基于证据的视神经炎的管理
Emilie Bergeron1,2, Marc A Bouffard1
1Division of Neuro-Ophthalmology, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Current opinion in ophthalmology
|October 17, 2023
概括
对视神经炎的及时治疗,包括静脉注射甲基prednisolone (IVMP) 和用于神经omyelitis optica光谱障碍 (NMOSD) 的plasmapheresis,可以改善视觉恢复. 建议在NMOSD和MOGAD治疗中使用长期免疫抑制.
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:
- 光神经炎呈现出多种不同的病因,包括多发性硬化症 (MS),神经炎光学谱障碍 (NMOSD) 和髓寡干细胞糖蛋白抗体疾病 (MOGAD).
- 区分这些原因对于有效的治疗策略至关重要.
研究的目的:
- 根据其特定的潜在原因,审查基于证据的视神经炎治疗方法.
- 要突出最近在NMOSD和MOGAD管理中的治疗进展.
主要方法:
- 对各种视神经炎病因的基于证据的治疗策略的文献综述.
- 分析当前的治疗选择,包括血合成,静脉注射甲基prednisolone (IVMP) 和疾病修饰疗法 (DMT).
主要成果:
- IVMP在急性异常或MS相关的视神经炎中加速视觉恢复,但不会改变最终的视觉结果.
- 及时的IVMP与血相结合显著有利于NMOSD相关的视觉神经炎,早期治疗与更好的康复相关.
- 新的DMT正在为NMOSD出现,现有的疗法可以适应MOGAD.
结论:
- IVMP是急性视神经炎的标准治疗方法.
- 血酶是NMOSD相关的视神经炎的关键辅助.
- 长期免疫抑制疗法适用于NMOSD和MOGAD患者,这些患者的视力表现不佳或经常性发作.
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