Early predictors of visual and axonal outcomes after acute optic neuritis

Nguyen, Minh N. L.; Zhu, Chao; Kolbe, Scott; Butzkueven, Helmut; White, Owen; Fielding, Joanne; Kilpatrick, Trevor J.; Egan, Gary F.; Klistorner, Alexander; Walt, Anneke van der

doi:10.3389/fneur.2022.945034

Cited by 3 publications

(7 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Not all results showed a simple increase of RD within the optic nerve, with Goodyear and colleagues [2015] ( 28 ) finding that RD within the bilateral optic nerve decreased immediately after ON and increased back to a normal level after 6 months. Interestingly, Nguyen and colleagues [2022] ( 111 ) discovered a non-linear trend where RD within the affected optic nerve was less than the unaffected nerve at baseline, whilst it yielded higher RD values 3 months after ON onset, a relationship which still persisted 12 months after onset. Goodyear and colleagues [2015] ( 28 ) also showed that the affected optic nerve showed reduced RD (along with reduced AD and MD) when compared to the unaffected nerve at onset, yet did not differ after 6-months had passed ( 109 ).…”

Section: Resultsmentioning

confidence: 99%

Diffusion tensor imaging of optic neuropathies: a narrative review

Cooper,

Tchernykh,

Shmuel

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background and Objective Diffusion tensor imaging (DTI) has been implemented in a breadth of scientific investigations of optic neuropathies, though it has yet to be fully adopted for diagnosis or prognosis. This is potentially due to a lack of standardization and weak replication of results. The aim of this investigation was to review DTI results from studies specific to three distinct optic neuropathies in order to probe its current clinical utility. Methods We reviewed the DTI literature specific to primary open-angle glaucoma (POAG), optic neuritis (ON), and traumatic optic neuropathy (TON) by systematically searching the PubMed database on March 1 st , 2023. Four distinct DTI metrics are considered: fractional anisotropy (FA), along with mean diffusivity (MD, axial diffusivity (AD), and radial diffusivity (RD). Results from within-group, between-group, and correlational studies were thoroughly assessed. Key Content and Findings POAG studies most consistently report a decrease in FA, especially in the optic radiations, followed in prevalence by an increase in RD and then MD, whilst AD yields conflicting results between studies. It is notable that there is not an equal distribution of investigated DTI metrics, with FA utilized the most, followed by MD, RD, and AD. Studies of ON are similar in that the most consistent findings are specific to FA, RD, and MD. These results are specific to the optic nerve and radiation since only one study measured the intermediary regions. More studies are needed to assess the effect that ON has on the tracts of the visual system. Finally, only three studies assessing DTI of TON have been performed to date, displaying low to moderate replicability of results. To improve the level of agreement between studies assessing each optic neuropathy, an increased level of standardization is recommended. Conclusions Both POAG and ON studies have yielded some prevalent DTI findings, both for contrast and correlation-based assessments. Although the clinical need is high for TON, considering the limitations of the current diagnostic tools, too few studies exist to make confident conclusions. Future use of standardized and longitudinal DTI, along with the foreseen methodological and technical improvements, is warranted to effectively study optic neuropathies.

show abstract

Section: Resultsmentioning

confidence: 99%

Diffusion tensor imaging of optic neuropathies: a narrative review

Cooper,

Tchernykh,

Shmuel

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…The strong association between the number of previous ON episodes and chiasmal MTR aligns with previous research on post-acute changes following inflammatory optic nerve lesions. 17,26 Lower MTR values are likely to reflect reduced microstructural integrity 10 which can result from both demyelination and inflammatory-related changes during the acute phase of ON, 13,27 while correlate with demyelination, remyelination and neuroaxonal loss in the longterm, [28][29][30] representing a useful marker of chronic damage and repair. 13 In our study, we observed that OC MTR values were lower in ON+ IDD patients, compared with HCs.…”

Section: Discussionmentioning

confidence: 99%

“… 17 , 26 Lower MTR values are likely to reflect reduced microstructural integrity 10 which can result from both demyelination and inflammatory-related changes during the acute phase of ON, 13 , 27 while correlate with demyelination, remyelination and neuroaxonal loss in the long-term, 28 – 30 representing a useful marker of chronic damage and repair. 13 …”

Section: Discussionmentioning

confidence: 99%

“…11 In the optic nerve, MTR has proven to be a valuable measure of early demyelination and predictor of axonal loss and remyelination after acute ON. 12,13 We recently reported that MTR values can also help the discrimination between relapsing-remitting multiple sclerosis (RRMS) and AQP4 + NMOSD. 14 The optic chiasm (OC) may be pathologically altered with acute ON through direct lesional involvement, which is more frequently observed in AQP4 + NMOSD, 2,15 or from secondary post-acute neurodegeneration from more anterior optic nerve lesions.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Optic chiasm involvement in multiple sclerosis, aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein–associated disease

