Neuro-ophthalmology Division, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School, Boston, MA, USA.
Neuro-immunology Division, Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Semin Ophthalmol. 2023 Aug;38(6):511-514. doi: 10.1080/08820538.2023.2211662. Epub 2023 May 10.
Despite the high incidence of optic neuritis (ON), and the growing number of therapeutic options for the long-term treatment of diseases associated with ON including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody associated disease (MOGAD), there are still only limited therapeutic options for treating an acute event of optic neuritis. These include steroids, plasma exchange (PLEX) and intravenous immunoglobulin (IVIG). High-dose steroids remain the mainstay of acute treatment. However, evidence is emerging that when optic neuritis is accompanied with certain atypical features that suggest a more unfavorable outcome this mandates special consideration such as early addition of other therapeutic agents or tapering the steroid very slowly. This review will distinguish between typical and atypical neuritis and discuss acute treatment options.
尽管视神经炎（ON）的发病率很高，并且有越来越多的治疗选择可用于长期治疗与 ON 相关的疾病，包括多发性硬化症（MS）、视神经脊髓炎谱系障碍（NMOSD）和 MO 抗体相关疾病（MOGAD），但对于治疗急性视神经炎事件，仍然只有有限的治疗选择。这些选择包括类固醇、血浆置换（PLEX）和静脉注射免疫球蛋白（IVIG）。大剂量类固醇仍然是急性治疗的主要方法。然而，有证据表明，当视神经炎伴有某些提示预后较差的非典型特征时，这需要特别考虑，例如早期添加其他治疗药物或非常缓慢地减少类固醇剂量。这篇综述将区分典型和非典型神经炎，并讨论急性治疗选择。
