Soltau J B, Hart W M
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Neuroophthalmol. 1996 Mar;16(1):9-13.
A case of bilateral retrobulbar optic neuritis with profound visual loss is described. Magnetic resonance imaging (MRI) with fat-saturation suppression and gadolinium enhancement done 15 days after the onset of symptoms demonstrated bilateral posterior optic nerve disease in a pattern similar to that seen in previously reported cases. However, subsequent retrospective review of an MRI study done at a different hospital during the first week of disease demonstrated a single focus of gadolinium enhancement within the body of the chiasm. This observation suggests that bilateral demyelination of the posterior optic nerves may begin as a single focus of chiasmal disease that then spreads to involve the proximal portions of the optic nerves.
本文描述了一例双侧球后视神经炎伴严重视力丧失的病例。症状出现15天后进行的脂肪抑制和钆增强磁共振成像（MRI）显示双侧视神经后部疾病，其表现与先前报道的病例相似。然而，随后对患者发病第一周在另一家医院进行的MRI研究进行回顾性分析时发现，视交叉体内有一个钆增强的单一病灶。这一观察结果表明，双侧视神经后部脱髓鞘可能始于视交叉疾病的单一病灶，然后扩散至视神经近端。
