Regos nervo neuritas ir uždegiminių genetinių žymenų sąsajos su pasireiškimu
Optic neuritis: relation between inflammatory genetic markers and occurrence of the disease
Punytė V., Liutkevičienė R.
Neurologijos seminarai 2019; 23(81): 117-122.
Santrauka
Regos nervo neuritas (RNN) yra regos nervo uždegimas. Pagal etiologiją RNN skirstomas į tipinę ir atipinę formas. Tipinis RNN dažniausiai siejamas su išsėtine skleroze. Atipinį RNN gali sukelti įvairios infekcijos, autoimuninės ligos ar kitos uždegiminės ligos. Nors RNN etiologija yra daugiaveiksnė, didelis dėmesys skiriamas uždegiminiams ir imuniniams procesams, kurie, tikėtina, prisideda prie demielinizacijos. Tipinis RNN pasireiškia poūmiu vienpusiu regėjimo aštrumo (RA) sutrikimu ir skausmu, kuris sustiprėja judinant akį. Atipiniui RNN yra būdingas labai stiprus skausmas arba skausmo nebuvimas, abipusis RA sutrikimas, kraujosruvos ir eksudatai regos nervo diskuose. Esant tipiniam RNN, tikimasi greito, reikšmingo RA atsistatymo, o atipinio RNN atveju RA atsistatymo prognozė yra nepalanki. Tobulėjant genetikos technologijoms, galima identifikuoti vis daugiau genų, kurie galėtų turėti įtakos RNN patogenezei.
Šiame straipsnyje apžvelgiame RNN epidemiologiją, etiologiją, patofiziologiją, kliniką, diagnostikos ir gydymo galimybes, sąsajas su IS.
Raktažodžiai: regos nervo neuritas, klinika, diagnostika, gydymas, išsėtinė sklerozė, IL-6, VEGFA, TIMP-3.
Summary
Optic neuritis (ON) is characterized as an inflammation of the optic nerve. Based on etiology, ON is classified to typical and atypical forms. Typical ON is often related to multiple sclerosis while atypical ON can be caused by various infections, autoimmune disorders or different inflammatory diseases. Although the cause of ON is multifactorial, a lot of attention is given to inflammatory and immune processes which are considered to contribute to demyelination of axons. Typical ON occurs as subacute unilateral decrease in visual acuity (VA) and pain which intensifies during eye movement. Atypical ON is characterized by intense pain or no pain, bilateral decrease in VA, hemorrhages and exudate in optic discs. In typical ON, fast and significant recovery of VA is common while in atypical ON, the prognosis of VA recovery is poor. Thanks to recent advances in the field of genetics, it is possible to identify an increasing number of genes that could be associated with ON pathogenesis.
In this article we briefly review the epidemiology, causes, pathophysiology, symptoms, diagnostics and treatment of ON as well as its relation to multiple sclerosis.
Keywords: optic neuritis, symptoms, diagnostics, treatment, multiple sclerosis, IL-6, VEGFA, TIMP-3.
Straipsnis lietuvių kalba | Article in Lithuanian
DOI: 10.29014/ns.2019.16
Copyright: © Neurologijos seminarai, 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License CC-BY 4.0 (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
NEUROLOGIJOS SEMINARAI • ISSN 1392-3064 | eISSN 2424-5917