AIM: To investigate the course of disease, clinical characteristic and clinical outcome of patients with idiopathic demyelinating optic neuritis (IDON) in final diagnosis and compare the results with those in western countries.rn METHODS: Clinical features of 137 cases of IDON with final diagnosis in the General Hospital of Chinese PLA form May 2009 to December 2010 were retrospectively analyzed.rnRESULTS: With a female to male ratio of 1:1. 54, 74 cases had onset in both eyes or one after another, and 63 cases had onset with simple eye. There were 28. 9% patients accompanied with oculogyria pain, 69.7% eyes with retrobulbar neuritis and 30. 3% eyes with papillitis. There were 58. 4% cases with visual acuity recovered to more than 0. 5; but there were also 21. 8% cases with visual acuity recovered to less than 0.1. The patients in lower age group ( ≤18 years) had a better recovery ofrnvisual acuity and those in higher age group (≥46 year) at the same time had a bad visual acuity. There were significant differences between two groups (P0.5;高年龄组(≥46岁)患者视力预后较差,仅47.3%患者视力＞0.5,三组统计学比较有显著性差异(P＜0.05).137例患者中共89例进行了水通道蛋白-4(AQP-4)的检测,28例(31.5%)结果阳性.我们发现AQP-4阳性组视力预后较差,和AQP-4阴性组比较统计学有显著性差异(P＜0.05).在随后2a的随访中,28例AQP-4阳性组的患者中,5例发展为视神经脊髓炎(optic neuromyelitis,NMO),1例发展为多发性硬化(multiple sclerosis,MS);在61例AQP-4阴性患者中,仅1例患者发展为NMO.结论:特发性脱髓鞘性视神经炎的自然病程和主要临床特点与西方国家报告较为相似,但也有不同之处.AQP-4可能对孤立性视神经炎患者具有诊断和提示预后的价值,AQP-4阳性提示视力预后较差,可能发展为NMO的危险性增加.
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