Yaqub Sheraz, von Hanno Therese, Stokke Arne, Skjeflo Trine, Neset Kirsti Agnethe
Barneavdelingen, Nordlandssykehuset, Prinsens gate 164, 8092 Bodø.
Tidsskr Nor Laegeforen. 2004 Jan 22;124(2):189-91.
There are many causes of acute visual loss in childhood. Inflammation of the optic nerve, optic neuritis, is rare. While mostly unilateral in adults, the disease often presents bilaterally in childhood. Furthermore, progression to demyelinating disease is unusual and optic neuritis has a better prognosis in childhood than in adulthood.
We describe an 8-year-old girl who over a few days developed painful eyes and profound visual loss. She had afferent pupil defect; ophthalmoscopy showed bilateral papilloedema, characteristic of bilateral optic neuritis. Current literature and guidelines are reviewed with regards to diagnosis and treatment of optic neuritis in childhood.
Steroids seem to be beneficial in the treatment of optic neuritis in childhood. Following five days intravenous administration of methylprednisolone and an oral taper over five weeks, visual acuity was almost normalised in both eyes.
After studying the literature, we started a treatment with good outcome. Although the prognosis is usually good in children even without treatment, it is important to be aware that there are cases in which treatment with steroids is recommended.
儿童急性视力丧失有多种原因。视神经炎症，即视神经炎，较为罕见。虽然在成人中多为单侧发病，但该疾病在儿童中常双侧出现。此外，进展为脱髓鞘疾病的情况并不常见，且视神经炎在儿童中的预后比成人更好。
我们描述了一名8岁女孩，她在几天内出现眼痛和严重视力丧失。她存在传入性瞳孔缺陷；眼底检查显示双侧视乳头水肿，这是双侧视神经炎的特征。我们回顾了当前关于儿童视神经炎诊断和治疗的文献及指南。
类固醇似乎对视神经炎患儿的治疗有益。在静脉注射甲泼尼龙5天并口服减量5周后，双眼视力几乎恢复正常。
在研究文献后，我们开始了治疗并取得了良好效果。尽管即使不治疗儿童的预后通常也较好，但重要的是要意识到存在推荐使用类固醇治疗的病例。
