Demonstration of Systematic Variation in Human Intraorbital Optic Nerve Size by Quantitative Magnetic Resonance Imaging and Histology

Karim, Salmaan; Clark, Robert A.; Poukens, Vadims; Demer, Joseph L.

doi:10.1167/iovs.03-1246

Cited by 64 publications

(68 citation statements)

References 14 publications

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“…However, surface coils focusing on the orbit may further improve the image quality. 89 Important MRI methods for research purposes include measures of optic nerve atrophy obtained using highresolution 3D T2-weighted sequences, 90 quantitative MRI techniques91 and diffusion tensor imaging. 92 These advanced techniques can assist in the early detection of clinical impairment, and enable quantitative estimation of the presence and extent of damage to the optic nerve.…”

Section: Research Protocolmentioning

confidence: 99%

The investigation of acute optic neuritis: a review and proposed protocol

et al. 2014

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| Optic neuritis is an inflammatory optic neuropathy that affects many patients with multiple sclerosis (MS) at some point during their disease course. Differentiation of acute episodes of MS-associated optic neuritis from other autoimmune and inflammatory optic neuropathies is vital for treatment choice and further patient management, but is not always straightforward. Over the past decade, a number of new imaging, laboratory and electrophysiological techniques have entered the clinical arena. To date, however, no consensus guidelines have been devised to specify how and when these techniques can be most rationally applied for the diagnostic work-up of patients with acute optic neuritis. In this article, we review the literature and attempt to formulate a consensus for the investigation of patients with acute optic neuritis, both in standard care and in research with relevance to clinical treatment trials.

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Section: Research Protocolmentioning

confidence: 99%

The investigation of acute optic neuritis: a review and proposed protocol

et al. 2014

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“…Modalities historically utilized for evaluating the optic nerve include clinical measurement using indirect ophthalmoscopy 10 , fundus photography 11,12 , both A-and Bscan ultrasound 13,14,15 , computerized tomography (CT) prior to the advent of MRI, Heidelberg Retinal Tomograph II 16 , spectral domain optical coherence tomography (SD-OCT) 17,18 , and magnetic resonance imaging (MRI). 7,8,9,19,20,21,22,23,24,25 Each of these modalities has its limitations. Funduscopic examination and fundus photographs can be difficult to obtain in young children without anesthesia and measurements of optic nerve size based on them must be adjusted for refractive error and axial length of the child's eye 6 .…”

Section: Discussionmentioning

confidence: 99%

“…Measurements of the optic nerve obtained by means of ultrasound may be limited due to poor penetration of sound waves into the retrobulbar region and misalignment. 24 Sonographic techniques rely upon advanced sonographers with meticulous technique and experienced interpretation. 14,24 Because of its relatively poor soft tissue contrast, CT is incapable of accurately assessing ON size except in severe cases in which the nerve may be grossly enlarged or decreased in volume.…”

Section: Discussionmentioning

confidence: 99%

“…24 Sonographic techniques rely upon advanced sonographers with meticulous technique and experienced interpretation. 14,24 Because of its relatively poor soft tissue contrast, CT is incapable of accurately assessing ON size except in severe cases in which the nerve may be grossly enlarged or decreased in volume. In addition, because of radiation dose implications, CT is less desirable as a screening tool in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

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The role of magnetic resonance imaging in diagnosing optic nerve hypoplasia

Lenhart

Desai

Bruce

et al. 2013

Journal of American Association for Pediatric Ophthalmology and

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“…Just posterior to the globe, right and left optic nerve diameters were 3.07 and 3.05 mm, respectively ( Figure 2), both subnormal compared with published values. 1 Imaging with a head coil demonstrated bilateral OMN hypoplasia in the skull base region, with the right OMN too small to resolve in any of the 1 mm thickness contiguous image planes obtained in the plane of its path ( Figure 3). These anatomic findings indicate bilateral but asymmetrical OMN abnormality.…”

mentioning

confidence: 99%

Magnetic Resonance Imaging Demonstrates Neuropathology in Congenital Inferior Division Oculomotor Palsy

Wu¹,

Isenberg

Demer

2006

Journal of American Association for Pediatric Ophthalmology and

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Isolated inferior division oculomotor nerve palsy (ONP) is rare. Acquired cases have been associated with neurologic or systemic disease. To our knowledge, congenital inferior division ONP is previously unreported. We present a case of congenital inferior division ONP in which magnetic resonance imaging demonstrated the structural neuropathy.A 21-year-old woman presented with lifelong largeangle exotropia and diminished vision acuity in her right eye (OD). She denied diplopia, periocular pain, cephalgia, migraine, head trauma, or prior surgery. Birth history was unremarkable. She had no history of diabetes mellitus, hypertension, systemic vasculopathy, or thyroid disease. She has three unaffected brothers and four unaffected sisters. General physical and neurologic examinations were normal. Cranial nerves were normal except for ocular motility. Cycloplegic refraction was ϩ4.00 ϩ 2.75 ϫ 150 OD and ϩ0.50 ϩ 0.50 ϫ 90 left eye (OS). Corrected visual acuity was 20/80 OD and 20/25 OS. Ptosis was absent. Both pupils were 7 mm in diameter with slight peaking toward 9:00 OD and were normally reactive to light and accommodation. The ocular versions are shown in Figure 1. At near with correction, there was 100 ⌬ exotropia with 10 ⌬ right hypertropia. Head tilt did not appreciably alter the hypertropia, but dissociated vertical deviation was present bilaterally. Abducting and vertical saccades were normal for both eyes (OU), while adducting saccades were bilaterally slow. Convergence was absent. There was bilateral optic disk pallor with cup-to-disk ratio of 0.5 OD and 0.3 OS. There was incyclotorsion OU on fundus examination.High-resolution magnetic resonance imaging (MRI) performed with orbital surface coils identified a smaller inferior division of the oculomotor nerve (OMN) OD than OS, with no identifiable motor nerve to the right medial (MR) and inferior rectus (IR) muscles, both of whose deep portions exhibited marked atrophy and abnormal internal bright signal on T1 imaging (Figure 2). The abducens nerve was readily demonstrable OU. The inferior oblique muscle was present bilaterally, but both lateral rectus muscle paths were superiorly displaced relative to the MR muscles ( Figure 2). Just posterior to the globe, right and left optic nerve diameters were 3.07 and 3.05 mm, respectively (Figure 2), both subnormal compared with published values. 1 Imaging with a head coil demonstrated bilateral OMN hypoplasia in the skull base region, with the right OMN too small to resolve in any of the 1 mm thickness contiguous image planes obtained in the plane of its path (Figure 3). These anatomic findings indicate bilateral but asymmetrical OMN abnormality. DiscussionThe OMN divides into superior and inferior divisions just before entering the superior orbital fissure. Classical signs of inferior division OMP were evident here, including large exotropia, hypertropia, incyclotropia, and discoria. Although pupillary light responses were spared, Good and coworkers have postulated that early embryologic damage could partially spare th...

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Demonstration of Systematic Variation in Human Intraorbital Optic Nerve Size by Quantitative Magnetic Resonance Imaging and Histology

Cited by 64 publications

References 14 publications

The investigation of acute optic neuritis: a review and proposed protocol

The investigation of acute optic neuritis: a review and proposed protocol

The role of magnetic resonance imaging in diagnosing optic nerve hypoplasia

Magnetic Resonance Imaging Demonstrates Neuropathology in Congenital Inferior Division Oculomotor Palsy

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