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Optikusneurit, ON

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Sakkunnig:


Definition:
Inflammatorisk demyelinisering av synnerven. Orsaken är okänd, men mer än hälften utvecklar MS efter 30–40 år.
Förekomst:
Cirka 1–3 fall per 100 000 per år, vanligtvis mellan 20–49 års ålder. Vanligare bland kvinnor.
Symtom:
En subakut oftast ensidig synnedsättning som utvecklas inom timmar till dagar, smärta eller obehag vid ögonrörelser, oförmåga att känna igen färger (sidoskillnad) är typiska. Synen kommer nästan alltid tillbaka inom en viss tid.
Kliniska fynd:
Nedsatt synskärpa och synfält. Nedsatt pupillreaktion vid direkt belysning.
Diagnostik:
Ögonbottenundersökning, neurologisk undersökning och MRT.
Behandling:
Högados kortikosteroider peroralt eller intravenöst. Plasmaferes, intravenöst immunoglobulin (IVIG) eller sjukdomsmodifierande behandling (DMD) kan övervägas.
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  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet
  • Rune Midgard, dr. med., overlege, førsteamanuensis II emeritus, NTNU