclerosis in Chinese patients with optic neuritis.- Patient age ranged from 13 to 54 years (mean, 35.8 ±11.3 years). Five cases presented as bilateral optic neuritis and 22 as unilateral. Visual function improved gradually from 2 weeks after treatment. Twelve (44.4%) cases showed disc swelling and ocular pain was also noted in 44.4% of patients. All cases that underwent visual field and visual evoked potential tests showed abnormality in lesion eyes. Of the 23 cases that underwent neuroimaging studies, including computerized tomography (17 patients) and magnetic resonance imaging (6 patients), 10 revealed optic nerve thickening. Four cases (14.8%) developed multiple sclerosis during follow-up (mean, 4.3 years). The-incidence of disc swelling was higher than that reported by the Optic Neuritis Treatment Trial, but the incidence of initial ocular pain, the presence of periventricular plaques, and the development of multiple sclerosis were lower in our study. The unilateral group had significantly better visual outcome than the bilateral group.

並列關鍵字

optic neuritis, Chinese, multiple sclerosis