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印度南部一家三级护理医院首次发作视神经炎的临床谱——一项回顾性分析

Clinical spectrum of first episode of optic neuritis in a tertiary care hospital in Southern India - A retrospective analysis.

作者信息

Vallinayagam Muthu K, Deepikadevi S N, Sainath Dipika, Balla Shravya C

机构信息

Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.

出版信息

Saudi J Ophthalmol. 2023 Mar 9;37(1):20-24. doi: 10.4103/sjopt.sjopt_166_21. eCollection 2023 Jan-Mar.

Abstract

PURPOSE

The purpose of this study was to determine the demographic and clinical patterns of optic neuritis (ON) in patients presenting to a tertiary health-care institute and to study the incidence of multiple sclerosis (MS), magnetic resonance imaging features in varied ON, treatment outcome, and prognosis.

METHODS

A retrospective analysis of patients with first episode of ON presenting to a tertiary care center during the period from March 2013 to March 2021 was done. Details of ocular examination were retrieved from medical records and statistically analyzed.

RESULTS

Three hundred and fifty-four participants with ON were included in this study. The mean age was 40.25 ± 12.2 years. The male: female ratio was 1:1.35. 48.1% had visual acuity of <3/60. Based on clinical presentation, papillitis was seen in 31.5% of subjects, neuroretinitis in 24.1%, and retrobulbar neuritis in 44.4%. Based on etiology, 79.6% were idiopathic, 1.8% presented with infectious ON, and 9.26% were associated with demyelinating disease (MS).

CONCLUSION

Females were predominantly affected. Idiopathic ON formed the major subset etiologically. Sixty-six percent had visual recovery of 6/18 or better following corticosteroid therapy. 9.2% revealed multiple intracranial lesions on neuroimaging, suggesting high association with MS. Therefore, early diagnosis, vigilant monitoring of steroid therapy, and regular follow-up screening for MS remain the mainstay of management in ON.

摘要

目的

本研究旨在确定在一家三级医疗保健机构就诊的视神经炎(ON)患者的人口统计学和临床模式,并研究多发性硬化症(MS)的发病率、不同类型ON的磁共振成像特征、治疗结果和预后。

方法

对2013年3月至2021年3月期间在一家三级护理中心首次发作ON的患者进行回顾性分析。从病历中检索眼部检查的详细信息并进行统计分析。

结果

本研究纳入了354例ON患者。平均年龄为40.25±12.2岁。男女比例为1:1.35。48.1%的患者视力<3/60。根据临床表现,31.5%的受试者出现视乳头炎,24.1%出现视神经视网膜炎,44.4%出现球后视神经炎。根据病因,79.6%为特发性,1.8%为感染性ON,9.26%与脱髓鞘疾病(MS)相关。

结论

女性受影响更为明显。特发性ON在病因上构成主要亚型。66%的患者在接受皮质类固醇治疗后视力恢复到6/18或更好。9.2%的患者在神经影像学检查中发现多个颅内病变,提示与MS高度相关。因此,早期诊断、密切监测类固醇治疗以及定期进行MS随访筛查仍然是ON治疗的主要方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4b/10032289/e3f178046c15/SJO-37-20-g001.jpg

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