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视觉系统参与状纤维酸蛋白星细胞病:两个病例报告和一个系统文献综述

Giacomo Greco¹, Stefano Masciocchi¹, Luca Diamanti¹

¹From the Department of Brain and Behavioural Sciences (G.G., S.M., E.V., P. Businaro), University of Pavia; IRCCS Mondino Foundation (G.G., S.M., L.D., P. Bini, E.V., E.M., E.C., E.R., R.B., D.F., M.G.), National Neurological Institute; Unit of Biostatistics and Clinical Epidemiology (O.E.F.), Department of Public Health, Experimental and Forensic Medicine, University of Pavia; and Neuro-Ophthalmology Center and Ocular Electrophysiology Laboratory (S.B.M.), Istituto Auxologico Italiano IRCCS Capitanio Hospital, Milan, Italy.

Neurology(R) neuroimmunology & neuroinflammation

|August 15, 2023

概括

状纤维酸蛋白 (GFAP) 天体细胞损伤常常涉及视觉系统,呈现各种症状,从视觉盘胀到视力丧失. 视神经炎很少见,但视觉参与可能表明复发风险更高.

科学领域:

神经免疫学神经免疫学
眼科医生眼科眼科
神经学神经学

背景情况:

状纤维酸蛋白 (GFAP) 天体细胞损伤通常与脑膜炎有关.
在GFAP星病中视觉系统的参与是公认的,但没有得到很好的定义.
这项研究调查了GFAP星病的视觉症状的频谱和意义.

研究的目的:

描述两个具有突出视觉症状的GFAP星病例.
系统地审查文献,以视觉参与GFAP天体细胞损伤.

主要方法:

两名患有GFAP星病变和视觉症状的患者的病例报告.
按照PRISMA指南进行系统的文献审查,分析了592名患者的临床数据.

主要成果:

25%的患者出现视觉干扰,包括无症状视觉盘 (50%) 和视觉症状 (17%).
严重的双侧视神经炎是罕见的 (6%),但与治疗反应不佳有关.
视觉干扰与更高的疾病复发风险相关 (35%对11%).

结论:

GFAP星病经常影响视觉系统,表现不同,从无症状的视觉盘胀到严重的视力丧失.
视神经炎是一种不常见的表现.
考虑在患有脑炎/骨髓炎和视盘的患者中进行GFAP抗体测试,特别是如果AQP4抗体是负的.
视觉症状可能预测更高的复发率,可能需要长期免疫抑制.

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