Clinical Features of Optic Neuritis in China

摘要

Objective: To document the clinical features of optic neuritis in a population of China and compare with reports of Western countries. Background: Optic neuritis is a common optic neuropathy well studied in Western countries. In English literature very few studies addressed optic neuritis in China. Method: Retrospective medical chart review of all patients admitted in a teaching hospital from 2002 to 2005 with a final diagnosis of idiopathic demyelinating optic neuritis. Results: Ninety-eight patients including 45 men and 53 women were collected, with a mean age of 25.7 years. Sixty-six cases (67.3%) were unilateral optic neuritis and 32 (32.7%) were bilateral. Eye pain was reported in 42 cases (42.9%). Visual acuity in 130 affected eyes varied from 0.8 to no light perception, with 0.1 or worse in 101(77.7%), between 0.1 and 0.4 in 15 (11.5%) and 0.5 or better in 14(10.8%). Fifty-two eyes (40%) showed disc swelling. Central scotoma was the most common (61%) localized visual field defect. Optic nerve enhancement was found in 85 of 121 eyes (70.2%) while 15 cases (15.3%) showed periventricular plaques in brain MRI. Positive oligo-clonal band or elevated myelin basic protein was found in 17 (17.3%) cases. Eight (8.2%) cases met the criteria of clinical definite multiple sclerosis and 4 cases had neuromyelitis optica. Visual acuity of 35 eyes (26.9%) improved to 1.0 or better while 37 eyes (28.5%) remained 0.1 or worse at the 3-month follow-up. Conclusion: Clinical features of optic neuritis in a population of China were documented. Less ocular pain, less brain MRI abnormalities, more severe visual loss and poor visual outcome were seen compared to reports of Western countries.