Longitudinally Extensive Optic Neuritis in Pediatric Patients
Longitudinally Extensive Optic Neuritis in Pediatric Patients
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DOI：
10.1177/0883073813520500
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发表时间：
2015-01-01
影响因子：
1.9
通讯作者：
Waubant, Emmanuelle
中科院分区：
文献类型：
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作者：
Graves, Jennifer;Kraus, Verena;Waubant, Emmanuelle
成人磁共振成像（MRI）上广泛的视神经脱髓鞘病变可能提示除多发性硬化以外的其他预后较差的诊断，如视神经肌萎缩症。我们报告了儿童视神经炎首发事件中纵向广泛病变的频率。受试者在发病后3个月内接受脑部或眼眶MRI检查，并在加州大学旧金山弗朗西斯科儿科多发性硬化中心接受评估。通过T2高信号或对比增强确定的病变长度盲法分级为缺失、局灶性或纵向广泛性（至少2个连续的视神经节段）。在25例受试者中，9例（36%）患有纵向广泛性视神经炎。广泛病变与非多发性硬化与多发性硬化诊断无关（P = 1.00）。年龄和病变程度之间没有观察到相关性（P = 0.26）。需要前瞻性研究来确定纵向广泛性视神经炎是否可以预测视力结果。
Extensive optic nerve demyelinating lesions on magnetic resonance imaging (MRI) in adults could indicate a diagnosis other than multiple sclerosis with worse prognosis such as neuromyelitis optica. We report the frequency of longitudinally extensive lesions in children with first events of optic neuritis. Subjects had brain or orbit MRI within 3 months of onset and were evaluated at the University of California, San Francisco, Pediatric Multiple Sclerosis Center. Lesion length, determined by T2 hyperintensity or contrast enhancement, was blindly graded as absent, focal or longitudinally extensive (at least 2 contiguous segments of optic nerve). Of 25 subjects, 9 (36%) had longitudinally extensive optic neuritis. Extensive lesions were not associated with non-multiple sclerosis versus multiple sclerosis diagnosis (P = 1.00). No association between age and lesion extent was observed (P = .26). Prospective studies are needed to determine if longitudinally extensive optic neuritis can predict visual outcome.