目的 探讨儿童肺炎支原体（MP）相关性视神经炎（ON）的临床特点、诊治和预后。方法 回顾分析1例MP-ON患儿的临床资料，检索分析国内外数据库中MP合并ON病例。结果 患儿为10岁青春前期女童，发热、头痛起病，血清MP抗体滴度>1:1 280，予阿奇霉素治疗后发热头痛迅速缓解。病程第23天出现急性视力下降伴眼球转动痛，视野缺损、视乳头水肿及视觉诱发电位异常，无其他神经系统受累表现，无脑病表现。查血髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)阳性，脑脊液和核磁共振检查结果异常，予以大剂量甲基泼尼松龙联合人免疫球蛋白静滴，视力恢复到发病前水平，3月后随访无复发。结论 MP感染可并发ON，与自身免疫或免疫复合物引起的脱髓鞘改变有关，顽固性头痛有提示意义，中枢神经系统脱髓鞘血清抗体检查有利于临床分型、指导治疗。

Objective To investigate the clinical manifestations, treatment and prognosis of pediatric Mycoplasma pneumoniae (MP)-associated optic neuritis (ON). Methods The clinical data of 1 child with MP-ON were retrospectively analyzed, and the cases of MP-ON in domestic and foreign databases were retrieved and analyzed. Results The patient was a 10-year-old prepubertal girl, and her onset symptoms were fever and headache. Her serum MP antibody titer was >1:1280. After intravenous infusion of azithromycin, the child's fever and headache were quickly relieved. On day 23 of the disease course, the patient developed acute vision loss with pain of eye rotation, visual field defects, papilledema, and abnormal visual evoked potentials. There were no other manifestations of nervous system involvement and no manifestations of encephalopathy. Laboratory test found positive serum myelin oligodendrocyte glycoprotein-antibody (MOG-Ab). Cerebrospinal fluid and MRI results were abnormal. After intravenous infusion of high dose methylprednisolone combined with human immunoglobulin, the vision of the child returned to the pre-onset level, and no recurrence was observed 3 months later. Conclusions MP infection can be complicated by ON, which is related to demyelinating changes caused by autoimmunity or immune complex. Intractable headache has suggestive significance. Serum antibodies detection of central nervous system demyelinating disease is beneficial to clinical classification and guidance of treatment.