Vallinayagam Muthu K, Deepikadevi S N, Sainath Dipika, Balla Shravya C
Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
Saudi J Ophthalmol. 2023 Mar 9;37(1):20-24. doi: 10.4103/sjopt.sjopt_166_21. eCollection 2023 Jan-Mar.
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.
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.
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).
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.
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。
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。
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。
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。
