Mashima Y, Oshitari K, Imamura Y, Momoshima S, Shiga H, Oguchi Y
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
J Neurol Neurosurg Psychiatry. 1998 Jan;64(1):124-7. doi: 10.1136/jnnp.64.1.124.
Some evidence suggests that the primary locus of the lesion in Leber's hereditary optic neuropathy (LHON) may be intraocular rather than retrobulbar. To clarify this issue, the condition of the retrobulbar portion of the optic nerve was evaluated in patients with the acute stage of LHON. High resolution MRI with fast spin echo sequences of the optic nerve complex in the orbit was carried out. Five patients with acute stage LHON were compared with seven patients with acute stage optic neuritis. On T2 weighted fast spin echo MRI, signal changes did not appear in the retrobulbar optic nerve complex in acute stage LHON. By comparison, patients with optic neuritis showed pronounced high signals in the optic nerve. Subsequent orbital MRI in the atrophic stages of the same patients with LHON showed an increase in signal intensity in the optic nerve toward the orbital apex in both eyes. The present results support the hypothesis that a primary lesion in LHON may be intraocular.
一些证据表明，Leber遗传性视神经病变（LHON）的主要病变部位可能在眼内而非球后。为了阐明这一问题，对LHON急性期患者的球后段视神经状况进行了评估。采用眼眶内视神经复合体的快速自旋回波序列进行高分辨率MRI检查。将5例LHON急性期患者与7例急性视神经炎患者进行比较。在T2加权快速自旋回波MRI上，急性期LHON患者的球后视神经复合体未出现信号改变。相比之下，视神经炎患者的视神经显示出明显的高信号。随后对同一批LHON患者萎缩期进行的眼眶MRI检查显示，双眼视神经向眶尖方向的信号强度增加。目前的结果支持LHON的原发性病变可能在眼内这一假说。
