Choy Bonnie Nga Kwan, Ng Alex Lap Ki, Lai Jimmy Shiu Ming
Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Block B, Cyberport 4, Hong Kong SAR, China.
Int Ophthalmol. 2018 Apr;38(2):557-564. doi: 10.1007/s10792-017-0491-9. Epub 2017 Mar 13.
To review the clinical course of adult patients with acute optic neuritis over 10 years in Hong Kong, and the results were compared with other studies among Asian and Caucasian patients.
This study retrospectively analysed the clinical features of 38 adult patients (51 eyes) presented with optic neuritis in a Hong Kong hospital over 10 years (2001-2010).
Optic neuritis had a female predominance (68%). The mean age of presentation was 40 years old. Disc swelling (39%) was more common compared to the optic neuritis treatment trial (ONTT). The recovery time ranged from no recovery to 5 years, with a mean of 6.0 months. However, vision continued to deteriorate despite initial improvement in 45% of patients. Only 11.8% of the eyes attained final visual acuity (VA) of 1.0 or better, while 31.4% had VA 0.1 or worse. Multiple sclerosis or neuromyelitis optica only occurred in 10.4% of patients. Three of our patients who did not receive any treatment showed faster recovery than the average.
Optic neuritis in Hong Kong is mostly a clinically isolated syndrome. Our patients presented at a later age and showed a worse visual outcome. Corticosteroid according to ONTT protocol remained our mainstay of treatment although it did not benefit our patients as much as ONTT study. More work on the long-term prognosis and treatment strategies is worthwhile among Chinese optic neuritis patients.
回顾香港成年急性视神经炎患者10年的临床病程,并将结果与亚洲和白种人患者的其他研究进行比较。
本研究回顾性分析了香港一家医院10年(2001 - 2010年)间38例成年视神经炎患者(51只眼)的临床特征。
视神经炎以女性为主(68%)。平均发病年龄为40岁。与视神经炎治疗试验(ONTT)相比,视盘肿胀(39%)更为常见。恢复时间从无恢复到5年不等,平均为6.0个月。然而,45%的患者尽管最初有所改善,但视力仍继续恶化。只有11.8%的眼睛最终视力(VA)达到1.0或更好,而31.4%的眼睛VA为0.1或更差。多发性硬化症或视神经脊髓炎仅发生在10.4%的患者中。我们有3例未接受任何治疗的患者恢复速度比平均速度快。
香港的视神经炎大多是一种临床孤立综合征。我们的患者发病年龄较晚,视力预后较差。按照ONTT方案使用皮质类固醇仍然是我们的主要治疗方法,尽管它对视神经炎患者的益处不如ONTT研究。对中国视神经炎患者的长期预后和治疗策略进行更多研究是值得的。