Department of Neuroscience/Neurology, Uppsala University, Sweden.
Acta Neurol Scand. 2011 Mar;123(3):207-10. doi: 10.1111/j.1600-0404.2010.01388.x.
To assess the frequency of bilateral and recurrent optic neuritis (ON) in multiple sclerosis (MS) and to compare these results with epidemiological data of ON in neuromyelitis optica (NMO) and recurrent ON without other signs of disease.
We identified 472 patients with diagnosis of MS from the Swedish Multiple Sclerosis Register. These patients were evaluated for the presence of ON and whether the ON was the presenting symptom of MS; unilateral or bilateral; monophasic or recurrent.
Twenty-one percent presented with ON as their first manifestation of MS. The proportion of patients developing a second attack of ON before demonstration of other manifestations of MS was 5.5% and the frequency of recurrent bilateral ON as the presenting symptom was 3.8%. Only two patients presented with simultaneously appearing bilateral ON corresponding to 0.42%.
Recurrent ON, whether unilateral or bilateral, is a common presentation of MS. As MS is a much more common disease than NMO, care must be taken when evaluating the work-up of patients with recurrent ON. In some cases repeated MRI and lumbar punctures are warranted to improve diagnostic accuracy, even in the presence of the serological marker NMO-IgG.
评估多发性硬化症（MS）中双侧和复发性视神经炎（ON）的频率，并将这些结果与视神经脊髓炎（NMO）和无其他疾病迹象的复发性 ON 的流行病学数据进行比较。
我们从瑞典多发性硬化症登记处确定了 472 名诊断为 MS 的患者。这些患者接受了 ON 的存在以及 ON 是否为 MS 的首发症状、单侧或双侧、单相或复发性的评估。
21%的患者以 ON 为首发症状。在出现 MS 的其他表现之前，发生第二次 ON 发作的患者比例为 5.5%，以复发性双侧 ON 为首发症状的频率为 3.8%。仅有 2 名患者出现同时出现的双侧 ON，占 0.42%。
复发性 ON，无论是单侧还是双侧，都是 MS 的常见表现。由于 MS 比 NMO 更为常见，因此在评估复发性 ON 患者的检查结果时必须小心。在某些情况下，即使存在 NMO-IgG 血清标志物，也需要重复 MRI 和腰椎穿刺以提高诊断准确性。
