Wang Junqing, Zhou Huanfen, Qin Limin, Peng Chunxia, Zhao Jie, Teng Da, Lin Dahe, Ai Nanping, Xu Quangang, Wei Shihui
Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
Department of Ophthalmology, The First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, China.
J Ophthalmol. 2017;2017:3458356. doi: 10.1155/2017/3458356. Epub 2017 Dec 11.
This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients.
A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON) between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45-65 years and age ≥ 65 years).
76 patients (99 eyes) were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45-83 years). Vision loss was severe at presentation, with initial best corrected vision activity (BCVA) < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD), 1.3% were diagnosed with multiple sclerosis (MS), 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years) developed NMOSD or MS.
Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.
本研究旨在描述一组中国老年患者的临床表现及预后情况。
对2008年5月至2012年11月期间首次发作视神经炎（ON）且年龄≥45岁的患者进行回顾性研究。在亚组（45 - 65岁和≥65岁）中分析发病时和末次随访时的临床特征。
共纳入76例患者（99只眼），其中58%为女性。就诊时的平均年龄为55.53±8.29岁（范围：45 - 83岁）。就诊时视力丧失严重，93%的患者初始最佳矫正视力（BCVA）<20/200，5年随访时53%的患者最终BCVA<20/200。最终BCVA与初始BCVA及视乳头周围视网膜神经纤维层显著相关。末次随访时，14.5%被诊断为视神经脊髓炎谱系障碍（NMOSD），1.3%被诊断为多发性硬化（MS），5.2%为慢性复发性炎性视神经病变，1.3%为感染性ON，19.7%为自身免疫性ON。老年组（≥65岁）均未发生NMOSD或MS。
年龄≥65岁的中国ON患者发生NMOSD或MS的可能性较小。尽管如此，他们发病时视力丧失更严重且恢复较差。