Bianchi,

Cortese,

Prados

et al. 2024

Mult Scler

View full text Add to dashboard Cite

Background: Optic neuritis (ON) is a common feature of inflammatory demyelinating diseases (IDDs) such as multiple sclerosis (MS), aquaporin 4-antibody neuromyelitis optica spectrum disorder (AQP4 + NMOSD) and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD). However, the involvement of the optic chiasm (OC) in IDD has not been fully investigated. Aims: To examine OC differences in non-acute IDD patients with (ON+) and without ON (ON−) using magnetisation transfer ratio (MTR), to compare differences between MS, AQP4 + NMOSD and MOGAD and understand their associations with other neuro-ophthalmological markers. Methods: Twenty-eight relapsing-remitting multiple sclerosis (RRMS), 24 AQP4 + NMOSD, 28 MOGAD patients and 32 healthy controls (HCs) underwent clinical evaluation, MRI and optical coherence tomography (OCT) scan. Multivariable linear regression models were applied. Results: ON + IDD patients showed lower OC MTR than HCs (28.87 ± 4.58 vs 31.65 ± 4.93; p = 0.004). When compared with HCs, lower OC MTR was found in ON + AQP4 + NMOSD (28.55 ± 4.18 vs 31.65 ± 4.93; p = 0.020) and MOGAD (28.73 ± 4.99 vs 31.65 ± 4.93; p = 0.007) and in ON− AQP4 + NMOSD (28.37 ± 7.27 vs 31.65 ± 4.93; p = 0.035). ON+ RRMS had lower MTR than ON− RRMS (28.87 ± 4.58 vs 30.99 ± 4.76; p = 0.038). Lower OC MTR was associated with higher number of ON (regression coefficient (RC) = −1.15, 95% confidence interval (CI) = −1.819 to −0.490, p = 0.001), worse visual acuity (RC = −0.026, 95% CI = −0.041 to −0.011, p = 0.001) and lower peripapillary retinal nerve fibre layer (pRNFL) thickness (RC = 1.129, 95% CI = 0.199 to 2.059, p = 0.018) when considering the whole IDD group. Conclusion: OC microstructural damage indicates prior ON in IDD and is linked to reduced vision and thinner pRNFL.

show abstract

Application of the international criteria for optic neuritis in the Acute Optic Neuritis Network

Klyscz,

Asseyer,

Alonso

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectiveThe first international consensus criteria for optic neuritis (ICON) were published in 2022. We applied these criteria to a prospective, global observational study of acute optic neuritis (ON).MethodsWe included 160 patients with a first‐ever acute ON suggestive of a demyelinating CNS disease from the Acute Optic Neuritis Network (ACON). We applied the 2022 ICON to all participants and subsequently adjusted the ICON by replacing a missing relative afferent pupillary defect (RAPD) or dyschromatopsia if magnetic resonance imaging pathology of the optical nerve plus optical coherence tomography abnormalities or certain biomarkers are present.ResultsAccording to the 2022 ICON, 80 (50%) patients were classified as definite ON, 12 (7%) patients were classified as possible ON, and 68 (43%) as not ON (NON). The main reasons for classification as NON were absent RAPD (52 patients, 76%) or dyschromatopsia (49 patients, 72%). Distribution of underlying ON etiologies was as follows: 78 (49%) patients had a single isolated ON, 41 (26%) patients were diagnosed with multiple sclerosis, 25 (16%) patients with myelin oligodendrocyte glycoprotein antibody‐associated disease, and 15 (9%) with neuromyelitis optica spectrum disorder. The application of the adjusted ON criteria yielded a higher proportion of patients classified as ON (126 patients, 79%).InterpretationAccording to the 2022 ICON, almost half of the included patients in ACON did not fulfill the requirements for classification of definite or possible ON, particularly due to missing RAPD and dyschromatopsia. Thorough RAPD examination and formal color vision testing are critical to the application of the 2022 ICON.

show abstract

Early predictors of visual and axonal outcomes after acute optic neuritis

Cited by 3 publications

References 38 publications

Diffusion tensor imaging of optic neuropathies: a narrative review

Diffusion tensor imaging of optic neuropathies: a narrative review

Optic chiasm involvement in multiple sclerosis, aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein–associated disease

Application of the international criteria for optic neuritis in the Acute Optic Neuritis Network

Contact Info

Product

Resources

About