Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aqu...Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.展开更多
文摘Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.
