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Abstract #8103 Published in IGR 4-3
Use of magnetic resonance imaging to differentiate optic neuritis and nonarteritic anterior ischemic optic neuropathy
Rizzo 3rd JF; Andreoli CM; Rabinov JDOphthalmology 2002; 109: 1679-1684
OBJECTIVE: To determine whether magnetic resonance imaging (MRI) of the optic nerves obtained during the acute phase can distinguish patients with optic neuritis (ON) from those with nonarteritic anterior ischemic optic neuropathy (NAION). DESIGN: Retrospective, neuroradiological, observational study. PARTICIPANTS: Sixty-four patients diagnosed as having either ON or NAION who were diagnosed by clinical criteria and imaged by MRI. METHODS: Demographic information on the MRI scans was masked and the patients were presented randomly and in a blinded fashion to a neuroradiologist (JDR) for determination of abnormalities. Reproducibility was assessed by presenting ten of the scans a second time to the same neuroradiologist. MAIN OUTCOME MEASURES: The presence or absence and location of abnormal MRI signals of the optic nerve. RESULTS: Evaluation of reproducibility revealed identical interpretations of the ten scans submitted a second time. The optic nerve was abnormal in the clinically affected eye in 31 of the 32 ON patients, but in only five of the 32 NAION patients. Thirty of the 31 ON patients who received gadolinium had enhancement, and 27 of the 32 ON patients had increased short T1 inversion recovery signal in the clinically affected optic nerve. The five NAION patients with abnormal scans in the clinically affected eye had increased short T1 inversion recovery signal, and in two of these, there also was enhancement of the optic nerve. For the ON patients, enhancement involved the entire length of the intraorbital optic nerve in 18 cases and the intracranial segment of the optic nerve in 19 cases. CONCLUSIONS: This study shows that MRI scanning of the optic nerve shows significantly different results between patients clinically diagnosed with either ON or NAION.
J.F. Rizzo 3rd, MD, Department of Ophthalmology, Harvard Medical School and the Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA. Joseph_Rizzo@meei.harvard.edu
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
