Gilbert Molly E, Sergott Robert C
Department of Neuro-ophthalmology, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA 19107, USA.
Curr Neurol Neurosci Rep. 2007 May;7(3):259-64. doi: 10.1007/s11910-007-0039-x.
Optic neuritis (ON) is the initial presentation in 15% to 20% of cases of multiple sclerosis (MS). Thirty-eight percent to 50% of patients with MS develop ON at some point during the course of their disease. The Optic Neuritis Treatment Trial (ONTT) provided much prospective data about the clinical presentation, clinical course with respect to treatment, and development of MS in patients with ON. The clinical course of MS initially involves episodes of demyelination followed by full recovery; however, later attacks often leave persistent deficits that lead to secondary progression of the disease. The risk of developing progressive neurologic deficits can be reduced by starting therapy with immunomodulating drugs early in the course of the disease. Optical coherence tomography is a noninvasive way to monitor patients with ON to determine if they are undergoing subclinical axonal loss of ganglion cells. Progression of axonal loss on optical coherence tomography may prompt a change in therapy or further imaging.
视神经炎（ON）是15%至20%的多发性硬化症（MS）病例的首发症状。38%至50%的MS患者在其病程中的某个阶段会发生ON。视神经炎治疗试验（ONTT）提供了许多关于ON患者的临床表现、治疗相关的临床病程以及MS发展情况的前瞻性数据。MS的临床病程最初包括脱髓鞘发作，随后完全恢复；然而，后期发作往往会留下持续的缺陷，导致疾病的继发进展。在疾病病程早期开始使用免疫调节药物进行治疗，可以降低出现进行性神经功能缺损的风险。光学相干断层扫描是一种监测ON患者的非侵入性方法，以确定他们是否正在发生神经节细胞的亚临床轴突损失。光学相干断层扫描上轴突损失的进展可能会促使治疗方案的改变或进一步的影像学检查。
