视神经炎的分类及临床特征  

The classification and clinical characteristics of optic neuritis

作　　者：翁欢 汪茜 陆肇曾 Weng Huan;Wang Xi;Lu Zhaozeng(Department of Ophthalmology,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院眼科

出　　处：《上海医药》2020年第1期3-5,14,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：视神经炎是中、青年人群最易罹患的致盲性视神经疾病,我国2014年发布的视神经炎诊断和治疗专家共识将其按病因分为特发性视神经炎、感染性或感染相关性视神经炎、自身免疫性视神经病和其他无法归类的视神经炎4类,其中常见的特发性视神经炎可再被分为多发性硬化相关性视神经炎(multiple sclerosis-related optic neuritis, MSON)、视神经脊髓炎相关性视神经炎(neuromyelitis optica-related optic neuritis, NMO-ON)和其他中枢神经系统脱髓鞘疾病相关性视神经炎3型。水通道蛋白-4抗体是视神经脊髓炎的标志性抗体,近年来发现视神经脊髓炎谱系疾病中有部分血清水通道蛋白-4抗体阴性患者的血清髓鞘少突胶质细胞糖蛋白抗体(myelin oligodendrocyte glycoprotein antibody,MOG-Ab)阳性。MOG-Ab介导的视神经炎的流行病学、临床特征、预后、影像学表现、生物学标志物和病理学过程与NMO-ON和MS-ON均有所差异,可能成为一种新的特发性视神经炎亚型。Optic neuritis is a common blind-causing acute optic neuropathy affecting young and middle-aged people.According to the Chinese Experts’ Consensus on Diagnosis and Treatment of Optic Neuritis published in 2014, optic neuritis can be divided into four categories based on the etiology: idiopathic optic neuritis, infectious or infection-related optic neuritis, autoimmune optic neuropathy and other optic neuritis that can not be classified.Idiopathic optic neuritis can be subdivided into multiple sclerosis-related optic neuritis(MS-ON), neuromyelitis optica-related optic neuritis(NMO-ON) and other central nervous system demyelinating diseases-related optic neuritis.Aquaporin-4 antibody(AQP4-Ab) is a marker antibody of neuromyelitis optica.Myelin oligodendrocyte glycoprotein antibody(MOG-Ab) was found in patients with neuromyelitis optica spectrum disorders, who were found to be AQP4-Ab seronegative in recent studies.MOG-Ab-mediated optic neuritis, NMO-ON and MS-ON are different in epidemiology, clinical characteristics, prognosis, imaging examination, biomarkers and pathology.MOG-Ab-mediated optic neuritis might be a new subtype of idiopathic optic neuritis.

关 键 词：视神经炎 特发性视神经炎 髓鞘少突胶质细胞糖蛋白抗体介导的视神经炎 

分 类 号：R774.61[医药卫生—眼科]