Division of Neuro-Ophthalmology, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA 02115, USA.
Athens Eye Hospital, 166 75 Athens, Greece.
Int J Mol Sci. 2022 Aug 29;23(17):9769. doi: 10.3390/ijms23179769.
Optic neuritis (ON) is an inflammatory condition involving the optic nerve. Several important typical and atypical ON variants are now recognized. Typical ON has a more favorable prognosis; it can be idiopathic or represent an early manifestation of demyelinating diseases, mostly multiple sclerosis (MS). The atypical spectrum includes entities such as antibody-driven ON associated with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD), chronic/relapsing inflammatory optic neuropathy (CRION), and sarcoidosis-associated ON. Appropriate and timely diagnosis is essential to rapidly decide on the appropriate treatment, maximize visual recovery, and minimize recurrences. This review paper aims at presenting the currently available state-of-the-art treatment strategies for typical and atypical ON, both in the acute phase and in the long-term. Moreover, emerging therapeutic approaches and novel steps in the direction of achieving remyelination are discussed.
视神经炎(ON)是一种累及视神经的炎症性疾病。目前已经认识到几种重要的典型和非典型 ON 变体。典型 ON 的预后较好;它可以是特发性的,也可以代表脱髓鞘疾病的早期表现,主要是多发性硬化症(MS)。非典型谱包括与视神经脊髓炎谱系障碍(NMOSD)和髓鞘少突胶质细胞糖蛋白抗体病(MOGAD)相关的抗体驱动的 ON、慢性/复发性炎症性视神经病变(CRION)和结节病相关性 ON 等实体。进行适当和及时的诊断对于迅速确定适当的治疗方案、最大限度地恢复视力和最小化复发至关重要。这篇综述文章旨在介绍目前在急性期和长期治疗中针对典型和非典型 ON 的最先进治疗策略。此外,还讨论了新兴的治疗方法和朝着实现髓鞘再生方向的新步骤。