Department of Neurology, Hadassah Hebrew-University Hospital, Jerusalem, Israel.
Neurology. 2011 Jun 14;76(24):2103-11. doi: 10.1212/WNL.0b013e31821f4602.
To assess the recovery process in patients after an acute optic neuritis (ON) attack, comparing static and dynamic visual functions.
In this prospective controlled study, 21 patients with unilateral, first-ever ON were followed over the course of 1 year. Standard visual tests, visual evoked potentials, and optical coherence tomography were assessed repeatedly. In addition, we developed a novel set of motion perceptual tasks to test dynamic visual deficits. fMRI examinations were performed to study the neuronal correlates for the behavioral findings.
Four months after the acute phase, the affected eyes had returned to normal performance levels in the routine visual testing. However, motion perception remained impaired throughout the 12-month period. In agreement with the clinical findings, fMRI studies showed recovery in cortical activation during static object recognition, as opposed to sustained deficit in tasks that require motion perception.
Sustained motion perception deficit following ON may explain the continued visual complaints of patients long after recovery of visual acuity. Cortical activation patterns suggest that if plastic processes in higher visual regions contribute to the recovery of vision, this may be limited to static visual functions. Alternatively, cortical activation may reflect the visual percept (intact for visual acuity and impaired for motion perception), rather than demonstrating plastic processes. We suggest that motion perception should be included in the routine ophthalmologic tests following ON.
通过比较静态和动态视觉功能，评估急性视神经炎（ON）发作后患者的恢复过程。
在这项前瞻性对照研究中，我们对 21 例单侧首发 ON 患者进行了为期 1 年的随访。反复评估了标准视力测试、视觉诱发电位和光学相干断层扫描。此外，我们还开发了一套新的运动知觉任务来测试动态视觉缺陷。进行 fMRI 检查以研究行为发现的神经相关性。
在急性期后 4 个月，受累眼在常规视觉测试中恢复到正常水平。然而，运动知觉在整个 12 个月期间仍然受损。与临床发现一致，fMRI 研究显示在静态物体识别过程中皮质激活恢复，而在需要运动知觉的任务中则持续存在缺陷。
ON 后持续的运动知觉缺陷可能解释了患者在视力恢复后很长时间仍存在视觉主诉。皮质激活模式表明，如果高级视觉区域的可塑性过程有助于视力恢复，那么这种恢复可能仅限于静态视觉功能。或者，皮质激活可能反映了视觉感知（视力完好，运动知觉受损），而不是显示出可塑性过程。我们建议在 ON 后应将运动知觉纳入常规眼科检查中。
