视神经鞘膜炎的临床及放射学特点 
Valerie Purvin, MD; Aki Kawasaki, MD; Daniel M. Jacobson, MD 
背景：视神经鞘膜炎是一种少见的眼部炎性疾病，与脱髓鞘病变明显不同。
目的：描述特发性视神经鞘膜炎的临床和放射学特点，并专门强调了能够帮助从临床鉴别视乳头炎的特点。
方法：回顾复习了2个神经眼科诊所的14例视神经鞘膜炎患者的病历。
结果：患者年龄从24-60岁，5人年龄超过50岁。所有的患者均有眼疼和/或视力下降。15眼中有8眼视力超过20/20。2眼的视野检查正常，7眼有旁中心暗点或弓形暗点。MRI检查发现视神经周围环形增强，有时伴眶内延伸。对皮质激素治疗反应很好。但4个患者在减少剂量后复发。
结论：与视神经炎相比，视神经鞘膜炎患者发病晚，中心视力保存更好。MRI表现为视神经周围增强，而不是视神经。对皮质激素的反应比视神经炎更好。但停止治疗后更容易出现复发。 

Arch Ophthalmol. 2001;119:1299-1306 

Background: Optic perineuritis is an uncommon variety of orbital inflammatory disease that is distinct from demyelinating optic neuritis. 
Objective: To describe the clinical and radiographic features of idiopathic optic perineuritis, with particular emphasis on those features that help to distinguish this condition from optic neuritis. 
Methods: We reviewed the medical records of 14 patients with optic perineuritis who were seen in 2 neuro-ophthalmology clinics. 
Results: Patients ranged in age from 24 to 60 years; 5 were older than 50 years. All patients had visual loss, eye pain, or both. The visual acuity was 20/20 or better in 8 of the 15 eyes. The results of visual field testing were normal in 2 eyes, and a paracentral scotoma or an arcuate defect was seen in 7. Magnetic resonance imaging scans demonstrated circumferential enhancement around the optic nerve, sometimes with intraorbital extension. Response to corticosteroids was dramatic; however, 4 patients had a relapse with lowering of the dose. 
Conclusions: In contrast to those with optic neuritis, patients with optic perineuritis are often older at onset and are more likely to show sparing of central vision. Magnetic resonance imaging scans demonstrate enhancement around, rather than within, the optic nerve. Response to corticosteroids is more dramatic than in patients with optic neuritis, and patients are more likely to experience recurrence after stopping treatment. 

Arch Ophthalmol. 2001;119:1299-1306