视神经炎病因学临床分析

Etiological study on optic neuritis

目的了解临床首诊为视神经炎患者的病因分布,并与西方国家视神经炎病因进行比较。方法对204例初诊为视神经炎的患者进行详细的眼科和神经内科检查以及影像学和实验室检查,参照国际认可的诊断标准进行病因学诊断。结果113例视神经炎患者中83例(73.5%)符合特发性脱髓鞘性视神经炎(IDON)。鼻窦炎在该组疾病中较为常见但仅为4例视神经炎患者的可能病因。发现结核性脑膜炎导致的视神经炎2例和梅毒性视神经炎1例。23例(20.4%)患者病因未明。结论特发性脱髓鞘性视神经炎是视神经炎最常见的病因类型。尽管存在某些病因学和预后方面的不同,该组视神经炎患者的病因分布与西方国家报告较为相似。

Objective To investigate the etiological distribution of the patients with optic neuritis in China and compare the results with those in western countries. Methods Ophthalmological and neurological detailed clinical and laboratorial examinations were performed on 204 patients with primarily diagnosed optic neuritis （ON）. We determined the etiologies using international accepted diagnostic criteria. Results Among 113 patrents with ON, 83 （73. 5%） were considered as with idiopathic demyelinating optic neuritis （IDON）. Sinusitis was common in these patients but was considered to be the probable cause of ON only in 4. Tuberculo-meningitis caused ON was found in 2 cases and syphilitic ON in 1. The causes of 23 cases （20. 4%） were unknown. Conclusions Idiopathic demyelinating ON is the most common pathogeny of ON. Despite of some minor differences of causes and prognosis, the etiology of presumed ON in our population is similar to that reported in western countries,