Buompadre María Celeste
Hospital de Pediatria SAMIC. Prof. Dr. J.P. Garrahan, Buenos Aires, Argentina.
Rev Neurol. 2013 Sep 6;57 Suppl 1:S139-47.
Functional impairment of the optic nerve is characterized by visual loss, dyschromatopsia, visual field defects, relative afferent pupillary defect, and swelling or atrophy of the optic nerve.
To describe the spectrum of acute optic neuropathies, focusing on clinical features, diagnosis and treatment with an emphasis on pediatric entities.
Optic neuritis may be monophasic, recurrent, or part of a polysymptomatic demyelinating process. The aim of the treatment is to reduce number and severity of attacks and prevent future disability. Infectious neuritis is secondary to different microorganisms (bacteria, virus, fungi, or protozoa). Treatment is related to etiology. Nonarteritic ischemic optic neuropathy or idiopathic optic neuropathy is the most frequent form and is secondary to a disorder of small retinal vessels. Leber hereditary optic neuropathy is an important cause of chronic visual impairment and is characterized by selective involvement of the retinal ganglion cells. Until now, no curative treatment is available. Visual acuity is frequently conserved in papilledema associated with intracranial hypertension. The aim of treatment is to reduce intracranial hypertension and risk factors in case it is secondary.
Acute optic neuropathies are broad group of entities, of different etiologies, and with a variable visual prognosis. Findings of neurological examination, fundoscopy, and neuroimaging guide diagnosis and prompt treatment.
视神经功能障碍的特征为视力丧失、色觉异常、视野缺损、相对性传入瞳孔障碍以及视神经肿胀或萎缩。
描述急性视神经病变的范围，重点关注临床特征、诊断和治疗，尤其强调儿科疾病。
视神经炎可能为单相性、复发性或多症状性脱髓鞘过程的一部分。治疗目的是减少发作次数和严重程度并预防未来的残疾。感染性神经炎继发于不同的微生物（细菌、病毒、真菌或原生动物）。治疗与病因相关。非动脉炎性缺血性视神经病变或特发性视神经病变是最常见的类型，继发于视网膜小血管疾病。Leber遗传性视神经病变是慢性视力损害的重要原因，其特征为视网膜神经节细胞的选择性受累。目前尚无治愈性治疗方法。与颅内高压相关的视乳头水肿时视力常得以保留。治疗目的是降低颅内高压以及在继发情况下降低危险因素。
急性视神经病变是一组病因各异、视力预后不一的疾病。神经系统检查、眼底镜检查和神经影像学检查结果指导诊断和及时治疗。
