Korean J Ophthalmol.  2017 Feb;31(1):71-79. 10.3341/kjo.2017.31.1.71.

Initial Pattern of Optic Nerve Enhancement in Korean Patients with Unilateral Optic Neuritis

• Son DY
• Park KA
• Seok SS
• Lee JY
• Oh SY

• KMID: 2368681
• DOI: http://doi.org/10.3341/kjo.2017.31.1.71

Abstract

PURPOSE
The purpose of this study was to demonstrate whether the pattern of optic nerve enhancement in magnetic resonance imaging (MRI) can help to differentiate between idiopathic optic neuritis (ON), neuromyelitis optica (NMO), and multiple sclerosis (MS) in unilateral ON.
METHODS
An MRI of the brain and orbits was obtained in patients with acute unilateral ON. Patients with ON were divided into three groups: NMO, MS, and idiopathic ON. The length and location of the abnormal optic nerve enhancement were compared for ON eyes with and without NMO or MS. The correlation between the pattern of optic nerve enhancement and the outcome of visual function was analyzed.
RESULTS
Of the 36 patients with ON who underwent an MRI within 2 weeks of the onset, 19 were diagnosed with idiopathic ON, 9 with NMO, and 8 with MS. Enhancement of the optic nerve occurred in 21 patients (58.3%) and was limited to the orbital segment in 12 patients. Neither the length nor the location of the optic nerve enhancement was significantly correlated with visual functions other than contrast sensitivity or the diagnosis of idiopathic ON, MS, or NMO. Patients with greater extent of optic nerve sheath enhancement and more posterior segment involvement showed higher contrast sensitivity.
CONCLUSIONS
Our data revealed that the pattern of optic nerve enhancement was not associated with diagnosis of idiopathic ON, NMO, or MS in Korean patients with unilateral ON. We believe further studies that include different ethnic groups will lead to a more definitive answer on this subject.

Keyword

Magnetic resonance imaging; Multiple sclerosis; Neuromyelitis optica; Optic nerve; Optic neuritis

MeSH Terms

Brain
Contrast Sensitivity
Diagnosis
Ethnic Groups
Humans
Magnetic Resonance Imaging
Multiple Sclerosis
Neuromyelitis Optica
Optic Nerve*
Optic Neuritis*
Orbit

Figure

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  Fig. 1 Axial views of gadolinium-enhanced T1-weighted fat-suppressed magnetic resonance imaging showing abnormal enhancement of the orbital segments of the left optic nerve.

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  Fig. 2 Illustrations of the segments of the optic nerve used in this study.

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