Ophthalmology, Nemours Children's Clinic-Wilmington/AI duPont Hospital for Children, Robison D. Harley MD Endowed Chair of Pediatric Ophthalmology, Clinical Professor of Ophthalmology and Pediatrics, Assistant Dean of Faculty Affairs, Sidney Kimmel Medical College at Thomas Jefferson University, Wills Eye Hospital.
Department of Pediatric Ophthalmology and Adult Strabismus, Wills Eye Hospital, Philadephia, PA.
Curr Opin Ophthalmol. 2018 Sep;29(5):419-422. doi: 10.1097/ICU.0000000000000509.
Pediatric optic neuritis may be challenging to diagnose and treat. Significant clinical investigation of optic neuritis occurring in adults guides current clinical practices. Differences in presentation and prognosis exist for pediatric patients with optic neuritis when compared with adults including the risk of developing multiple sclerosis. The aim of this review is to provide an update on latest advances in the diagnosis, treatment and current research concerning pediatric optic neuritis.
Limited case series and retrospective reviews constitute much of the data we know about patients with pediatric optic neuritis. Pediatric optic neuritis is included in the spectrum of neuroinflammatory diseases. Testing modalities (ocular coherence tomography and visual evoked potentials) and serologic testing (antibodies against aquaporin-4 and myelin oligodendrocyte glycoprotein) are being investigated for diagnostic and prognostic value. The low incidence of pediatric optic neuritis results in small sample sizes may contribute to conflicting results of different studies.
Recent advances in diagnostic and serologic testing in pediatric neuritis may offer better diagnosis, treatment and prediction of prognosis. Validation requires well designed prospective research.
儿科视神经炎的诊断和治疗颇具挑战。成人视神经炎的大量临床研究为当前的临床实践提供了指导。与成人相比，儿科视神经炎患者在发病表现和预后方面存在差异，包括发展为多发性硬化症的风险。本文旨在介绍儿科视神经炎的最新诊断、治疗和研究进展。
有关儿科视神经炎患者的信息多来自有限的病例系列和回顾性研究。儿科视神经炎属于神经炎症性疾病谱。检测方式（眼部相干断层扫描和视觉诱发电位）和血清学检测（抗水通道蛋白 4 抗体和髓鞘少突胶质细胞糖蛋白抗体）的诊断和预后价值正在研究中。儿科视神经炎的发病率低，导致样本量小，这可能导致不同研究的结果存在冲突。
儿科视神经炎的诊断和血清学检测的最新进展可能提供更好的诊断、治疗和预后预测。这需要精心设计的前瞻性研究来验证。
