Tatsugawa Maria, Noma Hidetaka, Mimura Tatsuya, Funatsu Hideharu
Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, 477-96, Owada-shinden, Yachiyo, Chiba 276-8524, Japan.
J Med Case Rep. 2010 Dec 10;4:404. doi: 10.1186/1752-1947-4-404.
It has been reported that the prognosis of optic perineuritis may be poor when initiation of treatment is delayed. Here we report the successful treatment of three patients with idiopathic optic perineuritis, including two in whom initiation of therapy was delayed.
Three Japanese patients (two women aged 73 and 66 years, and one man aged 27 years) presented with loss of vision (for five months, several months, and two months respectively) and pain on eye movement in the third case only, and were diagnosed as having idiopathic optic perineuritis. Fat-suppressed T2-weighted magnetic resonance images showed high signal intensity areas around the affected optic nerves, suggesting the presence of optic perineuritis. Two patients received steroid pulse therapy and the third was given high-dose steroid therapy. The visual acuity improved in all three cases.
High-dose steroid therapy may be effective for idiopathic perineuritis in patients without optic nerve atrophy, even if initial treatment (including moderate-dose steroids) has failed.
据报道，视神经周围炎若治疗开始延迟，预后可能较差。在此，我们报告3例特发性视神经周围炎患者的成功治疗情况，其中2例治疗开始延迟。
3例日本患者（2名女性，分别为73岁和66岁，1名男性，27岁）出现视力丧失（分别为5个月、数月和2个月），仅第3例患者伴有眼球运动时疼痛，均被诊断为特发性视神经周围炎。脂肪抑制T2加权磁共振成像显示受累视神经周围有高信号强度区域，提示存在视神经周围炎。2例患者接受了类固醇脉冲疗法，第3例接受了大剂量类固醇疗法。3例患者视力均有改善。
对于无视神经萎缩的特发性视神经周围炎患者，即使初始治疗（包括中等剂量类固醇）失败，大剂量类固醇疗法可能仍有效。
