Resumo
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- dor periorbital/retro-ocular
- perda da acuidade visual com escotoma
- dessaturação das cores/perda da visão das cores
- defeito pupilar aferente relativo (DPAR)
Другие диагностические факторы
- edema do disco óptico
- anormalidades neurológicas da esclerose múltipla
- fosfenos
- fenômeno de Uhthoff
- fenômeno de Pulfrich
- revestimento perivenoso
Факторы риска
- idade entre 30 e 50 anos
- sexo feminino
- etnia branca
- genótipo HLA-DRB1*1501
- fatores de risco para esclerose múltipla (EM; infecção pelo vírus Epstein-Barr [EBV], deficiência de vitamina D e tabagismo)
- infância em latitudes mais altas
- presença de doença autoimune
- exposição a doenças infecciosas, como doença de Lyme e sífilis
Диагностические исследования
Исследования, которые показаны в первую очередь
- ressonância nuclear magnética (RNM) - cranioencefálica
- Hemograma completo
- Velocidade de hemossedimentação (VHS)
- proteína C-reativa
- Venereal Disease Research Laboratory (VDRL)
- anticorpo anti-aquaporina 4 (AQP4), anticorpo anti-glicoproteína mielina-oligodendrócito (MOG) e anticorpo anti-proteína-5 mediadora da resposta à colapsina (CRMP5)
- ácido úrico
- enzima conversora da angiotensina (ECA) sérica
- fator antinuclear (FAN)
- dosagem de vitamina B12 e folato
Исследования, проведение которых нужно рассмотреть
- título de Lyme
- análise do líquido cefalorraquidiano
Алгоритм лечения
episódio agudo
doenças inflamatórias coexistentes (por exemplo, NMOSD, MOGAD, LES ou sarcoidose)
Составители
Авторы
Cris S. Constantinescu, MD, PhD
Chair of Neurology Emeritus
Academic Unit of Mental Health and Clinical Neuroscience
University of Nottingham
Nottingham
UK
Attending Neurologist
Professor of Neurology
Cooper Neuroscience Institute
Camden
New Jersey
Раскрытие информации
CSC has received research support or consultancy fees from Biogen, GW, Merck, Morphosys, Novartis, Roche, Sanofi-Pasteur, MSD, and Teva. CSC is an author of a number of references cited in this topic.
Thomas M. Bosley, MD
Knights Templar Eye Foundation Professor of Ophthalmology
Wilmer Eye Institute
Johns Hopkins University
Baltimore
MD
Раскрытие информации
TMB declares that he has no competing interests.
Рецензенты
Gus Gazzard, MA, MBBChir, MD, FRCOphth
Consultant Ophthalmic Surgeon
King's College Hospital
Honorary Research Fellow
Institute of Ophthalmology
London
UK
Раскрытие информации
GG declares that he has no competing interests.
John Selhorst, MD
Professor
Department of Neurology and Psychiatry
Saint Louis University
St. Louis
MO
Раскрытие информации
JS declares that he has no competing interests.
Efstratios Mendrinos, MD
Department of Ophthalmology
Geneva University Hospitals
Geneva
Switzerland
Раскрытие информации
EM declares that he has no competing interests.
Jonathan Smith, MD
Specialist Registrar in Ophthalmology
Royal Victoria Infirmary
Newcastle
UK
Раскрытие информации
JS declares that he has no competing interests.
Peter Sguigna, MD
Assistant Professor
Department of Neurology
The University of Texas
Southwestern Medical Center
Dallas
TX
Раскрытие информации
PS has received grant support from National Multiple Sclerosis Society, International Progressive Multiple Sclerosis Alliance, National Institute of Health (NIH), Center for Translational Medicine, Physician Scientist Training Program, and Department of Defense (DOD). He has received research support from Genentech, Clene Nanomedicine, and Patient Centered Outcomes Research Institute. He has received consulting fees from Medical Logix LLC, Genentech, EMD Serono, Horizon Therapeutics, and Bristol Myers Squibb. He is the inventor on a patent for OCT technology that is held by UT Southwestern Medical Center.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Petzold A, Fraser CL, Abegg M, et al. Diagnosis and classification of optic neuritis. Lancet Neurol. 2022 Dec;21(12):1120-34. Аннотация
American Academy of Ophthalmology. Optic neuritis - 2012. Jul 2012 [internet publication].Полный текст
Beck RW, Cleary PA, Anderson MM Jr, et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992 Feb 27;326(9):581-8. Аннотация
Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018 Feb;17(2):162-73.Полный текст Аннотация
Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol. 2010 Aug;17(8):1019-32.Полный текст Аннотация
Gal RL, Vedula SS, Beck R. Corticosteroids for treating optic neuritis. Cochrane Database Syst Rev. 2015 Aug 14;(8):CD001430.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Diagnósticos diferenciais
- Doença de Lyme
- Sífilis
- Infecção pelo vírus da imunodeficiência humana (HIV)
Больше ОтличияDiretrizes
- Optic neuritis
- Guidelines on diagnosis and management of neuromyelitis optica
Больше DiretrizesFolhetos informativos para os pacientes
Doença de Lyme
Artrite reumatoide
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