Wang X N, Wang J W
Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2024 Jan 2;104(1):31-37. doi: 10.3760/cma.j.cn112137-20231005-00636.
To investigate the etiology composition and clinical characteristics of bilateral optic disc swelling(ODS). The medical records of all newly diagnosed bilateral ODS patients admitted to the neurology ward of Beijing Tongren Hospital from January 2017 to June 2021 were retrospectively searched to classify the etiology, obtain demographic and clinical information, and compare the differences in clinical characteristics. A total of 131 patients with bilateral ODS were included, including 56 males and 75 females, aged 15-73 (39±14) years. The most common cause of the bilateral ODS was increased intracranial pressure (ICP)(56/131, 42.7%), followed by optic neuritis (ON)(40/131, 30.5%). Other causes included vascular optic neuropathy (13/131, 9.9%), pseudopilledema (9/131, 6.9%); uveitis (6/131, 4.6%), toxic optic neuropathy (3/131, 2.3%) and unknown causes (4/131, 3.1%). Idiopathic intracranial hypertension (IIH) (43/56, 76.8%) was the most common etiology for papilledema. In the comparison of the two main causes of intracranial hypertension and the clinical characteristics of ON in ODS, there was no statistically significant difference in the incidence of age, gender, complaints of ocular pain or headache, and hemorrhage of optic disc(>0.05). Visual acuity abnormalities and low vision were more common in ON group than the increased ICP group[36/40(90%) vs 33/56(58.9%), =0.001; 35/80(43.8%) vs 22/112(19.6%), <0.001], while severe papilledema was more common in increased ICP group[38/112(33.9%)vs 9/80(11.3%), <0.001]. The most common cause for bilateral ODS is increased ICP, but it can also be triggered by a variety of other causes. Optic neuritis(ON) is the most important differentiating disease in the study of Chinese patients.
探讨双侧视盘水肿(ODS)的病因构成及临床特征。回顾性检索2017年1月至2021年6月在北京同仁医院神经内科病房新诊断的所有双侧ODS患者的病历,以对病因进行分类,获取人口统计学和临床信息,并比较临床特征的差异。共纳入131例双侧ODS患者,其中男性56例,女性75例,年龄15 - 73(39±14)岁。双侧ODS最常见的病因是颅内压(ICP)升高(56/131,42.7%),其次是视神经炎(ON)(40/131,30.5%)。其他病因包括血管性视神经病变(13/131,9.9%)、假性视乳头水肿(9/131,6.9%);葡萄膜炎(6/131,4.6%)、中毒性视神经病变(3/131,2.3%)及病因不明(4/131,3.1%)。特发性颅内高压(IIH)(43/56,76.8%)是视乳头水肿最常见的病因。在比较ODS中颅内高压和ON这两种主要病因的临床特征时,年龄、性别、眼痛或头痛主诉以及视盘出血的发生率差异均无统计学意义(>0.05)。视力异常和低视力在ON组比ICP升高组更常见[36/40(90%)比33/56(58.9%),=0.001;35/80(43.8%)比22/112(19.6%),<0.001],而重度视盘水肿在ICP升高组更常见[38/112(33.9%)比9/80(11.3%),<0.001]。双侧ODS最常见的病因是ICP升高,但也可由多种其他病因引发。视神经炎(ON)是中国患者研究中最重要的鉴别疾病。