Borchert Mark, Liu Grant T, Pineles Stacy, Waldman Amy T
The Vision Center (MB), Children's Hospital Los Angeles, Los Angeles, California; Departments of Ophthalmology and Neurology (MB), Keck School of Medicine, University of Southern California, Los Angeles, California; Neuro-ophthalmology Service (GTL), Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Neurology and Ophthalmology (GTL), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Ophthalmology (SP), Stein Eye Institute, University of California, Los Angeles, California; Division of Neurology (ATW), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Departments of Neurology and Pediatrics (ATW), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
J Neuroophthalmol. 2017 Sep;37 Suppl 1(Suppl 1):S14-S22. doi: 10.1097/WNO.0000000000000551.
Few diseases blur the margins between their childhood and adult-onset varieties as much as optic neuritis. This report will review our state of knowledge of pediatric optic neuritis, as well as its relationship to the latest consensus definitions of neuroinflammatory disease. Current diagnostic and treatment options will be explored, as well as our potential to uncover an understanding of pediatric optic neuritis through systematic prospective studies. The risk of evolving multiple sclerosis is probably less than in adults, but pediatric optic neuritis is more likely to be an initial manifestation of acute disseminated encephalomyelitis. Steroids may hasten visual recovery, but they do not change visual outcome except in cases because of neuromyelitis optica. The role of puberty in modifying the presentation and risk associations is unknown. Prospective studies are required to resolve these diagnostic and management issues.
很少有疾病像视神经炎那样模糊儿童期和成人期发病类型之间的界限。本报告将回顾我们对儿童视神经炎的认识状况，以及它与神经炎性疾病最新共识定义的关系。将探讨当前的诊断和治疗选择，以及通过系统的前瞻性研究深入了解儿童视神经炎的可能性。发展为多发性硬化症的风险可能低于成人，但儿童视神经炎更有可能是急性播散性脑脊髓炎的初始表现。类固醇可能会加速视力恢复，但除了视神经脊髓炎导致的病例外，它们不会改变视力预后。青春期在改变临床表现和风险关联方面的作用尚不清楚。需要进行前瞻性研究来解决这些诊断和管理问题。
