Kaźmierczak Karolina, Malukiewicz-Wiśniewska Grazyna
Katedry i Kliniki Chorób, Oczu Collegium Medicum w Bydgoszczy, UMK w Toruniu.
Klin Oczna. 2006;108(7-9):285-9.
The aim of the study was to analyze the cases of retrobulbar neuritis and their connection with multiple sclerosis.
We follow in a retrospective (1989-2004) study 86 patients with retrobulbar optic neuritis, 59.3% of whom were females and 40.7% males.
Recurrent retrobulbar optic neuritis was observed in 8 patients (9.3%), it was 7% of all eyes and in 27 patients (31.4%), that is 47.8% of all eyes, it was bilateral. Multiple sclerosis was diagnosed in 8 cases, the same number of the patients was already treated because of SM. The most common initial symptom was decrease in visual acuity, which was poor (0.1 or worse) in 60% of the cases at the beginning. Pain occurred in 29.7%, pupillary defects in 28.7%, temporal or total pallor of the optic disc in 32.6% of the patients. Central field defect was rather rare in the group studied (22.7%), to compare with paracentral or peripheral one (46.6%). In most cases of the visual evoked potentials we noticed the elongation in the latency of P100. Among 31 cases of MRI examination of the central nervous system demyelination lesions have been revealed in 25.8%.
We observed more cases of bilateral optic neuritis and paracentral defects than other authors. A number of diagnosed multiple sclerosis patients was high taking into consideration relatively short period of observation.
本研究旨在分析球后视神经炎病例及其与多发性硬化症的关联。
我们对86例球后视神经炎患者进行了一项回顾性研究(1989 - 2004年),其中女性占59.3%,男性占40.7%。
8例患者(9.3%)出现复发性球后视神经炎,占所有患眼的7%;27例患者(31.4%)为双侧球后视神经炎,占所有患眼的47.8%。8例被诊断为多发性硬化症,同样数量的患者此前已因多发性硬化症接受过治疗。最常见的初始症状是视力下降,开始时60%的病例视力较差(0.1或更差)。29.7%的患者出现疼痛,28.7%出现瞳孔异常,32.6%的患者视盘颞侧或全苍白。在所研究的组中,中心视野缺损相当少见(22.7%),与之相比,旁中心或周边视野缺损更为常见(46.6%)。在大多数视觉诱发电位病例中,我们注意到P100潜伏期延长。在31例中枢神经系统MRI检查病例中,25.8%发现有脱髓鞘病变。
我们观察到双侧视神经炎和旁中心缺损的病例比其他作者报道的更多。考虑到观察期相对较短,确诊的多发性硬化症患者数量较多。