Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA.
Eye (Lond). 2023 Aug;37(12):2391-2398. doi: 10.1038/s41433-023-02477-0. Epub 2023 Mar 16.
Optic neuritis (ON) is one of the most frequently seen neuro-ophthalmic causes of vision loss worldwide. Typical ON is often idiopathic or seen in patients with multiple sclerosis, which is well described in the landmark clinical trial, the Optic Neuritis Treatment Trial (ONTT). However, since the completion of the ONTT, there has been the discovery of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies, which are biomarkers for neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody-associated disease (MOGAD), respectively. These disorders are associated with atypical ON that was not well characterised in the ONTT. The severity, rate of recurrence and overall outcome differs in these two entities requiring prompt and accurate diagnosis and management. This review will summarise the characteristic neuro-ophthalmological signs in NMOSD and MOGAD, serological markers and radiographic findings, as well as acute and long-term therapies used for these disorders.
视神经炎(ON)是全球最常见的神经眼科视力丧失原因之一。典型的 ON 通常是特发性的,或见于多发性硬化症患者中,这在具有里程碑意义的临床试验——视神经炎治疗试验(ONTT)中有详细描述。然而,自 ONTT 完成以来,已经发现了水通道蛋白-4(AQP4)和髓鞘少突胶质细胞糖蛋白(MOG)抗体,它们分别是视神经脊髓炎谱系疾病(NMOSD)和 MOG 抗体相关疾病(MOGAD)的生物标志物。这些疾病与 ONTT 中未充分描述的非典型 ON 相关。这两种疾病的严重程度、复发率和总体预后不同,需要及时准确的诊断和管理。本综述将总结 NMOSD 和 MOGAD 的特征性神经眼科体征、血清学标志物和影像学发现,以及这些疾病的急性和长期治疗方法。