Khadse Rutika, Ravindran Meenakshi, Pawar Neelam, Maharajan Padmavathy, Rengappa Ramakrishnan
Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India.
Department of Neurophthalmology, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India.
Indian J Ophthalmol. 2017 Mar;65(3):242-245. doi: 10.4103/ijo.IJO_939_16.
The purpose of this study was to report clinical features, neuroimaging, and visual outcome in pediatric optic neuritis (ON) in Indian population.
This is a retrospective study of children up to the age of 16 years, diagnosed with ON, that presented at pediatric and neuroophthalmology clinic of a tertiary eye care center, in South India, within the period of 2010-2015.
We identified 62 eyes of 40 children diagnosed as ON within the study period. The mean age was 11.15 ± 3.24 years (1-15 years) with mean follow-up of 13 months. In this series, there was female preponderance (67%). Mean logarithm of the minimum angle of resolution visual acuity at presentation was 1.14 ± 0.93, which after treatment recovered to 0.10 ± 0.26 at final visit (P < 0.001). Involvement was bilateral in 22 children (55%) and recurrent in 3 eyes of 3 children. Preceding febrile illness was reported in seven cases (18%). Four (10%) cases were diagnosed as multiple sclerosis (MS), one with neuromyelitis optica , and one with acute disseminated encephalomyelitis. One case was associated with tuberculous meningitis, 1 with septicemia, and 1 with bilateral maxillary sinusitis. Neuroimaging studies of optic nerve in 14 children demonstrated isolated optic nerve enhancement. Magnetic resonance imaging brain revealed white matter T2 hyperintense lesions separate from optic nerve in ten cases, of which four cases were diagnosed as MS.
Bilateral presentation was common, association with MS was low. Papillitis was more frequent than retrobulbar neuritis and prognosis was good in pediatric ON in Indian population.
本研究旨在报告印度人群中小儿视神经炎（ON）的临床特征、神经影像学表现及视力预后。
这是一项对16岁以下被诊断为ON的儿童进行的回顾性研究，这些儿童于2010 - 2015年期间在印度南部一家三级眼科护理中心的儿科和神经眼科门诊就诊。
在研究期间，我们确定了40名被诊断为ON的儿童的62只眼睛。平均年龄为11.15±3.24岁（1 - 15岁），平均随访时间为13个月。在这个系列中，女性占优势（67%）。就诊时最小分辨角视力的平均对数为1.14±0.93，治疗后最终随访时恢复到0.10±0.26（P < 0.001）。22名儿童（55%）为双侧受累，3名儿童的3只眼睛复发。7例（18%）报告有前驱发热性疾病。4例（10%）被诊断为多发性硬化（MS），1例为视神经脊髓炎，1例为急性播散性脑脊髓炎。1例与结核性脑膜炎相关，1例与败血症相关，1例与双侧上颌窦炎相关。14名儿童的视神经神经影像学研究显示单纯视神经强化。10例磁共振成像脑部显示与视神经分开的白质T2高信号病变，其中4例被诊断为MS。
双侧表现常见，与MS的关联较低。视乳头炎比球后视神经炎更常见，印度人群中小儿ON的预后良好。
