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儿童视神经炎——临床及电生理随访

Optic neuritis in children--clinical and electrophysiological follow-up.

作者信息

Tekavcic-Pompe M, Stirn-Kranjc B, Brecelj J

机构信息

Institute of Clinical Neurophysiology, University Medical Centre, Ljubljana, Slovenia.

出版信息

Doc Ophthalmol. 2003 Nov;107(3):261-70. doi: 10.1023/b:doop.0000005335.28820.05.

Abstract

Optic neuritis (ON) in children usually presents with visual loss, relative afferent pupillary defect (RAPD), abnormal optic disc appearance, defects of visual field and colour vision, as well as with abnormalities of visual evoked potentials (VEP). Both, clinical and VEP parameters, improve after the attack; the time until recovery, however, is as yet unknown. The aim of this study was to follow-up children with ON for 1 year and to determine clinical and VEP recovery. Twelve children (six with bilateral, six with unilateral ON) were studied in the acute phase and systematically followed-up for 1 year. The results show that initially, visual acuity was diminished in all eyes, while after 1 year, in only 14% of them. Optic disc appearance was abnormal in 83.3% of the eyes in the acute phase, and in 85% after 1 year. At the disease onset RAPD could be detected in 67%, visual field defects in 58.5%, and colour vision defects in 50% of eyes, but none of these abnormalities persisted in any eye until the end of study. VEP were abnormal in 83% of eyes in the acute phase and in 56% at the final follow-up (at 6 or 12 months). VEP normalization, when occurred, was mostly observed during the first 6 months. Complete clinical and VEP recovery was observed in three children. Both, clinical and electrophysiological recovery in children with ON were relatively substantial and fast within the first year. VEP improvement may indicate better prognosis.

摘要

儿童视神经炎(ON)通常表现为视力丧失、相对性传入性瞳孔障碍(RAPD)、视盘外观异常、视野和色觉缺陷,以及视觉诱发电位(VEP)异常。发作后临床和VEP参数均有所改善;然而,恢复所需时间尚不清楚。本研究的目的是对患有ON的儿童进行为期1年的随访,并确定临床和VEP的恢复情况。对12名儿童(6名双侧ON,6名单侧ON)在急性期进行了研究,并系统随访了1年。结果显示,最初,所有眼睛的视力均下降,而1年后,只有14%的眼睛视力下降。急性期83.3%的眼睛视盘外观异常,1年后为85%。疾病发作时,67%的眼睛可检测到RAPD,58.5%的眼睛有视野缺陷,50%的眼睛有色觉缺陷,但直到研究结束,这些异常在任何一只眼睛中均未持续存在。急性期83%的眼睛VEP异常,最终随访时(6或12个月)为56%。VEP恢复正常(若发生)大多在最初6个月内观察到。3名儿童实现了临床和VEP的完全恢复。ON患儿的临床和电生理恢复在第一年相对显著且迅速。VEP改善可能预示着更好的预后。

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