Hwang Jeon-Min, Lee Yong Jae, Kim Mee Kum
Department of Ophthalmology Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Korea.
J Pediatr Ophthalmol Strabismus. 2002 Jan-Feb;39(1):26-32. doi: 10.3928/0191-3913-20020101-07.
To study the clinical spectrum of pediatric optic neuritis in Korean children.
A retrospective analysis was performed on 23 patients with onset of the disease before the age of 16 years from 1995 to 2000. The degree of initial visual loss, subsequent visual recovery, magnetic resonance images, and associated diseases was reviewed.
There was no female predilection in the study group (43%) with a mean age of 8.9 years at presentation. Involvement was bilateral in 87% of patients. A preceding febrile illness within 2 weeks of visual symptoms was reported in 39% of patients. Of the 43 involved eyes of 23 patients, disc swelling was present in 51%, and central/cecocentral scotoma in 58% of the involved eyes. With a mean follow-up of 14 months, 79% of the patients had final vision of > or =20/40. Twenty-four (96%) of 25 eyes with intravenous steroid treatment and 10 (56%) of 18 eyes without intravenous steroids showed final visual acuity > or =20/40. Only 1 patient (4%) with multifocal signal abnormalities around the periventricular white matter developed multiple sclerosis.
Korean children with optic neuritis showed bilateral involvement with papillitis. The visual prognosis was relatively good and especially better in the patients receiving intravenous steroid treatment than in those without any treatment; however, this study is not controlled. Although a longer follow-up period is required, the development of multiple sclerosis is rare in Korean children with optic neuritis.
研究韩国儿童视神经炎的临床特征。
对1995年至2000年间发病年龄在16岁之前的23例患者进行回顾性分析。回顾了初始视力丧失程度、随后的视力恢复情况、磁共振成像以及相关疾病。
研究组中无女性偏好(43%),就诊时平均年龄为8.9岁。87%的患者为双侧受累。39%的患者在视觉症状出现前2周内有发热性疾病史。在23例患者的43只受累眼中,51%出现视盘肿胀,58%的受累眼出现中心/旁中心暗点。平均随访14个月,79%的患者最终视力≥20/40。接受静脉注射类固醇治疗的25只眼中有24只(96%),未接受静脉注射类固醇治疗的18只眼中有10只(56%)最终视力≥20/40。仅1例(4%)脑室周围白质周围有多灶性信号异常的患者发生了多发性硬化症。
韩国视神经炎儿童表现为双侧受累伴视乳头炎。视力预后相对较好,尤其是接受静脉注射类固醇治疗的患者比未接受任何治疗的患者预后更好;然而,本研究未设对照。虽然需要更长的随访期,但韩国视神经炎儿童发生多发性硬化症的情况很少见。