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莱伯遗传性视神经病变伴发多种相关疾病。

Leber's hereditary optic neuropathy companied with multiple-related diseases.

作者信息

Sun Ming-Ming, Zhou Huan-Fen, Sun Qiao, Li Hong-En, Liu Hong-Juan, Song Hong-Lu, Yang Mo, Teng Da, Wei Shi-Hui, Xu Quan-Gang

机构信息

Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China.

Senior Department of Ophthalmology, The First Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China.

出版信息

Front Hum Neurosci. 2022 Nov 3;16:964550. doi: 10.3389/fnhum.2022.964550. eCollection 2022.

Abstract

OBJECTIVE

To elucidate the clinical, radiologic characteristics of Leber's hereditary optic neuropathy (LHON) associated with the other diseases.

MATERIALS AND METHODS

Clinical data were retrospectively collected from hospitalized patients with LHON associated with the other diseases at the Neuro-Ophthalmology Department at the Chinese People's Liberation Army General Hospital (PLAGH) from December 2014 to October 2018.

RESULTS

A total of 13 patients, 24 eyes (10 men and 3 women; mean age, 30.69 ± 12.76 years) with LHON mitochondrial DNA (mtDNA) mutations, were included in the cohort. 14502(5)11778(4)11778 &11696(1)12811(1)11696(1)3460(1). One patient was positive for aquaporin-4 antibody (AQP4-Ab), and two were positive for myelin oligodendrocyte glycoprotein antibody (MOG-Ab). Three patients were associated with idiopathic optic neuritis (ON). Two patients were with compression optic neuropathy. Three patients were with the central nervous system (CNS) diseases. One patient was with proliferative diabetic retinopathy (PDR) and one with idiopathic orbital inflammatory syndrome (IOIS). At the onset, visual acuity (VA) in eighteen eyes was below 0.1, one eye was 0.5, five eyes were above 0.5, while VA in sixteen eyes was below a 0.1 outcome, three eyes experienced moderate vision loss. MRI images showed T2 lesions and enhancement in nine patients who received corticosteroids treatment; additional immune modulators treatment was performed on two patients. None of the patients had relapse during the follow-up time.

CONCLUSION

Leber's hereditary optic neuropathy can be accompanied with multiple-related diseases, especially different subtypes of ON, which were also exhibited with IOIS and compression optic neuropathy for the first time in this cohort. This condition may be a distinct entity with an unusual clinical and therapeutic profile.

摘要

目的

阐明与其他疾病相关的Leber遗传性视神经病变(LHON)的临床及影像学特征。

材料与方法

回顾性收集2014年12月至2018年10月在中国人民解放军总医院神经眼科住院的合并其他疾病的LHON患者的临床资料。

结果

该队列共纳入13例伴有LHON线粒体DNA(mtDNA)突变的患者,24只眼(10例男性,3例女性;平均年龄30.69±12.76岁)。14502(5)11778(4)11778 & 11696(1)12811(1)11696(1)3460(1)。1例水通道蛋白4抗体(AQP4-Ab)阳性,2例髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)阳性。3例患者合并特发性视神经炎(ON)。2例患者患有压迫性视神经病变。3例患者患有中枢神经系统(CNS)疾病。1例患者患有增殖性糖尿病视网膜病变(PDR),1例患有特发性眼眶炎性综合征(IOIS)。发病时,18只眼视力(VA)低于0.1,1只眼为0.5,5只眼高于0.5,而16只眼视力预后低于0.1,3只眼中度视力丧失。MRI图像显示9例接受皮质类固醇治疗的患者有T2病变及强化;2例患者接受了额外的免疫调节剂治疗。随访期间所有患者均未复发。

结论

Leber遗传性视神经病变可伴有多种相关疾病,尤其是不同亚型的ON,本队列中还首次出现了IOIS和压迫性视神经病变。这种情况可能是一种具有不寻常临床和治疗特征的独特疾病实体。

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