中华眼底病杂志2022年12月第38卷第12期Chin J Ocul Fundus Dis,,December2022,Vdl.38,No.12·955·指南与共识中国浸润性视神经病变诊断和治疗专家共识（2022年)中华医学会眼科学分会神经眼科学组通信作者：魏世辉，Email:weishihui706@hotmail.com【摘要】浸润性视神经病变(ION)是以视神经及其鞘内肿瘤细胞或炎症细胞浸润为特征的视神经病变。该病较为罕见，尤其是恶性肿瘤浸润或转移引起的1ON,极易误诊为视神经周围炎或视神经炎，从而延误治疗，并带来糖皮质激素治疗副作用相关风险。目前国内眼科医师对1ON的认识尚存在不足，临床误诊和漏诊率较高，针对1ON的诊断和治疗尚未形成系统的规范化指导意见。因此，为了规范1ON的诊治，中华医学会眼科学分会神经眼科学组组织专家，结合国内外研究经验，经过反复讨论，针对ON的定义、诊断和治疗提出规范化意见，以期指导O的临床诊疗工作，并为相关研究提供依据。【关键词】浸润性视神经病变；视神经周围炎；视神经疾病；诊疗准则；专家共识基金项目：国家重点研发计划项目(2018Y℉E0113900)；国家自然科学基金面上项目(81870662)D0:10.3760/cma.j.cn511434-20221107-00588Chinese ex pert consensus on the diagnosis and treatment of infiltrative optic neuropathy(2022)Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical AssociationCorresponding author:Wei Shihui.,Email:weishihui706@hotmail.com[Abstract Infiltrative optic neuropathy (ION)is characterized by the infiltration of tumor cells orinflammatory cells in the optic nerve and its sheath.ION is rare in clinic practice,and ION caused by directinfiltration or metastasis of malignant tumors is easily misdiagnosed as optic perineuritis or optic neuritis,whichmeans delayed proper treatment and makes patients risking possible side effects of steroid therapy.Currently,ophthalmologists are lack of sufficient knowledge about ION,which contributes to the high rate of misdiagnosisand missed diagnosis of ION in clinical practice.The diagnosis and treatment of ION have not yet formedsystematic standardized guidelines.Therefore,Neuro-ophthalmology Group of Ophthalmology Branch ofChinese Medical Association organized experts to propose consenus of opinions on definition,diagnosis andtreatment of ION,which helps to guide clinical diagnosis and treatment of ION,as well as basic researches aboutION.[Key words]Infiltrative optic neuropathy;Optic perineuritis,Optic nerve diseases;Practiceguidelines as topic;ConsensusFund program:National Key Research and Development Program(2018YFE0113900);General Projectof National Natural Science Fundation of China (81870662)D0I:10.3760/cmaj.cn511434-20221107-00588浸润性视神经病变(ION)是以亚急性或急性视医学会眼科学分会神经眼科学组经过集体讨论，提出力下降、视神经及其鞘内肿瘤细胞或炎症细胞浸润为本专家共识，以期指导ION的临床诊断和治疗工作，并特征的视神经病变。ION临床上罕见，尤其是恶性肿为相关研究提供依据。瘤浸润或转移引起的ION患者在临床上极易误诊为视神1ION定义和分类经周围炎或视神经炎(ON)而接受糖皮质激素治疗，后者不仅不利于ION病情缓解，还会让患者不必要地承ION是基于病理学检查结果提出的诊断名称。既担糖皮质激素治疗副作用的风险1。鉴于ION诊断困往研究将ION定义为视神经及其鞘内肿瘤细胞或炎症细难、临床预后差，而目前国内外对ON的定义、诊断和胞浸润引起的视神经病变，其病因包括原发性视神经治疗尚不一致，临床误诊和漏诊率较高。因此，中华肿瘤（如视神经胶质瘤和视盘黑色素细胞瘤等）、继
