视神经炎的分类及诊疗进展

Terminology,diagnosis and treatment of optic neuritis

视神经炎(ON)是导致青、中年人群急性视力下降的常见视神经疾病,其发病机制与免疫炎性反应后中枢神经系统脱髓鞘,胶质细胞增生、坏死密切相关。在白种人群中,ON和多发性硬化(MS)关系极为密切。随着对该病流行病学及病理机制研究的深入,ON的疾病谱也不断扩展,人们对ON的疾病分类、诊断、鉴别诊断以及治疗都有了更深刻的认识。以往按照疾病部位的简单分类已不能满足临床诊疗的需要,典型ON与不典型ON的提出为疾病的鉴别诊断及治疗奠定了基础。本文结合国内ON的疾病谱特点对该病的研究进展做一总结,有助于临床诊疗的规范化及个体化。

Optic neuritis（ ON） is the most common acute optic neuropathy affecting young adults. It is generally believed to be an immune-mediated inflammation causing demyelination,gliosis and necrosis of the central nerve system.It is commonly associated with multiple sclerosis in white populations. With the developments of epidemiological and pathological researches,recent progress has occurred to understanding the diversity of the spectrum of ON,the clinical features and the treatment. The classification system based on anatomy which unrelated to prognosis and treatment strategy has been replaced by typical and atypical form of ON with more guiding details for differential diagnosis and treatment.The review provides an update understanding of these developments combined with characteristics of ON in China.