Nutritional Optic Neuropathies: State of the Art and Emerging Evidences.
Nutritional Optic Neuropathies: State of the Art and Emerging Evidences.
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DOI：
10.3390/nu12092653
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发表时间：
2020-08-31
期刊：
影响因子：
5.9
通讯作者：
Schiavi C
中科院分区：
文献类型：
--
作者：
Roda M;di Geronimo N;Pellegrini M;Schiavi C
营养性视神经病变是双侧、对称和进行性视力损害的原因，伴有中央视力和对比敏感度的丧失、色盲和中央或中央焦斑。临床特征不是病理性的，因为遗传和毒性形式具有相似的体征和症状。由于减肥手术的普及和严格的素食或纯素饮食，它变得越来越普遍，所以最近甚至科学兴趣也在增加。特别是，近年来的研究集中在可能的发病机制，以及新的诊断和治疗策略，以防止发病，及时诊断和准确的营养补充，避免不可逆的视神经萎缩。目前，钴胺素、叶酸、硫胺素和铜的作用已经有了明确的证据，而烟酸、核黄素和吡哆醇的作用还需要进一步的研究来确定。本综述旨在总结营养性视神经病变的病因、诊断和治疗，不仅针对眼科医生，而且针对所有可能接触到可能患有营养性视神经病变的患者的医生，这是一种基本的多学科方法。
Nutritional optic neuropathy is a cause of bilateral, symmetrical, and progressive visual impairment with loss of central visual acuity and contrast sensitivity, dyschromatopsia, and a central or centrocecal scotoma. The clinical features are not pathognomonic, since hereditary and toxic forms share similar signs and symptoms. It is becoming increasingly common due to the widespread of bariatric surgery and strict vegetarian or vegan diets, so even the scientific interest has recently increased. In particular, recent studies have focused on possible pathogenetic mechanisms, and on novel diagnostic and therapeutic strategies in order to prevent the onset, make a prompt diagnosis and an accurate nutritional supplementation, and to avoid irreversible optic nerve atrophy. Nowadays, there is clear evidence of the role of cobalamin, folic acid, thiamine, and copper, whereas further studies are needed to define the role of niacin, riboflavin, and pyridoxine. This review aims to summarize the etiology, diagnosis, and treatment of nutritional optic neuropathy, and it is addressed not only to ophthalmologists, but to all physicians who could come in contact with a patient with a possible nutritional optic neuropathy, being a fundamental multidisciplinary approach.
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影响因子：
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作者：
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