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目的:报道1例罕见的临床上表现为眼眶炎性假瘤形式的视神经束膜炎,并且强调区分视神经束膜炎和脱髓鞘的球后视神经炎。方法:病例报道。结果:一个54岁的健康的马来西亚女性,主诉右侧持续性头痛3d伴有复视。疼痛与眼球活动相关联。脑部和眼眶MRI显示右侧视神经鞘和眶内脂肪条纹异常增强,未有异常的增强提示脱髓鞘疾病。这名患者诊断为右眼视神经束膜炎。从开始使用全身性的类固醇激素,维持并逐渐减量超过6mo。她的症状得到缓解并且直到最近的随访都没有复发。结论:所有的眼眶炎性假瘤病例都应该考虑存在视神经束膜炎的可能,在开始治疗前必须与球后视神经炎相鉴别。因为这两种疾病有不同的治疗原则和预后。
PURPOSE: To report a rare case of optic neuritis, which is clinically manifested as orbital inflammatory pseudotumor, and emphasizes the distinction between optic neuritis and demyelinated retrobulbar neuritis. Methods: Case reports. Results: A 54-year-old healthy Malaysian woman complained of persistent headache on the right side of the patient with diplopia. Pain is associated with eye movement. MRI of the brain and orbit showed abnormal enhancement of optic nerve sheath and orbital fat stripes on the right, with no abnormal enhancement suggestive of demyelinating disease. This patient is diagnosed with right-sided optic nerve fasciitis. From the beginning of systemic steroid use, maintain and gradually reduce more than 6mo. Her symptoms were relieved and did not recur until the most recent follow-up. CONCLUSIONS: All cases of orbital inflammatory pseudotumor should be considered for the presence of optic neuritis, which must be distinguished from retrobulbar neuritis prior to initiation of treatment. Because these two diseases have different treatment principles and prognosis.