Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University, New York, New York, USA.
Curr Opin Ophthalmol. 2018 Nov;29(6):514-519. doi: 10.1097/ICU.0000000000000527.
Neuroretinitis is an inflammatory disorder of the eye presenting with optic disc edema and the delayed development of a macular star secondary to optic nerve swelling toward the macular structures. Neuroretinitis can be divided into idiopathic, infectious (including neuroretinitis associated with cat scratch disease) and recurrent.
The clinical presentation of neuroretinitis includes impaired visual acuity, dyschromatopsia, relative afferent pupillary defects and visual field abnormalities - particularly cecocentral and central scotomas. Features suggesting recurrent neuroretinitis include poorer visual recovery and visual field abnormalities representing damage to greater parts of the optic nerve. Treatment of neuroretinitis is based upon the cause of the disease. Specifically, in patients with cat scratch neuroretinitis, visual recovery is often favorable regardless of treatment with medication. However, some authors favor treatment with antibiotics early in the course of disease to limit progression and ensure eradication of the organism.
Neuroretinitis can result from a number of infectious and noninfectious causes and it is essential that clinicians recognize the disease and determine the underlying etiology to ensure the best possible treatment and visual prognosis for the patient.
神经视网膜炎是一种眼部炎症性疾病,表现为视盘水肿和黄斑区星形病变延迟发展,这是由于视神经向黄斑区肿胀所致。神经视网膜炎可分为特发性、感染性(包括与猫抓病相关的神经视网膜炎)和复发性。
神经视网膜炎的临床表现包括视力下降、色觉障碍、相对性传入性瞳孔障碍和视野异常,特别是周边中心和中心暗点。提示复发性神经视网膜炎的特征包括更差的视力恢复和代表视神经更大部分损伤的视野异常。神经视网膜炎的治疗基于疾病的原因。具体来说,在猫抓病性神经视网膜炎患者中,无论是否用药物治疗,视力恢复通常都很好。然而,一些作者主张在疾病早期用抗生素治疗,以限制进展并确保消除病原体。
神经视网膜炎可由多种感染性和非感染性原因引起,临床医生识别这种疾病并确定潜在病因至关重要,以确保为患者提供最佳的治疗和视力预后。