Diffusion-Weighted Imaging and Post-contrast Enhancement in Differentiating Optic Neuritis and Non-arteritic Anterior Optic Neuropathy

Adesina, Ore‐Ofeoluwatomi O; McNally, J. Scott; Salzman, Karen L.; Katz, Bradley J.; Warner, Judith E. A.; McFadden, Molly; Digre, Kathleen B.

doi:10.1080/01658107.2017.1356856

Cited by 25 publications

(28 citation statements)

References 16 publications

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“…Although patients with vasculopathic risk factors had been excluded so as to rule out the inclusion of cases with microvascular causes, age itself could still be a risk factor for ischemic nerve palsy. Unfortunately, ischemic neuropathy and inflammatory neuropathy may be difficult to distinguish in MRI even in the optic nerve, which has a much larger diameter than any of the third or sixth cranial nerves [12]. The benign clinical course is also similar between ischemic or inflammatory third and sixth cranial nerve palsy.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic third and sixth cranial nerve neuritis

Park

Min

et al. 2019

Jpn J Ophthalmol

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Purpose To present cases with idiopathic third and sixth cranial nerve neuritis. Study design Retrospective observational study Methods The results of high resolution pre-and post-cranial nerve magnetic resonance images (MRI) with three-dimensional sequences for visualizing cranial nerves in patients with third, fourth, and sixth cranial nerve palsies who were treated at the Neuro-ophthalmology Department of Samsung Medical Center were reviewed. Patients with cranial nerve enhancement confirmed by experienced radiologists were identified. The medical records of these patients were reviewed, and their demographics, clinical presentations, laboratory results, and clinical outcomes were analyzed. Results Of 265 patients with third, fourth, and sixth cranial nerve palsy, 60 were identified by high resolution MRI as having enhancement of the corresponding cranial nerve. Among these, 17 patients with infiltrative, granulomatous, or tumorous lesions were excluded. In addition, 28 patients with identifiable causes of cranial nerve palsy, such as Miller-fisher syndrome, virus infection, or radiation-induced neuropathy, as well as patients with vasculopathic risk factors, were also excluded. Ultimately, a total of 15 patients with idiopathic third and sixth cranial nerve neuritis were included in this study. The mean age of these patients was 43 ± 15 years. Eight patients had sixth cranial nerve palsy, six third cranial nerve palsy (two partial and four complete), and one patient with complete third and sixth cranial nerve palsy. Nine patients received steroid treatment. Eleven patients recovered fully within a period ranging from a few days to one year. Two patients were much improved up to 1 month after initial presentation, but were then ultimately lost to follow-up. Another patient was lost to follow-up after the initial work-up. The other patient lost to follow-up had partially recovered during the first 6 months. Conclusions We present patients with idiopathic third and sixth cranial nerve neuritis. They tended to respond well to steroid treatment and to have good prognoses. In order to better understand the long-term prognosis of cranial nerve neuritis and possible association with other neurologic disorders, a larger scale and longer-term study is needed.

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Section: Discussionmentioning

confidence: 99%

Idiopathic third and sixth cranial nerve neuritis

Park

Min

et al. 2019

Jpn J Ophthalmol

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“…However, MRI and/or fundoscopic features of ON together with other clinicopathologic findings supported the diagnosis in our patients. Moreover, the presence of optic nerve abnormalities on routine MRI sequences is significantly associated with the diagnosis of ON rather than ischemic optic neuropathy in people (161, 162).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Recovery of Vision in Canine Optic Neuritis of Unknown Etiology: 26 Dogs (2003–2018)

et al. 2019

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Optic neuritis (ON) is a recognized condition, yet factors influencing recovery of vision are currently unknown. The purpose of this study was to identify prognostic factors for recovery of vision in canine ON of unknown etiology. Clinical databases of three referral hospitals were searched for dogs with presumptive ON based on clinicopathologic, MRI/CT, and fundoscopic findings. Twenty-six dogs diagnosed with presumptive ON of unknown etiology, isolated (I-ON) and MUE-associated (MUE-ON), were included in the study. Their medical records were reviewed retrospectively, and the association of complete recovery of vision with signalment, clinicopathologic findings, and treatment was investigated. Datasets were tested for normality using the D'Agostino and Shapiro-Wilk tests. Individual datasets were compared using the Chi-squared test, Fisher's exact test, and the Mann-Whitney U-test. For multiple comparisons with parametric datasets, the one-way analysis of variance (ANOVA) was performed, and for non-parametric datasets, the Kruskal-Wallis test was performed to test for independence. For all data, averages are expressed as median with interquartile range and significance set at p < 0.05. Twenty-six dogs met the inclusion criteria. Median follow-up was 230 days (range 21–1901 days, mean 496 days). Six dogs (23%) achieved complete recovery and 20 dogs (77%) incomplete or no recovery of vision. The presence of a reactive pupillary light reflex (p = 0.013), the absence of fundoscopic lesions (p = 0.0006), a younger age (p = 0.038), and a lower cerebrospinal fluid (CSF) total nucleated cell count (TNCC) (p = 0.022) were statistically associated with complete recovery of vision. Dogs with I-ON were significantly younger (p = 0.046) and had lower CSF TNCC (p = 0.030) compared to the MUE-ON group. This study identified prognostic factors that may influence complete recovery of vision in dogs with ON. A larger cohort of dogs is required to determine whether these findings are robust and whether additional parameters aid accurate prognosis for recovery of vision in canine ON.

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“…Diffusion restriction of the intraorbital optic nerve was predictive of acute optic neuritis over nonarteritic anterior ischemic optic neuropathy (NAION), whereas postcontrast enhancement of the optic disc in the absence of DWI findings was predictive of NAION. 4 The presence of postcontrast enhancement of the optic chiasm and lower ADC values were found to be the most important imaging characteristics for differentiating between NMOSD and optic neuritis caused by multiple sclerosis. 5,9 When applied as diagnostic criteria for NMOSD, the presence of low ADC values or optic chiasm involvement had a specificity of 78.1%, sensitivity of 77.8%, and diagnostic accuracy of 77.9%.…”

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confidence: 92%

“…5 ADC values may also vary with the chronicity of disease with more chronic cases having higher values. 7 DWI hyperintensities and postcontrast enhancement exhibit similar localizations within inflamed optic nerves, 4 suggesting that DWI may be an appropriate alternative for identifying acute optic neuritis when MRI with contrast is contraindicated. DWI has a sensitivity of 77%À83%, specificity of 80%À84%, and diagnostic accuracy of 80%À83% when used to evaluate optic neuritis.…”

mentioning

confidence: 99%