Особенности клинического течения атипичных демиелинизирующих оптических невритов: серия клинических наблюдений

Оптические невриты (ОН) часто могут развиваться в дебюте или быть одним из симптомов аутоиммунных демиелинизирующих заболеваний ЦНС. Создание новых методов лабораторной диагностики, совершенствование технических возможностей магнитно-резонансной томографии (МРТ), электрофизиологии и визуализации глаза значительно расширили спектр аутоиммунных невропатий зрительного нерва. Выделение различных типов ОН, с учетом клинических и инструментальных данных, позволяет сократить время до постановки диагноза основного неврологического заболевания. Согласно современным рекомендациям, необходимо выделять типичные ОН, развивающиеся в основном в рамках рассеянного склероза (РС), и атипичные ОН, являющиеся ведущими синдромами заболеваний спектра оптиконевромиета (ЗСОНМ) и заболеваний, ассоциированных с антителами к миелинолигодендроцитарному гликопротеину (МОГАР). В статье разбираются четыре клинических случая атипичного ОН в дебюте ЗСОНМ и МОГАР и подчеркивается высокая диагностическая ценность мультидисциплинарного подхода.

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