Pula John H, Macdonald Christopher J
Division of Neuro-ophthalmology, University of Illinois College of Medicine at Peoria, Peoria.
Clin Ophthalmol. 2012;6:1211-23. doi: 10.2147/OPTH.S28112. Epub 2012 Jul 31.
Optic neuritis can be defined as typical (associated with multiple sclerosis, improving independent of steroid treatment), or atypical (not associated with multiple sclerosis, steroid-dependent improvement). Causes of atypical optic neuritis include connective tissue diseases (eg, lupus), vasculitis, sarcoidosis, or neuromyelitis optica. In this manuscript, updated treatment options for both typical and atypical optic neuritis are reviewed. Conventional treatments, such as corticosteroids, therapeutic plasma exchange, and intravenous immunoglobulin therapy are all discussed with commentary regarding evidence-based outcomes. Less commonly used treatments and novel purported therapies for optic neuritis are also reviewed. Special scenarios in the treatment of optic neuritis - pediatric optic neuritis, acute demyelinating encephalomyelitis, and optic neuritis occurring during pregnancy - are specifically examined.
视神经炎可被定义为典型性（与多发性硬化相关，不依赖类固醇治疗而改善）或非典型性（与多发性硬化无关，依赖类固醇治疗而改善）。非典型性视神经炎的病因包括结缔组织病（如狼疮）、血管炎、结节病或视神经脊髓炎。在本手稿中，对典型性和非典型性视神经炎的最新治疗选择进行了综述。文中讨论了传统治疗方法，如皮质类固醇、治疗性血浆置换和静脉注射免疫球蛋白疗法，并对基于证据的治疗结果进行了评论。还综述了较少使用的治疗方法以及视神经炎的新型所谓疗法。特别探讨了视神经炎治疗中的特殊情况——儿童视神经炎、急性脱髓鞘性脑脊髓炎以及孕期发生的视神经炎。
