Hwang Joon Seo, Kim Seong-Joon, Yu Young Suk, Chung Hum
Department of Ophthalmology, Seoul National University College of Medicine, Chongno-Gu, Seoul, Korea.
J AAPOS. 2007 Dec;11(6):559-63. doi: 10.1016/j.jaapos.2007.04.021. Epub 2007 Sep 4.
To study the clinical characteristics of multiple sclerosis and associated optic neuritis in Korean children.
A retrospective analysis was performed on 10 patients with an onset of multiple sclerosis before age 16. Information on sex, age of onset, clinical course, laboratory findings, and clinical characteristics of optic neuritis was obtained.
The mean age at presentation was 7.31 +/- 2.99 years, and the mean duration of observation was 36.2 +/- 26.1 months. No female predilection (50%) was observed. The disease presented as relapsing-remitting type multiple sclerosis in all patients and transited to secondary progressive type in two cases (20%). No oligoclonal bands were found in any patient. Optic neuritis occurred in eight patients (80%); five (62.5%) of these had optic neuritis at the first multiple sclerosis attack, with all five manifesting bilateral simultaneous optic neuritis. Visual acuity recovered to > or =20/40 in 8 of 15 eyes (53.3%), but in 2 eyes (13.3%) visual acuity remained at < or =20/200. In the patients with optic neuritis, the patients who showed optic neuritis at initial presentation had a worse visual prognosis (p = 0.030, Mann-Whitney U-test).
In Korean children with multiple sclerosis, age of onset was younger than reported in other countries, and there was no female predominance. The prognosis for good visual acuity was worse in patients who initially presented with optic neuritis.
研究韩国儿童多发性硬化症及相关视神经炎的临床特征。
对16岁前发病的10例多发性硬化症患者进行回顾性分析。获取了有关性别、发病年龄、临床病程、实验室检查结果以及视神经炎临床特征的信息。
就诊时的平均年龄为7.31±2.99岁,平均观察时间为36.2±26.1个月。未观察到女性优势(50%)。所有患者的疾病均表现为复发缓解型多发性硬化症,2例(20%)转变为继发进展型。所有患者均未发现寡克隆带。8例(80%)患者发生视神经炎;其中5例(62.5%)在首次多发性硬化症发作时即患有视神经炎,且这5例均表现为双侧同时性视神经炎。15只眼中有8只(53.3%)视力恢复至≥20/40,但2只眼(13.3%)视力仍≤20/200。在患有视神经炎的患者中,初次就诊时即出现视神经炎的患者视力预后较差(p = 0.030,Mann-Whitney U检验)。
在韩国儿童多发性硬化症患者中,发病年龄比其他国家报道的要小,且不存在女性优势。初次表现为视神经炎的患者视力良好的预后较差。